Is Online Therapy for Me?

Are you wondering whether you'd benefit from seeing a therapist online? Do you doubt that online therapy can be as effective? Are you weighing the pros and cons of starting online therapy sessions?

Let's have a look at research and answer all your questions!

Online therapy, also known as teletherapy or e-therapy, is a therapeutic service provided through the internet. This could take the form of phone or video sessions via platforms such as Skype, Zoom, Teams or GoogleMeet, for example. Some therapists and services may also offer text or email therapy. More and more people are wanting to access counselling online for the following reasons...

Pros

It's convenient!

• No time or stress wasted in public transport.

• Effortlessly answer the phone or open your laptop.

• Being able to be in a comfortable and familiar environment like your own living room or bedroom.
  

It's effective!

• Therapy has been clinically proven to be as efficient via videoconferencing than in-person (1).

• Online counselling has been shown to be appropriate for clients with mild to moderate mental health issues (2).

• Clients with acute crises with no possibility for immediate in-person care have found counselling to be a viable tool (3).
  

It's accessible!

• Can access therapy at any time and from anywhere (4).

• Easy to access for people with physical disabilities (5).

• Practical for people living in a remote or rural area (6).

• A good accessible option for people suffering from agoraphobia, anxiety, or other mental health issues that restrict physical encounters (7).
  

It's affordable!

• No need to pay for childcare or adult/elder care in order to attend your sessions (8).

• No need to pay for fuel or public transport.

• Online sessions are sometimes cheaper than face-to-face sessions as they are cheaper to run for therapists e.g. no therapy room to rent.
  

It's flexible!

• Can fit more easily into a busy schedule (9).

• Changing an appointment time is usually simpler.
  

It's approachable!

• Some people feel more comfortable talking to someone online because the phone or laptop helps them to feel less vulnerable or awkward.

• Stigma associated with seeking mental health services or concerns about being stereotyped are reduced or eliminated.

• May facilitate more frequent contact between client and therapist.
  

It's anonymous and private!

• Clients are not seen entering the therapist's office (10).

• Perceived or actual anonymity can lead to what's called a 'reduced inhibition' which means greater openness in discussing emotional, vulnerable or taboo topics (11).

It's empowering!

• It is much easier to move to another therapist (12).

• The client has more control over their therapy. This helps balance the power between therapist and client, making the interactions more collaborative (13).

More choices!

• It is likely that there are more online therapists compared to local in-person therapists (14).

• Finding therapists who specialise in a specific mental health issue is made easier.

• Sometimes it's hard to find a local mental health professional who is taking new clients. More choices online means higher chances to find a therapist with availability!

While many people nowadays are choosing to have their therapy online, some wonder whether it would be the right choice for them, for the following reasons...

Cons

Technology issues!

• Fickle Wi-Fi connection / phone signal.

• Possible laptop/phone technical issues.

• Technical issues can lead to frustration or anger which can, in turn, disturb the therapy process or sessions.

• Some people feel uncomfortable or fear using technology (15).
  

Overlooks non-verbal cues!

• If you are having your sessions over the phone, your therapist cannot see your facial expressions or body language. These signals can often be quite telling and give the therapist a clearer picture of your feelings, thoughts, moods, and behaviours (10).

• Video chats can lack the intimacy and intricacy that real-world interactions offer.

• Some people may feel more comfortable undergoing therapy in a digital setting, especially younger people who are more intimately familiar with such methods of communication, but others may get more out of therapy that utilises more direct human contact.
  

Not a crisis service!

•  If your therapeutic relationship with your therapist is created online, it can sometimes feel tempting to phone or email them when you are needing urgent help. Most therapists and counsellors will not operate as a crisis service. You will need to contact other services to receive immediate help.

• If you are in distress, crisis, need urgent help or are at immediate risk of harm to yourself or someone else, contact your GP or emergency services on 999 immediately (if you live in the UK).

• If you are thinking about suicide or self-harm, and live in the UK, please contact the Samaritans on 116 123, NHS 111, Breathing Space on 0800 83 85 97 or Childline on 0800 1111.

• If you live in a different part of world, please contact your local emergency services and/or relevant helplines.

Tiredness and distractions!

• Some people may find it more tiring to be staring at a screen for an hour, compared to talking to a therapist face-to-face.

• It might be easier for the client to be distracted by parcel deliveries, phone or notifications.

Not appropriate for all therapeutic approaches!

• EMDR, for example, is best carried out face-to-face.

• In the case of severe mental disorders or for people who pose a threat to themselves or others, online counselling may not be suitable (16).
  

Therapists' qualifications?

• Accessing online therapy means that you could find somebody based anywhere in the world and there may be some differences in levels of qualification and training. It's crucial to make sure that your therapist is adequately experienced.

• When looking for a therapist in the UK, for example, have a look at whether they are members of any professional body. The most common ones are BACP, COSCA, UKCP and BPS. If they are, you can be reassured that they are abiding to ethical guidelines and that their training and qualifications have been vetted. This also means that if you have a bad experience with your therapist, you can contact their professional membership and make a formal complaint against them.
  

Not covered by your insurance?

Your health insurance company might not cover online counselling. It is best to check with your individual provider for guidance.

To sum up, online therapy can be an effective and convenient way to access therapeutic help but it doesn't mean it is right for everyone. Whether or not online therapy may be appropriate for you depends on your own preferences, technology proficiency or type of psychotherapeutic approach you are looking for.

If you are interested in trying online therapy, research your options and don't be afraid to ask questions! Finding the right online therapist can take some time, but it's well worth the effort.

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I am open to new clients!

I currently work exclusively online. Get in touch to book a free phone consultation or an initial session.

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References

[1] Fernandez, E., Woldgabreal, Y., Day, A. et al., (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clin Psychol Psychother, 1–15.

[2] Gun, S. Y., Titov, N. and Andrews, G., (2011). Acceptability of internet treatment of anxiety and depression. Australas Psychiatry, 19(3), 259-264.

[3] Haas, L. J. and Malouf, J. L., (2002). Keeping up the good work: A practitioner's guide to mental health ethics. Sarasota, US: Professional Resource Press/Professional Resource Exchange.

[4] Chester, A. and Glass, C. A., (2006). Online counselling: A descriptive analysis of therapy services on the Internet. Br J Guid Couns, 34(2), 145-60.

[5] Godine, N. and Barnett, J. E. (2013). The use of telepsychology in clinical practice: Benefits, effectiveness, and issues to consider. Int J Cyber Behav Psychol Learn, 3(4), 70-83.

[6] Zur, O., (2007). Telehealth and the technology for delivering care. In: Zur, O., ed., Boundaries in psychotherapy: Ethical and clinical explorations. Washington, US: American Psychological Association. pp. 133-46.

[7] Fitzgerald, T. D., Hunter, P. V., Hadjistavropoulos, T. and Koocher, G. P. (2010). Ethical and legal considerations for Internet-based psychotherapy. Cogn Behav Ther, 39(3), 173-187.

[8] Barnett, J. E. and Scheetz, K., (2006). Online counselling: A descriptive analysis of therapy services on the Internet. Br J Guid Couns, 34(2), 145-160.

[9] Drumb, K. B. and Littleton, H. L., (2014). Therapeutic boundaries in telepsychology: Unique issues and best practice recommendations. Prof Psychol: Res Pract, 45(5), 309-315.

[10] Bauman, S. and Rivers, I., (2015). Mental health in the digital age. New York, NY: Palgrave Macmillan.

[11] Fraser, L., (2009). Etherapy: Ethical and clinical considerations for Version 7 of the World Professional Association for Transgender Health's Standards of Care. Int J Transgenderism, 11(4), 247-263.

[12] Finfgeld, D. L., (1999). Psychotherapy in cyberspace. J Am Psychiatr Nurses Assoc, 5(4),105–10.

[13] Alleman, J. R., (2002). Online counseling: The Internet and mental health treatment. Psychother: Theory Res Pract Training, 39(2), 199–209.

[14] Chakrabarti, S., (2015). Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World J Psychiatry, 5(3), 286-304.

[15] Regueiro, V., McMartin, J., Schaefer, C. and Woody, J. M., (2016). Efficacy, efficiency, and ethics in the provision of telepsychology services: Emerging applications for international workers. J Psychol Theol, 44(4), 290-302.

[16] Brenes, G. A., Ingram, C. W. and Danhauer, S. C., (2011). Benefits and challenges of conducting psychotherapy by telephone. Prof Psychol: Res Pract, 42(6), 543-549.