When we moved therapy online, many of us wondered: how do we help clients connect with their bodies through a screen? The good news? Somatic work translates beautifully to telehealth when we get creative. Today, I’m sharing practical interventions that actually work in virtual sessions.
Why Somatic Work Matters (Even More) in Telehealth
Our clients are often sitting at the same desk where they experience work stress, in the same room where they doom-scroll, using the same screen that bombards them with notifications. Their nervous systems need somatic interventions more than ever.
Plus, many clients feel more comfortable exploring body-based exercises in their own space. No more awkward “everyone’s watching me breathe” moments in a waiting room!
Setting the Virtual Stage for Somatic Success
Before diving into interventions:
- Ask clients to find a private space where they can move freely
- Suggest they have a glass of water nearby
- Encourage wearing comfortable clothes
- Test their camera angle (can you see their shoulders and hands?)
- Normalize that this might feel weird at first
The Telehealth Somatic Toolkit
1. The 5-4-3-2-1 Grounding Technique
Perfect for anxiety and dissociation, adapted for limited visual field:
Guide your client:
- 5 things they can see (including items beyond the screen)
- 4 things they can touch (chair, feet on floor, clothing texture)
- 3 things they can hear (including ambient sounds)
- 2 things they can smell (or recent smells they remember)
- 1 thing they can taste
Pro tip: Have them turn their head to notice things outside their usual screen view
2. Bilateral Stimulation Without EMDR Equipment
No buzzers? No problem!
Butterfly Hug:
- Cross arms over chest
- Hands rest on upper arms
- Alternate tapping while breathing slowly
- Great for self-soothing between sessions
Heel Presses:
- Feet flat on floor
- Alternate pressing heels down
- Invisible to others if they’re in a semi-public space
3. The Window of Tolerance Check-In
Visual aids work wonderfully on screen:
Create together:
- Draw window on paper/whiteboard
- Mark where they are now
- Identify what moves them up (hyperarousal) or down (hypoarousal)
- Practice interventions to stay in the window
4. Seated Body Scan for Desk Warriors
Perfect for clients joining from work:
30-Second Version:
- Notice contact points with chair
- Scan from feet up through legs
- Check shoulder height (are they by your ears?)
- Soften jaw and forehead
- Three deep breaths
Make it office-friendly: “This looks like you’re just thinking deeply”
5. Temperature Play for Nervous System Regulation
Cold for Anxiety:
- Hold cold water bottle
- Ice cube on wrists
- Cold washcloth on neck
- Step outside briefly (if weather appropriate)
Warmth for Grounding:
- Heating pad on lap
- Warm tea to hold
- Fuzzy blanket for session
- Hand warmers in pockets
6. Movement Within the Frame
Shoulder Rolls & Neck Stretches:
- Demonstrates care for your body
- Releases tension from screen time
- Can be done while talking
Seated Cat-Cow:
- Hands on knees
- Alternate arching and rounding spine
- Links breath to movement
7. The Telehealth Safe Space Installation
Leverage their actual environment:
Guide them to notice:
- Comforting objects in their room
- Textures they can touch
- Photos they can see
- Scents in their space
This becomes a resource they can access anytime
8. Breath Work That Translates
Box Breathing with Visual Cue:
- Share screen with a box animation
- Or have them trace a box on their desk
- 4 counts each: in, hold, out, hold
Coherent Breathing:
- 5 counts in, 5 counts out
- Use phone app for pacing
- Great for couples sessions too
Creative Adaptations for Common Challenges
“I can’t move much in my space”
- Focus on micro-movements
- Isometric exercises (pressing palms together)
- Facial expressions and jaw work
“My family might hear”
- Silent techniques (body scanning, gentle movement)
- Typing sensations in chat
- Hand signals for communication
“I feel disconnected from my body on camera”
- Turn off self-view
- Close eyes during exercises
- Use props (stress ball, fidget tool)
Making It Stick: Homework That Works
Between-Session Practices:
- Voice memo of guided exercise
- Photos of body scan points
- Calendar reminders for movement breaks
- Somatic check-in texts to self
The Therapist’s Virtual Presence
Your somatic modeling matters:
- Demonstrate exercises first
- Keep your own body relaxed and grounded
- Use hand gestures to guide attention
- Mirror their breathing pace
When to Use What
Starting Sessions:
- Quick body scan
- Three breaths together
- Feet-on-floor grounding
During Difficult Content:
- Butterfly hug
- Temperature intervention
- Bilateral stimulation
Ending Sessions:
- Window of tolerance check
- Resource installation
- Grounding before logging off
The Bottom Line
Somatic work through telehealth isn’t a consolation prize, it’s an opportunity. Clients can practice in their actual living spaces, access their real comfort items, and build skills where they need them most.
The screen between us doesn’t have to mean disconnection from the body. Sometimes it creates just enough safety for clients to finally tune in.
Your Virtual Somatic Experiment: Try one technique from this list in your next three sessions. Notice what lands well with different clients. Build your own virtual somatic toolkit based on what works.
Remember: The best somatic intervention is the one your client will actually use.
Worksheets: Somatic Therapy Grounding Techniques
Need more support bringing somatic work into your practice? Schedule Now to explore how these techniques can enhance your therapeutic approach, whether virtual or in-person.
PMT 
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