Is In-Person Counselling Dead?
Perhaps this is overkill, but I feel the need to start this article with a trigger warning, out of concern that this subject matter, and the uncertainty that surrounds it, may provoke anxiety in anyone who comes to my office for their sessions. While I have no plans to leave my downtown Vancouver office at this time, please contact me if you have any concerns and know that I will always do everything I can to look after my clients’ needs.
As an older counsellor, it’s still a bit mind-blowing that the counselling session format has changed so much since the start of the pandemic. Pre-pandemic, I was offering about 80 percent in-person counselling sessions, and 20 percent phone sessions. My phone day was a “rest” day where I could avoid the hubbub of downtown Vancouver, working instead out of my then-unrenovated home office, which I jokingly referred to an “abandoned warehouse,” with its dark, ancient-painted walls with huge holes where screws used to be, a desk that was strewn with un-put-away office supplies and other miscellaneous refuse, and overhead lights that burned down on me in the most agitating fashion. For a rest day, there was nothing relaxing about this environment, which also says a lot about my low level of work self-care back then.
Fortunately when the first lockdown hit I was on a two-week break from work, which was, in all honesty, the most disorienting “vacation” I’ve ever had! I spent much of this time stewing and ultimately accepting that during lockdown it wouldn’t be possible to counsel out of my downtown therapy office, so what was I going to do?? I looked around at my home office and felt a little freaked out: I couldn’t bring people into my home either, so what were my options?
Ironically, about 3 months before, I had done the biggest clean out of my home office in all of Megan history. I had been on a year-long tear, “Kondo-ing” my house top-to bottom, and my office—which was also the storage room for a lot of family paperwork—was one of the last things that I had cleared out. It was a job that took me about five 10-hour days as I shredded, shredded, shredded and went through historical documents—many of which were sentimental—and others that reminded me of more painful parts of my childhood. Cleaning out that stuff was emotionally harrowing, yet ultimately very rewarding and, fast forward to 2020, I kept thinking about how grateful I was that I had taken care of these things back then and not while simultaneously having to deal with an unprecedented-in-my-lifetime pandemic.
While I’d had the clean-out part checked off, and I also recognized that I had a bigger problem on my hands: how was I going to look after my clients, with little to no disruption in their counselling? I had a few issues:
I had never done video counselling before—hell, I’d only ever Facetimed twice in my life—how was I…
- Going to do so smoothly and effectively, like I’d been doing this for years? And deal with my anxiety with technology mishaps?
- What platform was I going to use that would be both secure and compliant and BC privacy law?
- What equipment did I need and could my 8 year-old laptop be up to the job? Could I secure the needed equipment and furniture?
- Could I renovate my office enough to look like a welcoming counselling space that I’d want to work in and that clients would feel welcome in, virtually?
I also wondered whether clients would accept the new online counselling space, particularly long-term in-person therapy clients. Like for everyone, it was a time of great uncertainty.
Back to 2023
And, I think it’s fair to say that it’s still a time of uncertainty in the counselling profession. As the pandemic has ground on, I’ve seen more and more therapists end their leases and move to online instead. In fact, I’d never seen so much physical office space available in the city. And conversely, one of my dearest colleagues tells me that 60 percent of her clients come to her office, which also throws me for a loop. When I ran my stats at the end of 2022, I learned that 11 percent of my sessions were in-office. Also, I noted that in-person sessions are the most-likely-to-be-rescheduled session type.
As you all know, I’ve hung onto my downtown Vancouver office, hoping that time will clarify for me what it is that I need to do next. Again, the picture is not so clear, there are clear advantages to both in-person counselling vs. phone/video counselling. Let’s take a look!
The Live Experience – In a time when we are all overwhelmed by screens, nothing can replace the warmth and viscerality of direct human interaction. I feel it too when I go into the office.
The Office Environment – Many people have told me that they like my office: that it feels peaceful, or they point to objects that make them smile. Or they like the some of the options like having a blanket, using soft tissues, lying on the couch (yes, this happens sometimes!) or picking up a sensory toy. And I get comments, too, on the view. I like it too: the office has a lot of mostly-indirect light which floods me with a sense of well-being.
The Office Space Geography – It can be appealing to have a physical space to lay down your troubles that is not your home. For many of us, having this boundary can be helpful.
Effort=Intention – Some folks find that making the effort to travel to go to counselling increases the seriousness around their counselling and is a way of showing reverence for the process.
Travel Time – While many see this as a negative aspect of in-person sessions, some appreciate the brain break of commuting, especially when walking is involved. For others, this serves as mental preparation time for sessions as well as a way of decompressing after a session.
Privacy – In expensive Vancouver, where many people are living in close quarters or working from home, it can be difficult to find a space where one can talk privately. Going to a counselling office with closed doors and sound masking technology can lend a lot of privacy peace of mind.
Phone or Video Sessions
Ultimate Convenience – When the pandemic first started many folks were astounded at how convenient it was to have a counselling session. Counselling sessions could happen without requesting time off of work (for example, on a lunch break), without having to travel, or without having to also account for travel time. Many folks also feel less pressure to get gussied up if they’re not leaving the house.
Accessibility – Related to convenience, counselling became more accessible to folks that would otherwise not be able to access counselling, for example, people with very short windows of available time (childhood schedules, oppressive work schedules, travel barriers, health conditions, disabilities etc.)
More Therapist Choice – While the practice of counselling is still not regulated in BC, many counselling-related professions are regulated (e.g. registered psychologists, registered social workers) and serve clients within a particular geographic boundary. And some boundaries are very large! For example, a Vancouver client could now see a Prince George psychologist quite handily. The option of virtual now offers clients considerably more choice in therapists and is especially helpful for clients in small towns where there may only be one, or even no therapists available.
Ability To Move – Counselling can be a mentally intense process. Whether you’re experiencing mental health symptoms, are neurodivergent or for any other reason, it can be helpful to get up and walk during a without feeling self-conscious (most suited to phone counselling).
Anxiety – Face-to-face counselling is just too intimidating for some folks. I get it. Having the ability to do a phone call or turn off your webcam may be the difference between going to counselling or not.
Therapist Benefits – Perhaps strange to include here, but the reality is that therapists save thousands of dollars a year in rent and travel costs (especially if they are serving remote communities) by moving exclusively to online counselling.
So, back to the question: Is in-person counselling dead? Is it on life support? Or perhaps something in-between? So, far, I’m thinking that in-person sessions are here to stay but it’s still up in the air about how prominent they will ultimately be. For the time being, my physical counselling office is open!
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