Many of our services are now delivered online, whether it’s banking, shopping or healthcare, and we are increasingly used to the flexibility of accessing services from our own homes. Counselling is no exception.

Online counselling might not be for everyone, but for some people it can offer advantages over more traditional face-to-face counselling.

Often, when we have a problem, we turn to online search engines to find support or information that may help us understand what we are feeling, thinking or experiencing. This can be helpful, particularly for people who find face-to-face communication difficult or who have limited time or opportunity to access support in person.

Information found online is not, however, a substitute for individual therapeutic support. Online counselling provides an opportunity to work directly with a counsellor using methods such as video, telephone or written communication.

How does it work?

When beginning online counselling, your counsellor will usually spend some time getting to know you, understanding what has brought you to counselling and exploring what you hope to gain from it.

As with face-to-face counselling, it is important to consider whether the way of working is appropriate for you and your individual circumstances. This may include discussing your emotional wellbeing, any risks or additional support needs, your privacy, the environment you will be joining sessions from and what would happen if difficulties arose during an online session.

Experiencing significant distress or suicidal thoughts does not automatically mean that someone cannot work online. Instead, suitability and safety need to be considered individually, including what additional support or arrangements may be needed.

Regardless of the counselling medium you decide to use, it can be helpful to give yourself dedicated time and space for the communication. During busy lives, we often squeeze emails, phone calls and messages into spare moments. Counselling deserves space of its own where possible.

When meeting with a counsellor face to face, the counsellor takes responsibility for providing an appropriate private environment. With online counselling, you and your counsellor will need to think together about privacy and confidentiality. This might include finding somewhere you are unlikely to be overheard or interrupted, considering who has access to your devices and agreeing what will happen if the technology fails.

As with face-to-face counselling, therapy can sometimes be emotionally tiring. You may find it helpful to allow yourself some time for reflection or rest afterwards where possible.

Counselling via written communication

Some counselling can take place using written communication. For some people, writing offers valuable time to think about what they want to say and express experiences that may feel difficult to communicate aloud.

The arrangements for written counselling will depend on how you and your counsellor have agreed to work. Your counsellor should also explain how your information and communications are protected and any limitations associated with the technology being used.

Counselling via phone

Telephone counselling allows you and your counsellor to speak without being in the same physical space. Sessions are usually arranged for an agreed day, time and length, just as they would be for face-to-face work.

Some people appreciate not having to be seen while talking, while others find the absence of visual communication more difficult. Neither response is right or wrong; what matters is finding a way of working that feels suitable for you.

Counselling via video

Video counselling offers the opportunity to see and hear your counsellor in real time while working from different locations. Sessions are normally arranged for an agreed day, time and length.

Your counsellor should consider the privacy and security of the technology they use and explain any relevant arrangements to you. Because technology changes rapidly, the particular platforms used for online counselling may also change over time.

Advantages

Accessibility

Online counselling can make therapy accessible to people who might otherwise find it difficult to attend in person.

There may not be an appropriate counsellor nearby, or someone may live in a small community where greater geographical distance feels helpful for privacy. Online counselling can also widen the choice of counsellors available rather than limiting someone to those within travelling distance.

People who find leaving home difficult, people with disabilities, parents, carers and those with work or other commitments may also find online counselling more accessible.

Cost and convenience

Online counselling can sometimes reduce some of the additional costs associated with attending therapy, such as travel, parking, childcare or taking additional time away from work.

For some people, being able to attend a session without travelling also makes fitting counselling into everyday life more manageable.

Online counselling can take place from a private space of your choosing. There is no need to travel to a counselling venue or potentially meet someone you know entering or leaving the building.

However, privacy at home or elsewhere is not always straightforward, so it is worth considering where you will have your sessions and whether you can talk without being overheard.

A different way to communicate

Attending face-to-face counselling can feel extremely difficult for some people and may even become a barrier to seeking support.

For some, communicating online or by telephone can reduce some of the immediate social pressure they experience when another person is physically present. Written communication in particular can provide more time to think, reflect and decide how to express something.

Some people may find this makes it easier to talk openly; others may prefer the physical presence and immediate responses available when sharing a room with their counsellor. Different ways of communicating suit different people.

Disadvantages

Communication challenges

Communication can feel different when counselling takes place remotely.

In video counselling, many non-verbal cues remain available, including facial expression, tone of voice, pauses and some body language, but the counsellor may see less of the client’s physical environment and movement than they would in the same room.

Telephone and written counselling provide different information again. This does not necessarily make them less meaningful forms of communication, but both counsellor and client may need to pay closer attention to how they understand one another.

If you are unsure what your counsellor has meant, or feel that something has been misunderstood, it is always okay to ask for clarification.

Lack of physical presence

For some people, being physically present in a room with another person is an important part of feeling connected and understood.

Leaving home to attend counselling can also provide structure, a transition into and out of therapy, and a physical separation between counselling and everyday life. Online counselling does not automatically provide these boundaries, so it can be useful to think about how you might create them for yourself.

For other people, being in their own familiar environment makes it easier to engage with counselling.

Is online counselling effective?

Online counselling is now a well-established way of accessing therapy, although people’s experiences of it vary.

The therapeutic relationship remains important whether counselling takes place face to face, online or by telephone. If you don’t feel understood or comfortable with your counsellor, it can be useful to talk about this together. Sometimes a different way of communicating may suit you better; sometimes it may simply be that a different counsellor would be a better fit.

Not every client and counsellor will work well together, and it is okay to consider what you need from the relationship.

Online counselling is not limited only to people experiencing mild or moderate difficulties. Whether it is appropriate depends on the individual, their circumstances, the nature of the work, the counsellor’s competence and the support and safety arrangements that can be put in place.

Technological difficulties

Sometimes technology goes wrong. Internet connections can fail, devices can stop working or a session may unexpectedly be interrupted.

Your counsellor should have discussed what will happen if this occurs. For example, you might agree to reconnect, continue by telephone or rearrange the session depending on the circumstances.

Technology can also feel daunting if you are not confident using computers or other devices. Your counsellor may be able to help you understand what is required, and you can discuss whether another way of working would feel more comfortable.

Therapist credibility

It is important to check the qualifications and professional standing of any counsellor you are considering working with, whether you meet them online or face to face.

“Counsellor” and “psychotherapist” are not currently protected titles in the UK, so it is sensible to check whether a practitioner is appropriately qualified and belongs to a recognised professional body or accredited register.

You may also want to ask about their experience and competence in providing counselling online or by telephone. Working remotely brings additional considerations around communication, confidentiality, technology, boundaries and responding when difficulties arise.

Professional bodies such as the British Association for Counselling and Psychotherapy (BACP) provide searchable registers that can help you check a practitioner’s professional membership.

Conclusion

The flexibility of online counselling can be a real benefit for people whose circumstances make conventional face-to-face counselling difficult, as well as for those who simply prefer working remotely.

It also brings different considerations around privacy, communication, technology and the experience of not sharing the same physical space.

There isn’t one way of accessing counselling that will suit everybody. What matters is finding a counsellor and a way of working that feels safe, accessible and helpful for you, and being able to talk together about what you need as the work develops.

Image courtesy of: Hannah Wei