Internet counselling isn’t really ‘new’ anymore.
There have been professional internet counselling services for many many years. Some therapists like Kate Anthony began as far back as 2001 in the UK. But you could be forgiven for thinking online counsellors are wildly unqualified pirates, stealing everyone’s money and providing sub-par and unsafe services.
To be honest it’s tiresome.
A little while ago I was interviewed by an academic wanting to know more about how internet counselling works from an ethical standpoint.
At the time I confess:
I felt a little annoyed.
The same old worries and the same old questions came up that I hear over and over again.
The problem I have with these worries is that the people who are talking about them are usually not the actual people who are providing or receiving service within these spheres.
Therefore there is a cyclic nature to these articles and discussions around ‘I’m Afraid Of All Things Online’ with no real examples. No sense of movement as things are developing, just stagnation in a tired old puddle of blergh.
Some publications and journalists are not even really looking for a nuanced perspective, they’re looking for the most dramatic article.
There is such a dearth of negativity surrounding online spaces it’s enough to ruin anyone’s time on the interwebs.
I happen to think that internet counselling is pretty amazing. So I thought i’d share with you my answers to these questions based on my actual experiences as an online counsellor over the past 2+ years.
Are you creating dependency?
This is DEFINITELY the worry about internet counselling I find most strange. I personally offer ‘normal’ session options just as a professional does in-person. We figure out a time that is mutually suitable and then we meet at that time.
Sure, there are internet counselling services that are available 24/7 and include the ability to communicate with your counsellor via email or IM whenever you feel like it for a set period of time. But the counsellor’s role is to set boundaries in place around when they will respond.
Think about this: there are phone services that have been doing a similar same thing since at least the 1960’s. They do this in a boundaried way, dealing with the absolute most serious of issues, often anonymously, AND they save lives.
While those services don’t make the same person available to you at all times, they are there (thank god) and they do get regular callers who need help (I know because I used to be a Lifeline phone counselling volunteer almost 20 years ago).
I’ve found that my online clients, after experiencing our sessions, are actually more inclined to call a crisis service when it’s the middle of the night when they are in need rather than trying to reach me.
Those that have done so told me that it seemed less like a ‘weird’ thing to do after already working online with me.
So it is possible that internet therapy creates less dependence on ‘me’ and opens more potential to access support options. How positive is that?!
How do you create boundaries online?
A boundary is simply a CONTAINER for each person to be as safe as possible within the work. To be effective in this work, we create containers for ourselves and alongside our clients with the intention of eventually becoming redundant.
These containers will sometimes change over the lifetime of the counsellor-client relationship, depending on what is needed by all the people in the relationship. There is no right way to do this, and while some professionals do have poor boundaries or are inexperienced, the actual platform or system they use is really only as effective as the person operating it.
It is irrelevant whether or not the counselling is online or in-person.
Do people push the boundaries?
No more than in face-to-face counselling. Again, if folks are wanting to communicate in between sessions, it’s up to me (the online counsellor) to put boundaries in place around how often I allow that (if at all).
I have personally found, as i’ve gained experience, that for some people who choose online counselling, being able to send something in between a session is important (because they have drawn an image they want to share, or the anxiety was so incredibly high they got tongue-tied, and needed to write something down they couldn’t say, or they want to note something to talk about).
This contact adds richness to our connection that could be a little lacking at times not being in a room together. However I generally won’t respond other than to acknowledge what was sent, and that we will refer to it in the next session.
Basically this saves time and also allows something to be shared when it is ‘fresh’.
In over 2 years I have only had to block someone from communicating with me once, and that was with the person’s consent and part of their work on themselves. This would not be an unusual process for anyone who works as a mental health professional.
How do you make sure everything is legal?
Exactly the same as in face-to-face counselling: I use paperwork and documentation to get informed consent from clients. I make sure the platforms I use are compliant with current security standards, and I have professional indemnity (insurance) that covers the provision of internet counselling/health services globally (with the exception of the USA and Canada who have different laws).
What are the pros and cons of internet counselling?
There are the obvious cons: Not being able to ‘feel’ the energy of a person in the room; not being able to see someone’s full body (or face if there’s no video); technical difficulties; establishing credibility (NB: this should be the same as anyone practicing in-person therapy. We need to show that we are members of professional associations and fully qualified, hopefully at a university level. Check out my FAQ to see how I do it).
The pros however are in abundance. Accessibility, variety of communication methods, convenience, safety for you being in your space and having your chosen things around you, social stigma/privacy, and a whole bunch of things I talk about in this video.
How do you make sure you are attending to a client ‘in the moment’?
When we’re actually working together the only major difference is that we may need to be more verbal and explicit around how we are going to communicate troubling feelings. E.g: If you’re feeling panicked and I can’t see you, then you’ll need to let me know. That can be by using a particular word or even an emoji if we’re typing together. I also check in with folks- very simply: ‘how is this going for you’?
We use Mindfulness techniques in interesting ways: a common technique for getting ‘in the moment’ is to name things you can see, hear and feel. Imagine doing that across borders! We can hear cows VS planes or traffic VS birds. A technique designed to calm an unbearable situation can actually become fun.
I actually find that online clients ‘grip’ themselves in the moment and get through it more easily. They are more inclined to grab a pet or cuddle a pillow, pick up a piece of paper and draw or write (which is a double-fold intervention as it is a distraction as well as providing useful notes/doodles for the client to look at later on).
They’re in their own space, a place that feels comfortable, and we’re actually building their capacity to BE in that space even more safely as well as increasing a sense of control being in their own body.
Is internet counselling effective?
Is counselling effective?
I can say from the experience of being a client that YES it is, and it changed my life (though not necessarily in the ways I thought).
I can say from the experience of being a therapist that YES it is and it can change your life (though not necessarily in the ways you would have thought).
Really, this broader question is an entirely other blog post.
How can you guarantee that it is safe?
Here’s a major truthbomb (and perhaps a bit of a risk for me to say):
Counselling is never really ‘safe’.
How could it be?
You brave folks are Showing Up to work through some of life’s hardest stuff, wanting to feel better and live more fully. You want to be FREE of whatever has been holding you captive, no matter how beastly it is.
That takes guts, and sometimes it takes a bit of ‘getting gravel out of the knee’ to get to the healing bit.
Instead, i’d say we work on trust. Building a relationship. So that you will be ok to walk with me, through the jungle, and know that I can ‘hold’ space and create containers with you so we can handle whatever dangers we might encounter.
But can you only work with ‘non-serious’ problems?
Our role- as mentioned previously- is to create containers to be able to work through the Hard Stuff, with whatever you present (and often more).
Our role is to invite you to feel safe enough to do this work with us and trust us to be the right companion for your journey. We do our best to be trauma-informed in our practice. We take care to create a welcoming environment, to emotionally regulate ourselves, and in turn do that with you.
I also know what to look for in searching for a ‘local’ service if a client needs to see another professional alongside myself. From a distance I can still email or call a doctor, social or legal service; write a letter of support or explanation; and send links about organisations, forums and groups that might be of help.
The fact is the entire world is triggering.
Sometimes being online is actually SAFER because you can be in your very own space that you chose. My clients meet me from a private room at home, or in their car, or in a spare office, or even on their holidays. There’s less pressure to observe social norms such as eye-contact or wear presentable clothes.
You know what?
Counsellors hope you will find that over time you can tolerate bad feelings for longer and become more in control of- more knowledgable about- yourself, truly believe you are worthy, and have a deeply felt understanding that ‘this too shall pass’.
That you will feel braver speaking freely (and trust in your own compassion without needing to apologise for simply being alive) and living more closely in alignment with your values. That you will be less strangled by any form of toxicity that tries to choke you.
More of living in your very own ‘sweet spot’.
This is no different no matter what problem you present with.
In my experience, the ways that internet and in-person counselling are different are not the ways that most articles focus on. They’re far more subtle, nuanced, surprising and sometimes they’re even exciting and useful differences.
We are all just humans, and the vessels we use to find each other and connect through are becoming so much less relevant than the actual connection.
So my final thoughts are: You Do You. Do your research on the person rather than the platform, and then get help in any way and with anyone that works for you.
But do get help.
Are you thinking you might be in need of help? Contact me here to ask any questions or scroll down to sign up for my list and get your free mini-workbook ‘7 Steps to Begin Freeing Yourself from Self Hate and Other Nasty Problems’. I’d love to help you on your travels towards greater contentment. Love Nicole.