Camera Placements

Angles for Image Quality

Complementing the lighting, the camera placements and angles can create a clear or distorted image quality. The camera should be positioned in a way that avoids silhouetting (Figure 12.5), which can occur when there is too much backlighting from a window or light, making the person shadowed and difficult to see (Angus, 2020; Krupinski & Leistner, 2017; Simpson et ah, 2016). Further, providers and patients should avoid placing the camera with hallways, windows, mirrors, or reflective materials behind them, as each can create distractions and potential difficulties for the image due to reflections or background motion (Angus, 2020; Simpson et ah, 2016). Further, if a doorway is behind the provider or patient, it may be helpful to place a towel or other blocking material by the base to reduce shadows of others walking by. This may be especially important if the provider or patient has multiple people who may be walking by the room, or if they have pets that may be pacing or attempting to sniff under the door.

Example of silhouetting from background lighting

Figure 12.5 Example of silhouetting from background lighting.

Angles to Include All Participants

If working with a single patient who generally remains seated, the camera angle may not be a large consideration. However, if multiple adults are sitting next to each other, new members will be joining the session, or if children are sitting on the floor in addition to caregivers sitting on a chair or couch, the provider must consider the optimal angle to ensure everyone is in the view. If a provider has access to a camera at the patient’s location that allows for zooming, tilting, and panning, such features can be used to adjust the camera in real time. If such features are not available, the provider can coach the patient to rearrange the camera to capture a broader view. For example, the camera can be pushed back to capture a wider angle (Myers et al., 2017). While this approach may be the simplest and allow for a better view of everyone in the room, it also creates new issues. Most importantly, moving a camera back may reduce the provider’s ability to see more nuanced and smaller behaviors of those in the videoconferencing session. Ultimately, it is the provider’s judgment as to what angles will be best for the therapeutic processes, with some choices being functional as based upon available options, but not optimal.

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