Online therapy is immensely valuable and has a huge role to play in improving mental health and supporting personal growth. However  online support is very different from face to face counselling or psychotherapy. The differences need to be understood by both therapist and client for maximum benefit to be obtained from online therapy.

In it's commonest form, using something like Skype, online work is resembles face to face personal coaching rather than "therapy". In other forms such as via email or peer support forums the online world is so different to the face to face one it is difficult to relate it to a face to face environment. 

Subconscious body language is a significant part of how we communicate.  When working face to face, the experienced therapist is aware of, and using a wide range of verbal and non-verbal "channels". Most of these non-verbal channels are not present in online therapy.    

Coaching and psycho-education use the verbal channels almost exclusively, which suits the online environment. Because of it's use in coaching and education TA has the versatility to make the switch to the online world better than many other types of therapy

I have been providing online mental health support for nearly a decade and did my Masters thesis on the psychology of how people changed their support seeking behaviour in a mixed face to face and online environment.

My view is that working online is best in two scenarios

  1. Where the  goal is well defined and the client is looking for new ways to approach a specific issue in their life. This is very similar to face to face coaching and resembles the "psycho-education" phase of some types of face to face counselling. 
  2. Where appropriate face to face therapy is unavailable. In this situation the online process aims to help the client access previously unknown resources and/or act as a stand-in until face to face therapy can be started. It is important the client understands that online therapy is not equivalent to face to face work, and is being used because appropriate therapy of good quality is currently inaccessible. I have found the combination of one to one online counselling and online peer support forums produces excellent results in this situation. 

In the second group I've found online support is useful for the following clients.

  1. Clients living in a rural area where therapeutic support is limited or non-existent
  2. People living in an area where there are no English speaking therapists
  3. Where travelling to see a therapist is not possible. 
  4. Where appropriate specialist support is not available locally.
  5. Where local therapeutic support is offered by organisations or individuals with whom you may have a prior connection. In the psychotherapy and counselling profession this is called a  "dual relationship" and causes ethical, confidentiality and boundary issues.
  6. Where there is a sensitive issue that you do not wish to discuss with anyone in your area or community. 
  7. People who have completed the allocated therapy available from local sources and wish to build on the foundation it has given.

Online video orientated work requires a reasonable internet connection. As the connection quality decreases, the more difficult it becomes to do effective work. There comes a point when switching to a landline phone is required.

It is also important to have a quiet space where you can talk confidentially and not be interrupted. 

In face to face therapy, the therapy room is a "different" space, where interruptions are rare and confidentiality is paramount. The room is often furnished on a soothing way and the chairs encourage a relaxed posture. There are often additional tools designed to facilitate psychological exploration in the room. All these add to the potency of the therapy in ways that may not be present in the online space.  

If you'd like to talk about whether online therapy would be suitable for you please contact me