Screening for Trouble

Payal Das* hasn’t missed a single session with her therapist in the last five weeks, which is unusual for her as she invariably ended up missing at least one weekly session a month, if not more, earlier. The Delhi-based graphic designer suffers from social anxiety and mild agoraphobia, among other comorbidities, and the effort of travelling through the vast multitudes of the Capital to her therapist’s office was at times too daunting.

“My counsellor’s practice was being careful, so they instituted Skype sessions a week or so before the lockdown. And to be honest, I wish it had been done sooner because I so prefer online sessions. I’m in my own space at home, but still have this window to get the support I need,” says Das.

The ongoing pandemic is truly an unprecedented time, and among the businesses and services moving more and more online to continue providing for people are counselling clinics and psychologists, largely through video calling apps like Skype and Zoom. Patients are advised to sit in the same (quiet and private) space for all video sessions, with the same camera angle, to help maintain a sense of continuity.

“There was definitely a learning curve, more so for us therapists than kids and young adults,” says Dr Amit Sen, child and adolescent psychiatrist with Children First, New Delhi, adding, “We normally encourage in-person sessions, but with our physical space being shuttered, we have to find ways to innovate and find apps and other tech that can keep our online sessions as productive for our patients, especially the youngest ones who, at two to five year-olds, don’t particularly enjoy spending long periods in front of a screen. Our primary school, teen and young adult patients are very comfortable with tech solutions so it was smoothest for them to transition,” says Sen, while noting that the process of holding several consecutive sessions online can get draining for therapists.

Speaking of brain drains, several therapists and practices saw an ebb in sessions at the beginning of the national lockdown on March 24, only for numbers to surge as the crisis continues. “In the face of physical dangers, mental concerns can take a backseat, and in the first week or two, many people said they didn’t need online sessions and would resume our services once the lockdown was lifted. However, since then they have returned, and there’s been an uptick in new patients, as teens and young adults from Delhi-NCR as well as other cities have been reaching out to us, sometimes on their own accord, due to stress,” says Sen.

If the kids aren’t all right, the adults aren’t faring much better. “I’m glad that sessions with my shrink are continuing online, but I can’t help worrying about the fact that I’m sharing very personal things on an online medium. The news reports about Zoom bombing and video calls being hacked or recorded by strangers don’t help either,” confesses Neha Singh*, a freelance photographer in Mumbai, even though her psychologist has assured her that every possible precaution is taken to maintain privacy and security.
Trishna Agarwala, a Bengaluru-based psychologist accredited with the Psychology Board of Australia, says, “I decided to shut down my space from March 16 as I thought it better to play safe, and asked my clients if they comfortable switching to online sessions, which they were. Most of my clients have been with me for a while, so we already established a relationship, and they know I’m only a call or message away.” Despite a surge in requests, she’s taken on only two new clients since the pandemic, but only after much discussion and exchanging of information so as to best understand their needs.

This is because while Agarwala has been doing video sessions, she’s not the medium’s biggest big fan. “I’m old school in that I prefer sessions to be in-person as it’s easier to establish and maintain a rapport as well as pick up nuances you might over a video call. And of course with online, there are privacy concerns, as well as glitches and poor internet connections, which can impact intense sessions for the worse,” she says, noting, “But as the situation calls for social distancing, we can at least use the most secure apps and servers. Things like confidentiality agreements have already been a part of my process from the get-go, as required by the Australian board, which is very strict about privacy protocols and other guidelines.” India doesn’t have a similar regulatory board, in case you were wondering.

For all the good social distancing is doing, it’s not lost on therapists, or parents, that for younger children – the demographic Sen mentioned earlier  including those who are differently-abled or are on the spectrum – theirs is a vital age to learn socialising with others outside the family and the wider world. He says, “When children used to come to our space, they had toys and activities to engage with. Since the lockdown, we’ve found that doing group video calls, each child with one parent, makes them interact a lot more and engage in team activities and games.”
Man is, after all, a social animal.

*Names changed to protect identities