How helpful is online counselling?

Traditionally, counselling sessions are conducted face-to-face in safe surroundings. Sessions are confidential and free of interruptions. Predictability of time and place coupled with well-defined boundaries contribute to the creation of a trusting relationship.
 
In recent weeks, our lives have taken deep and sometimes drastic turns as a result of the COVID-19 pandemic. For many of us, facing the uncertain future ahead brings in us fear, anxiety, stress, worry and loneliness, as well as feelings of helplessness and powerlessness.
 
If, in our pre-pandemic lives, considering counselling as a way to explore and manage such emotions may have felt a little daunting, it may now seem completely inaccessible due to social distancing and other lockdown measures. Fortunately, counselling can also be done online. Let’s take a look at some questions you might ask yourself if contemplating online counselling:

• What options are available?
• How effective is online therapy?
• How credible is the therapist?
• How are confidentiality and security protected?
• What about technological mishaps?

Computer-mediated technology allows both client and therapist to be flexible timewise and distance-wise. Several options are available including webcam, voice only, or written exchanges either synchronous (in real-time) or asynchronous (delayed messaging).

Video sessions, telephone and instant messenger sessions happen in real-time and are conducted through an encrypted platform. Emails are exchanged normally once a week via a secure email provider. The use of end-to-end encrypted platforms ensures that contents of video audio and written exchanges remain confidential and inaccessible to a third party.
 
Each format enables the creation of a safe and confidential space, and both therapist and client are free from interruptions, allowing the development of a trusting relationship. It is the responsibility of the counsellor to use end-to-end encrypted online platforms to ensure confidentiality. It is also the ethical duty of the counsellor, who ideally is a registered data controller and data processor, to inform the client how their information is stored and when confidentiality can legally be broken.

Counsellors who are registered data controllers and data processors and abide by regulations imposed by such procedures often add that information on their profiles or websites. They should be able to provide you with a registration number if asked.
 
Much like in-person counselling, online and telephone counselling can help with a wide range of issues such as: 

• anxiety
• depression
• stress
• loneliness
• worry
• self-esteem
• lack of direction
• abuse
• relationship problems
• bereavement
• loss

The format of each session is similar to face-to-face counselling in that it contains a clear beginning, middle and end. As in face-to-face sessions, the online counsellor engages in active listening and curiosity while remaining free of judgement. It is important to acknowledge that there is the possibility of misunderstanding due to the lack of visual and sometimes audio cues. For that reason, the online practitioner might ask for clarification more often than they would in face-to-face sessions, simply to compensate for that deficit.

Another difference is the possibility of technological glitches, such as video and/or audio freezing during a session. To remedy this, it is good practice when engaging in computer-mediated exchanges, to agree to another means of communication should there be a problem with connectivity or the device.  These are the two main disadvantages of online therapy. On the other hand, it does offer advantages in terms of flexibility, accessibility, convenience, anonymity, affordability and choice of media.

Like anything, it has its limitations, one of which is that it cannot provide an emergency service. If you are seeking online counselling because you are having suicidal thoughts, are self-harming or suffer from a severe mental health condition, you are advised to seek support through direct treatment and in-person intervention.  
 
Despite the limitations of online therapy, it offers a wide range of possibilities for both clients and therapists. Progress made in the counselling room is equally achievable online and has been in use before coronavirus with much success.
 
To alleviate possible worries about the credibility of online practitioners, it is advisable to choose a therapist who is qualified and experienced in computer-mediated communication and who can, therefore, ensure that favourable conditions are in place for a positive outcome. In summary, online therapy, conducted by qualified and ethical practitioners is a viable and effective means of support, especially when face-to-face counselling is not accessible.