Psychotherapy has until recently been a primarily face to face activity. Yes, online methods have been around for a while, and stretch from working in writing alone right through to virtual worlds and avatars, but the bulk of therapeutic work has always been done in the therapy room. Until now. Now, psychotherapy has moved over-whelmingly online. So is it still worth it?
I’ve had to rapidly up-skill myself in providing psychotherapy by video to previously face to face clients, as well as finding myself using telephone for some sessions (as I often had in the past), and learning to use live chat and email as written media where circumstances demanded. Robust, in depth training has been essential, because it is not just a lift and shift, the therapeutic relationship is different.
My initial fear was that different would mean inferior. After all, how could I really sense a client who is not physically in the room? How would the energetic connection work?
What I have discovered is that in many circumstances different does not mean inferior, in fact it might be just what was needed. For sure the shift of delivery method has caused shifts in the therapeutic relationship, and that has in many cases been beneficial and kick started a different phase of work.
Online, research shows that clients are often less inhibited. They may say things that they would not bring into the room face to face. I have certainly noticed this. Where there is sufficient capacity in both client and therapist to be able to sit with this and look reflectively at what is arising and shared, this can be useful and powerful.
Online work does call for more careful preparation to build the therapeutic relationship, and to make sure clients are able to be with the emotions and reactions that may come up. It also calls for consideration of the ‘physical’ world consequences of what is explored, because the therapy is connected to the wider fields in which we live, and can’t be disconnected from them if it is to be of benefit.
Online work calls for more careful exploration of the information that is available. Whole body language is not accessible, in some cases even facial expression, or voice are not there. But much still is accessible, and there are considerable benefits to working with what arises. More words tend to be exchanged, more checking out, more active grounding and exploring, more clarifying and discovering. This can be a strength.
I have found online therapy to be as energetic, lively, slow, reflective, deep and affirming as face to face work. Just like in the room, it seems to me it’s the relationship that will determine the benefits of the work. If you feel the need for therapy and you’re not sure if online is for you, then shop around, and talk to a few people until you find a therapist you feel comfortable with.
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