Remote therapy

Remote therapy is here to stay! Remote sessions can take place in various ways which include video and phone sessions. There are great advantages of remote therapy, but sadly there are also some disadvantages you might want to be aware of before choosing between online video sessions or phone sessions.  

Reaching the most vulnerable

Clients who suffer from conditions like obsessive compulsive disorder (OCD) or agoraphobia might never have reached out for the help they needed if they had to have face to face sessions. Even if they did, they might have struggled to keep up with weekly appointments should they have had to leave their home to see their therapist.

There are also victims of abuse who risk their safety by reaching out for face to face sessions. The option of having remote sessions can give them the initial medium to get the help they desperately need.

Due to safety reasons, it isn’t easy to find professionals who offer home visits. Although remote sessions will not always be sustainable over a long term.

Although remote therapy might keep the patient stuck, it is certainly the best way for those who fall into certain categories to get connected to the services that can offer them help.

There are clients who live in rural areas who suddenly have access to a greater number of counsellors or therapists offering remote sessions. Remote therapy also means that clients in rural areas have access to a wider range of therapies.

People who work shifts might not have had access to weekly services before. Many places only offer sessions on a weekly contract where the sessions take place at the same time every week. Since the counsellor doesn’t always need to travel to a room that is only available at specific hours, they might now be able to offer sessions at different times each week depending on the availability of clients. 

video call

Safety

Seeing clients who are considered as high risk when it comes to safety (for example those who are ex offenders with a history of violent attacks or abuse) are now easy to reach. This could mean that services could be offered at increased frequency which could have a positive effect on their mental health.

But should these clients also be high risk for suicide or self-harm, then remote therapy could compromise the client’s safety. If a client is seen in the room, the police or ambulance can easily be called. The counsellor or therapist will always wait with the client until the emergency services arrive. Should the client and counsellor now been in different locations, the counsellor isn’t able to provide that support and safety.

Accessibility

Not all clients have access to online services. Many clients might be in an older age category and struggle with online access. Some older clients will struggle with Zoom or Skype sessions and might not even have a laptop or smart phone. Clients in their twenties often prefer remote sessions.

Privacy

It is always advisable that clients and therapists are in a private or safe space when they are in a session. However, when a session is conducted in a remote manner, it is not always guaranteed that it is the case. There might be a housemate in the room or someone who has access to the same network and who can hack into a session.

Professional skills

As therapist, we are experts in non-verbal communication. We notice when clients are avoidant, or when they are experiencing difficult emotions and we are trained to use what we see to help the client become aware of what is going on for them.

When a session takes place over the phone for instance, we cannot see the client. We might not be able to pick up if the client is neglecting self-care by not dressing in their usual way. We might not pick up if a victim of domestic abuse has another bruise.

With phone sessions, it is also more difficult to navigate silences. When a client is in front of us and they are silent, we can notice them and sit with them in their silence. Both client and counsellor can sit and experience what is going on and the counsellor can navigate the conversation in a way to help the client feel understood and less alone. 

When there is a silence over the phone, it isn’t always possible to tell what is going on for the client. Unless the counsellor is aware of this, the client will not have the benefit of being fully experienced.

Man on phone

Technology will fail us sometimes. Devices might not be fully charged, connection might be lost or the quality of the call can be less than desired. It needs to be discussed what would happen in such a case. Will the client be charged for a full session? Will the session time be extended? The counsellor might not be able to extend the session time if they have another client booked straight after. Will the session be moved?

With video calls many people find it awkward seeing themselves on a screen. They would rather prefer just seeing the other person. This is not always possible and can be distracting. Also, if a video session is done over a phone, the screen might be small and limited and again, part of the experience is limited.

If a therapist is conducting a session with a couple, they need to address each client by their name as the clients cannot always detect who the therapist is speaking to.

Etiquette

It is advisable not to do anything during a remote session that you would not do in a face to face session. It can be very distracting if you can hear the other person walking, eating or fiddling with something. It can also be very distracting in an audio session if there is background noise.

Since we cannot always avoid someone knocking on our door for instance, it is good to communicate in advance where something like that is expected.
Punctuality is very important with remote sessions. If the client is late for a session where there really is no excuse, then it could be an act of self sabotage. 

Remote sessions are here to stay. Whether you are struggling with anxiety, depression, stress, panic attacks or just feeling sad, remote sessions can be the key to unlock your door to change.

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 Sonica Mushi - MBACP, BA (Psych),

I am an integrative counsellor trained in Psychodynamic counselling, CBT, Schema Therapy, (EFT) based on attachment and a person-centred approach. I offer online, phone and face-to-face sessions for individuals and couples.

I'm based in the Hammersmith and Fulham area and work with my clients on a plan that is designed around their needs.… Read more

Written by Sonica Mushi - MBACP, BA (Psych),

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