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I am sure that anyone using Zoom is aware of the Chat feature. It’s how I share custom links with clients to join me in online games, but it has another use that has come in handy in my sessions.

Talking and therapy seem to go hand-in-hand, but for a number of reasons, a client might prefer not to engage in verbal conversation. Reasons I personally have experienced include:

  1. Clients with selective mutism might be unable to speak during sessions
  2. Autistic clients often have nonverbal periods, sometimes in response to stress
  3. In telehealth sessions, clients might be worried about privacy and think that someone might overhear what they say

In all three of these cases, a client might be able to write down what they want to say even if they cannot verbalize. Sometimes, a client with selective mutism or experiencing a nonverbal episode might be unable to type what they want to say, but it is helpful to show flexibility and offer different ways to communicate.

Although I am hesitant to endorse “text therapy” because I need more information on its effectiveness and safety issues, using the chat in a telehealth session means you can still see the client on video while using the chat, which addresses those concerns.

In my office, I’ve had clients write down things they would prefer not to say to me. Although some kids have slower typing speed, children who were able to write things down in sessions have been able to communicate using the chat, and it is much easier to read their handwriting!

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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