Many of our services are now delivered online, whether it’s banking, shopping or a Doctor’s appointments, we are increasingly embracing the flexibility of being able to access services in the comfort of our own homes. It should come as no surprise that counselling services too are increasingly finding themselves being used online. Online counselling might not be for everyone but it can offer some people advantages over more traditional face to face counselling.
Often, when we have a problem, we will turn to online search engines to find support, to find that helpful information that may clarify what we are feeling, thinking or experiencing. This can be hugely helpful, especially for those who find it difficult to communicate face to face or that don’t have the freedom in their day to seek support.
It’s not, however, a substitute for interactive professional counselling. Luckily, many counsellors have been training to bridge the gap and offer online services. Online counselling goes one step further, through the mediums of Instant Messaging (IM), Video conferencing, Email or Phone; counsellors are able to offer psychological advice and support.
How does it work?
Your online counsellor should initially spend some time getting to know what you would like help with. They may ask you lots of questions about yourself and your situation. This assessment process is important because online counselling isn’t considered safe for everyone. If a person is experiencing significant levels of distress, or are experiencing suicidal thoughts, then online counselling would not be a suitable medium and the counsellor will often help people to find other more helpful sources of support. Part of the assessment process will discuss what type of online counselling you feel you would like to work with and ensuring that it’s the best possible fit for you.
Regardless of the counselling medium you decide to use, it is important that you take the time to “be in” the moment with the communication. Often during our busy lives, we squeeze emails, phone calls and IM into spare moments that we have. Online counselling should not be something you multi-task on.
If you were meeting with a counsellor face to face, they would ensure you would be in a safe private space where you won’t be interrupted or overheard. With online counselling, it is up to you to create a safe space, and ensure that you use the appropriate software and log out, so that should your computer be opened by another, your secrets won’t be revealed. It’s important to ensure you have both space and time, perhaps with a warm drink, somewhere comfortable where you won’t be disturbed.
As with face to face counselling, be aware that sometimes therapy can be emotionally draining. You may need some time for contemplation or rest afterwards, so plan accordingly.
Counselling via Instant message – In order that your messages are confidential, your counsellor should introduce you to a software platform such as VSee which offers end to end encryption. This ensures that your messages remain safe. You would then book a session together, deciding mutually on a day/time and length of session when you are both able to meet.
Counselling via Email – Email counselling can be very helpful for people that live busy lives or have limited online connectivity. An arrangement is made with your counsellor about which day you will email them. Once your email is received most counsellors will respond within 48 hours. This gives you a lot of flexibility in how you access your therapy so that you fit it around your other commitments. Your counsellors should ensure that you only use email applications that offers end to end encryption such as Proton mail; this is to protect your privacy.
Counselling via Phone – When entering into phone counselling there are two different mediums that can be used. The first is the conventional phone call via a landline or mobile phone. At an agreed day and time your counsellor would contact you on the number you have provided. Alternatively, online voice apps that run through your phone or computer, such as Zoom can be used. It’s critical that these applications support end-to-end encryption.
Counselling via Video – Video counselling offers the chance to see and hear your counsellor in real-time. Your counsellor should direct you to software that is free and safe to use, such as Zoom or Vsee. You would then agree a day/time and length of your session as usual.
Online Counselling offers accessibility to those that might otherwise be unable to engage with counselling. For some, there may not be a counsellor nearby. It might be that everyone nearby is too well known and having counselling with a new person might protect confidentiality.
People that are unable to leave their homes or have a disability may benefit from online counselling. Parents or carers that don’t have any support can access counselling at a time that suits them.
Online Counselling can sometimes work out cheaper by minimising the amount of time you may need to take off work in order to access a service. Rather than paying for carers or childminders and taking into account travel time and cost, it can be more convenient to access online counselling.
Online counselling can happen in the comfort of your own home; there is no need to travel to a new environment or meet new people face to face. There is less chance of meeting someone you know on the way or of feeling self-conscious as you walk through the business door.
Attending face to face counselling can be extremely stressful for some people, and this may be enough to prevent them from seeking the help they would like. Counselling online, especially in the written format can provide a degree of anonymity that can remove the pressure of having another person immediately present.
It can help to have space in which you are free to write whatever concerns you. It also gives you the option to reflect on what has been communicated without worrying about the counsellor’s facial expression. Sometimes people can feel judged for being themselves. Written or audio counselling removes the potential to feel this way and can enable people to open up and be more honest about what is happening for them.
One difficulty with online counselling can be the absence of nonverbal cues. 80% of our communication comes from facial micro-expressions, body language, tones of voices and nuances. In online counselling, these things are absent. This can often lead to misunderstandings. It’s important if you are unsure at any time about what was meant that you are able to ask for clarification. Trained online counsellors expect and are ready to support clients through this difficult area.
Lack of physical presence
At times when we are experiencing emotional distress, part of what helps to heal is the physical presence of another who is listening and understands what is happening.
For some, leaving the house once a week for counselling helps to create a structure to their week. If they were to access counselling online, then it may reduce their opportunity to socialise and be generally get out and experiencing the world.
It’s early days, and very few studies have compared outcomes for face to face counselling versus online counselling. What we do know is that in counselling, it’s the quality of the relationship that makes a difference. So if you don’t feel understood or known by your online counsellor, take time to consider whether you would benefit from face to face counselling or just someone different to work with. Not every client gets on with every counsellor, and it’s okay to change until you find someone you feel comfortable with.
The absence of a physical person can sometimes make a diagnosis in terms of severity and risk quite difficult. Online counselling is only suitable for people that are experiencing mild to moderate difficulties. Online crisis interventions, such as the Samaritans, work in a different way to counselling and are specifically trained to work with someone that is in crisis using whatever medium is available.
Sometimes there are technical glitches. The computer, network, or electricity might just go awry and prevent a session from going ahead or may interrupt a session. Online counsellors expect that these things happen and usually have a plan B that you are informed about before beginning sessions. It might be that they will call you on a landline, or if it’s not fixable and dependant on the type of issue, they may just reschedule with you.
Downloading and using software that promotes encryption and confidentiality can be difficult if you aren’t confident with the use of computers. Counsellors will generally help you with this, but if it is something that really worries you, it may be an indication of needing a different type of counselling.
It can be harder to ensure that your counsellor is exactly who they say they are when working online. Counselling isn’t a protected title and so anyone can pretend to be one. It’s also important that you find someone that has specifically trained to work in an online way, as there are differences in practice than face to face counselling.
To ensure that your counsellor is qualified, you should check they are a registered member of the BACP or NCS, and look for membership of ACTO (Association for Counselling and Therapy Online). These organisations require their members to work within ethical frameworks that are put in place to ensure the safety and welfare of clients.
The flexibility that online counselling can offer can be a real benefit for many with hectic lives or that face challenges with conventional face to face counselling. It does, however, have its limitations and it’s not for everyone. You should carefully consider your own personal needs when deciding whether to take your counselling online or not. As always the important thing is to find a counsellor and a communication medium you are comfortable with.
Image courtesy of: Hannah Wei