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Online Therapy
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Online Therapy

We spend much of our lives online these days and increasingly more services are available online that traditionally would have been conducted face to face. This is the same with psychotherapy and counselling, and there is a growing availability of online therapy services around on the internet. So, is online therapy for you?

There are many ways to engage in therapy online, but for the purposes of this blog I’ll be considering online therapy that uses live video. This can be done with apps such as: Skype, Zoom, WhatsApp, FaceTime, BotIM etc. Whatever app is used, the most important thing to consider is the security. Only use an app that has a secure and encrypted connection.

There are many benefits to having therapy online and the most obvious might be the convenience of it. Rather than having to spend time travelling to a clinic, you can be at a location of your choice where you feel comfortable. This might be at home, in a private office at work during your lunch break, or anywhere where it is confidential and you won’t be overheard or disturbed. However, you will need to consider what you will do after the session has ended. Do you have time to compose yourself before you step outside the room and back to the office or family life?

Another benefit of working online is that you might have a greater choice of therapists available to you. Rather than having to choose those in your local area, you can work with the therapist of your choice wherever they are in the country. This can be particularly beneficial if you live in a remote area, or live abroad and want a therapist who speaks your native language. Additionally, if you travel around a lot, it can make it possible to access therapy wherever you might be.

Another advantage of online therapy is that it can make it easier to engage with therapy if you are anxious about going to a clinic in the first place, or have any difficulties with leaving home or accessing certain locations. Being able to engage with your therapist online can remove any of these potential barriers and you can get the support you need.

A lot of people wonder if online therapy is as good as face to face therapy, and that is an important point to consider. Certainly, there is a big difference. The rapport and connection you have face to face with a therapist will be different to what you build online. Some of the non-verbal clues to communication can be lost online so it’s important to be able to tell your therapist if they haven’t understood you, or if you don’t understand them. However, once you get used to working online with a therapist, the distance and technology can ‘disappear’ and you can feel very connected with your therapist.

Here are a few points you might want to consider if you want to access therapy online:

  • You will need to have a good, stable internet connection for the duration of your session.
  • It is best to have a few connection options available – such as wifi and data, and a couple of different options of apps – such as Skype and Zoom, to allow for tech difficulties.
  • You need to be comfortable working online and familiar with the tech you are using. It’s a good idea to turn off any notifications for the duration of your session as these are very distracting when you are trying to work with your therapist.
  • You need to ensure that the location you are in is private and confidential.
  • You should check the credentials and qualifications of your therapist before you engage in any online therapy. There is a growing number of people setting up online as ‘therapists’ with little or no training. Make sure your therapist is registered with a professional body such as UKCP.

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

Further reading by Dr Simon Cassar –

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

What is an integrative existential therapist?

What is Existential Psychotherapy – Video

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So what actually is a Psychologist?

It’s important to note that the term ‘psychologist’ is not actually a protected title.  So, anyone can technically call themselves a psychologist.  If someone claims to be a psychologist, then the question to ask is, what kind of psychologist are they, and perhaps more importantly, what qualifications do they have.

Undergraduate degrees may be undertaken as either a Batchelor of Science or of Arts.  Completing an undergraduate degree in psychology gives a good basic introduction to a wide range of psychological theories and applications, but not necessarily expertise in any one area.

The British Psychological Society describes psychology as:

‘the scientific study of the mind and how it dictates and influences our behaviour, from communication and memory to thought and emotion.  It’s about understanding what makes people tick and how this understanding can help us address many of the problems and issues in society today.’

There are many areas of both theory and application within psychology; health, educational, forensic, counselling, occupational, clinical, sports and exercise, and neuro.  Becoming qualified in one of these fields requires post-graduate study.

In the example of Clinical Psychology; the current route for training is a 3 year doctoral degree (after the undergraduate degree) which involves both university teaching days and days on placement with the NHS.  In order for someone to call themselves a Clinical Psychologist, they must have completed an approved training course, and be registered with the Health and Care Professions Council (HCPC).

The HCPC regulates all applied psychologists within the areas above. The below are protected titles, which means people can only use them if they have completed an approved training course and complete ongoing appropriate Continuing Professional Development.

  • Practitioner psychologist
  • Registered psychologist
  • Clinical psychologist
  • Forensic psychologist
  • Counselling psychologist
  • Health psychologist
  • Educational psychologist
  • Occupational psychologist
  • Sport and exercise psychologist

Any other titles, such as Media Psychologist, Celebrity Psychologist or TV Psychologist, such as are often seen in the media, say nothing about the qualifications or expertise of the individual.  Understandably this is often misunderstood by the public.  As a Clinical Psychologist it concerns me that people may put their trust in, or even pay for services delivered by, unqualified people.  In addition it is concerning that the reputation or credibility of the profession may be damaged by unqualified people providing a poor service.

It is a very confusing area, however, probably the most important thing to remember is if you are considering working with a psychologist in any of the fields above check that they are registered with the HCPC on www.hcpc-uk.org

 

Dr Emma Stevens, HCPC Registered, is an experienced Clinical Psychologist. She has an integrative approach drawing on Cognitive Behavioural, Systemic and Psychodynamic models, as well as Attachment Theory. Emma sees individuals primarily for sort-term work. Emma is available at our Lewes Practice.

 

Further reading by Dr Emma Stevens

Using the body to calm the mind

Emotional Well-being

What is EMDR?

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Online Therapy

We spend much of our lives online these days and increasingly more services are available online that traditionally would have been conducted face to face. This is the same with psychotherapy and counselling, and there is a growing availability of online therapy services around on the internet. So, is online therapy for you?

There are many ways to engage in therapy online, but for the purposes of this blog I’ll be considering online therapy that uses live video. This can be done with apps such as: Skype, Zoom, WhatsApp, FaceTime, BotIM etc. Whatever app is used, the most important thing to consider is the security. Only use an app that has a secure and encrypted connection.

There are many benefits to having therapy online and the most obvious might be the convenience of it. Rather than having to spend time travelling to a clinic, you can be at a location of your choice where you feel comfortable. This might be at home, in a private office at work during your lunch break, or anywhere where it is confidential and you won’t be overheard or disturbed. However, you will need to consider what you will do after the session has ended. Do you have time to compose yourself before you step outside the room and back to the office or family life?

Another benefit of working online is that you might have a greater choice of therapists available to you. Rather than having to choose those in your local area, you can work with the therapist of your choice wherever they are in the country. This can be particularly beneficial if you live in a remote area, or live abroad and want a therapist who speaks your native language. Additionally, if you travel around a lot, it can make it possible to access therapy wherever you might be.

Another advantage of online therapy is that it can make it easier to engage with therapy if you are anxious about going to a clinic in the first place, or have any difficulties with leaving home or accessing certain locations. Being able to engage with your therapist online can remove any of these potential barriers and you can get the support you need.

A lot of people wonder if online therapy is as good as face to face therapy, and that is an important point to consider. Certainly, there is a big difference. The rapport and connection you have face to face with a therapist will be different to what you build online. Some of the non-verbal clues to communication can be lost online so it’s important to be able to tell your therapist if they haven’t understood you, or if you don’t understand them. However, once you get used to working online with a therapist, the distance and technology can ‘disappear’ and you can feel very connected with your therapist.

Here are a few points you might want to consider if you want to access therapy online:

  • You will need to have a good, stable internet connection for the duration of your session.
  • It is best to have a few connection options available – such as wifi and data, and a couple of different options of apps – such as Skype and Zoom, to allow for tech difficulties.
  • You need to be comfortable working online and familiar with the tech you are using. It’s a good idea to turn off any notifications for the duration of your session as these are very distracting when you are trying to work with your therapist.
  • You need to ensure that the location you are in is private and confidential.
  • You should check the credentials and qualifications of your therapist before you engage in any online therapy. There is a growing number of people setting up online as ‘therapists’ with little or no training. Make sure your therapist is registered with a professional body such as UKCP.

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

Further reading by Dr Simon Cassar –

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

What is an integrative existential therapist?

What is Existential Psychotherapy – Video

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The Therapeutic Relationship and the Unconscious

Therapy is often referred to in terms of it being relational, or as a relationship, albeit a particular type of relationship, one that has very specific parameters, particularly around money, time, touch, and about whose inner life is there to be explored.

Despite this, in some ways, very one-way relationship, an awful lot of what goes on is a kind of relating. The therapist will encourage the client to speak as freely as possible and through a careful listening to the client’s words and to what is evoked in themselves, through this listening, they will try and relate as closely as possible to the clients experience and will feed this understanding back via their own comments, or interpretations.

What makes this different from other listening conversations, is that the therapists understanding and feedback will be influenced by the therapists training, specifically their own therapy and their learning of theories, which provide maps of mental structures and types of human experience and distress.

The therapist as well as listening to the stories, will also listen for patterns, for words, they will try and be attuned to what is going on emotionally for the client and also pay attention to the actions of therapy, to the how the client goes about relating to the therapist. When the therapist feels something useful has been understood, they will share this.

Sometimes this may not have been consciously known by the client, and this is why it can be useful. However, it can also be unnerving, as we like to believe we are the masters of our own houses, independent and not in need of the help of another.

Freud said there have been three great blows to man’s ego, the Copernican discovery that the solar system didn’t revolve around the earth, Darwin’s discovery that we are descended from animals, and share an essentially mammalian brain structure and Freuds own discovery that we have a dynamic unconscious, that the rational beings we like to believe ourselves to be is only one part of the story.

Part of this unconscious is the repressed unconscious, the place where we store the things we don’t want to know about ourselves, however these things are known at some level and we can expound a great deal of energy trying not to know them.

Getting to know and understand these parts of ourselves although often frightening to begin with, can actually be a huge relief as we come to know and accept these parts of ourselves, parts of ourselves that may seem like monsters under the bed and cast scary shadows but are usually essentially human characteristics.

 

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

A Nation Divided

Adolescence: the trials and tribulations

Does the male mid-life crisis exist?

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How do I choose a psychotherapist?

Deciding that you want or need psychological help can be a difficult position to arrive at.  Choosing the right practitioner to work with can feel like a daunting task with so many different fields of talk therapy, types of therapy and professional bodies overseeing the field.  This blog is a guide to helping you find your way to the right psychotherapist for you.

Counselling, psychotherapy or psychology?

Counselling, psychotherapy and psychology all broadly fall under the category of ‘talking therapy’.  They have much in common, yet are also very different.  I have previously written a piece on the difference between counselling and psychotherapy; the former being largely for shorter-term work and the latter being appropriate for deeper and long-term work on the personality.  We also have an in-depth page on psychology here so I shall not go into more detail about that here.

Depth of work

In choosing a psychotherapist, it can be helpful to have a sense of what it is you are seeking to gain from therapy.  Generally, psychotherapy is longer term than counselling and rather than working with one specific issue, is instead a relationship through which the client can work through relational patterns (with themselves and others), formed in childhood that they wish to change. Depth relational psychotherapy takes time – months to years – to understand and process relational, or attachment, losses. It is a commitment to a process of therapy and to oneself with sessions being as a minimum weekly, at the same time and on the same day each week.

Professional Body

There are a few professional bodies who offer voluntary registration to counsellors and psychotherapists – the BACP and UKCP. Whilst the BACP includes the ‘P’ for ‘psychotherapist in its acronym, the minimum training requirements of the BACP for someone to call themselves a psychotherapist are quite low. The UKCP, on the other hand requires all registered psychotherapists to undertake a minimum of four years of post-graduate training at an accredited training institution alongside a mental health placement and four years of personal therapy, before permitting applicants to join.  At Brighton and Hove Psychotherapy, all of our psychotherapists have trained at least to this standard and many far beyond.

Training

Psychotherapy training is long, challenging and requires the candidate to be in their own personal therapy throughout the training period.  Most training institutions are located in London, or further afield, and so a great deal of commitment is required to reach the necessary training standards. One of the main aspects that sets UKCP registered psychotherapists apart from counsellors is that they have been trained to ‘formulate’, which is another work for diagnose, or understand, more complex trauma and mental health issues.

First Appointment

If you have never previously been in therapy, then the prospect of the first appointment can be daunting. It is the job of your psychotherapist to set clear boundaries and create an environment that ‘feels safe, but not too safe’.  What does this mean?  Psychotherapy is about learning to tolerate difficult feelings and your psychotherapist is there to facilitate this process through their relationship with you.  They are not there to be liked, or to be your friend, as this would not be beneficial to you or to your process. If all goes well at the initial consultation then you and your psychotherapist may ‘contract’, or agree, to work together.  This means that they have assessed what work is required to facilitate change for you and you have decided that you are going to enter into an intimate relationship unlike one you have perhaps ever had before.

Length of Contract

How long is a piece of string?  Most psychotherapy can last for months or years, however little can be inferred from the duration.  For example, someone attending a year of therapy is not necessarily ‘healthier’ or ‘saner’ than someone who attends weekly for many years.  It is entirely dependent on the work required, how the client wishes to ‘use’ therapy and the relationship formed. Freud famously believed that therapy only begins when the client is no longer in a crisis.

Final Thoughts

Finding a good psychotherapist begins on paper but ends with a feeling, or a set of feelings.  As it is in the relationship that the unravelling of the past takes place, it is critical that as a client, you feel you can build a therapeutic relationship with your psychotherapist. The capacity to do this will hinge on their degree of training, clinical experience and therapeutic boundaries, as well as on it being a relationship that feels ‘safe enough’ – not too safe to not be challenging – within which the therapeutic process can unfold.  

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

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