It’s the most intense, meaningful part of a telehealth therapy session. Your client is on the verge of a profound realization that will change how they relate to others going forward. And then the sound cuts out. Or the video freezes. What do you do when your telehealth connection is interfering with psychotherapy instead of facilitating it? How can you diagnose telehealth connection problems?
Foundationally speaking, telehealth connection problems can usually be traced to one of seven sources, in order here of the chain of connection:
- The therapist’s device
- The therapist’s wi-fi
- The therapist’s internet connection
- The telehealth platform
- The client’s internet connection
- The client’s wi-fi
- The client’s device
It’s common for therapists and clients alike to presume that the platform is the problem. While all major telehealth platforms do have occasional hiccups, they’re usually very reliable — and they’re dependent on those other links in the chain all working as they should.
So the best approach to diagnosing telehealth connection problems and then resolving them is an outside-in approach, starting with the therapist’s and client’s devices.
Diagnosing device problems
All of the major telehealth platforms have minimum system requirements to ensure connection stability. If you or the client are on a device that doesn’t meet those minimum requirements, then it’s worth switching to a newer device. You may see connection stability improvements right away.
Even when the device meets the minimum requirements, if you or the client have other applications open, are running multiple monitors, or are otherwise taxing the device’s processing power, then the connection might hiccup or freeze even when the rest of that connection chain is solid. The therapist and client both should close other applications and monitors, and if necessary, take a look at CPU usage when the telehealth connection is active. (Here’s how to monitor CPU usage on a Mac.) If a device is getting warm, or its fan is working harder, during connection, that can indicate heavy processor use.
Diagnosing wi-fi and internet connection problems
Google offers a free internet speed test that can be used to test the quality of an online connection. Just use “internet speed test” as your search term. Some telehealth platforms also provide continuous monitoring of connection strength. Bear in mind that a quality telehealth connection relies on high upload speeds as well as high download speeds. Many home internet plans offer faster download streams than upload streams, and this can significantly impact two-way video connections.
Also bear in mind that signal strength and stability are different things. A while back, my home internet was fast when it worked, but it would stumble or cut out regularly. It was strong, but not stable. I ultimately needed to change providers to resolve the issue.
If connection speed or strength is the problem, it can be improved by moving or updating a wi-fi router, switching to a wired internet connection, or changing internet plans or providers. In my office, I pay extra for higher upload speed, and find that it makes a noticeable difference.
Diagnosing platform problems
The platform isn’t usually the problem. It’s at the center of a connection chain where any one weak link can negatively impact the telehealth connection on both sides. However, all telehealth platforms do sometimes have hiccups, errors, or brief downtime. They generally offer system-status pages that indicate whether there’s a known problem; that’s a good first place to look if you see unexpected changes in your connections. Otherwise, it’s only safe to assume the platform is the issue if the other possible sources of telehealth connection trouble have been investigated and reasonably eliminated.
One way to diagnose a problem as being on the platform level can be to have a backup platform available to use at a moment’s notice. If switching platforms leads to improvement, that doesn’t necessarily mean the first platform was the problem — it could be that the second platform has lower device or bandwidth requirements. But the cause for the improvement doesn’t matter as much as the fact of the improvement. If one platform works better for you than another, it makes sense to stick with the more effective platform.
Clues to help locate telehealth connection problems
The nature of a telehealth practice can help locate a telehealth connection problem. If you’re having problems connecting with one or two specific clients, then the issue is probably at the client end. If you’re having problems connecting with most or all of your clients, the issue is more likely to be on your end. It could also be the platform, or a combination of factors. Again, having a backup platform is a good test here. If you’re having trouble connecting through multiple platforms, it’s probably an issue on your end. If you only have an issue with one platform, it could be that platform, or it could be that your connection and hardware simply do better on the other platform.
Thankfully, these problems are all fixable. They’re easiest to fix if you have a sense of where to start.