You may have heard of counselling, but are less familiar with how this would be done online.
I work from a belief that using online methods of counselling can do a lot of good for people in different ways. The use of online counselling (online therapy) is growing and is already a well-established form of counselling. I will explain what the benefits are of using it, along with some important considerations that you might want to make. I will also mention privacy, confidentiality and trust, which are essential in any type of therapy, mentioning how counsellors take care of these important factors. Finally, I will tell you where you can find an online counsellor.
Are you looking for some support?
Perhaps you’ve thought that now is the time to get some counselling to deal with an issue. You’re aware that you've got a difficult situation going on in your life and you need some professional support. Or, maybe you may want to talk to someone about something that you’ve always struggled with and feel now is the right time to get it sorted.
Normally, most people would find a counsellor or psychotherapist to see each week in person, face to face. Coronavirus though has had a huge impact on the way we socially interact, which means we are limited in the face to face contact we have with one another.
The counselling landscape is changing
This has had a transformational effect on all businesses, including counselling and psychotherapy. More and more often, therapists are having to adapt in many ways. Crucially, they are moving their practice online because of the need to socially distance themselves and protect their clients, whilst continuing to support people with their mental health.
Alongside this, coronavirus has prompted the general public to change their behaviour in relation to the type of counselling they seek, beginning to see online counselling as more acceptable. An internet search volume tool from Google called Google Trends shows that more and more people in the UK since late May 2019 have been searching the terms ‘online counselling’ & 'online therapy'. The data in this graph shows how these terms have had increased popularity in the UK over the past year and suggest an increase in interest for these types of services.
In April 2020, the amount of people searching 'online counselling' and 'online therapy' was about 75% higher than a year ago.
What is online counselling?
Counselling has traditionally been done face to face, with the client and counsellor being in the same room. However, with the ever-increasing sophistication and reliability of technology over the past few years, more and more counselling is being done online using the internet. Some people have said that this loses the human element of counselling, though I would disagree. Having given counselling to people online, I have felt moved and touched by what my clients have said, just as I would have been if we had been sat in the same room together.
How is online counselling done?
Some online counselling involves working live, in the moment, either by video conferencing face to face or using instant chat messaging. Other online therapy can be done by email at the individuals own pace. This creates an increasing amount of choices for people in the way they can receive counselling. Counsellors therefore need to adapt their practice to meet the requirements of their clients. The counselling directory website provides a useful description of each of the different types of online counselling.
What are the benefits of online counselling?
Location
A lot of the benefits of online counselling relate to location. Being in your own space, away from others, is a real benefit for many people. It means you can be more in control of the amount of people who know you are having counselling, as there can be some social stigma about having therapy. Counselling at home means no one will know what you are doing, which is important if you have social anxiety. People can feel stressed about being seen going into a place that offers therapy.
Some people live with the fear of being discriminated against in public because of their identity. Online therapy means they can talk and work through strategies that will help them, in the safety and security of their own space. Some people may find travel difficult, or have a disability, they may be incapacitated or have issues related to being outdoors and also some are parents with small children. For all these people, online counselling can be more convenient, necessary and create more safety for them.
Some other benefits of counselling in your own location, relate to people who live in remote places. They become more able to access counselling, which they may not have otherwise been able to access. As you are in your own space, maybe at home, you won't have to pay any travel costs. Finally, if someone needs to travel for work or for other reasons, then as long as they can get online and talk in privacy, they can still have their counselling session, so online work offers greater flexibility.
A study in Australia, in 2006 by King et al, showed that adolescents reported more privacy and safety working online in their own space, along with being less emotionally exposed. This scientific study shows that there is evidence to prove that many people believe there are significant benefits to having counselling in your own choice of place.
Flexibility
Face to face counselling involves going to a certain place each week, at the same time, to see a trained professional and speak to them in person. Working online, you will still have a weekly session, helping to underpin structure and stability in the week, but you will be able to do this from the comfort of a space that you choose. As both counsellor and client don’t have to travel anywhere specific for the session, there may be flexibility also in terms of the timing of the session.
Working offline, by email or a messenger service, offers people a way of having counselling outside the constraints of structure and time. They have more space to consider what they are thinking and feeling and then generate a response. In addition, they also have more time to consider what the counsellor has written to them.
Having something written is longer lasting, the person reading it can read it again and again and consider the words at a deeper level. This is useful because often a lot of the nuances of what is said in a conversation can be lost, as conversations move on quickly. The written word overcomes these losses, (though it's important to remember what is lost using the written word, which I will mention below).
It’s possible to use a ‘nickname’ using the written word, which can help people to get counselling whilst holding on to some anonymity. This gives a degree of flexibility with the identity you using.
Counselling online can be very different to in-person counselling. So what else is there to consider?
Technical problems can be one of the issues when working online. The internet can be intermittent at times, there may be too many people using the web and this can make the connection poor and unreliable. Having a good connection is therefore essential for video conferencing in online therapy. Both the counsellor and client, can feel some anxiety about losing one another or being cut off if the internet connection is bad.
However, how you and the counsellor deal with issues relating to connection are important. Problems that may arise can help you deal with endings, learn how to facilitate problem solving or adapt to communicate in a different way. The internet most of the time works just fine, but we all have had issues with computers or connectivity and where necessary we have had to find a solution. Applying these practices in online counselling is just the same.
Online counselling is not suitable for some people with certain problems or conditions (such as suicidal intent or psychosis and schizophrenia). This is because it can be difficult for therapists to intervene in times of a crisis, though it's not impossible.
Important information can by missed out when people use the written word or because the video only shows a certain part of the body. For example, body language is an important social cue that we all use each day. Part of the work in counselling is that clients become aware of the positive effect they are having on their counsellor. They notice the effects in their counsellor's body language, whether they laugh, smile and show concern. This awareness helps to develop an internal representation of themselves in relation to another person. This can help strengthen positively the way they sees themselves. Counsellors too use body language as a way of assessing their clients and themselves. They do this in order to help build up an understanding of how to work on the issue that the client has brought to counselling.
Written words don’t capture the tone of voice, the phrasing, rise and pitch, the texture of how the words are spoken, the volume, the pauses and the speed of what is being said. There can be some ambiguity in what is written, with words being used that have multiple meanings. What one person writes as humorous, can be interpreted by another person as something that causes distress. Clarifying straight away what was meant, may not be possible with the written word, which leaves someone feeling unnecessarily uncomfortable.
Having somewhere quiet to talk, where you won’t be disturbed and where you can talk privately is essential. For some people this is not possible. In addition, for some people who want to talk about the people they live with, such as in domestic violence cases, this is not advisable.
Does online counselling work?
The following examples of research show that online counselling does work. Though more studies need to be done to build up a wider picture of the effects of therapy online. Links to the studies can be found in the reference below.
In 2014 Journal of Affective Disorders published an article about a study which was designed to test the effectiveness of the treatment outcomes of online therapy. The results of the study found that online therapy was equally beneficial when compared to face-to-face therapy for depression.
In 2018 Journal of Psychological Disorders published an article about a study that explored whether computer therapy for anxiety and depression was effective, acceptable and practical health care. The study reported that internet delivered CBT was 'effective, acceptable and practical health care'.
In 2012 a study by Kate Dunn found that asynchronous (email) messaging allowed people to a get a sense of empowerment and relational depth from their therapy, which may not have been possible had they avoided seeking help, because the only therapy on offer was talking therapy.
Can you trust the person you are having therapy with?
Providing support to the mental health of their clients is a passionate undertaking for counsellors and psychotherapists. They focus not only on the issues that the client wants to talk about, but also on the relationship between the two of them. This is because they know that one of the key factors about how successful therapy will be, is down to how the relationship is working between themselves and their client.
In order to help build and strengthen that relationship, therapists take great care to work ethically, to help develop trust and safety within the relationship. They are also required to do this because of the insurance they have and because of the guidelines from the organisations that they are associated with.
In addition, I've read comments online that suggest without meeting the counsellor, it's difficult to know if you can trust them. This perhaps is more relatable to counselling that involves the written word, because you never communicate verbally or face to face with the person doing the counselling. Counsellors therefore take great care to ensure that how they work, using whatever method has been chosen, is explicit and safe, so that their clients can trust in the process of the work that is to be done and in the counsellor.
It's a fundamental imperative that therapists do not cause any harm to their clients.
Is online counselling safe?
Confidentiality is absolutely crucial in talking therapy and so it is essential that counsellors and psychotherapists take great care to work within the legal guidelines of where they live. This is why people working in this field take great care to ensure that their client's privacy is protected. In the UK, legal guidelines about personal data were recently updated with a policy called ‘GDPR’ (General Data Protection Regulation). Counsellors within the UK need to comply with what is contained within this policy because there are legal consequences for not doing so.
Counsellors working online will undertake a thorough plan for working online, such as;
checking you have somewhere quiet that is private to undertake counselling
asking you to make sure you won't be disturbed
arranging video conferencing with you, explaining how to set this up
making contingency plans in case of technical issues with the internet
letting you know how information from you is collected, stored and for how long it will be kept, along with how it will be destroyed. They will ask for your consent to do this.
Interested? Then here's what to do next
Think about the different options of receiving therapy online. There are;
video conferencing (Zoom, Skype, Facetime, WhatsApp video and more)
live written chats, using Skype or WhatsApp text service or others (synchronous)
email & SMS (asynchronous)
Different methods of therapies have different benefits, along with different limitations. Each person needs to think about what is important for them, working out which method of counselling would be the right fit.
Some people may prefer the anonymity of emails or messaging, thus allowing them to trust in the process of counselling more, allowing them to open up their feelings. Others may not like not knowing who they are talking to and find they can only open up, when they can see and then trust who they are talking to. We are all different, so working online would work for some people and not for others.
You can find an independent local counsellor who has been trained to use online counselling or you could choose to go with a larger organisation.
But do your homework and shop around for a service and price plan that will work for you and your needs. A good place to start could be the Counselling Directory website.
Finally
So, in answer to 'is online counselling any good?' YES! There are many benefits to getting therapy online which at first may not be fully appreciated. Of course, it is essential to find a counsellor that you feel comfortable and safe to work with and with who you can share the many parts of your life. It is also important though, to consider the type of counselling you want to get. Going online for counselling can provide a lot of benefits to your lifestyle and to your psychological needs. Sometimes the most difficult decision is just starting the journey to understanding yourself better. I believe, for a lot of people, the use of digital tools will make counselling an easier journey to take on the road to self-discovery.
References
Andrews. G., Basub, A., Cuijpersc. P., Craskee. G., McEvoy. P., English. C.L., Newby, J.M.(2018) Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of Affective Disorders. Volume 55,April 2018, Pages 70-78
Dunn, K. (2012) A qualitative investigation into the online counselling relationship: To meet or not to meet, that is the question. Counselling and Psychotherapy Research, December 2012, 12(4):1-11
Google Trends
King. R., Bambling, M., Gomurra, R., Lloyd, C., Reid, W., Smith, S. and Wenger, K. (2006) Online counselling: The motives and experiences of young people who choose the Internet instead of face to face or telephone counselling. Counselling and Psychotherapy Research, September 2006; 6(3): 103108
Wagner. B., Horn, A.B., Maercker. A., (2014) Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders. Volumes 152–154, January 2014, Pages 113-121