Robert Augustus Masters Q&A Part Seventeen
April 16, 2006
A. arthur/adastra asks:
1. How would you characterize the similarities and differences between doing therapy in person versus over the phone? Would you consider the phone therapy less effective in some way? Do you charge the same amount for both types of therapy?
2. Would you continue to do phone therapy for a long period of time with someone, or would you consider it necessary to see the individual in person after a certain number of sessions?
3. Have you ever done couples therapy over the phone in a conference call? If so, how is that different from working with a couple face to face or working with an individual client over the phone?
Robert answers:
1. In-person therapy is generally more effective than phone therapy, simply because it includes not only the finely-attuned hearing and in-depth dialogue that’s essential to good phone therapy, but also an abundance of visual and somatic clues that help provide a fuller sense of the client, as well as the possibility of incorporating bodywork and other physically active practices (like acting out a part in a dream or switching back-and-forth in Gestalt contexts) in the session.
Having said this, I still think that phone therapy can be very effective, especially when it’s allowed to be more than just good dialogue. Once issues have been clarified and their contextual foundations illuminated, so that necessary connections are clearly seen, the therapist can let this be enough for the session -- and sometimes this is plenty, with no need to go any further -- or take it into deeper territory.
What does this look like? Here are some possibilities: 1) Basic meditation techniques can be taught; 2) a guided meditation, uniquely suited to and centered by the client’s key issue or issues, can be done, drawing the client into a more openly feeling and/or spiritually-rooted place; 3) the client can be guided into fuller emotional expression, perhaps through altering their breathing patterns and/or by expressing certain statements (which may include amplifying them); 4) if clients have written something as homework (from a previous phone session), they can be asked not only to read what they’ve written, but also to emphasize emotionally-charged parts, perhaps repeating them until there’s some loosening up of feeling; 5) some degree of psychodrama can be done once the primary elements of a particular issue have been clearly identified and examined.
There are, of course, lots of other possibilities in doing phone therapy. Ideally, after a few phone sessions, the client would make the trip to do some in-person sessions. But even if this is not possible, phone therapy can still be a valuable thing to do. And do I charge the same rate for phone sessions as for in-person sessions? Yes.
2. I don’t do phone therapy for a long period of time with a client. After a while (say, 3 or 4 sessions), I usually either wrap up the sessions (which often includes supporting my client in looking for a suitable therapist in their area) or have the client come work with me in-person.
3. No. A sizable portion of my private practice is with couples, and every such session I do requires that I keep my full attention on both persons and on their way of relating to each other. With single clients, I’m not witnessing and directly dealing with the intersubjective realms “between” them and another, but with couples I am, and to do so effectively, I need to be in their physical presence, so as to be able to observe firsthand what is passing between them. Yes, over the phone I could probably pick up a lot of relevant data just from hearing how each conversed with the other, but in person I would pick up much, much more. I would not do a group over the phone, and a couple is, in a psychotherapeutic context, the smallest possible group, but a group nonetheless.
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A. arthur/adastra asks:
1. How would you characterize the similarities and differences between doing therapy in person versus over the phone? Would you consider the phone therapy less effective in some way? Do you charge the same amount for both types of therapy?
2. Would you continue to do phone therapy for a long period of time with someone, or would you consider it necessary to see the individual in person after a certain number of sessions?
3. Have you ever done couples therapy over the phone in a conference call? If so, how is that different from working with a couple face to face or working with an individual client over the phone?
Robert answers:
1. In-person therapy is generally more effective than phone therapy, simply because it includes not only the finely-attuned hearing and in-depth dialogue that’s essential to good phone therapy, but also an abundance of visual and somatic clues that help provide a fuller sense of the client, as well as the possibility of incorporating bodywork and other physically active practices (like acting out a part in a dream or switching back-and-forth in Gestalt contexts) in the session.
Having said this, I still think that phone therapy can be very effective, especially when it’s allowed to be more than just good dialogue. Once issues have been clarified and their contextual foundations illuminated, so that necessary connections are clearly seen, the therapist can let this be enough for the session -- and sometimes this is plenty, with no need to go any further -- or take it into deeper territory.
What does this look like? Here are some possibilities: 1) Basic meditation techniques can be taught; 2) a guided meditation, uniquely suited to and centered by the client’s key issue or issues, can be done, drawing the client into a more openly feeling and/or spiritually-rooted place; 3) the client can be guided into fuller emotional expression, perhaps through altering their breathing patterns and/or by expressing certain statements (which may include amplifying them); 4) if clients have written something as homework (from a previous phone session), they can be asked not only to read what they’ve written, but also to emphasize emotionally-charged parts, perhaps repeating them until there’s some loosening up of feeling; 5) some degree of psychodrama can be done once the primary elements of a particular issue have been clearly identified and examined.
There are, of course, lots of other possibilities in doing phone therapy. Ideally, after a few phone sessions, the client would make the trip to do some in-person sessions. But even if this is not possible, phone therapy can still be a valuable thing to do. And do I charge the same rate for phone sessions as for in-person sessions? Yes.
2. I don’t do phone therapy for a long period of time with a client. After a while (say, 3 or 4 sessions), I usually either wrap up the sessions (which often includes supporting my client in looking for a suitable therapist in their area) or have the client come work with me in-person.
3. No. A sizable portion of my private practice is with couples, and every such session I do requires that I keep my full attention on both persons and on their way of relating to each other. With single clients, I’m not witnessing and directly dealing with the intersubjective realms “between” them and another, but with couples I am, and to do so effectively, I need to be in their physical presence, so as to be able to observe firsthand what is passing between them. Yes, over the phone I could probably pick up a lot of relevant data just from hearing how each conversed with the other, but in person I would pick up much, much more. I would not do a group over the phone, and a couple is, in a psychotherapeutic context, the smallest possible group, but a group nonetheless.
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posted by adastra at 8:43 PM
