Authenticity: Redefining Views of Professionalism in Telepractice with Karin Koukeyan

Welcome everybody. We're going to be talking about authenticity, redefining views of professionalism in telepractice. My name is Karine Hartounian-Koukian, and I am very excited to talk to you today about this topic, um, about professionalism in telepractice. This is certainly not meant to be prescriptive in any way. What we're going to talk about are some innovative ideas about professionalism and how it manifests itself through telepractice. And you're going to learn kind of how to explore these questions and find some answers for yourself in order to basically come out feeling like your authentic self through telepractice. So the goal of today's webinar— By the end of the webinar, uh, participants will be able to define professionalism in telepractice, identify your own set of boundaries for professional practice, and finally describe 2 strategies to balance authenticity and professionalism. Alright, so let's start off with the traditional definitions of professionalism. So traditionally, the definition of professionalism tended to rely on things like appearance, very surface-level things such as how one wears their hair, Whether or not somebody has facial hair. Also, dress tends to also be another one of those things that people would use as ways to measure professionalism. Jewelry was another aspect of this. Again, even going back a few years ago, people were relying heavily on whether somebody had piercings other than piercings on their ears as a measure of whether or not they were being a professional. And so based on all of these, another way that people define or traditionally look at professionalism is traditionally through communication style, the word choices that people would use, whether or not they were using slang or what's referred to as Standard American English. Are you showing emotion during your communication? Not to mention accent. I speak a lot about this topic about accents, especially since it is something that is very close to my heart, having grown up as a first-generation immigrant, and accent bias is real. These are what people have traditionally again referred to as the definition of professionalism. And so now we're going to start off by understanding where these thoughts came from. So basically, um, we want to start off by understanding where these norms came from. And, um, these traditional norms came from a very whiteness sort of philosophy. And so here's a direct quote from an article, and I have the reference right here. This is an excellent article that talks about the bias of professionalism. And so basically, the quote reads, the standards of professionalism, according to American grassroots organizer scholars Tema Okun and Keith Jones, are heavily defined by the systemic institutionalized centering of whiteness. In the workplace, this culture explicitly and implicitly privileges whiteness and discriminates against non-Western and non-white professionalism standards related to dress code, speech, work style, and timeliness. And again, traditionally we've adopted these norms without questioning them, and this is an excellent article that I would recommend everybody read about the bias of professional standards. We're kind of having to challenge those norms today, and we're gonna go back to the drawing board and ask ourselves some questions so that we can think about this differently. Alright, so some questions that we can ask ourselves are, how have you seen standards of professionalism play out in your workplace, whether or not it was an in-person environment? Or remote? And then how have you yourself contributed to these standards? And then what are some ways that you have seen others challenge professionalism standards at an organizational or individual level? So these are some good questions to get the conversation started. Now let's think about redefining professionalism. And a good way to do that would be to identify your own boundaries first. What do you consider yourself to be, uh, your own limits on different things? And, um, communicate it clearly to your clients. So as you're redefining professionalism for yourself, it's a good idea to know your boundaries and communicate it clearly to your clients and the schools or whoever it is that you're working with. And then finally, the tough part— sticking to it. So again, these 3 elements are what you would use to redefine professionalism: identify your own boundaries, communicate it clearly to your clients, and then stick to it. All right, so time for our first poll. When it comes to telepractice, how clear are you with your own boundaries? Very clear, I know when to say yes and no and I stick to it. Somewhat clear, most of the time but sometimes I make exceptions. Not really, I often find myself in uncomfortable situations. Or I have no clue. So we'll take a moment and do our poll. All right, and as the results come in, I see that 32% said that they are very clear. They know when to say no or yes and stick to it. That's awesome. And then we've got about 68% of folks that are somewhat clear. Clear most of the time, but unclear with their boundaries some of the time. They do make exceptions, and then it doesn't look like we have anybody who is unclear about their boundaries or has no clue. So that's great. All right. So moving on to our next area. All right. So additional considerations in telepractice: if you provide services through telepractice. Without considering the technological aspects of this modality, you may come across as being less professional. But if you really know what you're doing technologically, you're going to come across as much more professional and confident than if you're fumbling through things. So for example, the first thing you'd want to look at are the topics that we've covered here at Parallel, which include visual presentation. And so Dr. Jordan Wright here at Parallel has written some white papers on this topic. Your visual presentation— and we're not talking about hair or clothes here, we're talking about your camera positioning and whether or not you're able to show your entire face, or are you cutting off portions of your face. Um, again, it should be a no-brainer, but, um, some people, uh, don't realize that they need to have good lighting for telepractice. And so lighting is a big part of that visual presentation in telepractice. So next we have auditory presentation, and so auditory presentation covers the gamut from both having technology that runs smoothly so that the presentation is without any audio glitches, everything is clear, and hopefully no echoes, And then hopefully distraction-free as well, so that there is not a whole lot of noises happening in the background. Now, if something happens, the phone rings, the doorbell rings, that is not going to be a complete deal breaker. And we'll have to talk about that a little bit later on how you could navigate an unexpected situation like that. But hopefully, you know, typically you'd be dedicating this time to working in telepractice, so you want to make sure that your audio environment is distraction-free. And then of course another element would be privacy. So if there's a lot of noise in the background, it may indicate that this is not a completely private environment, and so that could be concerning too. So you want to make sure that you're presenting a private environment for your clients. All right, so next we've got background. And so backgrounds, the recommendations on those are that, that you're showing, if you are showing your background, and I know I've got a virtual background here as I'm presenting, but if you do have your background showing, that it should essentially be clutter-free. And the literature says that you should lean on the side of minimalism. There's always exceptions to that. I know I have colleagues that have bookshelves in the background, um, that they also may have some fancy cameras that will go up and down. And so they're able to raise the camera and talk about what's on the top shelf. And so they incorporate that as part of their therapy session, and that's perfectly fine. Um, and then there's even, um, the opposite information in the literature that shows that if you have a completely bare background that's completely stark, that might sometimes be distracting as well. And of course, when it comes to those virtual backgrounds, again, there's not one clear-cut set of rules that it has to be one way or the other. That what you should do is just choose them carefully in consideration of what you're doing. So again, here at Parallel, we do use virtual backgrounds, especially for our webinars. But again, if you are going to use a virtual background, be cautious. Sometimes the blur effect or the virtual backgrounds with animation might cut off certain body parts, or the individual might look like they're blending in with the background. So those are things that you want to be aware of. However, if you're using a virtual background for therapy, let's say you're using a green screen, it may be perfectly appropriate. Appropriate to use that. And so go into these sessions purposefully, mindfully knowing your situation. All right. We should also be aware of some verbal behaviors as we're doing telepractice. And so you need to basically, if you're going into these sessions, you need to show empathy and you really have to make sure that it's coming across through the computer. And so active listening, We talk about this a lot. So asking questions and then really listening and showing genuine interest, genuine concern, being present and really listening to those answers. Also the tone of your voice. So tone does convey a lot of emotion, and sometimes we might be unaware of how we sound. And so sometimes we might be having a bad day, and sometimes we might be tired. And so it all depends. And it all comes through in the tone of our voice. And we want to just have some awareness of that. And on days that we might be a little tired or not feeling our best, maybe being aware of that and either being honest with yourself or adjusting if you need to adjust or modify in the moment. Also, you should be aware that the tone of voice sometimes can be the basis of miscommunications. So again, having this awareness will hopefully help reduce those miscommunications. And so word choice. Now this has come up a few times already. So what we need to make sure is that we are choosing our words carefully based on the context. And so things like casual language or slang might be okay during certain times, but other times you may want to choose a little bit more formal language, and that might be okay in those situations and more appropriate. And so you want to think about whether you're working with a student or a facilitator. You might want to think about how old the student is. If it's a younger student, maybe casual language or slang or jargon wouldn't be a good idea. But maybe if they're an older student, maybe they're in high school or middle school perhaps, that might be something that you may want to use in therapy to build rapport with them. If you're working on something like figurative language or humor, it may make sense to do that. And then, of course, you want to make sure that you're very clearly expressing understanding and concern of their situation. Now, the other side of communication is nonverbal communication and behaviors, and eye contact is a big part of it. And so looking at the camera like I am doing now makes a big difference. avoiding looking at the video images of the individuals when you're looking at the screen. And so this is one of the areas that I have to constantly like remind myself and to make sure that I am looking up because it does make a big difference. And so we do have some white papers on that as well here at Parallel written by Dr. Jordan Wright regarding eye contact. And so Even though there is a tendency to look at the video image of the person, we need to be mindful about looking at the camera. And when you're also dealing with a second monitor, that is another thing. When you're looking at content on your second monitor and not necessarily looking at the camera, that does also impact— it doesn't seem like you're talking to that individual directly when you do that. So Just things to keep in mind and be mindful of. And so body language is very hard to convey over telepractice because you're not seeing the whole body. So be engaged, engaged, and the more you can be authentically engaged during that session, you don't have to force that body language. Another recommendation in the literature was to lean in a bit. and actually show interest in the conversation, nodding in agreement. And of course, you can go to the other extreme and do it so much that it doesn't seem sincere. But there's a balance, and you'll know what feels right. And so in that moment, you'll know how to adjust and be more authentic. And finally, facial expressions. So smiling and using facial expressions purposefully Of course, it goes without saying, if you're smiling and using facial expression purposefully, there's going to be some element of surprise. Make sure that you are responding appropriately to that element of surprise, or if something is upsetting, that you're using the facial expression that's appropriate to convey that. Alright, so it's time for our second poll now. Thinking about how you conduct your telepractice sessions, how satisfied are you with your nonverbal communication, your eye contact, your body language, your facial expressions? Very satisfied, I feel like I'm true to my personality. Mostly satisfied. A little satisfied. Or not at all satisfied, I need to rethink everything I do. All right, so looks like we have the responses coming in. And so we've got 41% that say that they're very satisfied, they feel like they are being true to their personality. Amazing. And then we've got about 57% that are mostly satisfied, and it looks like there aren't And there isn't anybody today that feels like they're not being true to themselves, so that's amazing. And so moving on to our next slide, ways to promote professionalism in telepractice. And so here we are going to talk about the key takeaways. So We want to make sure that, um, in order to promote professionalism in telepractice, some of these key takeaways are things to think about. So make sure to use best practices in your technology. The more confident you are, the more your technology works in your favor. You're automatically going to come across as a professional in telepractice. Be mindful of your verbal behaviors. During your sessions. Again, this is not a you need to do this or you should never do that, but just think about what you are doing and the context that you're in and whether or not it's appropriate, and then make an effort to use nonverbal communication that is appropriate for that context and for telepractice. Um, all right, and so now let's talk about some of the inevitable challenges to professionalism that we might experience. One of the articles that I reviewed as I was preparing for this presentation talked about some things that I've actually experienced personally, and, and so have my colleagues. We've all experienced these things, and so time boundaries are one of those big ones. Maybe not so much if you're working for a school, but definitely if you're working for a clinic doing telepractice because you might be seeing these clients in the afternoons after school or in the evenings or even on the weekends. And this starts to push those boundaries in general. And those time boundaries are basically going to be pushed. And so there is this tendency because of a remote atmosphere to feel like you can reach out to that person outside of those typical office hours. And in doing so, then there's a tendency to make yourself available 24/7. And that's something that definitely presents a challenge. There's even some literature that supports the effectiveness that supporting or doing coaching in this real-time manner might indeed help improve clients' behaviors and goals faster. But again, in doing so, you are pushing your own boundaries of what you feel comfortable with, um, when it comes to this. And so finally, timeliness in general is another area that might come up. And, um, and so are you arriving to your sessions on time, or are you late to your sessions? Are you having to cancel your sessions, um, uh, at the last minute? And so as the provider, you want to make sure that you're always being timely and you're not doing, um, anything that is Compromising that, and so these are things again that once in a while if something happens, that is okay. But you want to make sure it doesn't become a habit and pattern that you demonstrate over time. And so we also want to talk about environmental boundaries, and this has to do with being remote and the location of the services. So going back to what we discussed regarding privacy, this is so important. To make sure that where you are doing services is going to be a private location. And it's important that you're not going to be doing the services out of a coffee shop. And we hope that this far along in our telepractice journey that most people know about these things. But I'm sure there are still some folks out there that still think it might be appropriate or OK to do therapy as the provider in a public place. And so you have to be really careful about that. And also, if you're doing it in, in a home office, you want to also be aware of who else is in the home with you, your family members. Uh, just be sure that there is privacy for the clients with whom you're providing services. Um, so who's participating in these therapy sessions on both ends, for that matter? Um, it's a good idea in the literature says that it's a good idea to inform your clients about this on both sides, and also to make sure that you make modifications if appropriate before your session starts. Pets are another one that come up, and they can go both ways. So having a cat cam can be a really cool opportunity to talk about what's happening with the pet, and it can be a great source for speaking about a communication topic, developing a topic to discuss during However, pets that are constantly coming and walking over the keyboards and interrupting the session may not be such a good choice for certain situations. All right, and then finally, the boundary of communication. So communication boundaries. How much are you actually going to self-disclose about your own personal life? Are you going to talk about where you live? You may want to do that because it may be interesting to talk about the weather outside. Maybe you live in a place that's experiencing a snowstorm in June, and you know, here I am in Los Angeles, and we only get snowstorms every 100 years. So that might be a very interesting topic to discuss. And you might want to think about what is okay for you to discuss. Maybe it's okay to give your general location of where you are, but you may not want to disclose your exact address and some challenges to authenticity. That we might have as a result of all of these. You may be— maybe you're not naturally a very animated person, and so you are working in telepractice, and you're working really, really hard on being overanimated. And so this might pose some feelings of being unauthentic to your true self because you're having to do this. All right, so, and then we also have that maybe you're the type of person that wants to incorporate aspects of your personal environment in therapy. And depending on the circumstances, this may or may not be appropriate. Maybe you're very, very comfortable sharing all aspects about your personal life. And again, Depending on the norms of where you're working, maybe this is not that appropriate, or maybe it is. So you have to just think about the situation and the circumstances. All right, so now let's talk about ways that you can balance authenticity and professionalism. All right, so basically what you would want to do Some things to think about. You want to start off by understanding the norms and boundaries of the organizational system for which you work, and then ask yourself, are they more conservative or are they more relaxed than your own? And typically, if it's a school system, it will be more conservative, or it will err on the side of conservative. And so what you would want to do is, when defining these boundaries, you want to always err on the side of being more conservative. And by doing so, then you're going to be able to basically balance authenticity and professionalism. And now, as an added bonus, you may want to Once you define these boundaries, start taking some authentic risks to improve client engagement, and this is very case-by-case, and you want to approach this with caution, and you may be able to do that, for example, by using humor and using more of a casual language style to build rapport with your students. All right, time for our 3rd poll. How nervous does the idea of balancing authenticity and professionalism make you feel? Not at all. This makes total sense to me. A little nervous. Quite nervous. Terrified. This is super overwhelming. So let's take a moment and see what people have to say. All right. And so it looks like we have a pretty even split. Some say, 80% say not at all. It makes perfect, perfect sense to me. 20% say it makes them a little nervous. And so it doesn't look like anyone is quite nervous or terrified. All right, so some ways to promote authenticity. Here are some great questions to ask yourself. At the beginning of this webinar, I indicated that we're going to give you some tools and we're not going to spoon-feed the answers to you, but give you tools instead so you can navigate these situations that you might encounter. So some questions to ask yourself are, when am I comfortable Communicating with my students and clients? What topics are off the table? How much personal information am I comfortable sharing with my clients? How do I communicate these boundaries with my clients? And then finally, how will I set limits if my boundaries are crossed? So these are all really good questions that are going to have different answers for each of us because we are all individuals. All right, so some guiding principles to be able to balance authenticity and professionalism. Here are the main questions to ask yourself. Are the norms for the school or clinic you work for more conservative or relaxed than your own? And then how does this behavior or choice you're going to make affect the client during the session? Because after all, we are providing therapy for our clients. For our students, how is your choice going to impact that therapy session? All right, so now we're going to go into some scenarios. So scenario number 1, probably a pretty common one. You get a phone call during the session, and as the phone call is coming through, you see that it is your child's school calling. Most of us with children may have had this happen. And I know I have. So the nervous mom in me, the nervous mom energy takes over and I go into panic mode. And I'm thinking, oh my gosh, what's wrong? Something's wrong. They don't typically call. And so is it okay for me to answer that call or let it go to voicemail? And so I think it completely depends on the situation. It depends on your particular workplace. It might also depend on what happened before your child was sent to school. Maybe You knew that they weren't feeling well, and maybe you were expecting that they might call. Either way, you're not going to be able to call them back right away, or you're not going to be able to address the issue in that moment. So it might be wise to let it go to voicemail and plan to call in between sessions to see what's going on. And some other things that you might want to consider: it's a good plan that you let your facilitator know what's happening at the. School that there might be a few minutes delay in between sessions. It's also very important to communicate that. And another thing that we found out as we've gotten feedback from our schools was that things might come across a little differently through the video. So it's a good idea that if you are speaking on the phone, taking an urgent call, to maybe turn off your camera and of course make sure that you're on mute. But again, so just have that piece of privacy for yourself as you're taking this personal call. All right, so scenario number 2. All right, has to do with the provider's word choice during sessions. So we've got a provider that's using casual language with their students. Maybe they're using slang that the students use to be the cool Teacher or the cool therapist. The students think it's funny. Is this okay? I would say again, it depends on the situation, and if you're doing this as part of the goals that you're working on, maybe you're working on humor and figurative language. You want to make sure that you're doing this with older students. If the student is maybe in kindergarten, it might not be as appropriate. And Maybe also if the student has certain challenges and they're not able to process this very well, it might have the opposite effect. So it all depends again on circumstances, on environment, and the situation, but this could potentially be a good way to build rapport with your students and increase engagement. All right, scenario number 3. So we've got a provider that's having some issues with time boundaries. And it seems that this provider is logging on 5 minutes late for every session. And it seems that she starts her day off late, and it just kind of perpetuates. It goes from there. And so, and it happens quite frequently and often, but they are offering to make up sessions. And so in their mind, they've made up every single minute that they were late. And so it should be okay. Correct? Or is it? So I would say no. So no, for a few reasons. One, again, we're working off of the constraints of a very strict school system. Bell schedules are rigid. And so that is, you know, one reason why you would not want to have A habit of being late to sessions. All right. Now, last scenario, we've got a provider that has audio and video issues, and so the provider's camera positioning is cutting off her chin, and also there's a persistent echo, and there's a dog that barks during these sessions, and this provider tends to leave the session pretty regularly. To go address the issue. But she apologizes, comes back, and, and basically, would you consider this professional behavior? Probably not. And so the questions you're going to be asking yourself again, how is this affecting my client? It's impacting the session, right? It's interrupting the session. And also, would this be okay according to the norms of my workplace if I work for a school system? Probably not. These types of interruptions would not be acceptable. We're in telepractice, um, and already they might be thinking, you know, she's not really seriously working if she's working from home. So you don't want to add more issues to cause any additional negative thoughts. All right, so thank you so much for, uh, having me speak today on this topic of professionalism in telepractice. If you have any questions, please reach out to me at my parallel learning email address, and you can also find me on LinkedIn. Thank you again.