Why choose online therapy?
In recent years, therapists' use of digital technology has increased significantly. This impacts on many aspects of our work, including methods of service delivery (using a variety of different approaches which may be text-based, use video-conferencing links or perhaps involve engaging with automated tasks, questionnaires etc) and/or practice management tools, involving a wide range of administrative systems.
It can be very important to think carefully about what is best for you and to take time to make informed decisions about this, whether you are a practitioner or a client. If you are unsure about how to manage your digital presence and what kind of therapeutic engagement is best for you, I am happy to discuss this further with you before you decide what to do.
My background in online counselling and psychotherapy
I first explored the idea of working as a counsellor online in 2006, when asked to set up an online service at the university where I worked as a member of a wellbeing team for students. I researched the idea very carefully, finding out as much as I could about the experiences of both online therapists and clients before taking things further. I then completed an online training, joining a growing network of other professionals also developing work in this area. I have always been committed to the provision of ethical, professional and secure online services and the implementation of effective practice guidelines and standards.
I established this original service and began offering online therapy, initially through a pilot scheme which then became a permanent provision within student services. I discovered that not only could online therapy provide very rich and meaningful therapeutic experiences for a wide range of people, but it could also open doors to therapy for those who might otherwise be unable to engage with help of this kind.
Reasons for choosing online approaches
Here are some of the reasons people give for choosing online counselling:
- I have to travel around a lot in the course of my work (sometimes abroad) and cannot commit to regular face-to-face appointments
- It is hard to coordinate my busy schedule with that of my counsellor
- Physical constraints prevent me from being able to get to my counsellor's consulting rooms
- I feel embarrassed about talking to someone in person about my difficulties; I am much less uncomfortable when meeting my counsellor online
- I prefer not to be 'seen' by my therapist
- The relationship online feels more 'equal' and I feel less concerned that I am being judged
- I feel more in control of what I do or don't say
- I can 'try it out' online first, and perhaps decide to engage in face-to-face counselling at a later date
- There is more 'time to think' when my counselling can be done by email (or 'asynchronously')and when the emails can be composed carefully and revised before I send them
- Text-based counselling enables me to keep a complete record of all that happens in counselling
How does it work?
Modern technology means that we can communicate through the use of a secure video and/or audio link, using a platform such as Zoom (some video-conferencing platforms are more suitable for the provision of therapy than others). I offer advice to therapists working in this way to help recreate the security and confidentiality that clients would expect from seeing a therapist in person. A variety of platforms can be used on a PC, Apple computer, smartphone or tablet, so offering the opportunity to work securely at a distance.
Alternatively, it is possible to engage in online therapy using text, either ‘live’ (using an Instant Messenger - IM - program) or by email, which some people prefer as it helps them to feel more contained and protected and offers them ‘time to think’. Whatever medium you choose, sessions are always arranged in advance and by appointment, just as they are when therapist and client meet in a room together.
Sometimes I may suggest that we incorporate the use of online tools such as questionnaires, diaries and worksheets, into the work I do with clients and in supervision with practitioners. I take great care to ensure that all the tools and strategies I use are secure, confidential and ethical and have been rigourously assessed and tested in order for me to be able to provide these assurances.
Find out more about online counselling
After a couple of years' experience of delivering counselling online, I undertook more formal research into the impact of this approach, inviting clients and other online counsellors to participate in an academic study exploring the nature of the online relationship. This research has subsequently been published in more than 100 journal articles and cited in several books (see my publications list). This findings of this early research indicated that digital technology can be enabling and increase opportunities for equality, diversity and inclusivity. I am passionate about using digital technology to overcome traditional boundaries and facilitate counselling for those who may have unable or unwilling to seek help before. At the same time, I am committed to providing secure, ethical and confidential spaces to enable these counselling relationships to flourish.
During the COVID-19 pandemic, online counselling and hybrid approaches became the 'norm' (as opposed to being thought of as an unusual way of engaging in counselling) and this has had a considerable impact on both clients and practitioners. My most recent publication explores in more detail some of the questions and potential pitfalls that may arise in online settings (as well as the perceived advantages) and highlights the need for sensitive, informed assessment processes and service delivery when moving to this setting. See Person-Centred and Experiential Therapies 2021 Vol 20 Issue 4
I keep in close contact with professional colleagues who share my interests in the impact of digital technology on psychotherapy and counselling and I regularly make presentations to organizations, groups and at conferences.
In recent years I have worked closely with BACP to provide guidance for colleagues who are considering taking some of their work online in order to promote safe and ethical practice at all levels and across a wide range of settings.
