Different Approaches to Offering Therapy Online

Different Approaches to Offering Therapy Online

21 October 2016    Kate Dunn

When registering with a popular and well regarded directory for independent counsellors, prospective registrants are asked to “Tick here if you offer online counselling”.  What exactly might this mean, to both clients and colleagues searching the directory who look at the profile of an individual counsellor and see this declaration?  It may seem, at first glance, that this is a useful answer – and that it is a simple question.  However, it may be useful to reflect on the following thoughts. In fact, there are almost as many qualifications that may need to be applied when answering this question as might be applied to the question “Tick here if you offer counselling”. If you are unsure about this, here is some information to help you begin to think about what might be described as ‘working online’.

Online therapy can be delivered in one or more of the following ways (*please note, this is not an exhaustive list, nor does it imply relative efficacy or validity):

1. Using  a web-cam and video-conferencing software, so that a counsellor can see and communicate with a client in real time

2. By audio link only in real-time, using appropriate software

3. By Instant Messenger (IM) or ‘live chat’, again using appropriate software

4. Through some form of encrypted or secured email exchange (not in real time, but delivered asynchronously at previously agreed times)

5. Through a moderated secure group forum

6. Via a Social Networking site

7. Through the use of a computerised self-help program, which may either be entirely automated or which may involve some direct therapist-client intervention alongside the automated processes

8. In a virtual reality environment

9. Through the use of a game

Some counsellors employ a number of these approaches and may blend them, (sometimes also combining face-to-face meetings with their client) whilst others choose one approach alone.  Reasons for this vary enormously and need to be explored carefully at the stage of assessment.  A well-trained online counsellor will be able to help potential clients find the most appropriate approach for them, as well as assessing the suitability of online counselling generally for each individual when they first have contact with them.

The different approaches, particularly the first four mentioned on the list above, may be provided through the use and adaptation of popular and widely available software programs which counsellors already use for other purposes.  Making these approaches robust, secure and trustworthy in order to meet ethical and data protection requirements is complex and requires considerable technological understanding and input from the therapist.  Some costs may be involved initially in accessing the software and in ensuring compliance with certain standards.  More about this will be learned on online therapy training courses.  (See the ‘Training’ section of this site)

An alternative to this can be to enrol in an organisation that is offering a platform that has been specially designed to deliver some of these approaches in a secure and encrypted format that they have explored and designed to meet the needs of therapists.  Some platforms also include marketing, diary and payment systems within them, again with the aim of simplifying the process for counsellors and clients alike.  There may be an up-front cost to register with the organisation, a regular subscription process or alternatively counsellors may pay a percentage of their earnings to the platform provider for use of the platform.  Some providers allow counsellors to use their platform for clients they find independently, others only offer their platform to clients who come via their website or app.  Some providers require evidence of training and professional memberships and accreditation, including of having undergone some training to work online.  The recruitment process varies from provided to provider; it is worth looking both at the information provided up front as well as the profiles of a number of existing therapists on the site when considering the credentials and reliability of the platform or organisation you may be considering joining.  Some also offer training of their own and this may be a good starting point for those who are, as yet, unsure about the extent to which they may want to offer an online provision.  (Further details of some software and platforms can be found in the ‘Resources’ area)

What works for Whom?

The nature of individual differences and the diversity of online communication approaches means that there is no ‘one size fits all’.  Choices made by counsellors and clients may be limited by the technology available to them or the technological expertise they may have.  Equally, the nature of the issues that someone seeks to explore and the psychological impact of these issues on the individual, alongside aspects of their personality and experience may predispose them towards a more or less exposing approach, and their interpretation of what it is to be ‘seen’ and ‘heard’ by another may have a profound influence on their choice of approach.  It is wise to set aside any assumptions and for counsellors to be truly open to what their potential clients bring to the exploratory and assessment stages of any contact made. 

Counsellors should take care to ensure that the approaches that they use are made as secure and as reliable as possible and to work within the limits of their expertise.  They will need to explore these same thoughts with their clients and then decide together on the best way forwards; this may not always be to use the first approach requested by a client. 

This is only a brief introduction to what you may now realise is a complex area which both therapists and clients may need help in exploring.  The Online Therapy Hub provides a growing number of resources for both prospective and also existing online therapists.  We welcome your questions, comments and ideas for further articles.