Online Psychotherapy and Counselling

Online Psychotherapy is Thought to be Effective for Some Issues, but not a Replacement for Traditional Therapy

The use of modern technologies as part of the therapeutic process is on the increase and to mixed views.

Phone counselling has been around for many years and had been a very useful way for vulnerable people to reach out for help when it feels too difficult, either practically or emotionally, to meet someone face to face. Samaritans, for example is primarily a phone based mental health support network and has played an important part in offering support through a listening ear.

More recently, the use of computer technology has come to the fore as a way to achieve a therapeutic relationship outside the therapy room and has gained some supporters. Some research suggests that online, real-time therapy is more effective because the patient is in a familiar environment and therefore feels more at ease and less intimidated than they otherwise may feel in the therapy room.

Practically, online therapy is also useful in the international world in which we live. Expats may wish to see a therapist from their own country and culture who speaks their language or feels more familiar. For disabled people or those living in remote parts of the country, or those who have to be away for business, all who may struggle to get to a therapist, can also benefit.

Research by G.S. Stofle (2001) suggests that those patients functioning at a moderate to high level would benefit from online therapy. However, those with more severe mental health issues such as suicidal ideation, self harming or psychotic episodes would be better off seeing someone face to face.

A study produced by Kerr and Cohen (2011) found that students who sought therapeutic treatment for anxiety disorders online benefited equally with those who pursued face to face therapy.

However, although many of those within the ‘therapy world’ have embraced modern technologies as a way of reaching their patients, it seems to be the providers of psychotherapy who are more critical of them.

Some practitioners have claimed that online therapy cannot be considered psychotherapy. They feel that something is lost in the interaction between therapist and patient when the medium of technology is used. Although with systems such as Skype, some of the patients body language can been seen, which a therapist often observes in order to help understand what is going on for the patient, the underlying feelings and subtle messages that pass between people when they meet are gone.  An awareness of this human connection is invaluable to a therapist trying to help a patient  understand difficult, painful and sometimes unconscious emotions.

It would appear, therefore that within the therapeutic community, there is support for the use of technologies as a tool to reach inaccessible patients and for very cognitive therapies such as CBT. However, for more long term, in depth therapy, the support is still for traditional face to face psychotherapy where the proximity of the people involved and the subtle communications that pass between them are felt to be necessary for deeper understanding and development.

The Cavendish Psychotherapy Practice at 121 Harley Street, London, supports the use of modern technology as a way of maintaining contact with patients when it is not possible to meet in the consulting room. They use both Skype and phone for this end. However, this is a suppliment to the therapy they offer, not a replacement.