Top 10 questions about online therapy.

With the extra stress of Covid-19 there are so many already anxious people now experiencing bad feelings at a higher level.

Mind racing, taking ages to fall asleep, angry, irritable, feeling antsy and unable to sit still, there signs of stress/anxiety are a lot worse right now for lots of people.

While they might be more aware of the need to doing something about it what are the options?

Well, there are a lot of excellent therapists out there who are working online at the moment and many therapies work just as well via video chat as in person when people are ok with the technology. (I’ll put a few research links at the end in you’re interested).

I do a lot of training of therapists around the world and some common denominators have come up for many of us in what people are asking, so, here are the 10 most asked questions that have come up this past month:

1 What type of computer do I need for online therapy?

The number one concern has been what device, computer etc., will be needed. Happily, most video therapy is done over a mobile phone so for most people there is no extra tech requirement.

2 How do I pay?

I was stunned that so many people were concerned about how they would be able to pay the therapist. It speaks volumes about people’s true nature when they want to make sure they can pay their therapist for the work done.

Most therapists can take cards online or even over text these days, but bank transfers are an easy option too. Your therapist will have options in place for this and they should be easy to use too.

3 Does it work?

I’m surprised this wasn’t #1 on the list. There is a lot of research on the effectiveness of some therapies online and not for others. CBT is extensively studied and generally as effective online as in person. Many others do lend themselves to online delivery well too. Procedural therapies such as CBT and EMDR are often used online more than some others.

The main thing I’ve found is that at the end of sessions almost everyone has admitted they didn’t know how it would work at the start, but that they’re pleasantly surprised by the end.

That was my own experience too. As part of a Masters, I had to do some online therapy and was very sceptical to begin with but I was sold on it in a few sessions. It worked perfectly.

The main thing we need is your brain and your therapists brain working together. Video chat is great for that.

4 What if we are interrupted?

I plan on being interrupted. It’s much better than worrying about it. If there’s an interruption we simply take a few minutes and deal with it then get back to what we were doing. It’s never been a problem that way.

There have been a lot of interruptions in the past weeks. I’ve met several cats and dogs and one horse online. One dog decided to do what looked like Yoga while we were working. It was no issue. I generally think of animals as assistant therapists in such situations😊

Children will sometimes interrupt too. That’s fine when we’re prepared for it. An interruption is just that – an interruption. Then we get back to work.

Allow for it rather than dread it, is my advice. Any experienced online therapist will be ready for it too.

5 Do I need a microphone or headset?

No. Your therapist will probably use one to improve call quality, but your mobile phone, tablet, or laptop will be fine. If you have a headset or mic that you’re more comfortable with that’s fine, but it’s extra to what’s needed.

95% of all my online therapists use the in-built mic in the device they are on and it’s ideal.

6 Is it secure?

Nothing is ever completely secure. We can be overheard in most parts of life. However, I expect therapists to use end to end encrypted chat systems. They offer a high degree of security, but I imagine if the CIA wanted to hear us, they could 😊

The bigger concern, form my point of view, is does the person have a quiet place to talk freely without fear of being overheard? If living with an abusive partner, it might be very hard to find a time and place to talk openly. That’s probably a more frequent risk than the online encrypted system will ever be.

If someone can’t engage with their therapist from where they are that would be a concern for the success of the therapy. I’ve had several clients in their cars for privacy when on chat with me, but a secure place to be while engaging in therapy is a must.

7 Do I need to be at a desk or table?

No. If doing something requiring writing it might be easier, but a pad on the lap will probably work there too. After that it’s just down to how comfortable is best for the therapy in question.

8 Does online therapy suit everyone?

No. The biggest determining factor for suitable is probably how comfortable the person is with using online chat.

For example, my Dad is pretty old and doesn’t use a smartphone. I don’t think we’d ever get him comfortable on video chat, so for him it wouldn’t really be an option.

For anyone who’s ok with the idea of video chat it is probably ok. Even people new to it who are willing to try is OK. Fearful of it and avoiding it is a problem.

There are other considerations too. Few therapists would be set up to work remotely with someone at high risk of suicide for example. That level of care is certainly an ‘essential worker’s’ job and should still be face-to- face in this climate.

Urgent and critical care is still functioning face to face as needed so that’s not an issue for us online so much.

9 Are there any advantages to online therapy over face to face?

It surprised me to find that there are. Not just the obvious not having to travel to the therapists clinic, or the stress involved in that commute, but research shows that clients are more assertive online and more likely to speak their mind, they also often find it easier to open up about difficult experiences remotely than in person and this can be a big help. (I’ll throw a research reference below about this too).

10 What do we do about consent forms or paperwork?

There are many options. Some therapists have cut paperwork to the legally mandated minimums which makes it easier.
Adobi has an online signature feature which some are using.

Others simply ask for a photo of the signed form that’s emailed out, and the post still works so it can be posted out to you and sent back to the therapist if needed.

When I was dealing with my own decades of anxiety and depression, I drove 90 minutes each way to see that therapist. It was well worth it. However, if I was doing that more recently, I’d be seeing her partly in person and some online. Today with Covid-19 I’d like to think I’d have reached out online and not kept suffering the way I was.

There are lots of options out there. If you need a recommendation let me know and I’ll see who I can find who’s working online and specialises in the area of help you need.

Feel free to contact me. Anxiety/worry and trauma/PTSD are my own areas of specialisation, bit I know a lot of therapists so I can probably find someone good for whatever you need help with.

I’m pretty close to booked out at the moment but will have some places open in the coming weeks so if you wanted to see me for some help feel free get in touch too.

The important thing is, please, if struggling please reach out to someone. Help helps! Find someone who understands the issue and who has experience reducing it.

This is a time that can give us the space to spot the need for change and also the space to engage with that process of change.

Change is easier than you think.

Hope you have a great day,

085 1313700

Therapy comparisons to online therapy:

Barak, A., Hen, L., Boniel-Nissim, M. and Shapira, N. (2008) ‘A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions’, Journal of Technology in Human Services, vol. 26, nos. 2–3, pp. 109–60.

Benefits of online over in person therapy:

D’Arcy, J., Reynolds, W., Stiles, W.B. and Hanley, T. (2015) ‘The online calming effect: does the internet provide a more comfortable modality for conducting psychotherapy?’, in Riva, G., Wiederhold, B.K. and Cipresso, P. (eds) The Psychology of Social Networking: Identity and Relationships in Online Communities, pp. 17–28, Warsaw/Berlin: De Gruyter Open.