The popularity of online counselling has been steadily growing in recent years. However, during the pandemic, it has become the go-to medium for people to access counselling support. This article will look at what to consider with both online and telephone counselling. (In this context, ‘online’ refers to video call sessions. There are other mediums which also fall under this term not covered here, such as email or text-based counselling).
Aside from a pandemic, online and telephone counselling can be really useful mediums that enable clients to access therapy when they might not ordinarily be able to, such as:
- They are travelling or are not always in the same location
- They live in a remote location
- They are not able to travel or leave the house
- They prefer this as a means of communication
- It is convenient for their schedule
- They wish to work with a therapist with a particular type of specialism or modality not available in their local area.
What is Online Counselling?
Counselling sessions are carried out via a video calling platform, with the therapist and client both dialling in from their respective locations. Sessions will usually last for the same amount of time as an in-person session (e.g. 50 minutes). This is the closest medium to in-person therapy since the therapist and client can see each-others facial expressions and some body language as part of their communication. Most therapists use an encrypted platform such as Zoom, V-See or Doxy.
What is Telephone Counselling?
Telephone counselling can be offered either through normal phone lines (landline or mobile) or it can be offered via a video platform but with the visual aspects turned off. Again, sessions usually last for the same time as in-person sessions. Whilst the client and therapist are unable to see each other’s facial expressions, it does enable them to focus in on the voice and what is being said without possible distractions. Telephone counselling can be useful if you don’t have access to a reliable internet connection or you find visual communication difficult.
What to consider before starting online or telephone counselling
With in-person counselling, your therapist works hard to take care of you in the session and hold the space. This includes making sure the room is confidential and quiet, that you won’t be interrupted, that the chairs are comfortable, that you have water or tissues available etc. With online or telephone counselling, some of these aspects are outside of the therapist’s control, and so there are things that you can do to make the sessions more comfortable.
- Scheduling – Choose a time for the session when you can give your full attention and not be interrupted. Take into consideration the schedules of others in your household or location.
- Confidentiality – It is really important to choose a place where you feel confident in talking openly to your therapist without fear of being overheard by others. For this reason, it is recommended to use headphones rather than have your therapist on loudspeaker. Your therapist’s voice will carry differently via technology and is more likely to be heard than your own voice is in the room.
- Comfort – Choose a space where you can sit comfortably for the duration of the session. Think about what you might need to have with you, such as water, tissues, maybe even a note pad if you like to jot things down.
- Safety – It is important you can concentrate on the session without putting yourself in harm’s way. For example, it would not be appropriate to hold the session via loudspeaker whilst driving your car. However, you could pull over and park in a safe place where you will not be interrupted or overheard.
- Boundaries – Set boundaries with others in your household or location so that they know not to interrupt you, and that they give you any necessary space before and after the session.
- Grounding – With in-person therapy, you usually have travel time to the session which can help you to ground and prepare yourself for the session. It can be important then to give yourself time before starting an online session to prepare yourself, maybe taking some slow, deep breaths and think about what you want to bring to the session. If you have been unable to do this, you can always ask your therapist to do some grounding with you at the start of the session.
- Fully engage – Try to really engage with the session in the same way you would if you were in the room with the therapist. This might include turning off any technology which might disturb you (e.g. notifications from emails or text messages) or not being tempted to snack during the session. Also, remember this is a professional relationship, perhaps you are used to using video or phone communication with your friends and loved ones, so you might need to be conscious not to fall into ‘chatting mode’.
- Ending – Take time after the session to pause and prepare for getting back to normal life. This might include journaling about the session, doing some stretches, taking a walk or just physically shaking your arms and legs to help let go of anything you are still carrying.
FAQs about online counselling:
Is online counselling secure?
There are always risks with any technology, however, your therapist will have chosen a platform which they consider appropriately secure and encrypted. Platforms such as Zoom have a waiting room facility, which means that even if someone comes across the invite for the session, your therapist still has control over who they admit to the virtual room. You may need to think about security from your own end too, such as is the virus software up to date on your device.
Is communication different when working online?
With in-person counselling, your therapist may often rely on their ‘felt-sense’ of what is in the room and notice your whole-body language as part of the communication. As there is limited ability to notice this via video or by telephone, your therapist may check in more regularly to ask how you are feeling or be more overt in their interventions. For example, in-person, therapists may allow a period of silence to enable you to process. This is harder to do remotely, so they might tell you that’s why they are silent. Likewise, it is really helpful if you can let the therapist know what’s going on for you at that moment or ask for space to pause if you need it.
Will it feel different from in-person counselling?
This is a very individual experience. For some clients, it might feel more comfortable being in their own space whereas, for others, they might prefer having a separate location to go to. Also, for some clients, by having a sense of separateness they might feel more able to disclose difficult feelings to the therapist (known as online disinhibition), this can be really useful but the therapist will check in with you if they sense the pace might be too quick for you. If you are unsure about either method, discuss this with your potential therapist, it might be appropriate to have an initial session to see how it feels before committing to further work.
What information will I need to give?
Your therapist will need to have appropriate contact details for you to conduct the session, such as email address to send a video invite to, or phone number to call you on. They will probably wish to agree on a secondary contact method in case the technology fails before or during the session. The therapist might ask you to confirm where you are dialling into the session from and for details of an emergency contact. This is for safeguarding purposes, in case you become unwell or are in crisis, this enables the therapist to contact someone to help you.
Does online counselling cost the same as in-person?
Most therapists will charge the same fee. This is because you are paying for their time and expertise, whether that is in-person or online. It will depend on the individual therapist though, so it is something you can discuss with them directly.
What if I’m not familiar with technology?
If you really struggle with using technology, you may prefer to work with telephone counselling. However, if you would prefer the visual aspect of online counselling, your therapist will be able to give you some details about the particular platform they use, plus there are lots of simple tutorials available on YouTube. Your therapist might be happy to call you at the beginning of the first session to help talk you through how to get logged in. Alternatively, you could ask a friend to help you practice using the technology before you try it with the therapist.
What should I do next?
If you have a therapist in mind, get in touch and ask them how they work and how to proceed. Many therapists will be happy to have an initial discussion for you to discuss your concerns and ask any questions before you arrange a session. This will also help you get a sense of them as a person. The relationship between therapist and client is a key part of the work, so it is important to find a therapist who you feel comfortable with.