Online Therapy vs In-Person: What Will Mental Health Support Look Like After Lockdown?
The Covid-19 pandemic has meant that clients have had to see their therapists online
Therapist Gareth Strangemore-Jones considers how mental health support might look post-lockdown
You can find an online therapist or counsellor here
When dealing with matters of the mind, online therapy can be a highly effective way for clients to access their therapist. Online therapy is safe and highly convenient. The client can schedule an appointment at a time that suits them and have the session from the comfort of their own home. This can be very useful if clients are experiencing anxiety over leaving their home and going out into the community. It is also appropriate if someone travels a lot or has a very busy schedule, which would mean they wouldn’t have time to have therapy if it wasn’t online. It has been especially important during the pandemic when, in my practice, I have treated clients who are self-isolating, socially distancing or living in unhappy circumstances with others, in the most extreme and dire situations of loneliness and despair. For someone suicidal, online therapy is an immediate source of support which, of course, is vital.
My therapy is what can be described as integrative. According to a client's needs and wishes, I offer a personal programme of counselling, clinical psychotherapy, SFBT (solution-focused brief therapy), the very popular cognitive behavioural therapy (CBT), advanced medical hypnotherapy (involving self-hypnosis techniques to empower the client), NLP (neuro linguistic programming), solution-focused mindfulness, including fast-track breathing and anchoring techniques, and the latest research-based and clinically-proven neuroscience.
All of these methods are compatible with online therapy and in my experience all have produced excellent recorded results. The benefit of an integrative approach is the ability to create a personalised programme for the client, one which they can play a part in creating as the solutions and practices available are described and explained.
What is solution-focused brief therapy?
SFBT is a highly effective talking therapy aimed at speeding up the therapeutic process and encouraging the client to find their own solutions, which creates organic and durable results. At the core, solution-focused brief therapy hinges on the understanding that the client already has the right solutions for them to achieve a preferred future. As the therapist, it's my job to facilitate their journey, offering the platform and lighting the way, so to speak. If we are stressed, anxious or depressed, we often lose the ability to innovate, to try something different and to access these solutions. So, we often become stuck in a negative feedback loop. Depending on an individual’s situation and issues, solution-focused brief therapy generally creates a very quick recovery pathway for clients, which is a great positive. It is also proving to be longer-lasting.
What is hypnotherapy?
Hypnotherapy is widely misunderstood as people often think they will be induced into a completely unconscious state of mind where they will be out of control. This is not the case at all, especially in medical hypnotherapy, because with solution-focused work we desire the client to come up with solutions themselves, to problems they have identified they need solutions for.
This is best achieved in Theta (also known as Trance), which is simply the relaxed state between wakefulness and sleep. In this state of mind, the brain is very suggestible to guided imagery. So, if we’ve just been discussing positive changes during the psychotherapy (talking) part of the session, they will naturally, lucidly and consciously daydream about this during Trance Hypnosis and this really helps the mind to imagine how things can be better. Consequently, this helps the individual to actually practise this in their everyday lives. The subconscious mind is like a very natural, very safe virtual rehearsal room, which makes it ideal to work with ‘virtually’.
Can these types of therapy be effective online?
It is, of course, very beneficial for humans to enjoy regular positive interactions. This is because we produce what we call happy reward chemicals whenever we enjoy positive human contact. These neurotransmitters (brain chemicals) are a major factor in our mental health and general wellbeing because they encourage us to be happy, brave, confident and they foster high levels of confidence and self-esteem. We don’t actually need to be in the same room as someone to fully enjoy human interactions.
For me personally, there have never been any real issues working online and, being solution-focused, there is always a solution to any problem or challenge. Sometimes, a client’s internet connection is a bit weak but we have always managed to communicate effectively. Occasionally, a more mature client or one who deems themselves to be a techno dinosaur, will resist working online, but after they’ve had a session, they realise how easy it is, and end up being very comfortable with the process. I’ve had cats and dogs and children join the sessions – not all at the same time mind you! – but all this is part of the client’s life, so we just take it all in our stride.
Being a good therapist involves so much more than technique. It is about being able to read a person very quickly in order to help them; it’s about body language, facial expressions, verbal cues, questioning correctly, listening intently and facilitating the client to find their own solutions. It’s also about empathy, compassion, instinct and understanding the intuitive nature of humans.
I think we need to accept that our ‘new normal’ will continue to include a heavier bias towards online services in all sorts of fields: mental therapy and wellbeing, general health, education, translating, tutoring, training, shopping, catering, almost every sector you can think of. I have witnessed my clients, my friends and my family adapting to the recent enforced changes with extraordinary ingenuity and bravery.
It will not serve us as a global community to ignore the fact that we are living in a cyber age where all members of our society are in some way intrinsically linked to some form of technology. If clients are fearful of working online but it is their only option, it is going to benefit them enormously to work online with their therapist, who will ensure that they are confident and comfortable with it. This will result in them being braver to use technology in other areas that will help them.
This pandemic will have lasting effects on how we give and receive help. Now, I am ready to deliver therapy through whatever lines of communication a person prefers whether that’s in-person in our clinic in Penarth (which will reopen when the government advises us it is safe to do so), online video, Skype, Zoom, telephone, WhatsApp, Messenger, text or our own special software. As long as the individual who needs our help is getting the support they need, that’s the only important factor.