Online Counselling & Digital Overload
In general people who have been utilizing online counselling are somewhat ‘zombified’ and are desperately indeed of human contact!
It is questionable how effective the sudden influx of online services has been but we can safely say it has assisted some people adequately. Addicts on the other hand may well be struggling as online groups and counselling offers limited support. I would say that addiction related online services have simply not been as successful as face to face counselling and group therapy that was taking place prior to the pandemic.
Online Pros and Cons
Talking to someone online is better than not talking to anyone at all but I am sure there will be a group of potential clients who would simply avoid anything online! Computer literacy can be challenging for some people and the fear of being hacked or their personal details not being treated in a fully confidential fashion is a genuine fear for some people leaving them isolated. It would be fair to say that members of this same group would not attend face to face counselling either!
Addiction counselling online can be particularly challenging to address effectively. If a client’s attitude, behaviour or thinking pattern needs challenging then its much easier to do face to face as the body language can be read from both sides and the environment feels safer for the client being in the counselling room. The ambiance of a supportive counselling room setting cannot be created online. Regardless of how secure each room is the fact remains that two separate rooms are being used and psychologically this will negatively impact the therapeutic alliance.
The counsellor may well struggle to be assertive online for fear of losing some level of control over the distanced alliance! ‘What if the client turns off their computer’? ‘Is there a risk of worsening a clients existing situation’? I am sure a number of scenarios must go through a counsellors head meaning that their approach to therapy will be different and possibly not as effective when face to face!
Tea & Biscuits
If the client and counsellor have worked together face to face prior to the pandemic, then the online counselling may transmit quite well. A new client, on the other hand is a completely different challenge! The risk of ‘tea and biscuit counselling’ is very possible meaning that the alliance is based on ‘safety’ and not so much ‘trust’. The alliance may grow into a deeper level of therapy yet always at risk of remaining superficial and unsatisfactory for the client.
Rules of Engagement
Hopefully, counsellors, coaches and therapists are assessing their clients initially via a questionnaire in order to assess the client’s suitability for your skill set. Are the rules and expectations in place? Are you insured?
Counselling limitations must always exist and this applies to online counselling. When a client starts to discuss a topic that you find uncomfortable, are you going to challenge this and possibly refer? If the direction changes quite suddenly during face to face counselling, then this will be much easier to manage ‘live’ as the content will feel more controllable and perhaps less shocking! Any element of transference and counter-transference cannot really take place online.
Being empathetic online is surely an issue! Genuine responses go way beyond words, its about body-language, clear eye-to-eye contact and a tone that may not be transmitted so well.
Self-disclosure has always been a bone of contention for many years! Some say that this should ‘never’ happen, but many counsellors utilize good timing to self-disclose as a strategy to empathise and help strengthen aspects of trust and the therapeutic alliance. Self-disclosure by a counsellor online could be problematic for the counsellor who may also be concerned about privacy on the web!
In my humble opinion, unlike online shopping I do not think online counselling will be as popular! Managing an online counselling service is incredibly involved and needs to be accredited in some way and all ‘counsellors’ experience and qualifications need to be available.
Some may argue that online is no less productive than residential treatment! On the other hand though, Anxiety and depression counselling has proved to be helpful online but not so much for addiction disorders!
At the end of the day, most people ‘need’ human face-to-face interaction in order to exorcise their demons and move towards building a better relationship with themselves underpinned by the nurturing that comes with face-to-face talking therapy.
David is the Clinical and Development Director of Twin Rivers Rehab in South Africa and a UK Accredited Addictions Therapist with the Federation of Drug and Alcohol Professionals UK. Articles/Blogs are written with the assistance of researchers and other specialists in the field of addiction and the recovery process