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  • Fe Robinson

Myths about online psychotherapy

We are now a couple of months into a world where psychotherapy is being delivered mostly online. Just six months ago, many practitioners would have been throwing their hands up in horror at the thought of working in this way, and yet for many the transition has been made, and the work continues.

I am thoroughly enjoying my programme of learning around the different mechanisms to delivery online psychotherapy. While most of my work is done using videolinks, I am also enjoying experiences of working by telephone, and through written media, both using lifechat, and email. These different approaches call for different skills, and ask different things of both psychotherapist and client. That said, so many of my assumptions and beliefs have been proved wrong.

Today I wanted to share a few of the shifts I have consolidated in my own thinking as a result of the experiences I have been lucky enough to have recently:

Myth 1: You can’t use your feeling senses if you are not in the same room.

This has absolutely not been the case in my work. I find myself, and my clients, frequently moved by the dialogue emerging between us, and we have shared a felt sense of what is going on for them that is visceral and vivid. I am working differently to develop the relational field between us for sure, but it has been far deeper and more therapeutic than I expected.

Myth 2: You can’t do meaningful therapeutic work in writing.

This one I was a firm believer of before my recent studies and experiences. And yet, one of the deepest and most moving clinical experiences I have had of late was by livechat. I find the slow pace of this medium as I await my client receiving, reading and responding to a message, and they in turn await my reflections and questions enables a deep grounding and sense of my being with them. In these sessions clients and I have travelled together to places I doubt we would have reached in face to face sessions, and that has enabled different learning and movement in a number of situations. This work calls for a curiosity and an awareness of the way our mind fills in the blanks if we do not stay open, but this is something that can be actively worked with to good effect.

Myth 3: Boundaries will not be kept through online work, it’s not as safe.

A feature of clinical work is the way the psychotherapist with the client creates a space that feels contained and safe for therapeutic content to emerge and be worked with. The boundaries are clearly different to working in the same room, I do not have an influence over where the client is or how their room is set up for example. What is possible, however, is clear contracting and expectation sharing up front so that we both know what helps and hinders effective work, and an ongoing maintenance of the agreed boundaries to keep the work safely within what has been agreed. It’s also good to regularly explore how the client is experiencing the work, making adjustments as needed to maximise the benefits.

These are just three aspects of online work for which my perspective has shifted as I gain experience and knowledge. Online work is not for everyone, and its not recommended for all conditions and symptoms either. That said, if it’s something you initially rejected and yet you are currently thinking about therapeutic support, you may want to find out more and see if there is a way of accessing help that might suit you.


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