Breaking tradition: Online counselling sessions

Many people still prefer the notion of face-to-face counselling, in fact, in the counselling world there is still at times a perception that it is a better way of doing therapy as we can ‘see’ the whole person. However, here I explore how the online world can provide at times a much deeper therapeutic relationship, with a qualified and experienced online working counsellor, a huge amount of work can be achieved.

To explore this concept of difference, I embarked on trying a variety of counselling for myself, both online and face-to-face with different therapists. I wanted to know how it felt to be the client and make my own mind up (and I had my own stuff to process as we counsellors are human after all!).  

My conclusion is that there is no hierarchy between face-to-face and online working and I work well in my practice in both ways. The below describes some of my own unique feelings/thoughts/views towards being both the client and therapist in the online world. 

Online (video call) counselling sessions

Less stress (possibly)

Not having to travel was a huge bonus for me, my life as a busy working mum with neurodiversity to manage in my immediate family, meant saving time was a must. Having said that, what I realised from saving time in travel, was not just me cramming a session in, but that I could arrive into my counselling session calmer and less stressed as I avoided; the time pressure to be somewhere different, cost of fuel and parking or the stress of finding somewhere to park (not all counsellors work from their home these days) and I stayed comfortably in my own environment aiding my sense of relaxation.

Now what I know from my own clients is many feel the same when they choose online sessions with me. However, this is not to say this will work for everyone. Home is not always a place of relaxation, and many may be stuck at work having to log on for our session and that adds a dimension of stress of being overheard or seen after a session as you emerge from a meeting room. For some ND individuals, staring at a screen can be more exhausting, although many have found it useful in managing appointments when they forget them, without travel time they can usually juggle and arrive late more easily! 

Working with the highs and lows of the ‘disinhibition effect’

As a counsellor, I am prepared to see and hear about the different feelings of working together online. I am also acutely aware (as I have been that client) of the ‘disinhibition effect’, where a 2004 study found whilst online ‘some people self-disclose or act out more frequently or more intensely than they would in person’ (Sular, 2004).  

However, a trained therapist for online working will be holding the client safely ensuring not too much comes out sooner than even the client is prepared to experience and process. The disinhibition effect can also be used to a client’s advantage if they are used to masking outside the home, sat in the safety of their home they feel they can be vulnerable and even let you see some of their issues such as organising their home (a common factor with ADHD clients).  In fact, I worked with one client, a victim of domestic abuse, who was her business professional self in the room, however, when we switched to trying online sessions she relaxed straight away and noted the startling difference herself (this client did not of course live with her perpetrator). 

Visual experience and creativity 

It may be true we can’t draw together; however, we can still undertake breathing and mindfulness tools together and the sharing of screens on most platforms allows the sharing of documents and drawings for visual guides. It means, a different way of working creatively. However, if you as a counsellor or client enjoy sand tray work for example, then this would of course be difficult to recreate online. 

Increasing accessibility to counselling

The other aspect that it allows is for those too anxious for face-to-face sessions, sometimes due to crippling anxiety or indeed ASD/ADHD (although this can also mean they find the opposite and prefer face-to-face working), the online room is perfect. Also here we could include physical disabilities where the logistics of attending a session are tricky or impossible. I worked with a client through my contract with victim support who would have had to pay for a taxi out of her disability allowance, not something she could afford if I hadn’t offered online work as an option (ignoring the fact I also, unfortunately, have stairs to my therapy room).  

In summary, online working allows access to therapy where none may have been attempted, and on that level alone, it can only be a great thing. Many counsellors now offer both ways of working – choose wisely, and have an intro video call where possible. But ultimately, know that online therapy can, and does, work.