|Therapy at your fingertips||Apr. 15, 2012|
|Written by: Marilyn Linton, QMI Agency|
|Cyber-counselling helps the troubled among us from a distance|
Abby Linkmoller loves her therapist -- but she doesn't know if he's tall, short, bald or bearded, or lives in Toronto or Timmins. Unlike face-to-face therapy, Linkmoller does weekly online therapy -- on her computer by the toaster in her kitchen. "Yes, by email," says Linkmoller, an elementary school teacher. "And yes, it works!"
Linkmoller (not her real name) started therapy six months ago after a series of failed relationships made her want to examine patterns that seemed entrenched.
"Doing therapy this way means I don't have to take off work, pay for parking, or follow someone else's schedule," she explains. "It suits my life and email allows me to say things I don't think I could say meeting in person."
"With online, clients tell us they can get dinner done, take their kids to soccer, finish their house chores, then open up the email on their terms."
Cyber-counselling is the use of the Internet to provide counselling at a distance -- by email, chat or video or voice. Murphy, a psychotherapist who began doing face-to-face work but has cyber-counselled for 18 years, explains that emails from clients are reviewed by a therapist who emails back with questions, some interpretations, and points to consider in the process of establishing a therapeutic relationship.
"Email is an effective way of doing counselling," he says. "As a client, you get to think and ponder and put away and come back, and think and ponder and put away and come back to it. If I am in a room with a client asking a question, they have to give me the answer right away, but with email you get to slow down the process. A client can spend 11 hours a week (if he so wishes) reviewing an email and thinking about the questions we sent and creating a reply -- whereas if it's face to face, you have 50 minutes for the week and you are done."
Studies have shown that online counselling works as well as face-to-face. But Murphy admits that in not being able to read body language, therapists can miss tones of voice and non-verbal communication. In their practice, he and co-founder Dan Mitchell have developed techniques they teach their clinicians in order to compensate for the non-verbal.
Their company uses a variety of therapy types, including cognitive behavioral therapy, in what Murphy explains as "trying to understand what's going on in the person's experience, talking a little bit about the past in order to understand the present and future." While cyber-counselling isn't exactly anonymous (names and phone numbers are requested), many clients feel they can open up more because they're not working face-to-face. What they wear, their size, their shape, is not being judged.
But cyber-counselling is currently "buyer beware" territory with too few regulations. And like actress Lisa Kudrow, who plays a self-centred online therapist of questionable training in her hit web series Web Therapy, online therapists in the real world can be as poorly qualified as Kudrow's "Dr." Fiona Wallice.
So what should consumers look for?
"You want someone with qualifications, a graduate degree, past experience with face to face work, actual training in cyber-counselling, and membership in a professional association," says Murphy. Like in-person therapy, the bottom line is that online therapy is about communication and connection. But consumers need to be extra careful that the communication is secure. "Ask what kind of efforts are in place to protect your information."
Not for everyone
Pre-screens are done by online therapists to rule out serious psychiatric disorders such as severe depression, ongoing addiction, and schizophrenia. "If a woman tells me she is 5-feet-9 inches and weighs 80 pounds and thinks she is fat, she should be in therapy face to face. Someone who says he wears foil on his head to protect from aliens needs to be seen in-person and put on medication," says Lawrence Murphy. "Online counsellors need clinical intuition and knowledge. You need enough experience having worked with people in dire circumstances in order to be able to read an email and say, 'Something is very wrong here "¦'"
Who signs on?
"Gone are the days of three times a week at $200 a session," says Lawrence Murphy. "Most people want a problem solved. They don't want their personality reworked. They want to improve their relationship with their teens, they want to cut down on their drinking or get over their fear of spiders."
An evolving modality
Therapy Online has a research arm and also trains online therapists. The company has also worked to draft guidelines for the growing industry. Until there's an association of cyber-counsellors, consumers should ask their online counsellors who they are accountable to. For instance, many psychologists who don online work are members of the Canadian Psychological Association. "You need credentials to belong to an organization, says Murphy, who adds that it also gives consumers a way to address any complaints.
Like in Lisa Kudrow's improvisational spoof of online therapists, anyone can set up shop. "Look for someone schooled with a graduate degree as they would have learned about ethical decision making. You don't want someone who has just graduated with a BA and is starting to do counselling," says Lawrence Murphy. "People should say on their website who they are and list their credentials and it should be totally transparent."
|MORE COLUMNS BY MARILYN LINTON, QMI AGENCY|