Mary Smith headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype application on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Smith, a 33-year-old high school teacher, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer!”

And, she added, “I even e-mailed him that I was panicked about a first date, and he wrote back and said we could do a 20-minute mini-session.”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype has made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly.

“In three years, this will take off like a rocket,” said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. “Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can’t replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed.”

The pragmatic benefits are obvious. “No parking necessary!” touts one online therapist. Some therapists charge less for sessions since they, too, can do it from home, saving on gas and office rent. Blizzards, broken legs and business trips no longer cancel appointments. The anxiety of shrink-less August could be, dare one say … curable?

Ms. Smith came to the approach through geographical necessity. When her therapist moved, she was apprehensive about transferring to the other psychologist in her small town,  who would certainly know her prominent ex-boyfriend. So her therapist referred her to another doctor, whose practice was a day’s drive away. But he was willing to use Skype with long-distance patients. She was game.

Now she prefers these sessions to the old-fashioned kind.

But does knowing that your therapist is just a phone tap or mouse click away create a 21st-century version of shrink-neediness?

“There’s that comfort of carrying your doctor around with you like a security blanket,” Ms. Smith acknowledged. “But,” she added, “because he’s more accessible, I feel like I need him less.”

The technology does have its speed bumps. Online treatment upends a basic element of therapeutic connection: eye contact.

Patient and therapist typically look at each other’s faces on a computer screen. But in many setups, the camera is perched atop a monitor. Their gazes are then off-kilter.

“So patients can think you’re not looking them in the eye,” said Lynn Bufka, a staff psychologist with the American Psychological Association. “You need to acknowledge that upfront to the patient, or the provider has to be trained to look at the camera instead of the screen.”

The quirkiness of Internet connections can also be an impediment. “You have to prepare vulnerable people for the possibility that just when they are saying something that’s difficult, the screen can go blank,” said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and New York. “So I always say, ‘I will never disconnect from you online on purpose.’ You make arrangements ahead of time to call each other if that happens.”

Research on the effectiveness of on-line therapy shows the same effects, essentially, as in person therapy, so the practicality of on-line therapy outweighs the few negative issues, such as not sitting in front of the client and seeing his/her body language, eye contact, etc.  In addition, I am able to Skype with clients who are on vacation in other locals, and with athletes, who are out of town performing in major events and want to touch base with me before or after their events.  In short, I have found using Skype has grown my practice and dramatically increased my access to clients.

Dr. Jack Singer offers Skype Therapy with clients all over the world.  For more information, contact Dr. Jack at (800) 497-9880.

By Dr. Jack Singer

Stress and World Class Coaches by Dr. Jack Singer

Much attention is paid to the impact of stress on elite athletes, but until recently, the impact of stress on their coaches has been largely ignored.  What is really important about this new discovery is that the way coaches deal with their own stress directly impacts the performance of their athletes. 

The amount of stress a world class or Olympic coach experiences is a function of his/her perception of the demands (stressors) made by their job and their own ability to cope with stressors.  So much attention has been given to teaching athletes how to cope with the stressors of performing their sport,  but we now know that if their coaches do not cope, it will impact their coaching skills and ultimately, the athlete’s performance. 

World class and Olympic coaches complain about psychological, physical and behavioral responses to their stress, such as having low frustration tolerance, acting fidgety, and agitated.  These coaches complain of burnout symptoms, including mental fatigue and a sense of reduced enjoyment about their coaching roles.  This impacts their athletes, both because of the coach’s body language  and the tone of voice from the coach to the athlete.  These are both potential sources of strain for their athletes.

The solution is that professional Sport Psychologists should pay as much attention to helping coaches develop the skills and strategies needed to cope with the demands of world class coaching.  Only then will the elite athlete have the best opportunity to let his/her true talent shine.

I am also available for phone consultations with athletes around the U.S. and in-person visits with athletes in Southern California. Call today toll free at 1-800-497-9880 for a free 20 minute telephone consultation with Dr. Jack Singer.

Jack N. Singer, Ph.D.
Certified and Licensed Sport and Clinical Psychologist
Diplomate, National Institute of Sports Professionals, Division of Psychologists
Diplomate, American Academy of Behavioral Medicine
Certified Hypnotherapist, American Academy of Clinical Hypnosis

PESSIMISTIC  VS. OPTIMISTIC ORIENTATIONS

The world’s expert in the study of Optimism is Dr. Martin Seligman, whose book, “Learned Optimism,” is a classic in the field. Seligman’s research shows that pessimistic athletes and teams believe that losses and even poor performance during crunch time reflect their lack of ability to succeed .  These athletes and teams have learned to feel helpless in terms of controlling their performance, and thus their success or failure.

The research shows that when these athletes are confronted by unfortunate circumstances–such as, in tennis,  a series of double faults, windy conditions or the belief that their opponent is cheating — they will weaken, get angry, tighten up and believe they cannot succeed. This self-fulfilling prophecy almost always leads to continued poor performance, so the athlete will ultimately lose the set and match.  These pessimistic thinkers don’t expect to win the next time out and with this negative expectation, they most likely will lose subsequent matches.  This, of course, reinforces their negative view of themselves and their abilities and the negativity snowball is rolling down hill.

On the other hand, optimistic athletes look at the same negative events as temporary setbacks, and as opportunities to actually re-focus and crank up their performance during the rest of the match.  They recognize that they have ultimate control over their internal dialogue and how they view negative events.  For example, they may “blame” a poor game or set on being distracted by fans cheering for their opponent or on the weather on getting irritated by the opponent cheating.  They recognize that they can now change their thinking, re-focus on their game plan, re-capture the momentum and still grasp victory. Even if they eventually lose the match, these optimistic thinkers understand how to change their internal dialogue prior to and during their next match.  Accordingly, these players will go into the next match expecting success and will usually win!

WHAT COACHES NEED TO KNOW

There are wonderfully researched, brief methods available to determine whether a person (or even a team) is oriented more toward optimism or pessimism.  This is great news for both the athlete and his/her coach:

• All other things being equal, coaches should concentrate on recruiting athletes who are optimistically oriented.  They are definitely more successful over time than are pessimistically oriented athletes;
• For athletes already on a tennis team, learning their orientation can help the coach make better decisions related to spot positions and substitutions.
• The really good news is that a pessimistic orientation is a learned phenomenon.  Therefore, once the athlete understands her/his degree of pessimistic thinking, there are excellent programs for retraining that athlete to develop an optimistic orientation.  This will definitely lead to improved and more consistent performance.
• Entire teams can learn how to interpret defeat in an optimistic way.  This is a powerful and proven tool for improving team performance, particularly after a tough loss.

**You have permission to reprint in your publication or to your website/blog any articles by Dr.Jack Singer found on this Website as long as Dr. Jack Singer’s name and contact information is included. Jack Singer, Ph.D., Licensed Clinical Pyschologist, Sport Psychologist, Marriage, Family & Relationship Therapist, Professional Motivational Speaker. http://drjacksinger.com, toll free 800-497-9880.