August 7, 2018

The Benefits of Blending Online with Face to Face Psychotherapy

“I feel shy talking about this to a therapist” said Corinne. For Corinne a face to face encounter with a therapist was very difficult. She feared being seen and judged so she kept away from revealing burdening secrets.  Since young Corinne had suffered from social anxiety. As an adult she felt tense and inadequate when faced with new social situations. This was interfering with her career and making her increasingly frustrated.   Her situation improved when she opted for Online Chat-based Psychotherapy.  Here she could reach her therapist right from her living room.  “Doing therapy online allows me to worry less on what my therapist thinks about me” says Corinne.  As her insecurity subsided Corinne felt confident attending an in-person session with her therapist.

Blending online with face to face sessions is becoming increasingly popular in mental health care.  While the in-person meeting is very anchoring, the online environment can be experienced as a safer space to talk about embarrassing or stigmatizing experiences.  “Several times I’ve heard my colleague say that online clients reveal things to her they never revealed to their face-to-face therapist. That’s quite remarkable.” says Irvin Yalom a leading psychotherapist and writer.

The art of psychotherapy allows us the flexibility to create a harmonious blend between technology and genuine human interaction. Still many psychotherapists doubt its effectiveness saying that when online, therapists would be missing out on the visual and physical cues of the clients. Online therapy, however, is not intended to replace but rather to complement face to face therapy.  One explanation is that both speaking and writing can play a role in one’s recovery.  ‘What might be lost from the immediate give and take of natural conversation is gained from slowing the process down’ says Cedric Speyer pioneer of e-counselling services in Canada.

In troubling circumstances the mind struggles to make sense of the disjointed parts of the experience.  Writing enables one to unify that experience in a few sentences.  When this is shared with a therapist one gets immediate validation.  This in itself is very relieving.   “I thought I was going crazy but the therapist helped me to see all of it more clearly” said a 26 year old woman who does online psychotherapy through chat.

Researchers say that the Internet has enormous potential for psychotherapy, especially for reaching people who either do not have access to in-person care or are too time-limited.  “I spend most of my day attending to others.  With online therapy I get some ‘me’ time without leaving home” says a young mother who also started chat based e-therapy.

Despite its effectiveness, online psychotherapy is not suitable for everyone.  So how can one decide whether to choose online, face to face or a blended approach to therapy? Research indicates that therapists and clients need to consider both personal needs and preferences in order to create a care plan that best fits the situation of the client. People who are experiencing serious mental difficulties, those who feel suicidal or those who need a lot of support may need a direct in-person approach.

The clients who are more likely to benefit from online therapy are, among others, dealing with issues of anxiety, stress, loneliness and relationship difficulties.  In reaching out to a therapist they receive feedback, questions, insights and guidance for their concerns.  Indeed many are those who following a positive encounter online feel more encouraged to pursue face to face therapy.

In short the Internet gives one an easy way of testing the waters before diving into deeper self-exploration.

Shirley Galea MA Gest. Psych.
Shirley Galea is a psychotherapist and educator.  She works in private practice with adolescents,  adults and couples.
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