Written by listed counsellor/psychotherapist: Esmee Rotmans (UKCP Reg., Reg. MBACP)
22nd January, 20150 Comments
In a world where we carry out the majority of our activities over the Internet and increasingly more people of all ages spend significant amounts of time online, it is clear that cyberculture is here to stay. You may already use the Internet for shopping, banking, conferences, education and learning, socialising, dating, running an online business or getting medical advice. It does not seem that surprising that counselling is also available online. But does online counselling seem like a step too far? Surely the important part of counselling is to see the person face to face?
Many people would argue that non verbal body language constitutes the majority of communication. So how can online counselling help and how does it differ from in person counselling? Some of the advantages of online counselling are:
Online counselling means that many more people can access a counselling service. Some examples are: If you live in a rural area or live with disabilities that make travelling to a counsellor’s office difficult. You may have hearing difficulties and cannot access a counsellor with sign language skills nearby, you may have a phobia or other condition and you have become housebound. You may be very busy and want to save on travel time and cost or you may be living abroad.
Online sessions may be cheaper and you save on travelling costs and the time of travel.
Although most online counselling is similar to in-person counselling where you arrange an appointment, there tends to be more flexibility in the times of sessions being offered and also being able to switch to different media of communication, e.g. you may start with email counselling, but may want to switch to a session over IM (instant message) or audio. Or you may be abroad and the Internet connection may not be strong enough for video/audio calls or the time difference does not allow for a suitable time of a session, in which case you can switch to email sessions during that time.
There are different interface options in online counselling:
- Email therapy (an exchange of emails between client and counsellor).
- Instant messaging (client and counsellor communicate live via written form).
- Audio call (without any visual input).
- Video call (the closest to seeing someone in person, although you may only see the upper part of a person).
Whilst some of this may sound strange in a context of counselling, in fact, it is not dissimilar to forms of communication that we already know. Email counselling is similar to writing letters and can help the client and the counsellor to reflect on what they are writing. Written forms also provide a record which can be reviewed after the sessions. Voice Skype calls are essentially the same as telephone calls and the video calls are somewhere between a telephone call and in person counselling. When thinking of classic psychoanalysis, sessions were carried out with the client sitting lying on the couch and the psychoanalyst sitting behind them, so that the patient could feel free in their flow of thoughts and reflections.
Online presence and communication
As mentioned above there may be concerns about how to gauge what someone is saying without visual cues. However, when you think of events in your life, you may be able to think of examples of when you felt someone’s feelings over the phone - perhaps by the tone of their voice, or when you read someone’s email and sensed their emotions or the type of person they are. It’s all about reading between the lines. One of the pitfalls of written communication is that misunderstandings can happen more easily. However, a trained online counsellor will know to clarify any potential misunderstandings and of course these happen during verbal exchanges too.
A trained online counsellor will also be able to convey their presence and empathy in an online context and use their therapeutic skills appropriately for the benefit the client. Another potential hazard of online sessions is the possible disruption of internet. If brief, the session can resume; if extensive disruption happens, the session may need to be carried out via a different medium or rearranged for another time. Another point for consideration is that complete confidentiality cannot be guaranteed online, however, an online counsellor will ensure to make the sessions as secure as possible and advise the client of any limitation and possible alternatives.
How do different theoretical approaches translate into an online context?
Different approaches can be adapted to an online counselling medium. In fact, online CBT sessions have been offered for a while. Most principles from humanistic and integrative and transpersonal psychotherapy can be applied and even creative ways of working can be used online. Meditation techniques can also be taught during online sessions.
This is an area of counselling and technology that is constantly evolving and it is exciting to see how many more clients can benefit from counselling.
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