Online therapy is effective for older adults because it helps to remove barriers to treatment access. Many older adults do not drive, whether due to a health condition (e.g., vision loss or chronic pain), finances, or preference, which would limit their options to treatment. By participating in therapy online, older adults can access therapy in an environment that is comfortable to them (home) and minimize disruptions to care that in-person appointments can cause.

I approach therapy sessions by a process I call “orienting and contracting” – I discuss the agenda of the session (orienting) and then ask the patient if that sounds acceptable or if something added to the agenda (contracting). Often, a session will consist of a brief check-in about the time between sessions, review of any practice assignments, discussion of one to two core concerns, and then a check-out where we schedule the follow-up appointments and determine if a practice assignment would be helpful. I aim to be collaborative in sessions to ensure that we mutually agree on topics and goals, and are doing tasks relevant to those topics and goals.

If you are someone who is starting therapy for the first time, I would advise you to be gentle with yourself. Emotional pain and suffering doesn’t develop overnight, nor does healing. Much of what you struggle with might have been an effective response or “solution” to past problems, but this solution no longer works or has become self-defeating in some way and yet you are doing them anyway. It is okay if changing those patterns is hard. Be gentle with yourself if therapy feels scary or if you struggle to change.