CHICAGO TRIBUNE | APR 07, 2020 | 12:50 PM


A front-line health care worker, wracked with fear.

An international student stranded in the U.S.

A Chicago Public Schools teacher aching for her students.

They all want therapy, but with the novel coronavirus descending on Illinois, face-to face meetings are, in many cases, too dangerous. Instead, Chicago-area therapists are turning to an option that some hadn’t even tried before the pandemic began. They’re using teletherapy, in which the therapist and the patient communicate through video conferencing platforms including Zoom, TokBox, FaceTime and, with computer screens allowing both sides to read visual cues such as winces, half-smiles and eye-rolls.

Therapist Trina Armstrong holds a therapy session with a client via video conferencing at her home on April 6, 2020, in Niles. (Stacey Wescott / Chicago Tribune)


“It’s been a much better process of doing therapy than I ever could have imagined,” said Pamela Brand, a licensed marriage and family therapist in Andersonville who had steered clear of teletherapy before the crisis.

“Clients that I already know, I see them, they see me. There’s not a lot of interference and delay. It’s interesting to see clients in their own spaces, with their animals and their children. They have been so cooperative in carving out time and space to do this.”

The transition to teletherapy has been more of a tidal wave than a trickle, with therapists, who generally prefer person-to-person interaction, saying that it’s a safer way to serve their clients.

“Almost everybody’s doing it. I don’t know anyone who’s going in (to the office),” said Annie Rosenthal, a licensed clinical social worker on the North Side.

At the American Counseling Association, chief knowledge and learning officer Lynn Linde said that she suspects a significant number of counselors nationwide are meeting with their clients via videoconferencing: “What choice do you have?”

Several Chicago-area therapists said that requests for services by new patients have risen in recent weeks and that teletherapy was filling a real need.

Trina Armstrong, a licensed marriage and family therapist in Evanston and Chicago, said she recommends that her teletherapy clients try to find a quiet space to talk. In some cases, spouses have been caring for young children during therapy.

“A couple times the kids will run into the room because they miss Mommy, but we kind of just push through it,” Armstrong said.

Therapists report that stress, sadness and a sense of loss are common among clients, and anxiety is an overarching theme.

“The level of anxiety overall is through the roof,” said Rosenthal. “There are so many rabbit holes: What if? What if? What if?”

Some people are finding they lose track of time, a phenomenon highlighted by “What day is it?” jokes on social media. And some are angry, particularly about the hoarding of items such as toilet paper and what they perceive as poor social distancing practices by friends and neighbors.

Chicago psychologist Steven Nakisher said there’s a lot of fear among clients, compounded by the many unknowns surrounding the virus and the accelerated news cycle.

“In the beginning, every half-day felt like a whole new world as new information came in,” he said.

To Rosenthal, both the anger people are feeling and the strange ways we’re experiencing time make sense in light of an experience of trauma and loss. Trauma doesn’t just happen when a tornado hits or a child is abused, she said; more broadly, it happens when we experience something terrible that wasn’t supposed to happen.

That definition lines up with our experience of the coronavirus, she said. In addition, many of us are grieving: for lost jobs and graduation ceremonies, for our hobbies and our time with friends, for the simple freedom to get in a car and drive to a restaurant.

The virus is particularly difficult for clients who have underlying conditions, such as diabetes or lupus, that put them at higher risk, Brand said. Some are extremely worried about the virus.

“I can’t really tell them that they’re going to be OK,” said Brand. What she can offer is empathy, as well as advice about how to care for your mental health by exercising, following a schedule, returning to a hobby or activity you enjoy, and setting small, achievable goals, such as cleaning the closet or mending a pair of ripped pants.

Not all therapists are using teletherapy exclusively. Ralph Whetstine, a clinical psychologist in Schaumburg, said that he was still seeing some high-risk patients in person, including those who are suicidal.

Whetstine, who had a teletherapy client in a remote area of Canada before the coronavirus crisis started, said the approach allows him to reach out to areas that are underserved: “That’s a great plus.” On the negative side, he said some social cues can be lost in video: “I’m asking more questions, being more pointed” during online sessions, he said.

Over 80% of communication is nonverbal, Nakisher said. He asks his teletherapy clients to step back a bit from the camera, so he can get a fuller picture of how they’re feeling.

Several therapists said that this is a potential turning point for teletherapy, not as a replacement for in-person sessions in a post-pandemic world, but as a reliable alternative when in-person is impractical.

“This is not only doable,” Brand said of teletherapy, “this may be a great tool to use when a client needs to talk to us and they’re out of town.”

Nara Schoenberg


Nara Schoenberg is a features reporter at the Chicago Tribune, where she writes about health, relationships and books. She’s reported on the decline of LASIK surgery, tracked down the last free-roaming library cat in Illinois, and chronicled the tumultuous final days of Ernest Hemingway’s youngest son. She lives in Oak Park.