Latest / Okay, Hear Me Out. / We Hate Telehealth...
Transcript
- speaker-0: Welcome back to OK Hear Me Out. speaker-1: Where your hosts? I don't know. speaker-0: Well, are we? It's fine. Okay. Today we're gonna be talking about the difference between telehealth and being in person. And yes, we have a preference. Absolutely. speaker-1: And it's not a judgmental preference. It's just speaker-0: And it kinda is. Like not of y not of the clients. Not speaker-1: But time. speaker-0: of like doing the work in general. And speaker-1: Yeah. speaker-0: person's way better. speaker-1: It is, for a multitude of reasons and I'm sorry. speaker-0: I need to get some glasses because I feel very left out of the glasses theme. We're gonna go on speaker-1: I mean I've got some in my office that I can bring you. You're not gonna like speaker-0: Mm okay. I mean I have some in my office, but they're not as cool as yours. speaker-1: I mean minor readers because I'm old as shit and my eyes can't see the computer anymore. speaker-0: We'll look. I'll see if I can find myself some anywho. Anyway speaker-1: Wait. speaker-0: back to the real topic we got going on here. speaker-1: okay, so yes, in-person versus telehealth, there is definitely a preference on the therapist side for multiple reasons. speaker-0: I mean at least our side. Like I don't other therapists. Other therapists Which speaker-1: About telehealth. speaker-0: I don't understand, but like you do you boo. speaker-1: I definitely think, like, I obviously telehealth became a big thing during COVID. It served its purpose. There was a reason for it. there still remains a reason for it. Like, accessibility is a huge part of why telehealth exists. Absolutely. And that's so important to our field, to us, right? Like, I think that it needs to be a thing. speaker-0: Yeah, I love that I can see my clients like randomly on their lunch. speaker-1: Yes. yeah, it serves an important purpose. However, we do enjoy our in-person sessions a little bit more. Yeah. speaker-0: I feel like as a therapist, you miss so much in telehealth. Like so much of our work is like observational and like body based. Correct. The Like if my client's shaking their leg under the table when they're doing telehealth, I can't see it. So I can't record that in the note itself. And it is inform important information because that tells me that they're dysregulated, right? At least minimally. Yes. Depending on the client, like baseline-wise, they might just always be dysregulated. But like that's a good indicator that someone is be is dysregulated. So if I can't see that, I can't record that and I can't ask the appropriate questions. And I ask also might like dysregulate them more without knowing it because I'm asking them questions that maybe I wouldn't have. speaker-1: Yes. And I think one of the things that I learned in grad school very few things speaker-0: like you learned something yeah. speaker-1: one of the very few things and I actually learned it at my residency, right? So I did an online school and one week of the year we would have to fly in person of their choice to do like in person work. And speaker-0: When you actually learned something when you were in person. In person. Not speaker-1: Yes, what a concept. No way. Right? What a concept. So I learned from one of my favorite professors, she did a whole like thing on the importance of the body language, right? And I remember thinking there's no way that I am going to be able to focus on what their body language is telling me while they're speaking and I'm supposed to be retaining their information. And also being prepared with like what I'm supposed to say back and like have the appropriate things to say and like blah blah blah blah. That's such a Totally. But then you get into the field and it's like you just don't think about it. Like you just get into the work and it just it just happens. speaker-0: I was just telling one of my students the other day, right, like If you pick a modality that very much matches who you are as a person, you don't have to actually think. You don't have to think about picking an intervention, right? Like I am already naturally a very CBT person. Yeah. Right? So for me, I can just show up to sessions very authentically because I will I naturally spit out CBT things when I talk to people. So like instead of having to think about the intervention I'm gonna do, like my brain just naturally goes to C B T. Yeah. So like when I'm doing C BT with my clients, like that whole part like fear gets completely white. out because I just get to show up as who I am and my brain will just naturally do the CBT stuff, right? And like you have some people like you, you are very body you're a very body based person. Like you're naturally like that. So like for you it's a lot easier for you to notice like your fucking shoulders just went up. Yes. You just did this. You just did that. And so like that just comes out automatic. speaker-1: Yes. And I rem like I had at Area 51, I had one client who would constantly tell me certain things didn't stress her out or cause her distress. And meanwhile her fists would be clenched so tight, her fingers would be white. I believe me. She would cut off the circulation to her fingers. And I finally was like, I hear you're saying this, but your hands are telling me something very different. And those are the things that we don't get to see in telehealth. No, never. Right? Like we can't call that out. And she'd be my God, I didn't even realize I was doing that. And so it's like we miss out on those cues. speaker-0: Which means you miss out on intervention. speaker-1: Yes, like clients miss out on picking up on their own cues and then clinicians are missing out on how to like navigate what's actually happening. Yeah. So there's a lot that's missed in the in the telehealth world. speaker-0: there's a lot of things you that are really hard to do, like co regulate. You can speaker-1: You can. speaker-0: really hard because you're not and like you're not exchanging energy. speaker-1: No, not the same way. It's not so it is very hard. speaker-0: And building a relationship with someone is just significantly different on a yeah computer screen than doing it in person. speaker-1: It's not impossible. speaker-0: Well no, it's course it's not impossible, but it's very different. It is. speaker-1: Very different. speaker-0: It's a very different kind of relationship. It's very removed. speaker-1: Yes. So speaker-0: I don't know. Personally, like I prefer teleho I mean, I pre I don't prefer tele. I prefer in person. Yeah. because I I I just have a way more fun with my clients when we're in person. speaker-1: Correct. I also think that level of severity well yeah speaker-0: There's a lot of contradic in contradictions, right? speaker-1: Like and explaining that to clients I think is also it feels like such a tightrope. Yes it does of being like speaker-0: Hundred percent. speaker-1: Hey, by the way, you have too much trauma. I can't see you unless you're in person. Correct. And also like safety and Yeah. The need for in person connection and co regulation is so important that being like, I actually need you to come in person until we can stabilize you. Correct. And then I'm happy to see you telehealth if that's what you feel like you need. like safety speaker-0: With couples, like hard speaker-1: Sorry. Yeah. speaker-0: fucking pass. I am not doing couples therapy via telehealth. Absolutely speaker-1: I concur to that one. speaker-0: not. Like, no. It's hard enough to like manage a relationship dynamic when you have the energy in the room, not being able to feel like it's so different doing it via telehealth. I have done it a couple minutes and I hated it. Hated it. speaker-1: I will never do. speaker-0: It don't do it. It's not worth it. Because like at the end of the day, when you do in person, right? Like you can get that separation and have a client get up and say, I need to take a break and go leave. speaker-1: Yes. speaker-0: Like they can do that via telehealth, but I have speaker-1: Like you don't know what's happening in the speaker-0: z I have no idea where they're going. I can't go find them. I can't I'd like there's so much speaker-1: You don't know what the safety risks are. Like, are you going into the bathroom to go self harm? Are you going into the kitchen to go drink? Like there's so many unpredictable factors with relational work when someone gets up and leaves a room, let alone Yes. speaker-0: Therapy work in general, but speaker-1: Well, yeah, a hundred percent. Especially but especially with couples' work. If someone gets up and leaves, like there's to me, there's just too much. There's too much. Yeah. speaker-0: Which th so that would be one contraindication for me at least. Like, I'll do it if it's like a super stable couple and like we're doing maintenance work and we've been seeing each other in person for a while. It's like a one off maybe, or like maybe they just do like the once a month, once every other month, or even six month maintenance sessions. We're just checking in. Sure, why not? But like if it's like the first couple times you see no. Sorry, not happening. No. Absolutely not. It's a hard pass for me. Agreed. But there are a lot of therapists who do it. Like and Which good on like I just find I'm glad you can handle that. I can't do that. speaker-1: Yeah. speaker-0: I need you in front of me. A hundred percent. But like the like IPV, right? Domestic violence. It's a hard no. For for speaker-1: Enterprise. speaker-0: domestic no. For like for telehealth. That's a hard no. Absolutely speaker-1: The speaker-0: not. If you are in a domestic violence relationship, like you you that person should be coming in person. Because you need to be able to separate them from their abuser. speaker-1: Yes. speaker-0: The hard part is, is that in a case, mm, for those of you out there, I think was it you who told me about this or did we did we hear about this online? Where a therapist was doing sessions with a victim of like IPV and the victim was coming in and the abuser had like put like a recording device in her clothes or so or in her bag or some shit. Yeah, it was wild. speaker-1: I have not heard of fields. speaker-0: Yes it was why. speaker-1: I also am a little surprised it actually doesn't happen more. speaker-0: I mean it probably does. You probably just don't hear about it because no one probably thinks to check their fucking pat themselves down before they walk in. But like that's something to think about though, in the sense of like that's why telehealth's not appropriate. Because that person could be literally sitting behind the camera and you'll never know. And you could be doing significant harm. speaker-1: Correct. Yes, I think this is like my true crime background and a little bit of my twisted brain though. Like these are things that I do think about. yeah. It's like how often is someone like speaker-0: Tapping their phone. Like speaker-1: legitimately hiding recording devices in places that shouldn't be? And I don't know, I just I'm really not surprised and I really think that it probably happens more than we think and if it's not I wouldn't be surprised if that is actually a future thing more often. Yeah. speaker-0: So like something to think about, right? If you have someone who's in that kind of a situation, but like how do you handle that? You're gonna have to change your clothes when you get here? Leave your purse on the car? Like what do you do? speaker-1: But I I okay, so like I'm gonna take this to the next level of like unsafe relationships when you think you're at home, but your partner has put cameras in the house. Like there's nanny cams in the house. Yep, 100%. Like 100%. There's real consequences to doing telehealth when you are in unsafe relationships. speaker-0: Correct, hundred percent. speaker-1: Why are there Orbies in here? speaker-0: they're they're mine so that my clients couldn't fuck with them 'cause I need to clean them. Okay. speaker-1: I was like that's very random to be hidden in that podcast. speaker-0: Yeah, I just throw them in here. Gotcha. Anywho. Suicide and self harm. Yes. That's another contraindication for telehealth. However, it's a very slippery slope. Because like I've had clients who are telehealth only. Yes. That become suicidal. Like sometimes that part you just have to fucking deal with it. speaker-1: Yeah. speaker-0: Like and and it's it is hard because I mean but we've also have Erica. who somehow has literally had to offload clients because they're no longer appropriate for telehealth. speaker-1: Yeah. Well, it I mean it I think of people like Christy who's also a hundred percent telehealth, right? Like they there's agencies that are all a hundred percent telehealth. Like speaker-0: How do you like speaker-1: and I haven't it's been like a year since I've taken it telehealth training and so there's protocols in place for these things. but it's really about the safety planning and knowing that like you have to All through. Yes. Well which is the case in person anyways. speaker-0: Well no, because in person you can like be like, Sorry, I can't let you go home because I don't trust you're actually safe. If that person's freaking via telehealth, they can just not open the door. And like this you can go send somebody over there go check on them, but like but they're speaker-1: Yeah. speaker-0: But it's still like it's still gonna fall on you at that point because you are the therapist and like you didn't like you weren't able to actually take the appropriate steps because at the end of the day they probably shouldn't have been seen during telehealth. Because speaker-1: Yeah but speaker-0: you're back to appropriateness, right? Like speaker-1: Yes, and we legally allow in all of these states, right? And we were just talking about this. Like the other states that allow you. Like so if if we were to sign up freaking wild for telehealth in Florida while we are in an Oregon, yeah. And someone's suicidal, you're gonna take all of their resource like their information resource to you, their their living environment, how to call resources if there's an emergency. Yeah. And the most that you can do is send emergency services to them. Yeah. That is all you can do because they have legally allowed you to see them. This is true. So like it doesn't fall on the therapist because if we were seeing someone in Bend, we can't get to them. They can't come to us for in-person sessions. Like it technically not four hours away. speaker-0: Like You should you would be surprised people do intensives like that all the time. speaker-1: Intenses are very different than once a week therapy. speaker-0: Well but then again it goes back to right like you're not also gonna see somebody. Well, I wouldn't see somebody. That's like massively suicidal. speaker-1: But if they are coming to you for a year and then become suicidal. speaker-0: But to me that's different because you already have significant rapport belt. Again, that goes back to the trust. Right? speaker-1: Exact right. speaker-0: Like to me, like I've been seeing long term where they can become suicidal and I'll be like, Mmm, okay, what are we doing here? Okay, but like if it's a newer client, that's a different So agree. That I speaker-1: Well, a hundred percent. Right. It's not gonna fall on you. No. You know what I mean? Like there's a gray area there where it's like it's not gonna fall on the clinician when you're doing telehealth. If speaker-0: Hundred percent that I speaker-1: you are doing your proper due diligence to get their address, call EMS, like do all the things, like it's speaker-0: I'm thinking more like new clients. Like brand new. You know, right off the bat, they're like seven out of ten suicidal. speaker-1: putting on their paperwork and like or in your intake session they're telling you that they're suicidal. Yeah you refer them out at that point. At least that's what I would speaker-0: I mean I mean unless you specialize in suicidality via telehealth. Like maybe. That's a very sm kind speaker-1: Yeah, maybe but speaker-0: of therapy. Like I need to get my hands on you. Like Yeah. speaker-1: I that's not my forte. Yeah. speaker-0: Because again, like I said, there's so much that you can hide via telehealth. Correct. speaker-1: Well, and we've had clients. You specifically have had clients, but like I've had clients where they're like, Yeah, I threw all of my my sharp and then they're like, just kidding speaker-0: yeah, I've totally had that happen. I've definitely had that happen. Cough, cough. speaker-1: Uhhuh. speaker-0: Right. And then the next day they tattle on themselves. They're like, I didn't do it. I didn't throw it. speaker-1: Uh-huh. And thank God trust. speaker-0: Do try. speaker-1: Like. And like healthy form. Absolutely. speaker-0: Report Yeah, absolutely. speaker-1: Right? Like when you are in that place of like they know better and they want to do the things and they know that they don't want to blow that trust up. They're going to tattle on themselves. AKA. They are just like me. speaker-0: I'm a little inclined to do that though, because you're like, let me give you a nice healthy dose of forgiveness. speaker-1: Uh-huh. speaker-0: It's okay. Yep. And it is okay. speaker-1: It is because that's speaker-0: the healthy thing to do is like when you lie or you just don't say something and you come back and you do what you should have done the first time, like yeah I'm gonna give you all the things you should have do, don't worry about it. It's fine. Like I appreciate you being honest with me. Like you're like speaker-1: It's speaker-0: safety plan. Let's do a thing. Like health healthy relationships. Correct. speaker-1: Great. But like again, it goes back to a rapport, it goes back to all the things. And at the end of the day, telehealth and safety risks all come down to communication, seriousness, safety planning, what does your safety plan look like? Being very transparent as a clinician and being like, I don't f around with this shit. speaker-0: Yeah. Which all my clients do. speaker-1: Right. And there's been several clients where I'm like, here's the deal. Like I'm not a crisis counselor. Yeah. Like I have no problem calling and having a wellness or like a welfare check down on you. I have no problem saying you need to be committed. Like maybe you need a seventy two hour hold. Maybe that's the thing that you need right now. Like and if one Yeah, that's not but I will not the treatment plan that like anybody desires, but if that's what you need to stabilize, great. Let's let's talk about that. speaker-0: Yep. Unfortunately our medical system kind of sucks and very rarely actually stabilizes people. Correct. speaker-1: Mm-hmm. speaker-0: I don't have actually really I don't think I have a single client that has ever been committed and gone to the hospital and come out being like, I feel so much better speaker-1: Well, to be fair, most of the a seventy two hour hold is not gonna do shit for you other than keep you alive. speaker-0: Most of the time it's like, that was even more dramatizing. I speaker-1: Dude for real speaker-0: feel speaker-1: Well yeah, because they like speaker-0: Which is wild to me. I really wish that we could I really wish we could interview our one client that's a nurse that specifically works in that population. I speaker-1: my god. speaker-0: wanna know. Can we we could. We could use a voice thingy. speaker-1: The one that's down south? Mm-hmm. Yeah. speaker-0: We could use a voice changer. speaker-1: Mm. She would totally do it too. speaker-0: Yeah, should totally do it. Mm-hmm. we might need to sit on that. How that hashtag ethical code. Legit. Is this appropriate or not? speaker-1: Probably. speaker-0: Probably we'll need to sit on that one. speaker-1: But I feel like that would be the case for several clients. I like your job would be great to like interview for. Can we just anonymize you and speaker-0: We'll have to think on that because that's gonna be it's most likely a Wait speaker-1: That is a no way. speaker-0: listen, there's tons of them out there. I'm sure we can find another one. Well, but it's way more fun when you know them. speaker-1: It's a hundred percent more fun. speaker-0: Anywho, we are getting so off track. Okay, here's the other thing. For the love of fucking god, please do not do not do your session while you're driving. speaker-1: I literally just had this conversation yesterday. My client emailed and was like, Hey, I forgot about our session. I just got out of a meeting. It was like five minutes till. And they were like, can we either reschedule or can we do it via Zoom? And I was like, I have this time and this time available this week. Otherwise we can do it Zoom, but you cannot be driving. Yeah. And they responded and they were like, Well, I'm driving, so let's do this time on Wednesday. And I was like, For the love of all things, we've had this conversation more than once already. You cannot be driving while you do your session. speaker-0: I don't even like it when my clients are passengers. But speaker-1: Not speaker-0: like here's the thing though. Like, okay, now here's a good question. We're gonna get into this. At what point do we 'cause okay, you know me, I'm a big, big like we step in for our clients when they are engaging in patterns that they probably shouldn't be stepping in and like we navigate them through it in ways that are like we are really telling them, don't do this, right? For example, okay, if you have a client that's terrible boundaries, knows they have a session via Zoom at blah blah blah time and then you Log in and they're a passenger in a vehicle. They have headphones, but they're a passenger in a vehicle. What do you do? speaker-1: Reschedule. speaker-0: Why? If they're saying that they're perfectly comfortable being in that car, having that conversation within that with with that person in present, why? speaker-1: I mean, I have help. speaker-0: Because at what point are you actually now taking away their choice and being like, No, you can't do this if they are very fucking aware of the fact that they had a session, they chose to double book themselves and they're like, No, I'm totally fine with it, why? Then speaker-1: Yeah, I mean you're not wrong. speaker-0: at the end of the day, I'm like, Great, we'll do the session and we're gonna have a conversation next time about why are you overbooking yourself, And why are you doing therapy in front of other people? What speaker-1: Doing yeah, because at that point I actually you say you're comfortable, but you're still going to be filtering yourself. speaker-0: Well even as a therapist, like I'm like, okay, well I can't ask that question. Okay, well I can't ask that question. Because like I'm not gonna ask you a question about something super freaking personal that I know you don't even like talking about with me, with someone else in per in in the car with you. I'm like also That's speaker-1: But again, where like fuck it, I'm not speaker-0: a question Yes and you're gonna have to sit there in the discomfort. speaker-1: Exactly, my thought process is that like I'm not going to filter myself. You are telling me that you are comfortable, so you're going to be filtering yourself as the client because of who you're in front of, which makes the session ineffective. Correct. In theory. So like yes, you're could have the session and be like, okay, this is the choice that you're making, and I'm not gonna change it for you. However, ethically, doesn't even doesn't even the ethical code say that they have to be. Maybe not. speaker-0: Well, t I don't know if it's actually in the ethical code that says it's our job to make sure that they're within like us like a quiet, confidential place. Because to me, like if they live in an apartment like that's subjective. I mean, I know plenty of people who live in apartments whose walls are w fucking ice thin and you can hear through them. So like is that still considered confidential because they're in separate room? speaker-1: I mean? Yeah, I correct. speaker-0: What's the difference? I mean you have people who do tele I telehouse sessions on lunch and they go to like a low key coffee. speaker-1: The cafe. speaker-0: Cafe. They go to a local cafe and they're like sitting in the corner because they don't want to do it at work. You speaker-1: Yeah, see that I wouldn't speaker-0: know what I mean? Or they do it in their car. In the parking lot or something like that. speaker-1: That I'm fine with. I used to do it there in the car wall. I don't usually hear people when they're in their cars. Unless they're on airplay or whatever. speaker-0: Which some people do that. Which But like but again we're gonna go back to if that client is comfortable doing it in a cafe, why is it my job to tell them no? Because if that's the only spot that they have available to them, so you just can't do therapy now because No, absolutely not. If you're doing your own speaker-1: Well, one you can't do groups for sure. But speaker-0: individual therapy, like again, going to a fucking nail salon, I had a client do that one time. speaker-1: That one kills me. But like speaker-0: If if you're wanna do your fucking session and you're getting your nails done, again, why is that my job to yet again a conversation to be like, so why are we overbooking ourselves? And like, are you do you actually want to do therapy? Like speaker-1: Well, and I think that's a huge part of the conversation because to me, when you are doing it outside of a comfortable safe space, you are not actually putting in the work. speaker-0: Goes back to how do why do we get to decide what's considered a comfortable safe space? True. What if that person finds their fucking nail salon person to be very comforting and getting a nice hand massage while they're talking about hard things is safe for them. I don't know. Why do I get to decide that? Right? And I s that's one thing I struggle with our fields because it's like our field is all about choice. All about letting them make their own decisions. But then they all of a sudden are like, Well, but you can't do this, or you can't speaker-1: Only do it in these places. speaker-0: only do this. And it's like, Well, wait a minute. To me, this is information about my client. And a lot of therapists will be like, Well, it's your job to set boundaries. Well, I can't set boundaries for my client around where they do their sessions. That's their job. I'm taking that away from their like That's my information learning about like, you suck at this. Like you're terrible at setting. speaker-1: So let me add another layer to this. What happens when they make those choices and the environment is distracting from the session? speaker-0: Again, that goes back to like that conversation that you have. you make choices that don't actually align with what you say you want to do. To me, that's the conversation. You knew you had this therapy session. You knew this, you knew that. You still actively chose to essentially avoid speaker-1: Yeah. speaker-0: by putting yourself in a situation that pulled your attention away from doing the work. To me, I'm like, where do you want to do it? You wanna do it while you're pooping? That's weird. Don't do that. Like, speaker-1: Do that. Please for the love don't do that. speaker-0: how many clients realistically though, will will do that? They'll put themselves in situations where the therapist is like, This is iffy. I don't know. e ooh. Right? Because what happens if that client had a rough week last week? You can't fucking reschedule what if you don't have anywhere to put them? What if they're like struggling hardcore and they're in a situation where like you need to have the session with them? What do you do? What's the better decision ethically to cancel the session and make them wait three more, four more, five more days? You know what I mean? Like speaker-1: Yeah, well, and I think that's that's the ultimate question is like if you don't have space to reschedule them. But again, how much of that becomes a you problem versus a them problem? If they are overbooking themselves but they've had a hard week, where's speaker-0: I agree. But then again, speaker-1: the ethical line of like that's your responsibility? Exactly speaker-0: Exactly. speaker-1: versus like now I have to accommodate you because you overbooked yourself and made decisions, but you're having a hard time. speaker-0: But again, see, okay, here we go. We're getting on such a tangix, we're not even talking about fucking telehealth or in person anymore. But this also makes me think about the idea of like the whole like transference, counter-transference, and all that bullshit about like how they're impacting the therapeutic relationship and how many times clinicians would love to be like, You're pissing me off right now because you're disrespecting my time. You're disrespecting like the space that I've created for you. Yes. Right? Like But how many of us can actually say that to a client without the client like being like, you hurt my feelings and blah blah speaker-1: And having a bunch of shame about it. speaker-0: blah Hello? Where else does this show up in your life? Where you make plans with somebody And you fucking f ruin it because you overbook yourself or because you're not paying attention or because you're distracted. Like, and again goes back to having a good relationship with your client, but like I have good relationships with my client and I'm s a lot of my clients and I'm still get super nervous about bringing shit up like that. Yeah. Because it to me, it's so ethically gray, and so many therapists will jump on your fucking back. I'd be like, I can't believe you said that to a client. Why? It's true. speaker-1: And we praise modeling, right? Like we encourage it and speaker-0: Unless you're unless you're hurting their feelings. Correct. It well in the fucking life. speaker-1: That's exactly the thing is that like sometimes you have to have the conversations where it's going to hurt their feelings or it's going to upset them and it's going to be one of those things where it's like you're not gonna like this. No, but I need to say it. speaker-0: Like w speaker-1: Mm-hmm. speaker-0: so like I don't and ethically, right? Like where does that land? If a client says, like, I won't I'm totally fine doing this in the car, especially fucking teenagers, they do it all the time. I can't tell you how many times teenagers have in their car their friends, and I'm like, what are you doing? speaker-1: I don't see teenagers. speaker-0: I don't usually but this is Area 51 time, which makes much more sense. Okay, that makes sense. You put it in that context. Makes way more sense. Hashtag COVID. But like you think about all those like what are you gonna do? And where is the line between being flexible and being unethical? speaker-1: Well, I think that's that's the ultimate question. That's speaker-0: Who gets to decide that? speaker-1: the ultimate speaker-0: Jan on the fucking board who hasn't seen a fucking client in 19 years and probably doesn't even know what telehealth is because she's been retired for so long, telehealth didn't exist. my god. Like I speaker-1: Yep, there's not a channel. speaker-0: was just thinking that I was like, I'm really sorry if there really is a Jan. I was not actually talking about you indirectly. Sorry, Jan. But like you know what I mean? Yes. Like therapists are so quick to rake each other around the coals around like speaker-1: We really are a very sensitive bunch. It's fucking speaker-0: Looking annoying. speaker-1: It is actually very wild. Like and even having the conversation about like telehealth versus in person I feel like we could get a lot of flack for. speaker-0: Probably. How dare you insult me around my telehealth and say that I am not doing good or that bitch, I'm not saying you're not doing good enough work. I'm saying you can't see things that you would be able to see in person. And if you don't believe that speaker-1: End of sentence. speaker-0: Well, if you don't believe that, I have concerns about what you're looking for when you do therapy in person. Correct. speaker-1: Which is intro like I might have to actually have that conversation with Christy around this idea of like how much do you feel like you notice now versus when you were in person pre-COVID? Like how much do you like I will have to like interview her in one of our sessions. speaker-0: I'm gonna waste one of my entire session time just enabling here for my podcast. And Christy's gonna be like, What the fuck are you doing? She will totally You just tell you what, I will schedule a second session where we can do this. But she'll be like, No, absolutely not. She's not ready. speaker-1: I'll just sneak it in as like a ten minute Yeah, I think it's a good question though, for those that were previously in person versus telehealth. Like what they feel like they have noticed the difference. Yeah. speaker-0: So many questions. speaker-1: Dude, can we please I speaker-0: Hate doing telehealth all day. speaker-1: It is verudal. I don't know like a speaker-0: I've seen myself to a three by three square all day. speaker-1: Yes. There is something about the difference between in person and telehealth sessions that is so boring. I don't speaker-0: Soul crushing. speaker-1: but like why? What is it about? Because it's not the speaker-0: That's exactly what we were talking about. It's the disconnection. speaker-1: It is. There is a massive and it's not the clients. Like let us reiterate. Like clients No Like it has some One Hund. And speaker-0: My favorite glands are only helped like and how many times have you been like, God, I wish they were in person? I'm like, I wish they were speaker-1: A hundred percent. Every once in a while I'm like, so yeah, we're gonna come in and like say hi and they'll be like, maybe eventually and I get excited when they actually do. Yeah. But like I just there's something about like days that I have had clients where they will switch from in person to tele. speaker-0: Like the days where you come in for your in person clients and then half of them cancel. And then the ones who are supposed to be in person moved to telehealth and you realize you drove all the way to the office and didn't need to for speaker-1: You yes. My my two minute drive or less. speaker-0: I have a 30-minute drive to the office and I I always text her when I'm like, God dang it, I didn't even have to drive here. All my clients do to telehealth and I could have sat in my pajama pants all day. Which yes, we 100% do. I 100% sit in my pajama pants. speaker-1: Yes. Did you see the message that I sent you about this or that? No. I sent you a message where they do the like office this or that. And they put it up on the screen and then they step into like this or that. I was like, we need to do this with the office because one of them was like That would be so fun. I know. One of them was like wears paj pajama pants versus like dresses for telehealth speaker-0: Yeah. speaker-1: sessions. Absolutely. And I was like, who dresses up for telehealth? speaker-0: I mean I'm gonna be completely honest. I mean it's podcast at this point. No one it's fine. When I work from home, I don't even bother putting on a bra. I don't do it. Definitely don't. speaker-1: There's plenty of people who speaker-0: I just like full blown baggy sweatshirt that bitch up. I'm lit telehealth, that is one thing. Telehealth, speaker-1: That is the speaker-0: I can sit at home. I you think I look like a troll when I come here. Yeah. It's like a whole nother level when I'm at home. Like it's so bad. It's I believe I've got like eighteen different waters. At least you're hydrated. My snacks, my chapstick. Like I it looks like I live in that room. And then you just quickly run to the bathroom in between sessions. In between sessions. And speaker-1: Session. speaker-0: you know, it's fun. speaker-1: Yep. There is just something though. Like I agree. There's when you have to sit. I just that is the one thing I don't understand about clinicians who are only telehealth or just Erica. I just I can't. But she doesn't do that many back-to-back. She only does it. Is she finally increasing her load? Yeah. god, is she gonna be on the podcast? Yeah. We have to figure out how to make that happen. I gotta I gotta speaker-0: We'll have to ask her 'cause all multiple times. Yeah, you need to figure that out. Okay. I already texted Shannon and I just gave her two dates that she can pick from. Yeah. For her interview. speaker-1: We're gonna interview this bad boy up, guys. speaker-0: It'd be so fun. I'm so excited. I'm excited for Sandy. Yes! If you have people you think we should interview, even no matter how ridiculous they are, just send them to us and we'll see. I already have Taylor Swift on the list. It's speaker-1: We'll see how we can finish. my god. Ashley speaker-0: fine. It's gonna happen. I'm gonna manifest the shit out of this. speaker-1: You keep doing that. I'm going. speaker-0: I might have to go through Travis because Travis may be way more amenable to that idea. speaker-1: However. You put Taylor, I'll put Mariska. speaker-0: Yeah. speaker-1: space. That might be more feasible. That would that would be epic. Maybe it's not gonna be in here, that's for sure. No, that's gonna speaker-0: they're gonna be, but it's fine. That'll definitely have to be a telehealth day. That's gonna have to be I mean now that would be worth doing telehealth day. speaker-1: That one Yes it would. speaker-0: I mean although being in person would be way better, but it's fine. No. I have to make a list of all kinds of people that I'd love to interview that are completely out of our pay range. speaker-1: Are we gonna have to pay people like that? speaker-0: Do you think they do that for free? Bitch, we just got done making fun of therapists who think that they're worth five hundred dollars an hour to go to court. You don't think that Taylor Swift's gonna be like, you're gonna pay me some money to come hang out with you like for an hour? speaker-1: It's gonna be a five minute interview. So we can go. speaker-0: We're gonna be that fucking pawn star meme is the best I can do. my god, legit speaker-1: We've got a five minute interview to Swift's J speaker-0: So we got In fact we're not even gonna be interviewing her, we're just gonna be sending her the questions and she's just gonna video record her answering And speaker-1: For some male herself. speaker-0: then we'll videotape us asking the questions and we'll just edit it together. speaker-1: Yes. There you go. Legit. It's fine. That's how it's gonna work. For us poor folk. speaker-0: Poor phone. Help me, I'm poor. Anywho. All right. speaker-1: Okay. No. That's our take. Tell versus in person. Person's speaker-0: In person. speaker-1: way better. This is our opinion and only our opinion. Don't judge us. Or judge us and don't tell us about it. Don't forget. So until next time. See you later. Bye. speaker-0: Bahio se