Let’s be clear right from the get go… there is some controversy regarding the benefits of online therapy. When you look online you will be able to read credible information from various perspectives. Professionals who have been practicing for many years are generally expressing reluctance around using current technologies for psychotherapy as it does not offer the same experience that a face to face in the same room provides. Some refer to it as a simulated experience…
I have always been fascinated by resistance. It is frequently a part of the therapeutic experience. For most, resistance seems to be an inherent part of being human. We tend not to trust something/someone we don’t know. We need “evidence” before being willing to reduce our resistance. Things that are different we can find threatening and make assumptions often without challenging those assumptions. I say this because it directly effects how we perceive our world and create change, or not. At the vey least it’s worthy of exploring what the process of change is for each of us and to collate the commonalities, including the discussion regarding the validity of online therapy. I try to be aware of my own resistance and ask myself, “What am I afraid of here?”
So… I digress… back to the point.
Online therapy is a different experience than when you sit down with a professional psychotherapist. It has to be… it’s missing the physical presence as such the physically expressed “clues” may not be as apparent to some in a Skype type of connection. This will likely improve and be less of a concern (to some). With high speed internet coupled with outstanding video and audio connections available, there’s probably less missed than anticipated or thought by some…
Therapy, by its nature, is a journey between the client and the therapist and although I hope that all clients I work with will find their place of peace in the process, feel more self-empowered and learn through the time we work together… I am also aware that the client is the one doing the work with the guidance of the therapist. It is a mistake to not work with the client’s information and report. If they find something helpful… a particular method, comment, feedback etc…. I as a therapist should pay attention to that. So, it really isn’t up to me to say what’s helpful or not, I need to respond to a client’s ability to progress. I participate in guiding through that process using appropriate therapeutic techniques. If a client prefers the convenience of doing online work and finds it beneficial, then it is not for me to judge its relevance or benefit for them.
It may be easier for some to understand the difference between counselling and psychotherapy… With the risk of oversimplifying, counselling is typically session/time restricted like through an Employee Assistance Program or Family Health Unit or other similar “sponsored” agency. Counselling typically deals with immediate presenting concerns of a client currently experiencing a crisis of some kind. Counselling helps the client expand their understanding and perspective of that situation and provides strategies and options around what to do. Psychotherapy includes the initial process but includes, through an ongoing process, an exploration of what got the client to where they are. Issues of transference are important to a psychotherapeutic relationship as well as exploration of psychopathologies. The nature of most online therapy, although therapeutic, tends to be more like counselling. It tends to be more crises oriented and shorter in duration. Online counseling can lead into a deeper psychotherapeutic relationship and there is certainly benefit in getting help for a crisis that you are experiencing.
I was one of the “old school” psychotherapists who were adamant about not doing online therapy until I began to see that, in spite of the obvious differences, there are distinct advantages to online therapy.
I started with telephone therapy, working with existing clients who had moved or were working away from my office and not able to physically be present. Setting up appointment times became easier as we could set up a mutually convenient time that could also be outside my normal office hours, they could talk from their hotel rooms, offices, etc. and I could work from a location other than my office if I chose. Because I already had an established therapeutic bond, the work was reportedly beneficial and effective. Yes, again, it was a different experience, but still very therapeutic for the clients… and keep in mind, we were just talking on the telephone!
If you add the opportunity of video and having a “virtual” experience, I now believe that there is no reason to think that “virtual” therapy doesn’t work, in spite of the physical presence being missing.
Other advantages are:
Getting help is more convenient for clients who, because of social stigma or other fears or concerns, may not have accessed help previously.
There are no geographical boundaries. Clients can be anywhere in the world with the internet and access help.
Clients with physical or mobility challenges can access help more easily.
Clients that live in more remote areas can access help.
Scheduling can be done online at mutually agreeable times.
Payment can be done online.
Clients who have transportation challenges can get a similar experience from home.
Typically sessions with me are one hour in length. Clients can set up differing session times that may be more suitable for their schedule. They may only need half an hour and may need 2 hours.
Scheduling can be more regular with less concern about client’s typical work or family schedule.
Although online therapy is different, it offers a very similar therapeutic experience that most clients find convenient and beneficial.
Leland Clipperton, H.S.C.