Online Therapy – how to make the most of it
by Veronika | Apr 3, 2020
Whether you are thinking of switching from in-person sessions or thinking of starting out for the first time, there are a few things to consider that will help you make the most out of your Online Therapy experience.
As a newcomer to therapy you might be unsure about
- how secure and easy to use is online technology?
- how difficult it might be to form a real, close bond with a therapist online?
- how effective treatment and outcome might be?
Choosing a therapist who has experience with working online can be helpful as they will already have carefully considered data security and thought about what systems to use. Thus, they will be able to talk through any questions and concerns you may have. As they will be familiar with the pros and cons of meeting online, they can provide clear guidance for how to use video technology that should only require only minimal effort on your part.
However, perhaps you find yourself having to shift because your therapist has moved their practice to telephone or video consultations due to current COVID-19 circumstances. This transition can be jarring especially if your therapist is new to this kind of working. Read on for some tips how to navigate this transition.
Does online therapy work?
There is ample evidence and client reports that dispel myths about Online Therapy. In fact, a growing body of evidence shows outcomes in online therapy are similar to treatment in person. Various case studies have suggested that videoconferencing counselling can be an effective means of treatment delivery (Simpson, 2009).
A review of 23 quantitative and qualitative studies (Simpson & Reid, 2014) suggests that clients can form and feel just as strong a therapeutic bond via video or phone call as in person. Of course, sometimes a relationship doesn’t gel but this can happen independently of screen or room.
Some clients who have shifted from meeting in person say that working online seems to have brought them closer with their therapist and deepened the therapeutic relationship. Others who struggle with opening up have reported that being behind a screen, makes it easier for them to be open and talk about things that seem too difficult to tell when sitting together in a room.
6 tips to make the most out of Online therapy
1. Creating your therapy space and time
Online therapy can take place at any time and any place but don’t let this fool you! Therapy involves an emotional process and usually this would be protected in your therapist’s consulting room.
When you are meeting online it is just as important to make sure you have a safe space that is private and confidential. Whatever your environment, you want to set aside a dedicated time and find a quiet place without any distractions where you can think and feel, and your conversation won’t be overheard.
2. Giving yourself time to settle in or adjust
If this is your first time in therapy, you might want to give yourself some time to discover what works best for you on a practical level, such as space and time, as well as getting to know your therapist. It is a new relationship after all.
When shifting to online work from having previously met with your therapist at their office, it is important to acknowledge and grieve the loss of your in-person meetings which can entail a range of feelings from frustration and sadness to fear. Communicate your experience to your therapist.
3. Working out what is your best medium
Discuss with your therapist what technology you will be using together and let them know about any difficulties you may worry about. Agree a fallback if you are having trouble connecting. If you are using video, make sure you put your camera on a stable surface then sit back a bit so that your therapist can see your head and upper body.
Usually at the beginning of your therapy you agree a regular meeting space and time. Whilst the same framework will apply in principle, it might be useful to discuss some extra provisions for online work. For example, if you expect that on occasion you might find yourself unable to have privacy in your space, you could arrange a phone call instead of video allowing for some flexibility.
4. Taking advantage of the online space
When you meet at your therapist’s consulting room you enter their environment, which most commonly will not change much. However, using video calls means you are bringing your therapist into your space. Maybe you find your cat taking a curious stroll in front of the webcam, or you could show your therapist some meaningful belongings that you would otherwise not bring along to their office.
5. Naming your experience
Research suggests about 80 % of our communication is non-verbal (Carroll, 2005). When we sit together in a room, we note our mutual bodily cues and subtle facial expressions as well as have a felt sense of each other. Your therapist may sometimes comment on these observations.
In online therapy it can be more difficult for this stream of communication to be noticeable for your therapist, sometimes due to interruptions in the technical connection or background noises.
You can use this as an opportunity to practice self-awareness and your skills in naming experiences and expanding your “emotional dictionary”. For example, when your therapist says something that resonates you could say “When you just said this, I found myself feeling… “
6. Dialogue and feedback with your therapist
Don’t be afraid to share with your therapist what works for you and what doesn’t whether this is the platform that you use or their way of communicating or anything else. Especially if both of you are new to working online there can be some hurdles to overcome initially.
Addressing them straight away can foster your therapeutic relationship as you work through these hiccups together. Don’t forget your honest feedback is also a valuable source of growth for your therapist!
Abel, E. A., Glover, J., Brandt, C. A., & Godleski, L. (2017). Recommendations for the reporting of telemental health (TMH) literature based on a systematic review of clinical video teleconferencing (CVT) and depression. Journal of Technology in Behavioral Science, 1-13.
Backhaus, A. Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D., . . . Thorp, S. R. (2012). Videoconferencing Psychotherapy: a systematic review. Telehealth, Telepsychology, and Technology, 9(2), 111-131.
Barak A., Hen L., Bionel-Nissim M., Shapira N. (2008) ‘A Comprehensive Review and a
Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions’, Journal of Technology in Human Services, Vol. 26(2/4), Available online at http://jths.haworthpress.com
Caroll, R. (2005) Neuroscience and the ‘law of the self’, The autonomic nervous system updated, re-mapped and in relationship in New Dimensions in Body Psychotherapy. Totton, N. United Kingdom: Open University Press, 2005.
Osenbach, J. E., O’Brien, K. M., Mishkind, M., & Smolenski, D. J. (2013). Synchronous telehealth technologies in psychotherapy for depression: A meta-analysis. Depression and Anxiety, 30(11), 1058-1067.
Simpson, S.G. (2009) ‘Psychotherapy via videoconferencing: a review’, British Journal of Guidance and Counselling, vol. 37, no. 3, pp. 271–86.
Simpson, S. G., & Reid, C. L. (2014). Therapeutic alliance in videoconferencing psychotherapy: A review. Australian Journal of Rural Health, 22(6), 280-299.