Everything You Wanted to Know about E-Therapy: Part ONE
Do you want to get to therapy more regularly but something keeps getting in your way? The convenience of e-therapy could make for a good solution. Read on to see whether e-therapy might be for you.
E-therapy, e-counselling, online therapy, cyber counselling, virtual therapy, telepsychology—we’re not even sure what to call it yet, but it’s definitely here to stay. E-therapy takes place online instead of in person. You can choose from several delivery options, and you can do all your sessions virtually or combine e-therapy with in-person meetings.
The genius of online counselling is that I can reach you anywhere, anytime, in a capacity that works for you. Preliminary studies show that online counselling can be very effective. But e-therapy isn’t for everyone, and it’s important to weigh the pros and cons before making your investment.
Online counselling has some distinct advantages:
1. E-therapy saves you time
Traffic, transit delays, and weather can turn a one-hour appointment into a three-hour commitment, adding anxiety and aggravation to your already busy day. E-therapy makes it easier to get to therapy, saving you time and stress. This can make it easier for you to commit to regular therapy and yield quicker results.
2. It solves mobility issues
Do you have trouble getting around due to disability, injury or illness? Online therapy opens up multiple channels for you to access to a qualified therapist without leaving your own home. E-therapy can also be a good fit for mental health conditions like anxiety that make going out a challenge.
3. You can’t find the right therapist where you live
Do you live in a remote area with few mental health resources? Would you like to try a specialized form of treatment that none of your local practitioners offer (i.e., CBT, couples therapy, mindfulness)? Online therapy gives you access to a much wider range of trained and specialized professionals.
4. You have an unpredictable schedule
Something always comes up. Perhaps you have caretaking responsibilities for young children, aging parents, or a sick relative. Maybe you travel for work. Or you’re jugging too many responsibilities to feel confident booking anything days or weeks in advance. Online therapy creates a range of creative solutions, including an email format that lets you write and respond to me on your own timeline.
5. You feel weird talking face-to-face about your private thoughts
Therapy is supposed to be a safe space, but some people feel too vulnerable talking to a near-stranger about their most intimate thoughts and feelings. E-therapy can create a sense of distance and anonymity that helps clients open up. Researchers call this the “disinhibition effect,” and it can be an asset to us in therapy.
6. You don’t want to be seen anywhere near a therapist’s office
We’ve come a long way in de-stigmatizing mental issues, but some people still feel shy or uncomfortable about seeing a therapist. This may be a special consideration if you’re trying to keep your treatment private from family or friends. E-therapy takes place over a secure and confidential online platform that protects your privacy and anonymity. You never have to worry about bumping into anyone in my waiting room.
7. You’d rather write than talk
Some people don’t enjoy chatting about their challenges, but they’re great expressing themselves in writing. E-therapy offers text-based options for people who like to write but don’t want to talk about it. Text-based sessions also provide a written record that can be useful to reflect on later, and the software I use lets us post, share and collaborate on documents, which can enhance the overall therapeutic experience.
This all sounds great! But what are the challenges of online counselling?
1. Can I really connect with an online therapist?
Isn’t e-therapy a bit—impersonal? A strong therapeutic alliance or bond between client and therapist is integral to successful therapy. Research shows clients and therapists can connect well online, but it’s not for everyone. It’s important to consider your own feelings about digital communications and your comfort level with technology. If you’re trying e-therapy for the first time, know that it might take some practice to find your groove.
2. What about body language—don’t you lose a lot meeting in virtual space?
As a therapist, I get important cues from your physical body. Your posture, tone of voice, eye contact, mannerisms and gestures, even how you’re groomed, all provide meaningful information. In text-based exchanges, and even in video-sessions, some of this data is lost. E-therapy has some strategies for recovering these lost cues: we might use bracketing to express emotion (said optimistically), narrative description to set tone (“I’m sitting in my sun-filled office as I write this”), or even emojis to indicate emotion 😀. And writing style can itself prove very revealing of character and mind.
3. What if I don’t understand technology?
E-therapy requires a basic comfort level and facility with devices. Especially with text-based systems, you need to anticipate a learning curve. The system I use is user-friendly and offers immediate tech-support, but if you’re techno-phobic and the prospect of learning new technology fills you with anxiety, this may not be a great fit. Having a reliable internet connection is also key—it’s very frustrating to have your session repeatedly cut out.
4. What about privacy and security? Is it really safe to have my private secrets “out there?”
Don’t let this one slide. It’s important to use a safe and secure system for e-therapy and not just Skype, Facetime, the messaging function on your phone or your personal email account. Make sure your therapist has a system that complies with the Personal Health Information Protection Act (PHIPA), The Personal Information Protection and Electronic Documents Act (PIPEDA), and standards set by the College of Registered Psychotherapists of Ontario (CRPO).
5. Are there any conditions you can’t or shouldn’t treat using e-therapy?
Online therapy is not recommended for individuals with severe mental health challenges. I also do not recommend e-therapy for certain treatment modalities, such as somatic therapies that demand hands-on bodywork or psycho-dramatic techniques that require physical presence.
6. Can you work with couples or groups?
E-therapy offers a great vehicle for bringing together people with specific issues who are struggling to find or build support communities. Group members may come from diverse regions, which creates a distance and anonymity that some individuals find comforting. E-therapy has also been effectively used in couples and family counselling for high-conflict or long-distance relationships. The software I use has split screen technology and additional tools for groups (i.e., document sharing, chatting).
So … is e-therapy for you?
You are ultimately best situated to know whether e-therapy could be a good fit for you. Weigh the aforementioned considerations, and don’t be afraid to seek more information from a qualified practitioner. Be aware that while e-therapy can be very effective, it will be a different experience from face-to-face meetings and it can take some getting used to. Allow yourself a learning curve to get more comfortable with the technology and the process.
I believe it’s also important to acknowledge that e-therapy is a relatively new medium, and therapists are still working to developing best practices. Yes, this makes you a bit of a guinea pig. I take this on by having ongoing dialogues with my clients about how e-therapy is working for us so that we can recognize the strengths and limitations of working in these new mediums, and ideally adapt our interactions to create the best possible therapeutic relationship using these technologies.
I’m still with you. So how does e-therapy this really work?
If you got through all this and you’re still interested, check out my second post on the practical side of how e-therapy works. I’ll explain the delivery options available to you and describe in more depth what it really looks and feels like to meet your therapist online.
You can read recent articles on e-therapy here (scroll to the “additional links” section).