David Baxter PhD
Late Founder
Online Therapy - What I Have Found Works
by Sarah Luczaj
November 3, 2008
I was one of those therapists/counsellors who initially dismissed the whole idea of online therapy as missing out on the vital heart of therapy, the meeting of human beings, with their physical, mental, emotional and spiritual selves all present, interacting in subtle ways probably impossible to fully grasp with the intellect. How could this kind of relationship in all its intricacy be possible through a simple exchange of written words? Would it not be some kind of fatal over-simplification to even try?
However, I am now a practising online therapist/counsellor, and I have found that it is quite possible for therapy to work well in the online medium. (Note I don?t claim that it is always effective as face to face therapy is not always effective either. The success of therapy relies on a myriad of factors within and without both client and therapist.) Therapy can indeed work brilliantly in the online medium. Not just as a second best for people who are housebound or who for some other practical and/or health reason find online therapy the only option, but as real, robust, living therapy in it?s own right!
So online therapy can be perfect for people who feel at ease with the written word, who value exact communication, flexibility, self-direction, and maybe, as I expounded on in my Psychology, Philosophy and Real Life post online therapy for introverts it suits certain personality types down to the ground.
I find that the extra clarity of communication that is called for by online communication, or to be precise, email communication, the strategies which both parties have to devise in order to get around the lack of normal cues, all the extra checking out of understandings etc, may produce an advantage over face to face communication, in that by making larger areas of our communication explicit the possibility of assumptions being made is reduced. The dangers of fantasising, projecting, and the disinhibiting effect of online communication in general can all be specifically addressed and watched out for. These dangers are also present in face to face therapy but when the therapist is not particularly alert for them they may well go unchecked.
How therapy actually works out practically of course depends on what the individual therapist/counsellor offers. Some therapists offer a weekly slot, much like a face to face meeting in which emails are exchanged, or sessions are conducted via an instant messaging service, others offer (e.g. some of my colleagues on mytherapist.com) asynchronous counselling, whereby clients email whenever they like and the counsellor replies within an agreed amount of time.
I offer an arrangement which allows both for the flexibility of asynchronous therapy, the certainty of a definite appointment and a sense of a real meeting in real time. Clients email me throughtout the week as they please, and I reply during a set hour, during which the client may, but doesn?t have to be, also be present at their computer.
I have found that I actually feel closer to clients in their process as it works out in their everyday life, reading emails that they write to me at times which they choose, than when they attend a session once a week and have to try and both be in the present moment and the therapeutic relationship and also give a summary of the important events, thoughts and feelings which have arisen during the week. This dilemma of how to ?fit it all in? is even more acute when typing speed comes into play! This ?feeling closer? is not only a warm fuzzy sensation but a really helpful opportunity to accompany the client more closely and so be more facilitative and efficient.
I have also found that the heightened sense of presence provided by the ?meeting hour? is really helpful both for myself, the client, and the work, with a real sense of exchange and intimacy being felt.
With online therapy, as with therapy in general, efficacy depends on finding a therapist and a way of working that suits you.
by Sarah Luczaj
November 3, 2008
I was one of those therapists/counsellors who initially dismissed the whole idea of online therapy as missing out on the vital heart of therapy, the meeting of human beings, with their physical, mental, emotional and spiritual selves all present, interacting in subtle ways probably impossible to fully grasp with the intellect. How could this kind of relationship in all its intricacy be possible through a simple exchange of written words? Would it not be some kind of fatal over-simplification to even try?
However, I am now a practising online therapist/counsellor, and I have found that it is quite possible for therapy to work well in the online medium. (Note I don?t claim that it is always effective as face to face therapy is not always effective either. The success of therapy relies on a myriad of factors within and without both client and therapist.) Therapy can indeed work brilliantly in the online medium. Not just as a second best for people who are housebound or who for some other practical and/or health reason find online therapy the only option, but as real, robust, living therapy in it?s own right!
So online therapy can be perfect for people who feel at ease with the written word, who value exact communication, flexibility, self-direction, and maybe, as I expounded on in my Psychology, Philosophy and Real Life post online therapy for introverts it suits certain personality types down to the ground.
I find that the extra clarity of communication that is called for by online communication, or to be precise, email communication, the strategies which both parties have to devise in order to get around the lack of normal cues, all the extra checking out of understandings etc, may produce an advantage over face to face communication, in that by making larger areas of our communication explicit the possibility of assumptions being made is reduced. The dangers of fantasising, projecting, and the disinhibiting effect of online communication in general can all be specifically addressed and watched out for. These dangers are also present in face to face therapy but when the therapist is not particularly alert for them they may well go unchecked.
How therapy actually works out practically of course depends on what the individual therapist/counsellor offers. Some therapists offer a weekly slot, much like a face to face meeting in which emails are exchanged, or sessions are conducted via an instant messaging service, others offer (e.g. some of my colleagues on mytherapist.com) asynchronous counselling, whereby clients email whenever they like and the counsellor replies within an agreed amount of time.
I offer an arrangement which allows both for the flexibility of asynchronous therapy, the certainty of a definite appointment and a sense of a real meeting in real time. Clients email me throughtout the week as they please, and I reply during a set hour, during which the client may, but doesn?t have to be, also be present at their computer.
I have found that I actually feel closer to clients in their process as it works out in their everyday life, reading emails that they write to me at times which they choose, than when they attend a session once a week and have to try and both be in the present moment and the therapeutic relationship and also give a summary of the important events, thoughts and feelings which have arisen during the week. This dilemma of how to ?fit it all in? is even more acute when typing speed comes into play! This ?feeling closer? is not only a warm fuzzy sensation but a really helpful opportunity to accompany the client more closely and so be more facilitative and efficient.
I have also found that the heightened sense of presence provided by the ?meeting hour? is really helpful both for myself, the client, and the work, with a real sense of exchange and intimacy being felt.
With online therapy, as with therapy in general, efficacy depends on finding a therapist and a way of working that suits you.
