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  • Brock Caffee, LCMFT

Online Therapy

I try to keep things simple. This pandemic has really challenged me in that regard. life has certainly changed. As it has, I have tried very hard to keep improving my clients' experience in treatment.


I once said that online therapy was useful for a narrow range of therapy applications, but I am finding a new appreciation for online sessions. After a few weeks of consistent online sessions, my clients are consistently giving positive feedback about their experiences. I am feeling much more effective via the web. I am pleasantly surprised.


Online therapy was not invented, nor did it start with the COVID-19 crisis, but having the various tools for helping clients online has certainly helped in recent days. Additionally, I believe having constantly practiced in my own beliefs of ongoing collaborative work with my clients, patience, compassion, and flexibility are excellent tools to be applied through this change. I have seen some fairly impatient and rigid therapists struggling to make this transition. I can only imagine the client experience. I hope to help my clients through this, and I even believe we can grow together because of the experience, not just in spite of it.


Previously I have seen only a small percentage of my clients online, adding to my practice of "supplementing" work with clients over the phone when additional follow up might be appropriate. For the most part, I have typically spent the vast majority of my time talking with clients in my office, face-to-face. This is the first time when the realities of our time have superseded my strong belief that it just makes more sense to see people in person. Right now, it just does not. The risk is too great to see routine clients in person. The paradigm is shifting, and I am pleasantly surprised at how clients are responding in treatment over the internet.


As I have transitioned all of my clients to the online format recently, there have been some adjustments. Primarily, this is made much smoother with information that helps clients know what to expect. Here are a few relevant things I discuss with clients prior to starting online work. Many are common sense, but very important toward ensuring that therapist and client have a good connection:


1. Connection quality is important. Your internet speed is not your fault, but I find it can be an area where some clients feel insecure. It just needs to be tested, but don't avoid it. If your connection speed is not adequate, phone sessions may be a necessary work-around.

2. I try to remain as flexible and understanding as possible. This includes scheduling, length of session, and I try to offer additional options for connecting when available. I encourage clients to be very transparent about any concerns they might have about the environment, scheduling, or any other factor impacting the quality of their therapy experience. This is critical. The last thing I would want is for a client to try to "play along" and have a diminished experience due to a variable distracting or causing additional anxiety.

3. Think about any specific concerns about the environment you may have. Is it private? Is it safe? Are you worried about your kids barging in? If so, discuss these factors with your therapist. Some issues cannot be completely "fixed", but I find that my clients are often very relieved at how easy going I am with children when they have occasion to barge in. As long as my clients are not concerned with the privacy element, it is typically just a rare opportunity to glimpse into my client's real life in another way. In cases where real life does not allow for adequate privacy, uninterrupted time to talk, or other, I have even had clients meet with me from their vehicles. It seems to work much like a phone booth (but I do not hold sessions with clients who are driving---face it, it is emotional stuff and can be extremely distracting).

4. If you are nervous about the technology, it is a very good idea to consider the first session online like a "dry run". Not everyone has experience with teleconferencing software, and even those who do occasionally face complications. It seems like a good idea to do everything possible to alleviate any nerves or doubts about the tech, so sessions are about life, not about the technology.

5. Finally, don't be afraid to ask questions. Transitional periods are definitely a good time to talk through processes, rather than assuming how they might work. I am finding that my days are becoming more routine once again, but I still find that I am having to solve some logistical issues creatively. It never hurts to talk about it. This is especially important if your question relates to a specific approach or how your treatment will proceed over teletherapy. I am finding that teletherapy approaches are well-suited to a wide array of clients and clinical issues, including couples, parent-child issues, grief/loss, chronic mental health concerns, trauma, coping with divorce, substance use, teens, and a number of others. If you aren't sure, ask. It is certainly worth discussing.


This has been a challenging month for my clients, and it has been perhaps one of the most puzzling for me as a therapist. I feel like it has created stronger bonds between my clients and I as we seek to cope with the changing world, together. I am continuing to improve my processes for their benefit and for anyone I have not seen yet. If I can help you or anyone in your life, please contact me. I would love to hear from you!

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Brock Caffee, M.S. is a Licensed Clinical Marriage and Family Therapist, practicing in Lawrence, KS. He has over a decade of clinical experience with individuals and families. His experience includes many different people with a variety of concerns, including family and relationship issues, divorce, foster care, adoption, behavior concerns, addictions, trauma, grief and loss, forgiveness, and complex life transitions. He has served as clinical supervisor and behavioral healthcare manager. He has life experiences that have given him experiential insight into the world of parenting, divorce, step-parenting, and addiction recovery. At home he has three children, three dogs, and a very patient wife.

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Parenting Disclaimer: Parenting is complicated and sometimes difficult. Please understand that not all families are prepared to change tactics, and not all children will demonstrate the same preparedness for behavior change. If you feel that additional guidance may be necessary, please contact a family therapist in your area. If you are in the Lawrence, Kansas City, or Topeka area, you may contact me (brock@familystrategies.net) for a free telephone consultation.

The views expressed in this blog are meant to help enrich and inform personal exploration, to entertain, and to be fun when possible. The blog and its content are not a substitute for therapy. Advice offered in the blog should be considered only if consistent with your family values and with advice given by your own mental health professionals. Please seek consultation with a mental health professional in your area if you experience distress or feel you are in crisis. The National Suicide Prevention Lifeline is 1-800-273-8255


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