Online therapy is a new and exciting field. But sometimes it can be difficult to trust someone you’ve never met in person and seen only on the computer screen, even if he or she is a mental health professional.
It is also called e-therapy, e-counseling, or tele-counseling. There are many resources on the Internet if you want to pursue online therapy. People decide to talk with a counselor online instead of traditional counseling for many reasons: It is more convenient to talk while being at home in a more natural setting; there is no additional time and money spent on transportation; because the therapist you really want to work with does not live in your city; it can be more suitable for younger people who are more IT savvy; because online therapy fees can be more affordable than regular therapy; or something else. It can also save you the hassle around scheduling, and it’s easier to make cancellations, if necessary. For the therapist, it also means that he or she can cover wider geographical space—in fact, the whole world. The only limitation is the time difference, so that can limit the potential time slots for scheduling (for example, if the therapist and the client are ten time zones apart, that can limit therapist’s availability).
Still, talking online looks so much easier than going somewhere physically and talking for one hour—then heading back home afterwards. But there is something more significant at play here. When people imagine themselves in therapy for the first time, the most unpleasant thoughts are usually associated with unlocking themselves to the person they don’t know. Research shows that it is easier to overcome emotional barriers related to opening up to the therapist via online counseling. Nevertheless, the decision to start therapy is sometimes equally onerous because we have so much on our minds. Feelings of shame (“Is something wrong with me if I need therapy?”), denial (“It doesn’t really hurt so much, I can get over it on my own”) or simply fear of therapy itself, are the most common barriers that hold us back from asking for help. These are true and pretty much the same for online and offline therapy alike. It is so hard to venture into the unknown!
However, resistance to therapy can be also linked with the proliferation of symptoms of depression. Going to therapy could be a smart decision and can influence your well-being. Instead of thinking of therapy as a last resort, the more useful outlook on therapy might be seeing it as a part of mental hygiene. We need to take care of our own private mental space from time to time, which is equally important as taking care of our bodies. In this way, we can develop into healthier and integrated human beings, and experience greater satisfaction in life. It is not about “something being wrong with you” if you think you need therapy. There is nothing pathological about it. Many people who think they do not need therapy could actually make good use of it, as it could significantly improve their quality of life.
It is obvious that seeking help is a smart thing to do when you feel depressed, anxious or if you have some other psychological problems, or just personal characteristics you would like to see changed as they may be hindering your professional success or personal relationships. An aversion to therapy can act like a strong gravitational pull for negative emotions and the subsequent inertia can even exacerbate your anxiety or depression.
So, how does online therapy work?
In my everyday therapy practice, I’ve come to realize that it can be equally difficult both offline and online to make a decision about pursuing therapy. After the first session, however, people will typically feel more at ease while they are talking to me in the privacy of their homes—especially in the beginning stages. As time goes by, the difference between offline and online therapy will start to evaporate: This is especially true if clients combine traditional counseling with additional online sessions (for example, they have online sessions when they cannot show up in person). As it turns out, establishing client-therapist rapport, as a special kind of emphatic and shared understanding, is the same in online as in offline therapy. That kind of shared understanding is achieved in a slightly different manner in online therapy, because the nonverbal cues and communication are not as important and not at the forefront as in offline therapy. The therapeutic rapport is established more through some other means—for example, constantly giving feedback (equally applies for the client and the therapist). Some therapists find it difficult to work online and see physical presence as crucial for establishing a quality client-therapist rapport, which is an essential element of the healing process. They may see non-verbal cues as particularly important as well. This is also true for some clients, while others find it easier to communicate with their therapist online. Therefore, online counseling requires even more awareness, alertness and vigilance on behalf of the therapist in order to make the therapeutic relationship truly healing.
Overall, as much as it opens up opportunities, the Internet also poses a challenge for psychotherapy. Barriers to asking for help are pretty much the same as in traditional settings. Still, the Internet can help overcome or at least diminish a sense of shame and stigma associated with asking for help. The decision as to whether to start the therapy process is up to the client and should be made with an awareness that it is not only about solving issues, it is also about improving one’s quality of life and overall well-being.
Vladimir Mušicki, PhD 