What is online counselling? And does it work?
What is online counselling?
For the purposes of my practice, online counselling is a form of therapy that takes place exclusively online, via video calling services (such as Zoom, Skype or other telehealth software). However, it can also include any type of therapy that takes place via the web, including email, text-based, instant messaging, apps or computerised therapy programmes. I currently use Power Diary’s proprietary telehealth software for all online therapy sessions. Information about the security features of this platform can be found here. I will conduct all therapy sessions in a private, secure and confidential space, maintaining the same level of privacy you would expect from face-to-face counselling.
Who can benefit from video-based therapy?
Online therapy can help clients with the same types of issues that you might bring to face-to-face counselling, such as stress, anxiety and depression, coping with life transitions, bereavement, loss, work-related challenges, self-esteem, disordered eating and many others.
But, is it as good as F2F therapy?
Concerns over the ability to form meaningful relationships (1), worries over missing non-verbal communication cues such as crossing legs or fidgeting (2) and issues of video and sound quality, bandwidth and internet connection have often raised questions about its effectiveness. Some, such as those to do with connectivity, are valid and something that is discussed, and planned for in our first session. However, any worries about being able to build an effective online relationship, or whether you can see positive outcomes are less well-founded and certainly haven’t been my own personal experience. While the research base for video-based counselling is currently small, existing evidence suggests there is no difference between online and face-to-face counselling in terms of the quality of therapy, nor in the ability to develop a strong therapeutic relationship between client and counsellor (3, 4). The effectiveness of video therapy is comparable to f2f counselling (3) and results in significant reductions in the severity of mental health symptoms, with client satisfaction on par with F2F therapy (4, 5).
Indeed, some find that a screen can provide an additional layer of comfort and a protective barrier that feels less exposing, enabling a client to be more open about how they are feeling.1 The main difference is the ‘space’ in which you meet.
Ultimately, it's about what is right for you
Finding the right space to share your experiences is about finding an environment that feels comfortable for you, with a counsellor you can trust. Ultimately, the success of the counselling relationship is based on client choice and client preference. If you want to engage in online therapy, the chances are, you stand a much better chance that it will work for you.
If you'd like to find out more about online counselling with me, or ask a question, then please drop me an email at christine@thelosstherapist.co.uk
References
Chen, C. K., Nehrig, N., Wash, L., Schneider, J. A., Ashkenazi, S., Cairo, E., Guyton, A. F., & Palfrey, A. (2020). When distance brings us closer: leveraging tele-psychotherapy to build deeper connection. Counselling Psychology Quarterly, 00(00), 1–14. https://doi.org/10.1080/09515070.2020.1779031
Brahnam, S. (2017). Comparison of in-person and screen-based analysis using communication models: a first step toward the psychoanalysis of telecommunications and its noise. Psychoanalytic Perspectives, 14(2), 138-158
Richards, P., Simpson, S., Bastiampilllai, R., Pietrabiss, G., & Castelnuovo, G. (2018). The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist’s perspective. Clinical Psychologist, 22(2), 171-181.
Smith, K., Moller, N., Cooper, M., Gabriel, L., Roddy, J., & Sheehy, R. (2021). Video counselling and psychotherapy: A critical commentary on the evidence base. Counselling and Psychotherapy Research, June, 1–6. https://doi.org/10.1002/capr.12436
Thomas, N., McDonald, C., de Boer, K., Brand, R. M., Nedlejkovic, M., & Seabrook, L. (2021). Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems. Psychology and Psychotherapy.