© of A Yates 2011

Online Therapy information

Therapists offering online therapy are not supplying a type of treatment in itself, just describing a way to distribute the services we are offering to our clients over the internet, some counsellors and psychotherapists like myself only provide sound and video, while others also offer chat and email options as well.

What is online therapy?

Online therapy is a reference to online counselling and psychotherapy services, including chat and email options, was once considered a new way of delivering the therapeutic experience when talking to a therapist, now it is commonly used by millions of people to find help and support for addressing mental health problems while using modern technology to communicate over the internet. It started many years ago with email and chat programs, customarily known as chat-therapy or e-therapy, often using platforms like yahoo messenger MSN and Skype to talk to psychologists and counsellors. With the rise of modern internet enabled devices like smartphones computers and tablets, having therapy delivered over the internet became popular by demand, also commonly known as e-counselling, cyber counselling, online-counselling and in the US usually referred to as teletherapy by some therapists. No longer was online therapy restricted to email or chat, it grew to include video and voice communications, once again Skype was at the forefront of change. However, the world of therapy was slow to catch up, often dismissed by some therapists as not ethical or safe. Although online therapy has its issues, it was never the less pushed into existence due to the high demand for change, often from clients who wanted to experience therapy online because of the lower cost and convenience. Skype was the first popular VOIP method to be used, but it was heavily slandered by many therapists, as not being confidential even though at the time it was probably more secure than many other VOIP options and landlines. Many people still use Skype for therapy, and it is still considered to be a very safe and secure option, but now there are a number of choices from video conferencing software like Vsee, Wire and many others that claim to be more secure.

Therapy influenced by modern technology

As a therapist who has been working online for several years, I found that people in the modern technology-driven world like the freedom to choose where they receive therapy. Not being restricted to a therapist’s physical office, means they can choose to have the help and support that they need at home, they can do this anywhere that feels safe and comfortable to them. That could mean sitting parked in the car, in the office at work or hotel, as long as they can find a good connection they can have therapy online where ever they are in the world. By giving people the option to find a counselling or psychotherapy service over the Internet, many people have been able to access therapeutic services who would never have been able to do so before it became available via the Internet. Therapy is also becoming less expensive, by using encrypted communication programs like Skype, wire, Vsee, and other communication software, therapists working online can provide online counselling and psychotherapy to a much broader client base, all this without having to pay for office space and employ someone to answer the phone and book appointments. Websites just like this online offering a counselling and psychotherapy service has been growing in popularity for some time, it has given lots of people the freedom to find what they need when they need it, without being restricted to a physical locality

Using Skype for therapy

One way that this is very popular for providing an online therapy service is a program called Skype, using Skype you can use video or just sound and instant messaging to talk online to your therapist, all the communications between a therapist and their clients are encrypted to provide a good degree of confidentiality, although you can argue that Skype is not as secure as the other two options from Vsee and Wire, many people request they use Skype as they trust and understand the program. Skype.com

Using Vsee for therapy

Vsee is a communication software similar to Wire, it uses encrypted and secure communication between therapist and client and is aimed at the therapist and health market and especially for the American markets that need to be hippa compliant. Some people do not like Skype, so I offer this option as well as using Skype to provide a more flexible Internet therapy service. Find out more at http://vsee.com/

Using wire for therapy

Wire is another encrypted and safe way of communicating that offers full privacy along with a very secure set up, and it is available on a number of different operating systems https://wire.com/en/

Telephone counselling

Counselling services have been using the telephone to deliver therapy helping to support people for many years, help and support has been given to people who would otherwise not have been able to receive it. In some cases the only way that disabled people who are housebound or who are unable to travel can talk to a counsellor is via the phone, it gives them the access and support they can use. People have been using this way of receiving counselling before the internet was available, phone counselling has been shown to be as useful for some people as traditional face to face therapy, it is still used today as much as it ever was, with the added benefits provided with the mobile and smartphone devices. Now people are not restricted with landlines; they can be completely mobile based, Programs like Skype can also be installed and used on the majority of smart-phones, allowing the use of internet-based online therapy where ever you can connect to a mobile network.

Online chat counselling

Chat programs can provide a real-time interactive experience using a computer or a mobile device using text to talk to a counsellor directly. Chat programs tend to have more complex confidentiality concerns, and there are some issues with knowing whom you are talking to without any visual or voice interaction, but people still request it, and some therapists still provide online counselling with this method. This service only provides chat via secure apps, the therapist does not respond with chat or text but uses voice only to reply so that the client can chat via the app, but the therapist will respond using voice chat.

More choices with online therapy

The access to online therapeutic services over the Internet is not limited to any city or country and is available via computer or smartphone worldwide, as long as the connection can support it. There usually is much more choice regarding the available times and the number of days that the service is available to you, so if you work long hours a Sunday morning is maybe better for you than a Monday night, so more flexibility and choice when using an online therapy service. Having a video therapy session can help some people connect in a way that feels almost like being there in person, the visual interaction can help some people replicate face to face therapy sessions, and although it may be similar, it is not the same. It is a much better option than just using sound for people who need to have visual feedback when they are experiencing online psychotherapy and counselling. Not using the video for therapy, and Just using sound only is a bit like closing your eyes, for some, it is a better way to connect with their thoughts. Fewer distractions from visual stimuli and a better connection to their inner world, if you close your eyes and shut out the external visual world, are you then paying more quality attention to your inner world, try it and see. That is why I offer sound only as well as video, using video when experiencing therapy helps some people feel comfortable and connected, but it can feel intrusive to some. With only using sound to talk in therapy it can help some people feel more at ease, there is no need to dress up and impress or project the image you think I want to see. Instead, you can feel less judged and more in tune with what is important to you. Many people find, that using the sound only option when talking online very helpful, the main advantage that remaining hidden from the online therapist gives you, is that, it can allow you to feel more secure within yourself, it can help make the therapy experience feel less stressful and will enable you to talk openly about personal issues. It then becomes more about you and your needs; it is not about how embarrassed or anxious you feel in front of a camera talking about your thoughts feelings and life experiences. Feeling more relaxed by not using a webcam may help you deal with painful thoughts and feelings. The benefits of feeling less stressed and anxious when having therapy, are often experienced immediately and eventually could help you to make the changes you need in your life on your terms.

Online therapy with flexible appointments

A therapist working online or off-line will offer similar options in regards to the number of sessions per week and the length of the therapy session. In general, a number of sessions are usually provided at seven-day intervals; therapists primarily accept this as an appropriate time interval allowing an excellent working balance for both the therapist and the client. Sometimes more sessions are needed for more acute short-term support, at the other end of the spectrum, some people may only need one session every two weeks or even one or two per month. Each session will typically last between fifty or sixty minutes, but some sessions can last for up to ninety minutes. The longer time frame is very dependent on the situation and is not generally used as a standard, but the extra-long session can be beneficial with complex cases where the client feels they need more time to express or think over the emotions and beliefs involved.

Advantages and disadvantages of online therapy

Some of the advantages You can stay hidden from view while in therapy. There is no need to travel to see the therapist when you can use the Internet for counselling. Flexible appointment times, including evenings and weekends. Talk from home and feel more relaxed in your home environment. Physical disability is not an issue finding therapy. (No steps or lifts or travelling to and from) There is more choice regarding what online therapist you can use. It can be less embarrassing talking about some personal issues. You can keep your privacy by staying anonymous. You can talk via phone or PC with Skype to talk to a counsellor. Connect from work or any place you have a connection. No one need know you are seeing a therapist with Skype. It’s physically safer for you. Some of the disadvantages Online therapy is not always suitable for serious mental health issues such as bipolar and schizophrenia without local clinical support. You need to feel confident using a computer. You need to understand how to keep your computer secure. As with any technology, it is possible that hardware can fail or go wrong leaving you unable to communicate. If you make recordings of the session you “must” encrypt it if your PC is stolen all data on your hard drive can be looked at and used unless it’s encrypted. It is not safe for people who are feeling suicidal or in crisis without more information and backup available. Qualifications do not mean that much online as different countries have different requirements, so you need to ask more questions. There can be issues with some slow connections in some parts of the world, and it is not always possible to use video if the connection is slow.

Not everyone agrees

Regarding therapists working online, it is worth mentioning that some therapists to this day do not like this way of providing help and support over the internet, they think it is not beneficial to the client and carries too many unknown risks, or that it is not classed as actual therapy and not confidential or secure. It has been argued that treating internet addiction online, for instance, is enhancing the problem not providing a good way of challenging the dependency. In my opinion as a therapist, there are obviously some concerns providing therapy online, but I believe the advantages for the clients by far out way the possible problems. I do know from my own experience of running a private therapy practice online for several years, that providing an internet-based therapy service has its issues, I also understand that online therapy is not the same as working with face to face clients, there are some subtle but significant differences. I had to learn all this from my own experience with trial and error, working as a therapist providing therapy services over the internet, because when I started providing therapy online, there was no one to ask or gain information from at that time.

The problems with online therapy

Being one of the first therapists to provide online therapy I had to discover the good and the bad all on my own, I found that in my experience there are aspects of a service like this that are indispensable. By providing therapy over the internet I have enabled people to seek the support they can not find in any other way, this has allowed people to find the help they need in a way that works for them. However, you cannot escape from the facts that online therapy services are prone to possible technical problems from a number of inherent weaknesses. There are possible problems associated with the quality of the connection, although it has improved substantially compared to a few years ago, there can occasionally be issues with the functionality of software or hardware that could disrupt the online therapy interaction. This means that at any moment a problem could disrupt an online therapy session, and in some cases create a situation where the client feels helpless and anxious. This is obviously not helpful to either the client or therapist, especially if the client is in crisis or experiencing other personal difficulties.

Confidentiality and security problems

Problems with confidentiality always need careful consideration; there is always a risk that clients will not be using the best practices regarding their security requirements. I have had prospective clients, wanting therapy via their computer, but had no working anti-virus or firewall. So I was unable to take them on as a client until they had fixed the issues, and then listened to and understood the information I provided about using best practice to keep their device secure as possible. Only if I was satisfied would we continue. Even then I have to trust that my clients continue to use reasonable security practices when opening emails and keep their system up to date to protect their confidentiality.

Not for everyone

Not everyone should have therapy online; this is my personal opinion, but I would not recommend that people with a severe psychotic mental illness, reach out to any therapist seeing clients on the internet. I have no objection with psychiatrists or clinical psychologists talking to their patents online, as they would in all probability have the experience and knowledge as well as all the necessary information available to be able to respond appropriately in a time of crises. Any therapist who wants to work online has to be aware of the risks involved, from what I have seen, some are not fully aware. As I am only dealing with neurosis and do not usually deal with psychosis (unless working in conjunction with a psychiatrist), I have to be as careful as I am able to be, to screen out high-risk factor clients that would not be suitable for online therapy services. Unfortunately, no screening will completely remove that risk, and that is always a problem to be aware of when working with clients online, especially those who are hidden or anonymous.
THERAPY PROVIDED ONLINE
Online therapy sessions with sound only
Online Therapy Service
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© of A Yates

Online Therapy information

Therapists offering online therapy are not supplying a type of treatment in itself, just describing a way to distribute the services we are offering to our clients over the internet, some counsellors and psychotherapists like myself only provide sound and video, while others also offer chat and email options as well.

What is online therapy?

Online therapy is a reference to online counselling and psychotherapy services, including chat and email options, was once considered a new way of delivering the therapeutic experience when talking to a therapist, now it is commonly used by millions of people to find help and support for addressing mental health problems while using modern technology to communicate over the internet. It started many years ago with email and chat programs, customarily known as chat-therapy or e- therapy, often using platforms like yahoo messenger MSN and Skype to talk to psychologists and counsellors. With the rise of modern internet enabled devices like smartphones computers and tablets, having therapy delivered over the internet became popular by demand, also commonly known as e- counselling, cyber counselling, online-counselling and in the US usually referred to as teletherapy by some therapists. No longer was online therapy restricted to email or chat, it grew to include video and voice communications, once again Skype was at the forefront of change. However, the world of therapy was slow to catch up, often dismissed by some therapists as not ethical or safe. Although online therapy has its issues, it was never the less pushed into existence due to the high demand for change, often from clients who wanted to experience therapy online because of the lower cost and convenience. Skype was the first popular VOIP method to be used, but it was heavily slandered by many therapists, as not being confidential even though at the time it was probably more secure than many other VOIP options and landlines. Many people still use Skype for therapy, and it is still considered to be a very safe and secure option, but now there are a number of choices from video conferencing software like Vsee, Wire and many others that claim to be more secure.

Therapy influenced by modern

technology

As a therapist who has been working online for several years, I found that people in the modern technology-driven world like the freedom to choose where they receive therapy. Not being restricted to a therapist’s physical office, means they can choose to have the help and support that they need at home, they can do this anywhere that feels safe and comfortable to them. That could mean sitting parked in the car, in the office at work or hotel, as long as they can find a good connection they can have therapy online where ever they are in the world. By giving people the option to find a counselling or psychotherapy service over the Internet, many people have been able to access therapeutic services who would never have been able to do so before it became available via the Internet. Therapy is also becoming less expensive, by using encrypted communication programs like Skype, wire, Vsee, and other communication software, therapists working online can provide online counselling and psychotherapy to a much broader client base, all this without having to pay for office space and employ someone to answer the phone and book appointments. Websites just like this online offering a counselling and psychotherapy service has been growing in popularity for some time, it has given lots of people the freedom to find what they need when they need it, without being restricted to a physical locality

Using Skype for therapy

One way that this is very popular for providing an online therapy service is a program called Skype, using Skype you can use video or just sound and instant messaging to talk online to your therapist, all the communications between a therapist and their clients are encrypted to provide a good degree of confidentiality, although you can argue that Skype is not as secure as the other two options from Vsee and Wire, many people request they use Skype as they trust and understand the program. Skype.com

Using Vsee for therapy

Vsee is a communication software similar to Wire, it uses encrypted and secure communication between therapist and client and is aimed at the therapist and health market and especially for the American markets that need to be hippa compliant. Some people do not like Skype, so I offer this option as well as using Skype to provide a more flexible Internet therapy service. Find out more at http://vsee.com/

Using wire for therapy

Wire is another encrypted and safe way of communicating that offers full privacy along with a very secure set up, and it is available on a number of different operating systems https://wire.com/en/

Telephone counselling

Counselling services have been using the telephone to deliver therapy helping to support people for many years, help and support has been given to people who would otherwise not have been able to receive it. In some cases the only way that disabled people who are housebound or who are unable to travel can talk to a counsellor is via the phone, it gives them the access and support they can use. People have been using this way of receiving counselling before the internet was available, phone counselling has been shown to be as useful for some people as traditional face to face therapy, it is still used today as much as it ever was, with the added benefits provided with the mobile and smartphone devices. Now people are not restricted with landlines; they can be completely mobile based, Programs like Skype can also be installed and used on the majority of smart-phones, allowing the use of internet-based online therapy where ever you can connect to a mobile network.

Online chat counselling

Chat programs can provide a real-time interactive experience using a computer or a mobile device using text to talk to a counsellor directly. Chat programs tend to have more complex confidentiality concerns, and there are some issues with knowing whom you are talking to without any visual or voice interaction, but people still request it, and some therapists still provide online counselling with this method. This service only provides chat via secure apps, the therapist does not respond with chat or text but uses voice only to reply so that the client can chat via the app, but the therapist will respond using voice chat.

More choices with online therapy

The access to online therapeutic services over the Internet is not limited to any city or country and is available via computer or smartphone worldwide, as long as the connection can support it. There usually is much more choice regarding the available times and the number of days that the service is available to you, so if you work long hours a Sunday morning is maybe better for you than a Monday night, so more flexibility and choice when using an online therapy service. Having a video therapy session can help some people connect in a way that feels almost like being there in person, the visual interaction can help some people replicate face to face therapy sessions, and although it may be similar, it is not the same. It is a much better option than just using sound for people who need to have visual feedback when they are experiencing online psychotherapy and counselling. Not using the video for therapy, and Just using sound only is a bit like closing your eyes, for some, it is a better way to connect with their thoughts. Fewer distractions from visual stimuli and a better connection to their inner world, if you close your eyes and shut out the external visual world, are you then paying more quality attention to your inner world, try it and see. That is why I offer sound only as well as video, using video when experiencing therapy helps some people feel comfortable and connected, but it can feel intrusive to some. With only using sound to talk in therapy it can help some people feel more at ease, there is no need to dress up and impress or project the image you think I want to see. Instead, you can feel less judged and more in tune with what is important to you. Many people find, that using the sound only option when talking online very helpful, the main advantage that remaining hidden from the online therapist gives you, is that, it can allow you to feel more secure within yourself, it can help make the therapy experience feel less stressful and will enable you to talk openly about personal issues. It then becomes more about you and your needs; it is not about how embarrassed or anxious you feel in front of a camera talking about your thoughts feelings and life experiences. Feeling more relaxed by not using a webcam may help you deal with painful thoughts and feelings. The benefits of feeling less stressed and anxious when having therapy, are often experienced immediately and eventually could help you to make the changes you need in your life on your terms.

Online therapy with flexible

appointments

A therapist working online or off-line will offer similar options in regards to the number of sessions per week and the length of the therapy session. In general, a number of sessions are usually provided at seven-day intervals; therapists primarily accept this as an appropriate time interval allowing an excellent working balance for both the therapist and the client. Sometimes more sessions are needed for more acute short-term support, at the other end of the spectrum, some people may only need one session every two weeks or even one or two per month. Each session will typically last between fifty or sixty minutes, but some sessions can last for up to ninety minutes. The longer time frame is very dependent on the situation and is not generally used as a standard, but the extra-long session can be beneficial with complex cases where the client feels they need more time to express or think over the emotions and beliefs involved.

Advantages and disadvantages of

online therapy

Some of the advantages You can stay hidden from view while in therapy. There is no need to travel to see the therapist when you can use the Internet for counselling. Flexible appointment times, including evenings and weekends. Talk from home and feel more relaxed in your home environment. Physical disability is not an issue finding therapy. (No steps or lifts or travelling to and from) There is more choice regarding what online therapist you can use. It can be less embarrassing talking about some personal issues. You can keep your privacy by staying anonymous. You can talk via phone or PC with Skype to talk to a counsellor. Connect from work or any place you have a connection. No one need know you are seeing a therapist with Skype. It’s physically safer for you. Some of the disadvantages Online therapy is not always suitable for serious mental health issues such as bipolar and schizophrenia without local clinical support. You need to feel confident using a computer. You need to understand how to keep your computer secure. As with any technology, it is possible that hardware can fail or go wrong leaving you unable to communicate. If you make recordings of the session you “must” encrypt it if your PC is stolen all data on your hard drive can be looked at and used unless it’s encrypted. It is not safe for people who are feeling suicidal or in crisis without more information and backup available. Qualifications do not mean that much online as different countries have different requirements, so you need to ask more questions. There can be issues with some slow connections in some parts of the world, and it is not always possible to use video if the connection is slow.

Not everyone agrees

Regarding therapists working online, it is worth mentioning that some therapists to this day do not like this way of providing help and support over the internet, they think it is not beneficial to the client and carries too many unknown risks, or that it is not classed as actual therapy and not confidential or secure. It has been argued that treating internet addiction online, for instance, is enhancing the problem not providing a good way of challenging the dependency. In my opinion as a therapist, there are obviously some concerns providing therapy online, but I believe the advantages for the clients by far out way the possible problems. I do know from my own experience of running a private therapy practice online for several years, that providing an internet-based therapy service has its issues, I also understand that online therapy is not the same as working with face to face clients, there are some subtle but significant differences. I had to learn all this from my own experience with trial and error, working as a therapist providing therapy services over the internet, because when I started providing therapy online, there was no one to ask or gain information from at that time.

The problems with online therapy

Being one of the first therapists to provide online therapy I had to discover the good and the bad all on my own, I found that in my experience there are aspects of a service like this that are indispensable. By providing therapy over the internet I have enabled people to seek the support they can not find in any other way, this has allowed people to find the help they need in a way that works for them. However, you cannot escape from the facts that online therapy services are prone to possible technical problems from a number of inherent weaknesses. There are possible problems associated with the quality of the connection, although it has improved substantially compared to a few years ago, there can occasionally be issues with the functionality of software or hardware that could disrupt the online therapy interaction. This means that at any moment a problem could disrupt an online therapy session, and in some cases create a situation where the client feels helpless and anxious. This is obviously not helpful to either the client or therapist, especially if the client is in crisis or experiencing other personal difficulties.

Confidentiality and security problems

Problems with confidentiality always need careful consideration; there is always a risk that clients will not be using the best practices regarding their security requirements. I have had prospective clients, wanting therapy via their computer, but had no working anti-virus or firewall. So I was unable to take them on as a client until they had fixed the issues, and then listened to and understood the information I provided about using best practice to keep their device secure as possible. Only if I was satisfied would we continue. Even then I have to trust that my clients continue to use reasonable security practices when opening emails and keep their system up to date to protect their confidentiality.

Not for everyone

Not everyone should have therapy online; this is my personal opinion, but I would not recommend that people with a severe psychotic mental illness, reach out to any therapist seeing clients on the internet. I have no objection with psychiatrists or clinical psychologists talking to their patents online, as they would in all probability have the experience and knowledge as well as all the necessary information available to be able to respond appropriately in a time of crises. Any therapist who wants to work online has to be aware of the risks involved, from what I have seen, some are not fully aware. As I am only dealing with neurosis and do not usually deal with psychosis (unless working in conjunction with a psychiatrist), I have to be as careful as I am able to be, to screen out high-risk factor clients that would not be suitable for online therapy services. Unfortunately, no screening will completely remove that risk, and that is always a problem to be aware of when working with clients online, especially those who are hidden or anonymous.
THERAPY PROVIDED ONLINE