Online Therapy

What is online therapy?

Online therapy is counselling and psychotherapy that is provided to you through the use of computer or other digital device (smart phone / tablet / smart TV). It can be text based – via email, or online chat; Voice only – via phone or call applications, or it can be video and voice – via tele-conferencing or bespoke healthcare applications. Online counselling may be able to help with a wide range of issues including :

  • Anxiety
  • Stress
  • Loneliness
  • Relationship difficulties
  • Bereavement, grief and loss
  • Depression
  • Self-Esteem

If the difficult you are facing is not on this list or it doesn’t quite fit, please contact me.

What online therapy I offer

I offer online video therapy, which given some of the differences noted above, is the closest thing to working face-to-face. I use a range of different platforms, all of which have session security inbuilt as part of their ethos. All these platforms are ISO27001¹ and/or HIPAA compliant²:

  • Zoom
  • Doxy.Me
  • VSee

I do not use Skype, WhatsApp, Face-time or similar platforms as they do not offer sufficient session security, or require the sharing of too much personal / device information and thus cannot ensure client confidentiality.

Are there any differences between online therapy and Face to Face Therapy?

One of the great advantages to Online Therapy is the convenience it offers of having therapy in your own home, no matter where you live, or my practice is based.  If you would struggle to make a face-to-face session because of other time commitments such as work, difficulties travelling to see me, or are a person with disabilities, then Online Therapy might be a way for you to access the support and help you need.

Online therapy is broadly similar to face-to-face therapy and research has shown it to be as effective. There, however, are a few differences that should be considered when choosing between online and traditional in-person therapy:

¹ The ISO 27001 family of standards explain how to implement best-practice information security practices

² HIPAA is a US federal law that governs the protection of sensitive patient health information

Suitability

Whist effective and similar, online therapy may not be suitable for all people or all situations.  We will both need to consider whether it is the right choice for you, or if another form of therapy would be better. We can start to do this during an initial consultation call and continue during our first session.

If I am unable to help you, I will offer information or alternative sources of support.

Confidentiality

In face-to-face counselling, client safety and confidentiality are ensured by the room in which we meet.  When working online, we are both in our own respective locations (e.g homes) and we need to consider who can see us, overhear us, or potentially disturb us during our session.  The security of the medium chosen to communicate over needs to be considered too, some may be open or have limited security potentially allowing our communications to be listened into.  The use of a medium with inbuilt encryption helps to limit this. We may also need to consider the device that is being use – is it your personal device, your companies’, or a shared family device?  Companies may install monitoring software on their devices and so I would not recommend using them for online therapy.  With shared devices, it is possible that other users might install software that monitors online activity – parental control software or malicious applications are examples here.

Notifications and interruptions

Depending on the device being used, you may find that the session is interrupted by other applications, emails, or indeed incoming phone calls.  These can all affect the flow of a session and have a way of happening at the most inconvenient time.  So far as possible it is recommended not to use your smart phone for our sessions as calls cannot be blocked without the use of additional apps.  When using other devices please close down all other apps to minimise the likelihood of being interrupted.

Things may get missed

As we will not be together in the same room, certain things may be missed – a look, a gesture or perhaps tone of voice. Video conferencing typically captures the shoulders and head, so we will both be unaware of what is happening for the other lower down in the body. Depending on the device(s) being used, it may be harder to hear each other and it can be easier to misunderstand what has been said, or the context (how it was meant) behind it.

Online Disinhibition

A curious effect of working online is something called Online Disinhibition. When we are physically near to someone, what we choose to say to that person is often influenced by being in their physical presence. When working online, that influence is missing. In its place, there can be a sense of anonymity and of the relationship being ‘game like’ or imaginary – consider how we use video screens to entertain ourselves with fictional movies and box-sets. This can lead to feeling less vulnerable, that what we say or do doesn’t matter, that anything can be said. You may find yourself saying more about yourself than you are used to, and doing so quite early on in our therapeutic relationship. You may also find it easier to express feelings such as anger and become upset than you would do when meet someone in-person.

Session endings

When working online, the ending of sessions can feel a little abrupt – One moment you are in the session with me, and the next you are not. The minute or so of gathering belongings and walking to the door that occurs in face-to-face therapy softens the ending, offering a progression towards the session end. Likewise, the journey home can give time to reflect, and re-orientate oneself towards everyday life. Both these aspects are missing when working online, and daily living can come back in very quickly.

If possible, I suggest taking 10 – 15 minutes at the end of the session to give yourself space before re-engaging with what lies outside the room.



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