At Bright Heart Health, we are constantly surprising ourselves with what can be accomplished via telehealth therapy. One of the major cornerstones of our eating disorder treatment program is cognitive behavior therapy (CBT). We teach our clients to gain awareness of their thoughts so they can learn how their thinking impacts their feelings, and in turn, their behaviors. Our clients learn how to challenge negative thinking and distorted thinking patterns to begin to free themselves up to take conscious action in-service of their recovery. They also start to realize how distorted thinking and negative self-talk are something that they have control over, and that they don’t have to believe everything that they think.
We knew how powerful CBT skills are to those who apply them in their recovery. What we did not know and what have been excited to learn is that there are some built-in advantages to using CBT skills with our clients on our video conferencing platform as compared to traditional face-to-face group therapy. I wanted to share these experiences as telehealth becomes more popular.
First of all, the fact that everyone is in their own comfortable private space behind a computer lends an inherent quality of privacy to the therapy process. Although all groups are conducted with everyone’s face visible to everyone else’s, there are not many other cues available for clients to pick up additional information about one another. When group therapy is conducted via the Internet, there are no awkward transitions from the therapy room down to the parking lot where a client is feeling obligated to listen and try to fix another client’s problems on their own, without the support of their therapist. When group is over, our clients simply log off and instantly transition back into the safety of their homes. A Bright Heart client rarely has to worry about bumping into a fellow client when they’re out with their friends for the evening, so there is a built in level of privacy our clients enjoy.
Telehealth frees up clients from compulsive body checking and comparing during group therapy.Dr. Patricia Schroeder
Many of our clients have reported to us that this extra feeling of privacy and anonymity allows them to feel safer in opening up about some of their most shame inducing thoughts and feelings much sooner in the therapy process than they had experienced a more traditional program. In traditional therapy programs, clients are put into the inherently stressful situation of joining a group of people they don’t know in an unfamiliar place. Sometimes the fear about this is enough to prevent somebody from accessing much needed treatment. Our clients report that they experience a more comfortable emotional distance from the other clients that helps enable them to speak up. Bottom line is, our clients are able to come in and get straight to work!
The majority of our clients have shared that being able to participate in group therapy from their own homes has given them a very comforting sense of security. Some choose to have their beloved pets sit with them on their beds, others jump straight into their pajamas or curl up under a blanket for therapy, and others can relax knowing they can hear their sleeping kids in the next room if they wake up during group therapy. Having these familiar comforts surrounding them seems to allow our clients to feel less guarded in sharing personal details with the other group members.
Another unexpected benefit to treating eating disorders via videoconferencing is that the clients rarely see each others’ bodies. When clients log in to participate in group therapy, we can generally see their face and whatever is in the room behind them. Our clients sit up close to the computer with only their faces in the frame of view. This frees up clients from compulsive body checking and comparing during group therapy. Many clients have disclosed to us that they have often avoided going to therapy just because they were so self-conscious about other people seeing their bodies, especially other people who have eating disorders. There is a highly competitive aspect to eating disorders that leads people to constantly compare their bodies against those around them, and it can be extremely distracting to their therapy process and can lead to strong urges to engage in disordered eating behaviors. Often times, body sizes actually vary quite drastically in our groups, and our video conferencing format removes many of the visual cues that highlight the differences in body size. Clients have shared with us that knowing that only their faces were going to be seen made them feel so much more comfortable in taking the risk to show up to group therapy. In Telehealth, clients are able to focus on learning the skills more easily without this distraction — it just takes body comparison out of the equation.
Using the Internet also enables us to quickly share documents and videos that support skills training. Oftentimes in group we will be discussing a certain CBT skill and one of our clients will want to share a video or Internet meme that relates, and they’re able to do so in real-time. This ability to collaborate gives clients a sense of ownership in their recovery. Not only can CBT skills be effectively taught and learned via telehealth, but there are many built-in, unique circumstances that enhance CBT training for our clients. Clients can engage in the therapy process more quickly due to unique sense of safety they have by remaining in their homes. They enjoy an increased sense of anonymity from behind a computer screen, often all in different states from one another. The experience less anxiety and in opening up about thoughts and feelings they’re deeply ashamed about from the comfortable distance of the Internet. And finally, they’re unable to get caught up in comparing their body against their peers in treatment which saves them from a great deal of distraction and urges to avoid treatment or engage in eating disorder behaviors.