I started online consultations as the result of the national situation with covid-19 in March 2020. Prior to that time, I had never undertaken online consultations as I was under the belief they would not work well. However, to my surprise I have been proven wrong to the extent that when the country is safe again from covid-19 I plan to continue a mainly online practice with very limited face to face consultations each month.
Feedback from young people and parents has been overwhelmingly positive regarding online consultations; some of these families have experienced both face to face and online consultations with me as they were under my care pre pandemic but would now choose to continue online for the ease and flexibility it provides. Often families and young people think the young person will be unable to engage and open up online but I have not found this to be the case. There are a very small number of young people who wish me to have my camera on but they ask to have their camera off and that is fine. I do prefer to see the young person but I am happy to accept what is right for them at that point in time. Most of these anxious young people eventually turn their camera on after a session or two although I place no pressure for them to do so.
Online consultations are often less stressful for parents and young people than those face to face as they do not have to travel, park if driving, find the clinic, wait with others in the waiting area, be greeted by me wearing a mask instead of a smile and be in a space that feels alien to them. They can sit with their pet, a fidget toy, a cup of hot chocolate, whatever makes them feel comfortable and chat in the home setting where they normally feel most at ease. If they need a break, that’s fine, I can chat to their parents instead. If the young person wishes to be seen alone, as most do, some parents go into another room and some go out for a walk to provide complete privacy. If a young person wants an adult in the consultation at all times, that is fine too. Often parents want to speak to me alone for a few minutes to give background; I work the consultations however the young person and their family wishes.
Many young people are so used to being on screens, it feels quite natural to them. It is still possible to build a good rapport over the screen. I do have some young people who are nervous telling me certain things and if so, they have the option of using the chat function to type to me privately. There are so many options we can use to help the young person feel comfortable with the process.
Online consultations have given so much flexibility for young people from all over the country to be seen who otherwise might struggle to find an appropriate private specialist near them. It means parents can “zoom in” from their work and if children are happy to, they often choose to “zoom in” for follow up appointments from a private room at school; families miss far less school and work which they appreciate.
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