We are all learning very fast how to relate to people through the use of computer screens instead of face-to-face. Many of us were using Skype or other online platforms in the past for social or business calls. Now we do this all the time with patients and students, sometimes in very emotional or vulnerable circumstances. We cannot display empathy in the way touching, hugging or with small nuances of facial and bodily expressions. We are all finding other ways of doing so.
For the last two months, I have been doing my usual work providing supervision for groups of colleagues from the caring professions (including doctors and ministers of religion) using mainly Zoom. I am still learning how to do it well. Some of these people are dealing with a lot of tragedy every day, including deaths and funerals. These are some of the rules I now have for fostering empathy when talking remotely with them. Some of them are very practical.
- Choose the environment carefully: for example, a background like a living room that looks human and personal, but without distractions like loud paintings or lots of photos.
- It’s important to practise the technology well and to use it smoothly, so you can concentrate fully on communicating with people.
- Check that everyone else is familiar with the technology so they can also concentrate. Explain which functions to use in the session. Personally, I prefer it when people do not use “chat” during supervision so we can all just look at each other.
- Try to have a list of everyone’s phone numbers or email addresses in advance, so you can communicate with people quickly if they lose their internet connection or the technology crashes.
- Do everything you would normally do in a face-to-face session. This includes asking everyone to introduce themselves, and using “ice-breaker” exercises (e.g. “what brings you joy at the moment?”). Ask people not to take phone calls or look at their phones if possible.
- Tell people it’s fine to stand up and walk around because it is hard to look at a screen for a long time. Schedule a break at least every hour.
- Be aware that some people will be in isolation with partners or family, but others will be physically alone, so this may affect what they want to say or how much emotion they want to show.
- Remember that body language such as smiles and hand movements look smaller on a screen. You may have to display them more openly so they are visible.
- Explain that silence is fine, even though it feels unnatural at first on a screen. You can ask people to practise a five-second silence at the beginning of the session while everyone concentrates on still feeling connected with the group.
- Encourage people to talk to each other during the session, not only to the facilitator, and to say someone’s name when they do this, because you cannot see who they are looking at (e.g. Luigi, I want to ask you about something you just said.”)
- If someone is very upset, make sure they have time to express this, and check how they will get support after the call – for example from a family member or in a one-to-one phone call.
- Be honest about what is missing from remote conversations, for example by saying “I would love to give you a hug” or “I’m so sorry I cannot hold your hand at this moment.”
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Thank you, John! I will be presenting on Narrative Telehealth practices for first year medical students, this article is very helpful! Cheers, Limor