During the pandemic, a number of couples doubted the efficacy of telehealth. Some couples who I saw pre-pandemic chose not to continue until we could meet in-person again. Others had child care issues.

Pre-pandemic I wouldn’t consider meeting with someone via telehealth if I had the option of working with them in-person. During the stay-at-home order, that wasn’t an option. During the stay-at-home order, new couples in-need trickled in, hoping video conferencing would impact their relationship.

I am pleased to say that this forced experiment has been a success. After months of being locked down, I am now concluding couples counseling with couples I never met in-person. 

When meeting with couples in-person, couples talk directly to each other, and I move my chair closer if couples escalate. Escalation provides the teaching moment in couples counseling—when I stop the action and point out what they are unknowingly doing. Then I coach or model how to be more effective.

Since couples are also talking directly to each other during telehealth, escalation also occurs. Instead of moving my chair forward, I use my voice to get their attention and give feedback. What happens in videoconferencing mirrors what happens in the office. And now there’s a whole set of soon-to-be graduating couples that I never met in-person. 

Instead of sitting on my couch, couples are sitting on their own couches in the comfort of their homes (minus the commute). What’s different is that I sometimes meet family members. A young child may wander into the room. I have a mother who frequently holds her newborn when he’s not napping. I have a couple who enjoys a glass of wine at the end of their work-at-home day as we chat about their relationship. Entering my couples’ homes is a treat and seeing couples continuing to progress via telehealth is rewarding—from my couch to yours.

~Richard Rein