7 Ways to Maintain a Therapeutic Alliance via Teletherapy

23 August 2022

August 23, 2022

In: Therapy News & Events

teletherapy call


  • The therapeutic alliance is the foundation of successful relationships with mental health clients.
  • Research shows that it’s possible to create and maintain a strong personal presence via teletherapy.
  • A few tweaks to your existing practices can help you create a virtual environment where your clients will feel safe and secure.
  • CSTelecare, a ClinicSource add-on, makes offering virtual health visits easy.

Can a therapeutic alliance be built and maintained online? Research is increasingly finding the answer to be yes. When done well and with good intentions, mental health therapists can create a teletherapy environment that makes their clients feel safe and supported.

Personal Presence and the Therapeutic Alliance 

As a mental health professional, you know that the therapeutic alliance is the foundation of a successful relationship with a client. Bonding through physical presence is a key component of building that alliance. Is it possible to recreate that feeling of physical presence through a computer screen? 

While teletherapy is not a new idea, the COVID-19 pandemic has prompted a lot of research on the subject. One recent study found that clients are generally satisfied with online therapeutic relationships with their therapists.  

In an article by Shari Geller, PhD, the author concluded that therapists can build a strong therapeutic presence with patients via teletherapy. It can take extra thought and effort on the part of therapists, but teletherapy can be an effective way to deliver mental health services.

Let’s explore actions that therapists can take to create and maintain a therapeutic alliance with their virtual clients. 

6 Ways to Maintain a Therapeutic Alliance via Telehealth

As a practicing therapist, you already know how to create a physical space that makes clients feel secure. A few additional considerations are all you’ll need to transition to a comfortable virtual space.

1. Create a Professional Environment

sitting at home using a laptop

If you’re working from home, try to recreate your office space as closely as possible. Consider the screen size and distance you need to allow your clients to see as much of you as possible, as opposed to just a head shot. 

Also consider your clients’ comfort with eye contact as you choose how close you want to be to the camera. Dr. Geller recommends asking your clients if they feel you’re too close, too far away, or just right, and make adjustments accordingly.

Be sure that your lighting lets your clients see you clearly, without glare or shadows. Work with your clients at the first session to help them set up in an optimal position for you to see them clearly, as well. 

2. Help Your Clients Feel Safe

Even if you have been seeing a client for a long time, go over your emergency practices at your first video session. Remind them of your emergency plan, and reassure them that nothing has changed. 

During sessions, note that video communication requires more direct eye contact than an in-person encounter. Use this to your advantage by paying close attention to the client’s microexpressions and using mirroring to project a sense of safety and empathy. 

Pay particular attention to your own facial expressions and gestures, as visual cues and body language become much more important in a video-based session. 

Dr. Geller suggests keeping your notes at a location near or above your screen to give the appearance that you are still making eye contact with your client as you refer to your notes.

3. Establish Clear Communication Practices 

Make sure to establish communication practices from the beginning so that your clients know what to expect and how to best communicate with you. 

For example: 

  • What types of communication are best for your clients to use with you? Email, text, phone? 
  • What hours should your clients expect to hear from you? What’s your typical response time? What’s the fastest you expect to respond? 
  • What should your clients do if something comes up and they can’t make a scheduled appointment? 
  • What are the best ways for your clients to communicate with you when emotions are running high?

4. Use Video as Intervention

If your clients are in an environment where they feel safe and supported, you can use video to add some extra interventions to the therapeutic process. 

Here are some ideas you can try:

  • You can record a video of your patient doing a relaxing activity and play it back to them when they’re feeling stressed.
  • You can record yourself doing a guided meditation for the patient to play back when they feel anxious.
  • You can record a role-playing exercise, then analyze the video together.

video conference

5. Keep the Communication Channels Open 

If you encourage your clients to contact you by phone in an emergency, make sure to keep the line free. If you don’t have a dedicated line for your therapy work, consider putting your phone on Do Not Disturb or setting a special ringtone for your therapy calls. 

If your clients prefer to communicate via text or email, make sure to respond in a timely fashion and that your responses are thoughtful. A few key words can go a long way to help your clients stay connected between visits.

6. Use the Power of Technology Outside the Session Room

Technology can be a powerful tool in the hands of a licensed therapist — beyond the counseling session. If you haven’t looked into the many ways you can use technology to help your clients, now is a great time. 

For example, you can ask your clients to use online CBT platforms or social media apps to monitor and track their mood and symptoms and help them set goals. You can also send them helpful resources, receive feedback from them, and schedule regular check-ins. 

7. Use CSTelecare to Provide Remote Telehealth Services

CSTelecare is a powerful tool that lets you provide remote counseling and support to your clients seamlessly from within your ClinicSource EMR.  

CSTelecare is designed to be user-friendly and customizable. You can tailor your services to meet the unique needs of each client, using features such as secure messaging, real-time video sessions, automated appointment reminders to stay connected with them, and built-in consent forms and screen sharing. 

CSTelecare offers flexible scheduling options, making it easier for you to accommodate your clients’ schedules (and yours!) by providing care outside of traditional office hours.

The service also ensures the privacy and security of patient information through end-to-end encryption and HIPAA compliance, giving you and your clients peace of mind.

With CSTelecare, you can offer your clients a comprehensive telehealth solution that enables you to deliver secure, high-quality care more efficiently and effectively. You can expand your reach, enhance your clients’ access to care, and ultimately help more people improve their mental health and wellbeing. Listen to our podcast to learn more.

Teletherapy Is Here to Stay

Many therapists weren’t ready to embrace teletherapy when COVID made it imperative for many. However, others have been using the technology for years and have discovered its many benefits.

Teletherapy has expanded access to mental health services for many people, including those in rural or low-income areas and those who are homebound. It has also provided a more comfortable environment for people who experience social anxiety, prompting many to get help who otherwise may not have.

For these reasons and many others, teletherapy is here to stay. And with a few tweaks to your existing practices, you can easily create an environment where you can cultivate a strong personal presence. 

There’s no reason for a digital venue to stand in the way of a successful therapeutic alliance with your clients. When used correctly, it can even enhance it.

ClinicSource for All Types of Therapists

To run your therapy practice most efficiently, you need modern therapy EMR and practice management software. ClinicSource is an all-in-one solution that will help you manage all functions of your practice with a single sign-on.

ClinicSource was designed for therapists, by therapists. Find out how ClinicSource integrates scheduling, reporting, and billing to boost productivity, improve patient experience, and increase revenue for therapy practices like yours. Book a demo today.

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