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Technology and Therapy - the new paradigm shift you cannot avoid

Most, if not all therapy training consists of how to create a relationship with a person in the therapy room. We call this the therapeutic alliance or working relationship. The interesting fact here is that when we are present with another person we can be ‘present’ or have ‘presence’ because they are physically there in the room with us.

But what if the client is not present? What if they are either in a) a different location and using a video conferencing program, email, phone or b) the meaning I am actually alluding to which is the lack of presence. Lack of presence may be due to a number of reasons, for example clients can often have defence mechanisms such as dissociation from trauma and stress, lack of emotional regulation, Shame and a myriad of psychodynamic mechanisms from displacement to repression.


However, this is not the type of presence I am referring to for this article. I am discussing the ability of young people to be present with you in the room, whilst having a device nearby (in their pocket or on the chair) that enables them to be present and connected to the rest of the world. Yes, I actually mean the potential to be connected to the rest of the world. You see if the child’s device has the potential to connect to the rest of the world, the world has the potential to be connected to the device. It sounds scary but needn’t be, if there are the correct and appropriate safety mechanisms and programs.

Now this isn’t an article all about e-safety, as I will recommend that you need to go to the sites named below and learn or brush up your skills on a regular basis, you will need these skills to be up to date and there is no getting away from this new shift into technology.

Which brings me neatly to the issue that may appear in your waiting room, therapy room and even outside of it.

You see because of the very nature of internet ready devices brings many issues and some of these may be;

A. The presenting issue such as a referral for cyberbullying (a current definition of this is in my recent research)

B. One that is contained within the presenting issue, such as low self-esteem that turns out to be connected with an issue such as cyberbullying

C. One that is hidden from you such as underage/illegal activities on the internet

D. What you do with the actual device and contract once it’s in your room.

For example, do you have to ask your client each session the following question: “do you have a device with you today?”And if the answer is yes, then what?

To get you thinking legally, ethically and morally you need to know what a device can do, what the apps and sites can do or what you can be involved with (both intentionally and out of your remit). This means you need to have the same level of knowledge that the users of this technology and developers have. Which to be perfectly honest is an impossibility. So the next best option for you is to become ‘savvy’ with this technology. I feel personally that as counsellors we cannot avoid this technological world and our position in our therapy rooms has become enmeshed with this virtual and physical world, much like the propositions of the conscious and unconscious.

However, the reality of the virtual world opens up new possibilities of counselling of the future. My recommendations professionally would be to learn about this world by keeping up to date with the issues. I recommend that you need to visit the e-safety sites at least once a month as technology is changing at a rapid pace. Use CPD to enhance your knowledge of this world by getting the right kind of knowledge that overlaps counselling and technology. Lastly use the technology and learn how to keep yourself safe when using it. It really does matter. You may need to provide psycho-education to parents or clients and you need to offer them (and yourself) the most reliable and trustworthy information.

Author's Bio


Catherine Knibbs is a Child/Adult Trauma Therapist and Author. She is the leading researcher on Cybertrauma in the UK, specialising in online abuse in all forms and provides consultancy, education and training on this topic. She is a consultant for an AI online safety robot called Oyoty, writes for Internet Matters and in her spare time is completing a dual MSc.

Contact Catherine Knibbs at

For further information follow the links to:


1 The art of Presence by Eckhart Tolle2 The Body keeps the Score by Bessel Van De Kolk3 Mindsight by Daniel Seigel4 Daring Greatly by Brene Brown5 Freud, Psychodynamic theory of defence mechanisms.6 Cybertrauma by Catherine Knibbs

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