To maximize the effectiveness of your telehealth telepresence in sessions with clients or patients, replicate an in-person clinical encounter as closely as possible. Issues can be separated into two categories: maximizing telepresence workflows and maximizing appearance, popularly known as the “Zoom look.”
When working with individuals, best practices for maximizing one’s telepresence workflows are slightly different from those that involve working with a telepresenter, who presents the client to the provider, or a group, such as a family or in telehealth group therapy. In all cases, providing a clear explanation of the roles of each participant is essential to minimize anxiety and foster a strong therapeutic alliance.
How To Improve Your Telehealth Telepresence
TBHI offers these suggestions for improving telehealth telepresence workflows:
- Eliminate all activities that can distract your client or patient. These include eating, drinking, checking text messages, and looking off-camera. If you face a window, stop yourself from watching outdoor activities.
- Be sure to be about arm’s length or more away from your camera. Being too close to the camera can make you appear frightening or domineering.
- Be mindful of your voice. Today’s microphones are very sensitive and can easily pick up your voice when adequately positioned. Move your microphone, headset boom, or earbud microphone to your lips to maximize sound. Avoid heavy breathing, lip-smacking if eating (another no-no), or drinking, sniffling, snorting, grunting, etc.
- Sit up straight without leaning too far back or forward. Sit as if you would in person. If you use pillows, be aware of how they appear on your viewer’s screen.
- Keep clutter off-screen. While you may think you can see the full extent of your viewer’s ability to see your room, test that view by using a link to your room and carefully examine the corners of their view. Some videoconferencing platforms allow the patient to see more of your room than you see on your screen, potentially revealing whatever you may have stashed in the corners of your room.
- Dress professionally and plan for emergencies. Keep an extra shirt or blouse in your home office if you are called to your computer for an emergency. Err on the side of propriety. Avoid showing cleavage or chest hair. Again, dress as if you were in the clinic.
- Position yourself. Your location on-screen is optimal when your eyes appear 1/3 of the way down your viewer’s screen. This positioning simulates eye contact with a person who has a body. This proper positioning will prevent your viewer’s brain from struggling throughout the session with trying to make sense of your eyes if they appear at the bottom of the screen. To maximize your telepresence, put some of your body in the frame. It can be a visual and cognitive strain for your participant to only see your eyes and forehead, a white ceiling, or just one of your eyes. Position yourself adequately and ask that your telehealth participants do the same at every session before starting the content discussion.
- If you conduct your session by phone, place the phone on a stable surface. Use a wide-mouth cup or glass to prop the phone into position firmly. Securing your phone will prevent noise from holding it in your hand or flopping over to show the side of a pillow on your desktop. Noice and unexpected camera angles can distract your client and disrupt their flow.
- Avoid making unrelated sounds. Don’t move papers, open drawers, drum fingers, or file nails. Many microphones are exquisitely sensitive and can detect even the slightest paper rustling. Invest in a noise-canceling microphone to prevent unwanted ambient noise from reaching your patient. Create a clinical experience, not just a video call. The goal is to strive for seamless communication between all parties.
- Prepare ahead of time when sharing your screen. Finessing the switch to your desktop or a website can be complicated and should not be left to chance. If you are tempted to share your screen, pull up the desired page or image before sharing your screen. Many clinicians have been embarrassed by erroneously sharing private information with unsuspecting clients or patients.
- Working with telepresenters. In classic telehealth models, telepresenters are often used to accomplish more complex tasks, such as administering psychological assessments. Telepresenters work with clinicians to plan the event ahead of time.
- Change style with groups. Conducting group therapy involves several complex issues. Assuring that all participants follow the suggestions outlined above can be best accomplished with a group contract discussed and signed before allowing new members to join your telehealth group. An example of a simple suggestion to increase everyone’s telepresence is to be mindful of transmission delays when interacting. Pause before responding to each person’s comment or question to minimize the feeling of being interrupted by lagging voice and video transmission.
Perfecting Your Telehealth Appearance or “Zoom Look”
- Look into the camera but avoid locking your eyes on the camera. The goal is to look and behave naturally.
- Make sure you have good lighting. Also, consider using a background to mimic an exam room.
- Control lighting from windows. Invest in adequate window coverings to avoid bright spots that make it difficult for the viewer to see your face.
To maximize your telepresence, practice recording yourself while talking to a colleague. Then show the video to a handful of trusted family or friends. Ask what they like and what they like less. You are apt to receive valuable feedback.
Software Features to Improve Your Video Appearance (“Zoom Look”)
Some video packages allow users to improve their video appearance-related telepresence by altering video camera settings. Several video platforms allow the user to alter their appearance, including Zoom. Users can find instructions for altering their video settings by searching “Zoom touch up my appearance.” Zoom allows the user to adjust the brightness and the “blur” on the camera, effectively removing unwanted detail. These settings will remain operational to maintain one’s chosen “Zoom appearance” or “Zoom look.”
Telehealth Video & Telephone Best Practices
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