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online therapy

Online Therapy – What to Expect from Your Therapist and Yourself

Plenty of promising research studies support the achievement of a solid therapeutic alliance between clients and counsellors using online therapy formats. But, there are some important factors impacting this alliance that include how much experience your counsellor has logged in the world of cyber therapy. Your counsellor’s training in therapy models and ethics are a significant factor, but so is their experience and training in online therapy and Telehealth formats.

Some Differences from Traditional Counselling

There is evidence that counsellors must work a little harder, ask questions that dig a little deeper, or take a bit longer to explore just how their client is reacting to a given experience or event in online therapy.

The reason? Social cues are simply more challenging to read on a screen. When a client’s full body is no longer in view, how is a counsellor to know what’s really going on emotionally? This takes more experience, more patience, and more consideration for what are often called “process-oriented questions” that aim to help clients more fully explore and verbalize their response to a given challenge or issue.

These questions are part of an experienced counsellor’s repertoire of “micro-skills” that prompt them to remain curious in their assessments and not take everything they see, hear, and sense at face value.

It’s a good idea to hire a counsellor who has at least three years of experience in their field. In the case of intern counsellors, they should have weekly supervision sessions that help them to hone these skills and practice them with guidance to ensure responsible, ethical and effective service.

Getting the Most out of Your Home-Based, Counselling Session

An important consideration for all prospective clients of online counselling is that they are assured to experience a safe, professional atmosphere for a personal service that’s now, essentially, taking place in their own home.

How do we maintain those all-important boundaries in these personal spaces? One way to optimize security in your online counselling experience is to make sure that the agreed upon time for the session makes it possible for both counsellor and client to ensure that the room used for counselling is cleared of any other listeners, observers, or distractions. A closed door, a white noise machine (these can be purchased online for reasonable prices), and plenty of notice given to roommates and family members helps to ensure privacy and security. A plan for any unforeseen interruptions is also a good idea. Agree to end a session or at least pause (including an agreement to leave the meeting and minimize the screen) if someone or something intrudes. Agree to a code word that can be texted to indicate the “all clear” so that a session may resume once the interruption is dealt with.

Expect your counsellor to check in with you at the beginning of each session and at intervals to ensure your space feels like a place where you can speak your thoughts and feelings without fear of being overheard, or unexpectedly interrupted. Similarly, your counsellor’s virtual therapy room should appear free of distractions and depict a relatively neutral space, devoid of any personal photographs or furnishings that reveal too much personal information about your counsellor’s personal life, or home environment. Your counsellor should present as professional in dress, manner, and online space despite the convenience of showing up on your personal device.

Getting the most from your online session means showing up on your own screen with in a comfortable chair, shutting down any applications on your device that could interrupt the service, readying a notebook (to track your thoughts/feelings or note any “homework” ) and ensuring no use of substances or no medications were consumed beforehand that may impede your attention. A skilled therapist will help you to check in with yourself about your own readiness for the session that day, and you may notice more questions since the screen impedes their ability to observe you. Counsellors are trained to be good observers as well as listeners. They will need to investigate your wellbeing in some new ways in this format in order to more accurately gauge progress, assess readiness for change, and get a sense of any risks posed to your overall wellbeing. 

Preparing in Advance for Your Online Therapy Session

Taking a few minutes prior to the start of your online session is helpful to think over what you’d like to discuss, and what you feel you’re ready to discuss in that 50-minute hour. This may be one of the most important aspects of therapy in this brave new world as research demonstrates that there is always risk of sharing too much too soon over a screen. A skilled therapist will take the time to check in with you about disclosures you’ve made in previous online sessions to see how you’re feeling about such experiences.

The pace of therapy greatly impacts a client’s overall satisfaction with the experience of therapy.  It’s a therapist’s job to address any feelings of regret, guilt, or fear of judgement that clients may experience as a result of over-sharing due to the impacts of screen-mediated conversations. A skilled therapist helps you to feel validated, reassured, and emotionally supported in your effort to integrate difficult experiences, deal with sudden change, or cope during a crisis. Although therapeutic moments can be anxiety-producing and may elicit intense feelings, clients should not feel hurried or pushed in a given direction that could result in setbacks or premature withdrawal from therapy.

It’s normal to feel challenged in therapy, but its’ not normal to feel rushed, pressured, or obliged to share more than you feel you’re ready to share. An experienced therapist will not shy away from addressing such experiences with you, in a thoughtful and non-judgemental manner. All interpersonal experiences are grist for the mill in therapy. Talking over any discomfort that arises for you will be helpful to get the most from your counselling experience. 

Maureen Manning is a Registered Clinical Counsellor (RCC) who began exploring online options for her therapy clients after using video counselling to complete practical components of a clinical training in 2018.  Once a self-described technophobe, Maureen continues to explore how technology may be used to improve access and remove barriers to mental health services including location, stigma, and mobility challenges for clients with physical disabilities or chronic health conditions. She coordinates the Family Counselling Program for Hollyburn and is the Senior Clinical Manager of Family Programs for Hollyburn Family Services. You may reach her at email hidden; JavaScript is required