Covid-19 and online therapy

Until a couple of months ago, no one would have imagined that half of the world was soon going to be in lockdown, that we would be stuck at home with no chances to meet our loved ones, unable to travel and visit friends or family, without an office to rush to in the morning, or schools to leave the kids at… 

Our habits have been turned upside down and after an initial reaction of denial, shock and anger perhaps, now we’re doing our best to adapt to the current situation. 

Coronavirus is an invisible new inhabitant of our world that has altered our perception of time, relationships and sense of security. However, this ‘break’ could really represent a good opportunity to reshuffle our routine and think both our life and habits through. Is there anything that you wish to leave behind in the pre-Coronavirus times? Were there things you may have taken for granted and not appreciated enough? Was the pace of your life too fast? Were you missing out on the important things? 

With quarantine underway, fear of contracting the virus, economic instability, fear of losing or actual loss of our loved ones, forced and prolonged isolation are all significant risk factors that may take a significant toll on our mental health.

Prolonged lockdown is indeed presenting different challenges within different age groups. Apparently young people are mostly struggling with boredom, family conflicts and in complying with social distancing rules, whereas the most vulnerable (the elderly and people with health problems) are struggling with solitude. People in their 40s and 50s seem to find it difficult to handle home-schooling and work altogether (S. Barari et al, 2020). 

Scientific research suggests that the main effects of prolonged quarantine consist in increased anxiety, depression and irritability, plus an increase of post-traumatic stress symptoms in healthcare workers that are exposed to emotionally-charged situations on a daily basis. The longer the quarantine lasts, the worse the impact on our mental health may be.

In these difficult times, mental health support becomes even more vital and, given social distancing measures, online counselling is the only viable way to therapy.

How does online therapy work?

Online therapy works exactly like face-to-face therapy. In parallel with the massive use of technology in our daily lives, mental health support has been recently delivered in non-traditional ways, other than the classic face-to-face offline approach. Phone and video calls, emails and also instant messaging are being used as the means to deliver therapy. Consultation via video call is the most frequent one and, as I personally believe, the best way to access online counselling. Several GDPR compliant platforms can be used, such as Skype and FaceTime. The sessions work exactly like face-to-face therapy in terms of duration, frequency, confidentiality and how therapy is held.

Is it more difficult to open up online compared to face-to-face meetings?

Not necessarily. Research suggests that young people feel more comfortable with internet-based counselling, especially via instant messaging compared to other traditional forms of psychological support. Anonymity seems to promote more direct communication while reducing feelings such as shame and embarrassment (Kuka, 2014).  

Will the relationship with the therapist feel different compared to face-to-face therapy?

The idea of talking about inner struggles with a therapist never physically met before may raise concerns in some of us. ‘How can I trust a person I have never met? Will the therapist be able to get a full picture without body language cues?’ are indeed common questions. The screen may sometimes represent a barrier when reading non-verbal cues, but research suggests that online therapy is as useful as face-to-face therapy and that patients report good rates of satisfaction by using this method. After all, if you think about it, nowadays there is an abundance of things happening online. We take on new hobbies, make new friends, exchange ideas with like-minded people, hold group meetings and, sometimes, fall in love, too! In my personal experience, it is possible to establish a solid therapeutical relationship with a therapist online, despite the traditional face-to-face experience still being the preferred method for some people.

Does online therapy work? 

Personally, I believe in the efficacy of online therapy and my experience so far has been promising. Data collected in scientific research suggest that online therapy has the same efficacy of face-to-face therapy. In particular, internet-delivered Cognitive Behavioural Therapy (CBT) has proved its efficacy for treating anxiety as well as depressive disorders and its effects last over time (Wagner, 2014; Andrews, 2018).

Is online therapy suitable for everyone? 

Online therapy is suitable for most people, yet it may not be for everyone. It is not recommended for people with suicidal intent, psychosis or acute psychiatric disorders. In general, online therapy is not recommended for people experiencing acute conditions that may require the patient to seek medical help. If you wish to try online therapy, a good internet connection and a quiet and private environment to take the call are important. Feeling comfortable opening up is key, therefore you may want to find a suitable time and place where your privacy is protected.

Which therapist should I choose?

The process of picking your therapist is a very personal one. Check the credentials as well as the qualifications of your chosen therapist to understand whether their area of expertise matches your requirements. Then, in the same way as face-to-face therapy, proceed to book an initial session with a couple of therapists or have a quick phone chat with them to address your questions and see how you feel. Your inner guidance will tell you - the best therapist for you is the one you feel comfortable opening up to.

Andrews G, Basu A, Cuijpers P, Craske MG, McEvoy P, English CL, Newby JM. ‘Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis’, Journal of Anxiety Disorders, vol 55, April 2018, Pages 70-78

Wagner B, Horn AB, Maercker A. “Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial”, Journal of Affective Disorders, volumes 152–154, January 2014, Pages 113-121

Barari S, Caria S, Davola A, Falco P, Fetzer T, Fiorin T, Hensel T, Ivchenko A, Jachimowicz J, King G, Kraft-Todd G, Ledda A, MacLennan M, Mutoi L, Pagani L, Reutskaja E, Roth C, Raimondi F Slepoi. “Evaluating COVID-19 Public Health Messaging in Italy: Self-Reported Compliance and Growing Mental Health Concerns”

Kuka DL (2014) “Adolescent Help-Seeking: The Promise of Text Counseling”. Retrieved from Sophia, the St. Catherine University repository website: https://sophia.stkate.edu/msw_papers/350

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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Written by Ilaria Tedeschi

Ilaria Tedeschi is a cognitive behavioural psychotherapist, BACP and HCPC registered, working in Marylebone, London, both in English and Italian, with adult and adolescent clients experiencing depressive, anxiety, sleep and relational issues.… Read more

Written by Ilaria Tedeschi

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