Would You Want to Do Therapy Online?

[David Baxter PhD]

Would You Want to Do Therapy Online?
by Elisha Goldstein, Ph.D.
Wed, Sep 28th 2011

As more and more people grow up in the digital age, we are become more accustomed to connecting to people through online pathways. If you grew up only knowing the internet, this all makes sense, it doesn’t seem strange to walk around and talk to your friend or family on the computer while seeing their face. You’re even used to the fact that you don’t actually look into one another’s eyes but at the respective screens instead (although I’m guessing that will change). But what about therapy online?

There are many therapists who are jumping on the bandwagon and connecting through various secure sites to do their online therapy. Companies like Skype, Californialivevisit.com, and Breakthrough.com are banking on the idea that video-based therapy is going to be in big demand. There’s less obstacles, it’s cheaper without gas and rent, and you can be more flexible with your time. Seems attractive to both sides. But what gets lost?

When I’m doing therapy with someone I’m not only looking at their face, I’m having an awareness of their body, what are they doing with their hands? How are their feet positioned, are they shaking? What does their breathing look like, is it rapid through the chest or does it seem calm? Unfortunately, I can’t see these things when I’m on Skype.

That doesn’t mean therapy can’t be effective online, but it does simply point to the fact that the therapist can’t get the whole story.

With that said, I run a number of groups online where there have been wonderful changes and insights by the participants. Some have said they like the online version better because they feel less intimidated and feel safer to open up which enables greater change and healing.

Whenever looking at a new medium, it’s too easy to feel threatened by it in some way if we’re comfortable in our old ways and throw the baby out with the bathwater. It’s also too easy for other people to blindly embrace it overlooking certain deficits or challenges that may arise.

It seems to me that in the coming months and years ahead, video-based therapy is going to become a reality as an option to do psychotherapy and it’s going to be very attractive as life gets busier and connecting through a screen becomes more comfortable.

This is all a great experiment at this point. Some people have tried it and loved it while others have gone back to traditional face-to-face. Some do a hybrid, seeing therapists when they can live and online the rest of the time.

What are your thoughts on this experiment? What are the benefits that you see, the drawbacks?

See also the poll above.

 

[suewatters1]

I used the online therapy a few months back when I paid $15.00 to talk to a Psychiatrist in email type format. We corresponded many times and I did enjoy it because I felt stuck at the time and I needed to get another opinion and he was very good. We would post replies when we were online so the other can read later if they are not online at the same time. But I do like face to face better because the DR's can tell if your lying or not or your body expression and facial expression gives them answers that you probably don't even realize your giving them.

Sue

 

[Pedrx]

If online therapy makes it available to more people then that surely is a deciding factor. Presumably it can be cheaper for reasons you describe and it is nodoubt easier to pour your sometimes embarrassing troubles out to a monitor than a face.

You miss out on the physical signs but – and am only guessing here – a number of clients are only there for a shoulder to cry on: a replacement for the clergy in this increasingly ‘lonely’ world originally and more recently the GP, at least in the UK, where they no longer have the time.

Perhaps one drawback is this ease of availability may create more dependence on your profession, though that may not give you much cause for complaint.

How is this Forum subsidized, by the way? Advertising perhaps? And while I’m here what about my post from yesterday re introducing some form of self-analysis to children? And what is this diagnosis NOS? Sorry, I’m digressing.

Back to your subject I guess increased online therapy is likely whether we like it or not,so the sooner genuine alternatives are offered the better. Obviously the system is open to abuse and, historically, there has been no shortage of ‘victims’ to abuse.

 

[Daniel E.]

Presumably it can be cheaper

Yeah, I think that is a huge potential advantage, especially for those without insurance who live in cities where the cost of living is high. And, as you allude to, the convenience, especially for asynchronous communication like e-mail.

As someone who is in traditional face-to-face therapy now, what I would like the most is a hybrid approach that combines online and offline therapy -- such as having both in-person and instant-messaging sessions. Some therapists are doing that already. And, of course, a lot of therapists already answer e-mails from clients.

How is this Forum subsidized, by the way? Advertising perhaps?

And donations

 

[choco chip]

It can be a great approach for some cases and not for some other... I feel, even in future, we'd need to make a combination of both the approaches. No single approach would actually work effectively throughout.

 

[Thehurtstopshere]

I think I would like it because when I used to go in and spend an hour on really tough stuff I hated having to drive home, navigate traffic jams and try and hold it together til I got home. On here, I get my own pace of sharing, a sense of control, sense of community, it feels safe.

 

[GDPR]

I think online therapy would be great for those who are not able to find a therapist they can see face to face.Or for those that feel more comfortable doing it online,because it's better than no therapy at all.

 

[Banned]

I do all my therapy online now. It's not bad. Some of it is written and some of it is Skype. The flexibility is great and it saves me quite a bit of time.

There are downsides - there are definitely things I'd prefer to talk about in person vs via technology, Skype can sometimes cut out quite a bit, I struggle with privacy in my house, and I sometimes feel a bit detached from the process.

But, I really really like my therapist and this is the current option I have, besides finding a new therapist, which I'm not ready or wanting to do at this point. We make it work for us.

 

[PrincessX]

Skype is extremely unsafe. I do not know what other alternatives exist for online therapy. Stay away from Skype.

 

[Banned]

Skype is ok. FaceTime is HIPPA compliant so that is an option too. There is another one through Google. Skype is well encrypted tho.

 

[Retired]

Skype is extremely unsafe. ..... Stay away from Skype.

What information brought you to that conclusion?

 

[PrincessX]

Maybe just bad luck, but I know it is very easy to record anything going on on Skype. It happened to me before with private conversations on personal issues that were recorded with free spyware/malware. And I am talking about records of video + insant messages. I personally would never try to violate someone's privacy like that, but the option is out there. I have no idea what are the statistics, how often does this happen to other people. I personally would not use Skype for anything containing private info after this happened.

 

[PrincessX]

Of course, any technology poses risks, same might happen with other programs or even when using a phone. Overall, I think online therapy is a great idea. For people living in big cities it saves hours of commute and for people living in small towns it offers the advantage of not meeting your therapist in the mall or in the park. For me, I would rather buy safe software or install quality anti-virus protection than spend 1-2 hrs driving + 25$ for parking.

 

[Retired]

It happened to me before with private conversations on personal issues that were recorded with free spyware/malware.

Was this recording done on your system or on your correspondent's system? Was it voluntary or surreptitiously done with neither party's knowledge being malware as you alluded to?

I understand there are utilities available for this purpose, so it's like anything else on the internet, where we have to be careful about what we disclose that can be directly linked to us, if we want to maintain privacy about specific matters.

 

[PrincessX]

It was installed on my system and it was of course with neither party's knowledge. It was a disaster. I was talking to a close friend who is a psyhiatrist and we shared a lot of personal and private information online. Of course, I informed the other party This was almost an alternative to therapy for me.
Nothing is private or safe nowadays.

 

[Retired]

It was installed on my system and it was of course with neither party's knowledge. It was a disaster. ............
Nothing is private or safe nowadays.

Now that is more serious, when a potentially unwanted program (PUP) becomes installed on one's system without one's knowledge nor consent. Presumably then, the author or perpetrator was using harvesting information from your system for his/her own benefit and was invading your privacy.

Has your system been restored to safe and secure state?

Do you know the source and the origin of this malware?

What steps have you taken to protect your system in the future?

 

[PrincessX]

I changed my computers, have Anti-Virus and do not share private information online. I also started reading more about computers, but I am not very ahead yet, due to having a hectic life.

---------- Post Merged at 09:51 PM ---------- Previous Post was at 09:30 PM ----------

I forgot to mention my husband installed this malware on my computer, I guess that makes it not a PUP. But there was no way to find out that there is such a program installed while using skype, which I found frustrating.

 

[Retired]

I forgot to mention my husband installed this malware on my computer

Do you mean it was installed intentionally for the purpose of recording your Skype conversation?

If this is your own computer, you need to password protect it. If it's a shared computer, you need to create your own user account, and password protect it for the same reason.

If you don't know how to check for programs and processes that are running, have a computer professional check your computer, clean it up then password protect it with a secure password. A secure password contains upper and lower case letters as well as numbers and at least one symbol. The password should not have any connection to you, like a birthday or address, but make it something you can remember. I like to use words spelled backwards: Y3kc1M#suoM This password is MickeyMouse spelled backward using a secure formula....(e is upper case 3)