6 Tips for Improving Telemental Health Communication
“Seek first to understand, then to be understood,” self-help guru Stephen Covey advised in his well-known book, 7 Habits of Highly Effective People. A similar principle applies to telemental healthcare—only the task is more complicated than it seems.
Bridging the distance gap with videoconferencing and mobile apps is one thing. Bridging the language gap and other communication differences is another. Here are some tips for overcoming communication challenges during online counseling sessions.
Language and Communication Differences in Telemental Health Clients
Online counselors are bound to encounter communication obstacles when working with clients, starting with language differences. Clients for whom English is a second language may struggle to convey the full scope of their experience to a therapist who only speaks English, for example. Such differences are likely to become more common as telemental counseling expands in use around the globe.
There can also be other communication differences, as an extension of the fact that telemental health initiatives are now being employed to treat a wide variety of mental disorders, from addiction to autism to obsessive-compulsive disorder. That diversity of therapeutic needs implies an almost equally diverse range of communication differences.
As further illustration, consider the following scenarios:
- A child with Autism Spectrum Disorder may have a very limited vocabulary and auditory processing that only compound their difficulties understanding what is being vocalized.
- Someone with a drug or alcohol addiction may also have a co-occurring diagnosis of OCD, which amplifies their shame and anxiety, making it even scarier to put their struggle into words.
- A client may be severely cognitively impaired, functionally illiterate or may have a fluency disorder that causes them to stutter.
In each of these cases, online therapy services will be more effective when they take into account individual communication differences.
How to Bridge the Communication Divide
On that note, here are some suggestions for accommodating language and communication differences that may arise in various online therapy contexts:
- Try using a translation gadget on your phone or computer. Some videoconferencing platforms, like Skype, have an embedded translation tool that interprets the conversation in real time. If that’s not an option, check out what mobile apps may be available to you. Try to find one that’s user-friendly, so that it’s not a big distraction during sessions.
- Repeat back to the client what you think you heard and ask whether you heard them correctly. That lets the client know that you are doing your best to hear them and really want to be able to understand. That also gives the client a chance to correct or elaborate on what they have shared.
- Pay attention to body language. Whether it’s in person or via videoconference, body language can be a powerful form of non-verbal communication. Pay attention to facial expressions, posture, hand motions, etc., for signs of what they may be feeling yet unable to communicate in words. Then ask for the client’s feedback about what you’re sensing.
- Be inclusive of other non-verbal forms of communication as well. We now know that people have different learning styles, after all. One person may be an aural and verbal learner; another person may be more of a visual learner. Then there are those of us who are kinesthetic learners, who learn by physically doing a task. If a client is having trouble communicating with you or understanding what you’re saying, take out a sheet of paper and try communicating by writing or drawing. In some cases, you may need to get creative. Even music can be a communication tool for understanding what a client can’t tell you with words.
- If you get stuck, refer the client to someone who can better overcome the communication hurdles, based on what you know about the client’s profile. We all have limits, including with respect to our ability to deal with any communication problem that may come our way. Knowing what these limits are is the better part of wisdom and professional responsibility. In some cases, online counselors may need to refer the client to someone else. We cannot be experts in every clinical area of expertise after all, so there is no shame in referring a client to someone better qualified to help. In fact, it means you’re taking your job seriously!
Anna Ciulla, the Clinical Director at Beach House Center for Recovery, is responsible for designing, implementing and supervising the delivery of the latest evidence-based therapies for treating substance use disorders. She has a passion for helping clients with substance use and co-occurring disorders achieve successful long-term recovery.