Online Therapy: Is It Really That Different?

Jul 09, 2020

coronavirus , onlinetherapy

Many of us might have concerns that online therapy isn't going to feel the same as face-to-face therapy
While it may not, that doesn't mean it will be less effective – you may even find some additional benefits. Therapist Joshua Bourne explains further
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As we move further into the digital age, the difficult reality for many therapists can come from connecting with you, the client. What does 'connecting with you as the client' mean? I am not referring to connecting with you using a type of therapy (for example cognitive behavioural therapy (CBT) or psychodynamic psychotherapy). No, I am not here to discuss these therapies. Instead, I am talking about the medium used to connect with you.

There are many different types of media used in therapy. For example, it could be face-to-face. It could be over the phone, text message or email. Think about it; you more than likely have used these different ways of communicating with family members, friends or others you know. Specifically, though, the medium I would like to bring to your attention is video and its application in therapy, particularly when comparing it to the traditional face-to-face therapy.

I am not just an advocate for online therapy because I have used it personally for a long time. Especially in these times, where illness, jobs, or family may separate us, being able to connect using technology is even more important. And that's not all; using technology as a way of connecting with people is part of a growing trend among therapists, as more and more therapists are beginning to open up to the idea of using different mediums when seeing clients.

Advantages of video therapy

While there is research (Day and Schneider, 2002; Germain, Marchand, Bouchard, Guay, and Drouin, 2010) that compares remote therapy and face-to-face therapy, my own work experience has shown some great advantages to using this technology, which includes but is not limited to:

1. Not just telling, but showing

Think about this. When you are with a therapist in his or her office, you think about your home environment. It's one thing to tell the therapist about your life at home, but being able to show an object from your home (say, a picture of a loved one) in real-time, provides not only a clear picture (quite literally) as to what your life is like, but in doing so, you show the therapist in real-time without being inaccurate.

2. Convenience and flexibility

This goes without saying, doesn't it? It can be tough to get to your therapist, because of traffic, illness, both or other reasons. You can instead meet at your home, perhaps not at the same time every time, but at a moment when you feel you have the energy to put in the work of discussing your life with the therapist.

3. Relationship building

You might think that to grow your relationship and trust with your therapist, you need to be there in person? Not true. This can be done via remote therapy. Trust comes from feeling you are listened to and being given full attention, but at the same time, knowing your therapist is a human too. Through a computer screen, you can maintain everything you have in-person: eye contact, hearing the therapist's voice and words, while also knowing that your therapist struggles just like you. For example, this could be with technology or internet connectivity issues. Humanising your therapist can come with enormous therapeutic benefits.

Concerns regarding online therapy

Using video conferencing technology in therapy is not without concerns. Here are a couple I have seen with experience:

1. Technology issues

Yes. Struggling with that internet connection, getting cut off in the middle of a session or not being sure how to use different video platforms can make clients doubt whether using it is for them. However, as mentioned earlier, I have found that when clients know the therapist may struggle too, it presents a level of honesty and openness that might help clients trust their therapist more. Also, the struggle of using the technology is a great way to use problem-solving skills, gain confidence and show to others in your life that you are incredibly competent!

2. Confidentiality

This is another concern I have seen with clients. Some think that confidentiality can only be maintained in the physical room itself. Therapists will often use the words "safe space" to describe a room you are in with him or her. The online therapy space is just the same, but that does not mean you, as the client, trust that yet! To work around this, I often talk to my clients about what might happen if there is fear about someone else walking into the room in your home, for example, which might breach confidentiality. Having a plan beforehand can help you feel more secure and can, of course, continue to help you build trust with your therapist.

Think about what matters to you

The question to ask yourselves is whether there is a significant difference in your experience between talking to people in-person and talking to them via video. It might be that the relationship you form with your therapist transcends the medium used in therapy. Think about it. Don’t just imagine an experience seeing your therapist via video conferencing, but instead imagine a friend or family member. Did you feel heard? Did you see that the person across the screen was looking directly at you? Did you feel like you were able to connect with that person?

What we can begin to see is that therapy from a distance may not seem like such a distance after all. If you can bring objects from your home to you and your therapist’s computer screen, you are bringing an added element you may not have considered.

If your relationship with your therapist matters more than whether you see him or her in person or on a screen, you may not feel too distant from your therapist, no matter where in the world you may be connecting from.

Joshua Bourne is a verified welldoing.org online therapist