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Online Therapy: is it for you?

Flexibility is the main perk any online therapeutic work can provide. By therapeutic work I mean therapy, counselling, psychotherapy and life coaching.

Flexibility is why online therapeutic services have grown so much lately. Individuals with a lack of time, lack of mobility and/or lack of access to therapy for whatever reason request more and more the possibility of accessing therapeutic services online.

image by Alisa Anton

For some it might also be easier than having to go to a specific place due to their fear of being seen going to therapy and their own judgement about people seeking help. That in itself would be something worth addressing in therapy.

In any scenario, your reasons for choosing the online setting over the face to face setting would need to be addressed before and at the beginning of the therapeutic work with your mental health practitioner. I would advise not to hesitate to review those reasons and your choice of setting. This could come both from your initiative or the practitioner.

How does it work?

The frequency and length of the sessions shouldn’t change. In some instances, the rates of the practitioner might, in which case you might want to reflect if it participates in choosing the online setting over the face to face setting. I would invite you to wonder about the value you put in yourself and your mental health. When I say mental health, I mean the whole integrated health: physical, emotional, psychological and spiritual.

The cancellation policy and modality of payments might also vary, depending on the practitioner, and so is the media chosen. Skype and FaceTime seem to be the most commonly used, at least in the UK. Make sure to address with your therapist your concerns about the media chosen and to request their guidance if you need it. You might also want to discuss your preference on whom is to call when the session is to start.

Is there any imperative?

Making sure you understand how to use safely and confidentially the technology involved is an imperative of any online practice. Confidentiality is crucial. You need to make sure, - especially when sharing computers -, that no one will access your credentials, any written content about your sessions and even in some cases the fact that you are in therapy and with whom, if you wish to keep the latter information private.

Though there is no dedicated therapeutic space per say, the quality of space and its privacy are key. Ideally, you will always use the same space to participate to the regularity and continuity essentials to the therapeutic process. Ideally, you will avoid having your sessions in your bedroom as it is one of the most charged personal space that can be. The quality of sitting is to be considered. You will also make sure as much as possible that there will be no disturbance to any of your sessions. That includes not having to worry about someone potentially able to listen to your ongoing session.

How does it differ from Face to Face Counselling?

Though it does offer a great flexibility which might come with a great piece of mind in notably preventing you some anxiety regarding the commute or else, online counselling, in my opinion, doesn't offer the same quality of holding both in terms of space and of the counsellor's presence.

Having a dedicated space for therapy can create a very unique holding, notably due to its neutrality (no involvement in your private life outside therapy). Many have written about the benefits of the therapeutic space.

Online Counselling will require for you to use a personal or professional space not specifically dedicated to your therapy. A space charged with other memories, attachment or reluctance, emotions and thoughts that might burden in a certain way and to a certain extent your therapeutic time.

For some, this pre-existing content can be experienced as a reassuring familiarity that may or may not prevent you from exposing yourself the same way you would in a face to face setting. Knowing how to gradually expose yourself with the growing trust in the therapeutic relationship and the organic unfolding of the therapy is an essential and beneficial aspect of any therapeutic process. No matter how you experience the space you will use for your online sessions, this experience and the experience of the online setting itself will need to be addressed in therapy to prevent it from impacting negatively onto your process.

Being physically in the presence of your therapist/counsellor/psychotherapist is another asset of the face to face setting. The physical presence and its energy tend to benefit greatly the bonding with the practitioner, - bonding is essential to the therapeutic process -, and the holding the latter can provide.

Also, when working with humanistic methods such as psychosynthesis which involves notably the awareness of the client's body language, the online setting reduces what can be read for your benefit. On another hand, the online setting may provide sometimes a greater reading of facial expressions.

When possible, I would advise to meet face to face with the chosen therapist before confirming your choice and engaging in online therapeutic work together.

Is it to say that online counselling is less effective than face to face counselling?

I believe there is no clear answer to that, no matter of the research available or the personal/professional views one may have. I will say that I don't believe this is adapted to everyone's personality/identity and situation. I can say that I have seen it working as effectively as needed. I will also reinforce the need in any therapeutic setting to discuss regularly how you are experiencing the process, its setting and the therapeutic relationship.

Remember: therapy should always be a safe, accepting, respectful, supportive and a holding partnership between you and your therapist to work towards improving your well-being and mental health.

How to choose?

You will need to reflect with yourself and then with the practitioner on the reasons of your hesitation and/or choice. Is it a matter of convenience? Is it laziness to commute and what could it say about your readiness to commit and engage in your therapeutic journey? Is it because it is either online therapy or no therapy at all due to your personal circumstances? If it is the latter, the choice might be easy: get the support you feel you need and that you can get.

When both options are possible to you, take the time to wonder. What attracts you in both options? What are the aspects you don't like about each option? If you were to choose the online setting, would you meet its imperatives? Now that you have read a bit about the differences between the two settings, do you feel any of the settings could meet your needs?

Please, don't forget that the mental health practitioners work doesn't start when you meet but beforehand to help you address this choice and any other questions/hesitations you might have.

I will conclude by insisting that no matter what the setting or practitioner chosen, it is crucial to choose a professional registered with a respectable recognised professional body such as the BACP (British Association of Counselling & Psychotherapy), NCS (National Counselling Society) or the UKCP (United Kingdom Council for Psychotherapy).

In many countries including the UK, anybody can use any mental health title (Therapist, Counsellor, Psychotherapist, Life Coach…) but it doesn’t mean they have either the training nor the necessary ethics to provide you with a safe and useful service. Would you trust a non-trained non-recognised dentist to take care of your teeth? A Surgeon who didn’t go to medical school to operate on your heart? Your mental health deserves the same safe consideration.

Authors Bio


Lucas is a qualified Psychosynthesis Counsellor (MBACP), offering great understanding of the imperatives, aspirations and struggles of creative/artistic and/or corporate individuals. Lucas is dedicated to helping individuals unfold and express their identity (cultural/gender/sexual & personality) while improving their relationships with themselves & others (including body image & sexuality).

To learn more from Lucas you can get in touch via his website here

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