A Reflection: 12 Years As An Online Therapist

During the lockdown, Online Therapy is becoming popular. Therapists who never thought about it are rushing offers onto the web, primarily to help existing clients but also to maintain income levels. Many of the offers that I see are on a par with my early attempts in late 2008.

I have now being practicing online for about 12 years after taking the jump from my office based practice. From the early attempts using Skype and low internet bandwidth, I have moved to fiber optic internet and encrypted video systems.  Of course, this level of technology is an essential part of what I do and without it, nothing works. However, there is a lot more to it than that.

When I first decided to stop having clients in my office and gradually move online, I had no idea what to expect. Not many were doing it at that time and those who were used it as  back up if someone couldn’t attend. This was generally phone based and I also did this if someone’s car broke down or they were ill. However, I wanted to take it completely online with video interaction. I had the idea then that this was the future, that eventually, nobody would be visiting a therapist in his or her office . Twelve years on, there are many more therapists online but people are still utilizing office based services. I still firmly believe the thought I had at that time and there are signs that online based services are taking a real hold…in the UK and US especially.

I would like to think I  have learnt a lot over the last 12 years and hopefully, I am putting that to good use. The differences, I have found have been rather staggering, but I firmly believe that online therapy practiced seriously and with the client’s best interests at heart, is just as effective as being in an office based environment. I have had to learn a whole new skill-set that is needed to work online. 

I have written here before that the decisive factor in the therapeutic process is the relationship between the therapist and the client. Online Therapy has been criticized because many feel that this relationship cannot ever be the same as in a traditional therapy setting. My experience is that there is no basis for this thinking. Online therapy practiced well, will actually promote this process rather hinder it. I cannot talk for other therapists working online but due to the fact that I allow clients to reach me between sessions by email or text, the relationship has the best chance of being developed.

Another criticism often aimed at doing therapy online is that it doesn’t cover one of the most important aspects of interaction…that is analyzing body language and facial gestures. Again, due to the quality of video imaging software programs available, it is just like being in a therapist’s office. Equally, privacy is taken care of with encryption and it is the therapist’s responsibility to ensure this happens.

The bottom line is that taking therapy online is an intense experience for client and therapist alike. However, as technology improves, one can assume that more and more therapists will take that step. I myself, have found it a rewarding experience working with different faiths, cultures and nationalities.

This is not a nine to five job and I am often still working at 11 pm and I always work at weekends. Using technology to its fullest, I use encrypted email and an encrypted chat system to offer support between sessions. Many clients have said that this “full service” offering has accelerated their progress. 

The online experience is a very convenient but also brings challenges to the client and the therapist. From a therapist’s view (my own), it usually means long hours working early mornings and late nights as you “travel” across time zones. Hours spent in front of a computer screen (self-care is important) and then a realisation that even though sessions are finished, there are mails to answer.  It also means to have an internet and social media presence. That means time taken to write articles, produce podcasts and videos, post on social media on top of all the normal admin associated with client notes. It also means being available between sessions to answer emails and enquiries from prospective and existing clients. Something that was not such a feature my office setting before. It is also to be an information source and I get many emails from people who just want to ask a question. This is all part of the online experience for the client and one that an online therapist must be willing to perform. This is why not every therapist is suitable to transfer their practice online.

For the client, it is the ultimate in convenience. Sessions can be taken from anywhere, the home office, on trips even in the car (yes…that happens). There is no traveling, parking, taking time off work and sessions can be done at any time. I get clients who say to me that they chose to work with me online for that very reason and more. They can see me before or after work. I can be reached by just sending a mail and they feel supported through crisis at the click of a mouse. Clients rarely cancel due to illness or the weather and always seem to be able to find the right place to have a session. How much better can it get than sitting at your kitchen table with coffee in hand?

4 Thoughts

  1. Good for you Doc. I find therapist who have a blog and interact online are at the cutting edge. Many mindful based therapists engage online.

    As a civilian non therapist who has run a mindfulness group in person for seven years and a blog for longer, my blog has influenced and helped more.

    I believe it has to contain a desire to improve from the client that results in daily action that produces results. From your willingness to work at 11 at night and weekends shows you adapt to help.

    With a client ready to take action our relationship, our caring about helping them is key

    They must trust and feel secure to face their demons I believe

    Give yourself gratitude for your insight and risk to adapt and change accepted norms

  2. In my opinion therapy online can be as effective and maybe more

    I have had a few different therapists but my healing happened more through reading, meditating applying the skills I obtained

    In America you generally see your therapist every week or every other week fit an hour session

    That means 52 hours a year in therapy

    If we say 24 hours of waking hours a day times 365 days a year which equals over 5,000 hours

    5,000 hours versus 52 hours

    I got direction in therapy
    I healed in the other 5,000 hours

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