Frequently Asked Questions
How long will therapy take?
In most cases we consult weekly, although more/less frequent contact can also be arranged.
I offer both short and long-term therapy. Current guidelines for short-term therapy are 6 – 24 sessions. Long-term therapy has no time limit, although we review your needs as we go along.
What can I expect in my first appointment, and thereafter?
In the first 1 – 3 sessions I do a careful assessment to understand your background and difficulties. During this phase we will talk about whether you may need a short-term or longer-term process. I will reflect on whether I am able to provide the assistance that you need, and if I am not, I will help you to find another practitioner that may be better suited. Therapy is a highly individual relationship and must feel like a good ‘fit’. Please let me know if my approach does not feel right for you, in which case I am also happy to assist with a referral.
Therapy starts from the first meeting, but the process may feel a bit slow in the first couple of assessment sessions. I will be asking many questions about your life history as well as your current concerns, to make sure that I have a thorough understanding of your experience and needs. As we move beyond this assessment phase, I will impose less of a structure and the idea is that we talk about whatever feels pressing or important to you on the day.
What are the tech requirements for online therapy?
For video therapy you will need a computer/laptop/phone with Zoom (or alternative platform that we agree upon) installed, and an internet connection fast enough to support video conferencing (at least 2 Mbps). (You can check your internet speed by going into Google in your browser, typing ‘Speed test’, and then running a speed test.)
To ensure a stable internet connection, it is preferable to use an Ethernet cable or sit close to your router.
We will agree on back-up plans in the event of a poor or lost connection. This may involve changing platforms, shifting from video to audio, and/or rescheduling – depending on your preferences.
How do I know that therapy will be private and confidential?
Privacy and confidentiality are essential features of psychotherapy. In face to face therapy the therapist ensures that the consultation happens in a private space and that everything shared is kept confidential. When working online, both the therapist and client need to take steps to ensure that all communication is private, and cannot be overheard/seen/intercepted by third parties.
I work alone from a home office with no one in earshot (you may occasionally hear my dogs barking); I use secure platforms; and I keep my virus software updated.
I ask clients to do the following:
· Arrange a private location, where you do not have to worry about being overheard or interrupted.
· Never use a public computer or device for therapy.
· Ensure that there is a virus scanner installed on your device and that this is kept up to date.
· For email therapy, keep your email account secure with a long password, preferably at least 16 characters long.
· For instant messaging therapy, make sure that the device that you are using is password protected so that no one else has access to therapy chats.
What is the evidence base for online therapy?
Online therapy is a relatively new field so there are limited large, controlled studies of efficacy. However, the research that has been done is promising and suggests that online therapy may have distinct advantages. There is good evidence that it is a safe form of treatment for mild to moderate distress. In certain cases, severe distress may be better managed with face to face treatment. If I think that you are likely to benefit more from working face to face, I will discuss this with you and help to arrange an appropriate referral.
Clients report the following advantages of online therapy:
· Access to treatment from the comfort of one’s own home (or other space of one's choice).
· Access to treatment for clients that live remotely, travel frequently, or are housebound.
· Access to a wider range of therapists, who may also have specific areas of interests and competencies that match the needs of the client.
· Scheduling flexibility: online therapists are more likely to have availability on weekends or outside working hours.
· Clients with privacy concerns often prefer the anonymity of online consultation (i.e. not having to request time off work, or risk bumping into acquaintances at a therapist’s office or student counselling centre).
· More introverted or socially anxious clients often prefer online therapy, particularly text-based forms that use email or instant messaging.
· Some clients report that they feel more comfortable and empowered in the therapy process when they are in their own space rather than a therapist’s office.
· A good therapeutic alliance is one of the best predictors for successful treatment in therapy. Clients rate online alliance as highly as face to face alliances – interestingly, even with text-based forms such as email therapy.
· Some clients feel more able to share difficult material when working in a text-based modality such as email or texting therapy. This is particularly the case for clients who may struggle with feelings of shame or social anxiety.
· Some clients find it helpful to be able to share experiences as they arise, without having to wait for a scheduled appointment. Working online in text-based formats allows this.
· Some clients appreciate having more time to reflect or ‘process’ what the therapist has shared, before having to respond. Again, working online in text-based formats allows this.
References
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Rice, S., Gleeson, J. & Davey, C. et al. (2018). Moderated online social therapy for depression relapse prevention in young people: pilot study of a ‘next generation’ online intervention. In: Early Intervention in Psychiatry 12: 613-625.
Richards, D. (2009). Features and benefits of online counselling: Trinity College online mental health community. In: British Journal of Guidance & Counselling 37(3): 231-242.
Sucala, M., Schnur, J.B., Constantino, M.J. et al. (2012). The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review. In: Journal of Medical Internet Research 14(4): http://www.jmir.org/2012/4/e110/ (accessed 9 January 2020).
Weitz, P. & Sukthankar, R. (2015). Non-verbal communication and its role in online Instant Messaging therapy setting. Unpublished.