Before the advent of online counselling and telephone counselling , physical presence in the counselling room would have been deemed essential to achieve a successful therapy outcome. Now, however, as people spend increasing amounts of time online the counselling profession has needed to adapt in order to meet the demands for a more diverse range of counselling services delivery.
Skype and telephone counselling are by their very nature not face to face counselling in the same room. Clients and therapists do not occupy the same physical space but they do communicate synchronously i.e. the therapist and client are engaging in a therapy session with one another in real time.
Today, Skype and other online platforms for counselling are mainstream and are more and more the preferred medium of the young seeking therapy and service users of Employee Assistance Schemes (EAPs) so should more counsellors/ therapists be offering this method of delivering their services to potential clients?
What follows is a bit of a potted history of my experience so far of working with clients using Skype and some of the pros and cons.
From 2000 to 2013 I was living in Bali in Indonesia. Most of my clients were transient ex pats. Some lived in Bali, others were in Bali on holiday from Singapore, Jakarta and Papua. Those on holiday were usually teaching English in International schools or working for NGO’s. Most of my clients came via word of mouth or through on line advertising.
Client issues were varied but often related to work/life balance issues, problems at work, being overwhelmed by events in their lives and relationship and health issues such as the one mentioned below.
When the clients left the Island they would continue their counselling or therapy via Skype. Although I came back to the UK in 2013 I continued to work with my clients oversees and still do to this day in addition to attracting new overseas clients usually through referrals and new UK based clients.
In addition I have Skype counselled clients who I have never personally met and have been counselling some of them for years. One particular client in SE Asia has been a client since 2005 and was a referral. She now arranges to Skype with me on an ad hoc basis when she needs to talk to someone outside of her circle of family and friends.
In terms of technical issues associated with Skype, the most common problem I experience is a break in the connection or a poor quality sound connection. This possibility is something I discuss with the client when we have our first Skype therapy session or free 30 minute consultation session. Breaks in the session or poor quality communication can be damaging to our relationship if not managed properly and an acceptable strategy adopted.
The advantages however far outweigh the disadvantages. I can speak to clients in their own homes or in their cars or wherever is convenient for them, in different time zones to my own and from the comfort of my own home. It brings certain individuals to therapy that could not physically attend sessions, particularly the elderly or those with no access to transport. Autistic clients and those who prefer more anonymity also tend to prefer counselling via Skype and I will write more about video free and telephone only counselling and therapy at a later date.
Disadvantages tend to relate to certain work being best carried out face to face. I do not undertake trauma therapy via Skype.
There is also the possibility of a client being interrupted by family if they are at home or by their home phone. Children may stick their heads in the door, someone may knock at the main house door the phone may ring. All of these things need to managed by addressing them before therapy starts as do clarifying strategies for dealing with them.
Some therapists have argued that one cannot create a meaningful therapeutic relationship with a client when using Skype. Personally, this has never been an issue for me or my clients. I have always managed to create a feeling of connection with them and them with me despite the physical distance between us.
There have also been arguments that the non verbal cue aspects (lack of full body visibility cues such as for example tapping feet, wringing of hands) are compromised by the use of Skype as the full body cannot necessarily be seen, but it can, there is no reason why not. Having said that only being able to see a client’s face or upper body has not stopped me intuiting that something is going on with the bits of them I can’t see and I will refer to it directly and ask them what they are doing.
In terms of contracting I have devised a Skype contract which I send to clients and which they usually sign with an electronic signature.
Fees are agreed in advance and payment usually made by bank transfer or paypal and at least 48 hours prior to a session.
If you think having Skype available as an option would make it easier for you to enter into therapy I would be happy to hear from you and arrange a 30 minute free consultation.
Jan Merrills – 07807 466174