Online counselling? Don't be silly
Skepticism is understandable. How could counselling (supposedly all about the relationship) work well online when the very medium renders it an 'unreal' relationship?
First thing's first: by 'online' counselling I mean email, instant message, voice or video sessions. This article refers to one-to-one counselling. I believe that the principles hold for online supervision too.
Further, I'm referring to online counselling as an additional way of expressing oneself; it's not a substitute for face-to-face therapy. Or indeed vice versa: face-to-face therapy cannot offer some of the benefits of online counselling.
It seems that many, like myself, are drawn by the convenience of working online. Perhaps however, we also share quiet doubt about whether it is possible to build a strong relationship without meeting in person. A fundamental loss of intimacy a surety? As well as a loss of information? A lot of what counsellors understand about clients is from observation (and checking that out). I am able to observe less - sometimes nothing - when working online.
Feedback, however, indicates that these things are not to the detriment of counselling if both counsellor and client are willing and committed to the process. Problems arise when both do not opt in: for example a counsellor wanting existing face-to-face clients to work online after a relocation. Many of these clients simply may not want online counselling!
The key point is that for those clients that really want it, web based counselling can work. Clients tend to meet their aims. This is based on the experiences of colleagues I have spoken with, as well as my own.
Maybe you too will be surprised to hear the more subtle ways in which online counselling works for clients. For example - I have sought permission to share this - feeling more in control of therapy by being in their own physical space (often their own homes). This has implications for more equal power relations. Lovely. Also, having more charge about what to share (an online counsellor cannot see/sense quite as much). For potential clients, this could be the difference between counselling being do-able, and 'too much'.
Of course online counselling is more accessible to some people with disabilities. Not to be underestimated. I am embarrassed to say, for example, that I did not even consider access when hiring a room for face-to-face therapy in London.
Considerations for counsellors and clients starting out online
Counsellors, reflecting on the below may help clarify information and expectation:
Assessment: for someone in acute distress, is online counselling suitable?
Is it important to me to have a supervisor experienced in online counselling?
How familiar am I with online counselling literature/training?
What does the BACP Ethical Framework say about online counselling? Am I keeping up-to-date with the proposed changes to the Framework relating to technology?
Clients, perhaps look out for your counsellor to:
Communicate that they are in a confidential space (alone, in a soundproof room) and check that you have found a similar space if possible.
Explain how security and privacy is ensured with email.
Check how well (or not) the online element is working for you, especially after the first session or two.
Discuss how a bad connection will be handled, including implications for payment.
Explain/negotiate how and when will payments be made.
The complexity of counselling online contrasts with brevity of this article. Others may prioritise differently when thinking about competent and ethical online practice. I would love to hear these ideas: this is, as ever, ongoing learning for me.
Related articles from our experts
Dr Kornilia Givissi, Counselling Psychologist (HCPC Reg, DCounsPsy)March 16th, 2017
Cate Campbell MA, MBACP (Accred), MCOSRT (Accred), MAFTMarch 23rd, 2017
Andrea Harrn Psychotherapist and Author of The Mood CardsMay 13th, 2011
Imi Lo: Psychotherapist, Art Therapist, Supervisor (MMH,UKCP,HCPC,MBPsS)March 29th, 2015
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