Therapy at a distance - is it really that distant?

As we move further into the digital age, the difficult reality for many therapists can come from connecting with you, the client. What does 'connecting with you as the client' mean anyway? I am not referring to connecting with you using a type of therapy (perhaps cognitive behavioural therapy or psychodynamic psychotherapy). No, I am not here to discuss these therapies. Instead, I am talking about the medium used to connect with you - the client!


There are many different types of media used in therapy. For example, it could be face-to-face. It could be over the phone, text message or email. Think about it; you more than likely have used these different ways of communicating with family members, friends or others you know. Specifically, though, the medium I would like to bring to your attention is video conferencing and its application in therapy, particularly when comparing it to the traditional face-to-face medium. By video conferencing technology, I am of course referring to the software you may know already that you can download onto your computer, such as Skype.  

I am not just an advocate for video conferencing because I have used it personally for a long time. Especially in these times, where illness, jobs, or family may separate us, being able to connect using technology is even more prevalent. And that's not all, using technology as a way of connecting with people is part of a growing trend among therapists you may see, as more and more therapists are beginning to open up to the idea of using different mediums when seeing clients.

Advantages of using video conferencing in therapy

While there is research (Day and Schneider, 2002; Germain, Marchand, Bouchard, Guay, and Drouin, 2010) that compares video conferencing and face-to-face media in therapy, my own work experience has shown some great advantages to using this technology, which includes but is not limited to: 

1. Not just telling, but showing: Think about this. When you are with a therapist in his or her office, you think about your home environment. It's one thing to tell the therapist about your life at home, but being able to show an object from your home (say, a picture of a loved one) in real-time, provides not only a clear picture (quite literally) as to what your life is like, but in doing so, you show the therapist in real-time without being inaccurate.

2. Convenience and flexibility: This goes without saying, does it not? It can be tough to get to your therapist, because of traffic, illness, both or other reasons. You can instead meet at your home, perhaps not at the same time every time, but at a moment when you feel you have the energy to put in the work of discussing your life with the therapist.

3. Relationship building: You might think that to grow your relationship and trust with your therapist, you need to be there in person? Not true. This can be done via video conferencing. Trust comes from feeling you are listened to and given full attention, but at the same time, knowing your therapist is a human too. With seeing through a computer, you can maintain everything you have in-person; that being eye contact, hearing the therapist's voice and words, while also knowing that your therapist struggles just like you. For example, this could be with technology or internet connectivity issues.  Humanising your therapist can come with enormous therapeutic benefits.

Concerns with video conferencing therapy

Using video conferencing technology in therapy is not without concerns. Here are a couple I have seen with experience:

1. Technology: Yes. Struggling with that internet connection, getting cut off in the middle of a session or not being sure how to use video conferencing can make clients doubt whether using it is for them. However, as mentioned earlier, I have found that when clients know the therapist may struggle too, it presents a level of honesty and openness that helps clients trust a therapist more. Also, the struggle of using the technology is a great way to use problem-solving skills, gain confidence and show to others in your life that you are incredibly competent!

2. Confidentiality: This is another concern I have seen with clients. Some think that confidentiality can only be maintained in the physical room itself. Therapists will often use the words "safe space" to describe a room you are in with him or her. The video conferencing space is just the same, but that does not mean you, as the client, trust that yet! To work around this, I often talk to my clients about what might happen if there is fear about someone else walking into the room in your home, for example, which might breach confidentiality. Having a plan beforehand can help you feel more secure and can, of course, continue to help you build trust with your therapist!

In summary: think about what matters to you

The question to ask yourselves as clients is whether there is a difference in your experience between using video conferencing technology and talking to a therapist in person. It might be that the relationship you form with your therapist transcends the medium used in therapy, whether with the same therapist is in-person and video conferencing, or whether you were seen by different therapists. Think about it. Don’t just imagine an experience seeing your therapist via video conferencing, but instead imagine a friend or family member. Did you feel heard? Did you see that the person across the screen was looking directly at you? Did you feel like you were able to connect with that person? 

What we can begin to see is that therapy from a distance may not seem like such a distance after all. If you can bring objects from your home to you and your therapist’s computer screen, you are bringing an added element you may not have considered.

If your relationship with your therapist matters more than whether you see him or her in person or on a screen, you may not feel too distant from your therapist, no matter where in the world you may be connecting from.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London, Greater London, SW6 3PA
Written by Dr Joshua Bourne
London, Greater London, SW6 3PA

Dr Joshua Bourne is a Counselling Psychologist registered with the BPS, BACP and HCPC. He has over 7 years of training and work experience offering evidence-based practice in the field of Psychology, both in therapeutic and business psychology contexts. He works with adults and families and invites you to visit his profile for more information.

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