Just What Are We Talking About?

Two years or so ago, a lot of people were talking about Zoom Fatigue and then this social conversation seemed to largely stop. I wondered to myself, are people no longer Zoom fatigued? Is the gradual uptick in in-person counselling sessions solving this problem? I don’t know the answers to these questions exactly, but I still want to write about this topic, particularly if it’s not trending anymore. I’m weird like that.

In my under-exhaustive research I chanced upon a study from 2022  which surveyed the literature on Zoom fatigue and proposed the following definition:

“Zoom fatigue (synonym: videoconference fatigue) is defined as somatic and cognitive exhaustion that is caused by the intensive and/or inappropriate use of videoconferencing tools, frequently accompanied by related symptoms such as tiredness, worry, anxiety, burnout, discomfort, and stress, as well as other bodily symptoms such as headaches.”

This same research went on to identify several significant contributions to Zoom fatigue, and I thought it might be interesting to see how these relate to video counselling. And I want to be clear: I’m a fan of video counselling; I can’t think of what would have happened to the future of Willow Tree Counselling if I hadn’t been willing to pivot and embrace video during the pandemic. And now, in 2023, online therapy has firmly claimed its seat in the arena of legitimate (and popular) professional counselling modalities.

And one more thing: as I progressed in my writing of this article, it became a beast. I had no idea I’d have so much to say about this topic. I’ve relied heavily on headings to help you zone in on the factors that interest you most.

Why Fatigue? (Factors, Factors)

The research I cited above identified several key contributors to Zoom fatigue and I’ve also been helped along the way by the Jane App’s tutorials as well as some cool technical stuff from photographer Gia Goodrich. And a lot comes from my personal experience providing online therapy.

And I get it: some of us don’t really experience Zoom fatigue—particularly if we don’t spend much time on videoconferencing platforms. But if you’re a counsellor, you’re probably doing this a lot!

Communication Asynchrony

What

More commonly known as glitching, this can look like…

• Audio cutting out (sometimes followed by rapid speech to “catch up” the conversation)
• A mismatch between the audio and a video (think: badly dubbed movie)
• Audio but no video/frozen video
• Frozen video and no audio

Why It Can Be a Problem in Therapy

As you can imagine, we’re often talking about issues that require a sensitive response. When video is glitching and a counsellor isn’t hearing, or is delayed in hearing what the client is saying, the lack of response or lag in response can be off-putting to clients, and disorienting to the counsellor.

Possible Causes

• Poor internet connection (not fast enough, router too far away, other people using the network)
• Older, slower computer or phone
• Using data for the video call in an area with poor service
• Too many open tabs or applications competing for bandwidth
• Unsupported browser, browser that has not been updated
• Interfering browser extensions
• A computer cache that has become too large

Possible Solutions

• Check internet speed by doing a speed test like fast.com The folks at the Jane App recommend a minimum speed of 15mbps for successful video calls.
• Get closer to your router or use a wifi extender, particularly if you’re dealing with concrete walls or other labyrinthian home layouts.
• Use an ethernet cable and plug into your router directly – this is what I do, and it’s awesome.
• Upgrade your internet, if this is an option financially
• Ask if housemates would be willing to take a break from the Internet or temporarily stop streaming
• Ensure you are using a internet browser that’s compatible with the video platform you’re using. For those who meet with me via the Jane App, it’s Chrome!
• Ensure that you are keeping up with browser updates – this bit me once and I now heed all reminders!
• Lower video quality if available.
• Ensure your computer or phone is charged before the call or plug in your charger for the call.
• Exit and re-enter the call.
• Re-start your computer or phone.
• Clear your browser’s cache.

Image Problems

What

Factors may include:

• A blurry or pixilated image
• Difficult to see face (a room with poor light, being backlit or having no light on your face)

Why It Can Be a Problem in Therapy

• It’s disconcerting for both client and counsellor if they cannot properly see one another.
• Counselling is all about human connection and we have to work a little harder for that when we’re not in the same room with one another.
• When we can’t read one another’s facial expressions, it can make interactions disorienting and more subject to misinterpretation.

Possible Causes

There can be a number of possible causes: this list is not exhaustive!

• Poor internet connection (poor wifi: not fast enough, router too far, too many people on the network).
• Poor cell service.
• Sub-optimal internal or external webcam.
• Software issues (if using a camera app).
• Inadequate lighting – particularly in dark or small rooms.
• Having too many tabs or apps open.
• Video platform does not have permission to access camera.
• Incompatible browser or browser not updated.

Possible Solutions

• Jump on the call 5 minutes early and test your camera. We may not realize we’re blurry.
• Ensure internet speed is adequate.
• Restart camera.
• Ensure camera is on and connected.
• Light yourself from the front not the back – facing a window is great (if available), use a desk lamp, or even turn up the brightness on your computer all the way. It really does make a difference!
• Use an external webcam or webcam app (most internal webcams are middling at best).
• Exit and rejoin the call.

Bad Audio

What

Mostly commonly:

• No audio.
• Lagging/speeded audio.
• Microphone echo or audio distortion.

Why It Can Be a Problem in Therapy

• If counsellor and client cannot hear one another adequately, important information gets missed!
• It can be mistaken that the other person is not listening, is inattentive or has strange timing in their responses.
• It’s distracting and prevents participants from being ‘in the zone.’

Possible Causes

• Poor internet connection.
• Poor cell service.
• Audio is accidentally off or is off on the platform by default.
• Platform does not have permission to access microphone.
• External microphone not plugged in.
• Wrong microphone selected.
• Incompatible browser or browser not updated.
• Too many tabs or applications open.

Possible Solutions

• Join call 5 minutes early to test your microphone.
• Sometimes it works to keep the video on, turn off the audio on the platform and use the audio from a phone (the two parties call one another).
• Consider switching to a phone appointment.
• Close tabs and any unnecessary apps.
• Consider using an external USB microphone, which can greatly improve audio quality.
• Ensure your browser is up to date and compatible with your video platform.
• If you have more than one microphone, consider switching to see if your backup works instead.
• Check internet speed, move closer to a router, or plug in with a USB cable.

Framing Problems

What

There can be a lot of unintended intensity when it comes to framing yourself for video. If you’re super-close to the camera, and your video partner sees only your head, writ large, it can be a lot to take in. Conversely, if you’re so far away from the camera, it can create a disconnected vibe.

Ideally your head is just below the top of the frame and the bottom of the frame is around chest level. Here, not only is the emotional intensity level more balanced, there is more opportunity to read one another’s body language—an important tool in communication!

Why It Can Be a Problem in Therapy

• You may be accidentally conveying a different emotional tone than you intend in your camera framing. If you think about it: if you were to see a counsellor in-person, you would not be sitting so close to them to only be able to see their face, nor should they feel so far away that you feel distant.
• I you’re out of the frame or partially in the frame, non-verbal communication (expressions, gestures, etc.) will get missed.

Possible Causes

• Camera at a bad angle.
• Not taking the time to centre oneself in the frame.
• Not understanding the possible emotional and practical effects of poor framing.
• In a rush to start video call.

Possible Solutions

• If your camera has a preview option, take the time to check your framing before the call starts, ensuring your head and chest are in the shot. There is a lot of information on the Internet about the finer points of this.
• You may need to use books to elevate your computer, or a pillow behind your back to help with positioning. If you’re using a laptop, you’re about an outstretched arms length away from your keyboard.

Eye Contact Woes

What

If your camera is too low, too high or at a strange angle, you may look avoidant or more uncomfortable than you intend, to your counsellor. The reverse can be said for counsellors. Well-positioned eye-contact can’t be beat!

Why It Can Be a Problem in Therapy

• This can interfere with the sense of emotional connection.
• Can convey emotions that you don’t intend.

Possible Causes

• Lack of knowledge around this issue.
• Camera at a bad angle (often too low).
• In a rush to start call (no time to prepare in advance).

Possible Solutions

Bring the camera to eye level. This usually involves elevating it using a stand, books or boxes. -A chair that raises and lowers can also help you get at the right level.

Shaky Camera

What

If you have a tendency towards motion sickness, headaches or sensory issues, there’s almost nothing more awful than a camera moving around while you’re on a call. Often seen more with folks using phones or tablets for the call, this can also be a problem if someone is using a laptop placed on their lap, and they’re shifting or fidgeting during the call.

Why It Can Be a Problem in Therapy

Counsellor or client cannot give their full attention to the session if one or both are feeling dizzy or nauseous.

Possible Causes

• Lack of knowledge that this is a problem.
• Doing a video call while walking (please don’t!—there are safety issues too).
• Not having somewhere to prop up one’s phone or tablet.

Possible Solutions

• Put your device on a flat surface.
• Don’t use while walking (switch to audio only).
• Find an object that you can lean your device on (even a coffee mug can work great for a phone, in a pinch).

Under- or Over-Distracting Backgrounds

What

Traditionally, private counsellors typically put a lot of work into their physical office spaces. And it can be harder to do this from a virtual standpoint:

• There is a smaller field of view to work with.
• It’s harder to “decorate”; the virtual space may not feel as personal.
• Counsellors may lose touch over time of how the background appears to clients.
• We may be using a shared office space with a lot of belongings or clutter. As a result, counsellors may opt for a blurred background or a virtual background.
• Sometimes, clients and therapists find themselves in session in front of backgrounds with a lot of stuff: knick knacks, clutter and more.

Why It Can Be a Problem in Therapy

• Virtual backgrounds can be distracting as a person seems to be unnaturally floating in space, taking away our concentration. Most of us don’t have green screens in our home!
• Cluttered environments can be so interesting that they take our minds off of the session.
• Therapist environments that are too busy have the potential to look unprofessional or if too blank, sterile.

Possible Causes

• Not having a dedicated space to have a session.
• Being in a multi-use space: offices and rooms that are used by others at various times.
• Not realizing what is captured on the background or not knowing how to change it.

Possible Solutions

• Consider a real-life background, which looks more natural.
• If you don’t have a way to escape clutter, even a blank wall can be helpful.
• Avoid overly intimate settings like beds.

Self-View

What

Most video platforms have the option to toggle self-view on or off.

Why It Can Be a Problem in Therapy

Having self-view on can be distracting for both clients and therapists as it can heighten self consciousness, making it more difficult to relax into the session and get into the zone.

Possible Causes

• Not knowing how to turn self-view off.
• Enjoying looking at oneself (no judgment, here!)

Possible Solutions

• Turn off or minimize self-view. Or ask your counsellor where the feature is to turn it off.
• Use self-view before the session starts to make sure that your camera is working properly and that you’re positioned well and easy to see. Once you’ve established this, consider turning it off for the session.

Group Counselling Appointments

What

When clients are couples, families or groups, whose members are in separate locations.

Why It Can Be a Problem in Therapy

Author Arthur Brooks cites a key problem with this format: users “focus on many people at once in a small field of view, which is confusing and unnatural.”

• This can also be a problem for neurodivergent people who may struggle to process more than one thing at a time.
• Focusing can be harder to do if clients and therapists are tired, and if its not a way of communication that we engage in regularly.
• Admittedly, the flow is different virtually than we would see in a group in-person counselling session, as it’s more difficult to gauge the cadence of a conversation, resulting in participants accidentally interrupting one another more frequently. This tendency is also increased if there are Internet speed delays.

Possible Causes

• As mentioned above, if Internet speeds are not sufficient to handle the requirements of the call.
• If there are too many people on the call (especially when they don’t all fit onto the screen).
• Having the call on “gallery view” rather than “speaker view” (although not necessarily an option for therapists who are taking in all aspects of the session, whether clients are speaking or not).

Possible Solutions

• In-person sessions, if available, can be helpful.
• Therapists should be mindful about the size of the groups they are running and the mental processing demands this can put on their clients – limiting participants especially when it comes to therapy groups.
• Decide whether speaker view or gallery view makes most sense for you and your brain.

Multitasking Opportunities

We may find ourselves doing things we would never dream of doing if we were live in a therapists office: checking our email, surreptitiously answering text messages, even answering the phone. We may get up to make a snack and leave the camera frame.

Causes

There is research to suggest that we are less inhibited over video than we are in-person, which can affect our decisions in virtual counselling sessions. We’re not trying to be rude, the context just feels different and we act differently as a result.

We may think that our counsellor can’t tell that we’re doing other things. Sorry, we often can, particularly when we see the lighting change on your face or hear the clattering of your keyboard, or your eye contact changes markedly.

Why It Can Be a Problem in Therapy

This is a big topic and I actually wrote an article about it previously. While I typically don’t take multitasking personally, my concern is more for clients’ experience: what are you missing when you’re distracted in your session? Or, if I’m talking and I’m boring, please let me know!

Possible Solutions

• My number one recommendation is turning off notifications as well as your phone’s ringer before the session. Do not disturb mode is your friend, here. This applies to counsellors too, as leaving it on, can quickly lend an unprofessional pall to the session.
• Write a list or do a brain dump before the start of the session. Trying to remind yourself what you have to do after counselling, while you’re in counselling, can be a tremendous burden. Once the session is done, you can go back to your list.
• If your multitasking or distractibility is related to neurodivergence such as ADHD, talk to your counsellor about it. Does the session need to be broken up in a way that better suits you? Do you need to move around or use a fidget toy to help your concentration but you’re worried that the counsellor might think it’s weird? Let them know!

Lack of Privacy

I addressed this factor previously, but put simply, we may not have an entirely private space to talk to our counsellor.

Possible Causes

• We’re in a small space and others are home/nearby.
• We’re in a public space and we can’t find a private place to have our video session.

Why It Can Be a Problem in Therapy

• We may be challenged to open up in the way that we need to to get the most out of counselling.
• Leaking confidential information could put our emotional or physical safety at risk, particularly in situations where there is family or intimate partner violence.
• Others overhearing what you are saying could cause problems for you interpersonally or inadvertently hurt them.
• The counsellor may hold back on what they say to you out of fear of compromising your privacy.

Possible Solutions

• Wear headphones/earbuds so others can’t hear what your counsellor is saying.
• Close your door.
• Place a noisy fan (best) or a white noise app on your phone outside your door.
• Ask if people in your home would be willing and/or available to step out for an hour or wear noise cancelling headphones.

Concluding Comments

Despite ragging on video, I feel strongly that it’s a valid, beneficial and accessible form of counselling. Receiving counselling has never been more convenient. And while there are parts of it that can exhaust us, there are many practical ways of counteracting Zoom fatigue. Be well, everyone 💛