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.
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 — and yet this is exactly where the opportunity lies.
Many clients actually feel more comfortable exploring body-based exercises in their own space. No more awkward “everyone’s watching me breathe” moments in a waiting room. When we meet clients where they are — literally — somatic work can go deeper than it might in a traditional office setting.
Setting the virtual stage
Before diving into any somatic intervention, a little setup goes a long way. Ask clients to find a private space where they can move freely, suggest they have water nearby, and encourage comfortable clothes. It also helps to check their camera angle — ideally you can see their shoulders and hands. And always normalize that this might feel a little strange at first. That’s okay. Most things worth doing do.
The toolkit
8 somatic interventions for telehealth
01
5-4-3-2-1 Grounding
A go-to for anxiety and dissociation. Guide clients through five senses — five things they can see, four they can touch, three they can hear, two they can smell, one they can taste. The key adaptation for telehealth: encourage them to turn their head and notice things outside their usual screen view.
Works especially well at the start of a session to drop out of “screen mode.”
02
Bilateral Stimulation
No buzzers needed. The butterfly hug — crossing arms over the chest and alternating taps on the upper arms — is a simple, self-administered option that translates beautifully on screen. For something even more discreet, heel presses (alternating each foot while seated) are nearly invisible and grounding for clients in semi-public spaces.
Teach the butterfly hug as a between-session self-soothing tool.
03
Window of Tolerance Check-In
Visual aids shine on screen. Have clients draw a window on paper or a whiteboard, mark where they currently feel they are, and together identify what tends to push them toward hyperarousal or hypoarousal. From there, you can practice interventions in real time to help them stay regulated within the window.
A shared screen or whiteboard makes this even more interactive.
04
Seated Body Scan
Perfect for clients joining straight from work. A 30-second version — noticing contact points with the chair, scanning from feet upward, checking shoulder height, softening the jaw and forehead, then three slow breaths — is enough to shift the nervous system. It’s quiet, contained, and completely invisible to anyone passing by.
“This looks like you’re just thinking deeply” — a reassuring reframe for office settings.
05
Temperature for Nervous System Regulation
Cold activates the dive reflex and can quickly reduce anxiety — a cold water bottle, ice cube on the wrists, or a cold washcloth on the neck all work well. For clients who need grounding rather than calming, warmth is the tool: a heating pad, warm mug to hold, or a soft blanket for the session can create a felt sense of safety that words alone can’t always reach.
Ask clients to keep a water bottle nearby — it doubles as a cold intervention when needed.
06
Movement Within the Frame
Gentle shoulder rolls, neck stretches, and seated cat-cow (hands on knees, alternating between arching and rounding the spine) all fit within a camera frame and take less than a minute. These movements release the tension that accumulates from screen time and demonstrate to clients that caring for the body doesn’t require leaving your chair.
Model these yourself — your willingness to move on camera normalizes it for clients.
07
Safe Space Installation
One of the unique advantages of telehealth: clients are already in their actual environment. Guide them to slowly notice the comforting objects around them — textures they can touch, photos they can see, scents they can smell. This isn’t just an exercise; it becomes a real resource they can return to between sessions, anchored in the space where they actually live.
Invite clients to photograph their safe space anchors as a between-session reminder.
08
Breath Work
Box breathing translates seamlessly — share a simple animation on screen, or have clients trace a box on their desk while you count together (4 counts in, hold, out, hold). For something gentler, coherent breathing at 5 counts in and 5 out is easy to pace with a free phone app and works beautifully in couples sessions where breathing together can itself become a co-regulation experience.
Breathing together in a couples session is co-regulation in action.
When clients push back
Not every client will dive in willingly — and that’s okay. For clients who can’t move much in their space, micro-movements and isometric exercises (like pressing palms together) are enough to engage the body. If privacy is a concern, silent techniques like body scanning and gentle movement keep things contained. And for clients who feel disconnected from their bodies on camera, try turning off self-view, closing eyes during exercises, or using a small prop like a stress ball or fidget tool to bring attention back to physical sensation.
The most important thing is to meet resistance with curiosity rather than pressure. Ask what feels manageable. Start small. Somatic work builds over time, and even a 30-second body scan done consistently is more powerful than a longer exercise a client never tries again.
Making it stick between sessions
The real magic happens between sessions. Consider recording a voice memo of a guided exercise clients can replay on their own. Encourage calendar reminders for movement breaks, or suggest a brief somatic check-in text to themselves — just a few words about what they notice in their body at a specific time each day. These small practices build the habit of body awareness in the places and moments that matter most.
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.
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 — because the best intervention is the one your client will actually use.
📄 Download: Somatic Therapy Grounding Techniques worksheet
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