Choosing Online Therapy
Some people may find that face to face counselling is the only method they wish to use and that is OK, but it may be that online therapy is a better choice for you.
Your initial assessment with your therapist will clarify with you if online therapy is a good choice for you or if face to face therapy is more suited to meet your needs.
Online counselling may be your ideal form of communication to obtain good therapy to help you with your crisis….it has been proven that participating in online counselling is just as effective as face to face counselling.
“Overall, the outcome literature appears to support the feasibility of online therapy. Teletherapy appears to produce therapeutic changes in a client in a similar manner to traditional therapy. This occurs in spite of obvious differences in the medium of transmission and communication (i.e. speaking directly to a person in the same room versus digitally facilitated communication over distance). ……the evidence provided, strongly points in the direction of seeing online therapy as roughly equivalent to FTF”.
Publication, Psychology at a Distance: Examining the Efficacy of Online Therapy by Ryan Baird Thompson, Portland State University, 2016
When we talk about online therapy it is therapy given over the internet via a piece of technology using a certain platform….for example we may use video linking using a choice of technology:- laptop, computer, tablet or mobile phone and the platform we choose to use may be Zoom, Microsoft Teams, Messenger, Facetime, Snapchat, Skype and Instagram…there are many!! Online therapy also includes telephone therapy.
The benefits of choosing online therapy are wide! Choosing to have therapy online means you have the flexibility to choose who, when and where!
If you are choosing a therapist who delivers online counselling, you have the geographical movement you would not be able to have with face to face counselling, meaning your therapist could be anywhere in the UK (I am going to make the assumption that we, my client and I are both in the UK. This is because each country has its own laws about practicing online and as I reside in the UK; I abide by the UK laws. Each therapist must be able to abide by the laws of their clients residing country)
Having this flexibility means you won’t have to deal with long waiting lists as you can find a therapist who can work with you pretty quickly, this also means you have a choice too….you can choose to work with a therapist who is specific to your needs i.e.: a bereavement counsellor or one that practices with a specific model i.e. CBT.
You may feel safer seeking out therapy online. Some of us feel vulnerable walking into therapy, the physical act of entering a building or even just going outside is enough to make your anxiety grow and for panic to set in. Choosing to have therapy online takes this away and gives you the control of knowing you feel safe in your own environment.
Being in your own environment has its benefits, you feel more relaxed, can choose where you have your therapy…. sat in your garden or sat in your bedroom for example. If you find it difficult even motivating yourself to get dressed, sitting in your pyjamas is ok too!
Another benefit to online therapy is that you may find it difficult to find a private practitioner or centre that can meet your physical needs, you may be a wheelchair user or have impaired vision or hearing. If you are in your own home and comfortable in your own home, your physical needs will more or likely already being met.
As you can see there is much positivity about using an online therapist but it can also present its own challenges (although I believe for each challenge we are presented with we have something to learn and in that respect does it not become a benefit?)
Some of the challenges related to online therapy are those surrounding the technology and the ability to be able to use it confidently. We are all familiar with phones and most of us are familiar with the internet, but this is where you will find the most challenging of the challengers…. reliability of your technology and the platform you choose to use!
Being aware of the difficulties that might occur can give us the advantage, we all know that the internet can drop out it is knowing what do when it does. Some of this I discuss here in “Methods of Communication and Environment” and will be explored further with you if you decide you would like to have online therapy and we draw up a contract together.
Methods of Communication and Environment
So, you like the idea of online therapy and you believe it can meet your needs, you have found the right therapist, so the next thing to consider is which form of communication is right for you and is your environment safe and comfortable?
Before you can start your counselling session you really need to be aware of the environment around you and how safe it is. As a counsellor I work confidentially and ethically to meet your needs professionally and I am responsible for my own environment that I work in, as a client you have to be aware of your own environment and take responsibility for it.
When you are due to attend your appointment check out where you will be participating in that appointment, do you feel safe in your space? Is it confidential, can anyone hear you, are they able to walk in on you? It might be an idea to invest in a set of headphones if you do not already have any if you intend to have your sessions via video link. Headphones are also a good option when using a mobile phone for sessions as they you free up your hands. The biggest advantage to using headphones is that they allow only you to hear what your therapist is saying to you.
Feeling happy and in control of your own environment will give you confidence and enable you to relax and build a trusting relationship with your therapist….and this can only be beneficial to the counselling work.
I offer the following forms of communication as an online therapist;
Most of us are familiar with using a telephone or mobile phone and most of us are comfortable using this form of communication and overall, it is a reliable form of communication. When using your phone bear in mind the following:- is the strength of your phone signal reliable, do you have a clear landline, are you up to date with your bill payments, are you going to “run out” of credit? These are important things to think about as you would not want your therapy session to end abruptly.
Knowing that your phone call won’t be interrupted by connection issues is not enough, you also need to switch off any disruptions that could disturb you, like the settings on your phone….the notification settings for incoming calls, texts and emails…these can all be distracting if left on.
If telephone therapy is your choice of communication, we will agree to an appointment time and day for me to call you. This will be further discussed when completing your contract.
If you wish to stay anonymous and for your conversation to be encrypted, then the platform method would be something to explore, for example Zoom offers you the choice to use a service that will encrypt your call and also allows you to stay anonymous
You may feel a chatroom gives you more anonymity and so you feel more comfortable and confident to “chat”. One of the advantages with chatrooms is that it gives you the choice of having a transcript of your session. This may help you after your session has ended as sometimes we can feel a little overwhelmed when we have shared emotive information. Sometimes we can misinterpret what was said. Having the transcript will give you the time to go back over what was discussed, it may offer you a different sense of what it was like in the moment or a different perspective.
Again, be mindful of how good your internet connection is and how much data you have if you are using a mobile phone.
If chatrooms are your preferred method of communication, I will send you a secure link which will send you to an encrypted chatroom at an agreed time and day. Further information of this will be discussed when putting our contract together.
If you find writing suites you better, you will probably find emailing a great way to communicate. By writing down what it is you are dealing with and how that is affecting you, you can clarify through the written word exactly what that is to your counsellor. Writing is often a cathartic experience giving you a space to put down difficult matter and then getting rid of it by hitting the send button!
For each of your emails (usually up to a thousand words) you will receive an email reply from your counsellor. A plus point for you if you choose this method is that you have a record if you wish to keep them, like the chatroom transcript a copy maybe useful to clarify and understand any correspondence that may have been missed.
Again, be mindful of mobile signal and internet connection. You may want to check how secure your email is too; I would not recommend using your works email. There is further discussion on security down the page.
If you decide to use email therapy, I will ask that you use an encrypted platform and recommend to you Proton Mail. Setting up an email address is quite simple, and you can follow the instructions on the drop-down menu above under Online Therapy or hit the How To Guide button below.
It is your choice when you send an email to me and I will endeavour to reply within 48 hours. Further information regarding timings etc will be laid out in our contract.
You may still want some face to face contact with your counsellor and video calling is ideal for this. Video calling can give you a sense of being in the room with your therapist which may be important for you to establish your therapeutic relationship.
Video calling is performed through a platform, examples of which I have discussed earlier.
One of the great benefits of video calling and using a platform like Zoom is that you can have the option to turn off your own video camera and just have the counsellor there on screen….this is often a relief for those who find seeing themselves difficult or a distraction.
You can also play around with the size of the screen too so both you and the counsellor can find a look that you feel comfortable with. The three methods, video, audio and chat can all be accessed or turned off so the range of choice of how you use them is wide giving you more flexibility in the way you communicate and receive your therapy.
Again, like the other methods of communication it is important to know you have a reliable internet connection.
If you decide that video calling is your preferred method of online therapy and wish to book a session with me, I will send you a secure link to join an encrypted meeting at your chosen time and day.
There will be further information regarding this laid out in the contract we agree to abide by.
Other things to consider when choosing online therapy
One of the things you can do to help the running of your session and to lessen the probability of a technical disruption is to make sure that your network is as clear as it can be before your session. If you have programmes open which take up a lot of data, it is advisable to shut these down. Examples of programmes that take up a lot of data are live streaming programmes, downloading programmes, watching videos, listening and downloading music, and gaming. Also be aware of any programmes you may be running if you are working from home. If you have a number of these running at the same time, they will certainly slow down your internet speed.
I would also change any timings on your auto update modes, these are likely to close and restart programmes you have open and running. I always allow my updates to run when I know I will not be online, usually late evening or overnight.
How confident are you that the equipment and platforms you choose are secure and safe from cyber-attacks?
I can only be responsible for my own technical equipment, as for the platforms I choose to use, they can only be as safe and as secure as to the terms and conditions of data protection information given to me by those producing these platforms.
My advice to you is that you keep up to date with your own security software and spend some time reading through the privacy policies, procedures and terms and conditions of the suppliers of the platforms you choose to use.
I would advise against using any free public Wi-Fi as this will not be secure!
As I use Zoom as a platform for video calling and chatroom, I currently know that they provide end to end encryption for one on one sessions (June 2020). If you decide that you would like video calling or to use the chatroom facility, I may ask you to download the Zoom app. (please check out the drop down menu under online therapy to access "how to" guides) or click here >
If you decide that emails are your preferred way of communicating, I use Proton Mail as my platform to send and receive client emails which are encrypted end to end by this platform. I would encourage you to have your own Proton Mail email address for the purpose of online email therapy so we both know that encryption takes place at both ends of our communication. (Please check out the drop down menu under online therapy to access "how to" guides) or click here >
You may want to think about your personal security too, who are you sharing your devices with, including any computers you are using? If so, you may want to delete your footprint by deleting your internet history and emptying the recycle bin.
Under the heading Online Therapy there is an additional dropdown menu with a heading “How To Guides”. Here you will find links on how to set up and manage different forms of technology and how to access and set up the platforms Zoom and Proton Mail. These are either direct links to the platform companies themselves or links to You Tube videos These will help you to be prepared when you move forward with online therapy.
Alternatively, click here >
If you are still not sure what method of therapy would best suit you or you feel you would like to try a method but are not confident, I offer a free taster session. This will help you gain some confidence before committing to a particular style….and as always, this is your therapy, your time….if you find it isn’t right for you, lets discuss it and see what we can do together to help you feel more comfortable and relaxed in your sessions.