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Should You Require Cameras During Virtual Group Therapy?

Dr. Coleen Vanderbeek is a licensed professional counselor, specializing in human development, neurodiversity, and Dual Diagnosis.

Cameras on or Cameras off?

Should clients in a group therapy session be expected to keep their cameras on? This is a difficult question.

Requiring that a client (especially if they are a child or adolescent) keep their camera on during group sessions can be clinically counter-productive, and potentially even harmful. For most psychotherapeutic groups, the intended goal or function is to facilitate a sense of belonging or relatability through understanding and the sharing of common experiences.

One of the fundamental rules of group psychotherapy is that the group environment is one of safety, in which a client can be vulnerable enough to explore and process complex emotions free of judgment and criticism. While these traditional rules and goals can still be achieved in a virtual group setting, the clinician must be extremely mindful of the differences. For example, typically clients will be participating in virtual groups from their homes. Requiring that group members turn their cameras on, opens them up to exposure to where they live, who they live with, the conditions of their home life, and so much more. This disclosure can not only be therapeutically damaging, but it can also open clients up to potential harm.

With virtual platforms, there is an element of visual overshooting. That is, you see the background, as well as the client. Clients may not want to show their surroundings, and in a group setting, there is really no reason why they should. Online is different than in person, and we really need to adapt in order to provide our clients with the best, safest, and most productive clinical interventions.

For children and adolescents, this can be potentially even more harmful. The younger generation is one that is fully immersed in the virtual world. They are more technologically savvy than some of us who are older and can pick up on things that we may miss or overlook (especially when we are trying to facilitate a group session). Requiring that group members keep their cameras on, can open them up to being bullied, harassed, intimidated, and other harmful behaviors. As clinicians it is our ethical duty to “do no harm,” this statement takes on a whole new meaning in regard to the virtual realm.

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Online, EVERYONE can see you. Yes, this is true to some degree of in-person groups as well, however typically in person, you can tell who is and who is not looking at you. In addition, in person, most participants will focus their attention on whoever is speaking. Online, allows for more anonymity, allowing for participants to engage in more voyeuristic type behaviors that would not be acceptable in person. Behaviors that if they did occur in person, the facilitating clinician would be able to correct. In an online platform, it is very difficult for a clinician to know that this is occurring, let alone correct the behavior.

Another tip to remember is that just because someone is “looking” at the camera, does not mean they are participating. It is very easy to be doing other things such as playing games, checking e-mails, and scrolling through social media while having the virtual platform running in the background. It may appear as though a client is engaged when in reality they aren’t paying attention at all. Tradition cues like eye contact are not relevant in an online platform, as they can be misleading. Instead, we need to develop new ways of identifying group participation and engagement.

Keep in mind that cameras can be extremely draining on bandwidth. Not all of our clients can afford or even have access to higher-quality internet services. Requiring that a client keep their camera on, may reduce their ability to fully engage in a group session. Reduced bandwidth typically results in frozen screens, inconsistent audio, and overall general poor reception. Imagine the effect this can have on an anxious client. It can be extremely dysregulating, resulting in the opposite of the intended effect and going against what you are clinically trying to achieve.

Lastly, keep in mind that a client can turn off the camera for “good” reasons just as much as it could be for “bad” ones. Assuming the negative is a sure way to rupture your therapeutic rapport. Trust your clients and allow them the freedom to make these decisions on their own. Processing their choice in individual, more private, sessions can help the clinician to understand the client’s intent behind their actions as well as to provide the client with further opportunities for self-empowerment.

As modern clinicians, we need to learn new techniques for the provision of therapy in virtual environments. Focusing on developing new skills, versus trying to force old ones into an inappropriate format will result in greater success. If you find that you are struggling with this, perhaps some self-reflection on why is in order. Self-reflection is always a useful practice, but it can be especially helpful when developing new skills. Am I struggling because I do not have enough information, am I feeling challenged due to a lack of competency, is this an issue of control? All of these are common responses to have when we are learning something new. Do not forget to have grace for yourself during this process.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

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