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November 28, 2022 by BHP Leave a Comment

Online versus In-Person Therapy

When Covid struck we could no longer deliver therapy face-to-face and so this meant that many of us had to adjust to therapy online using a video web platform such as Microsoft Teams or Zoom. This was both challenging for the therapist and the client, however many people now prefer therapy online.

Research has shown that therapy using a video web platform is just as effective as in person therapy. Studies published in the Journal of Psychological Disorders and the Journal of Affective Disorders, Behaviour Research and Therapy have shown that online CBT and counselling are as effective as in person therapy in helping people address a wide range of issues including anxiety and depression.

There are some obvious benefits to online therapy such as therapy in the comfort of your own home, not having to leave your house so no travelling to appointments; the convenience of accessing appointments anywhere providing you have internet access and privacy. I have had some clients attend appointments in their car or sitting in their garden and even whilst on holiday. There is also the anonymity of not having to go to a therapy practise setting for appointments. There is also something about not having to meet your therapist in person which can allow some clients to open up more.

There is no doubt that some clients prefer the connection of in person therapy. They feel it allows for a more fulfilling relationship. In addition, some clients are already having to work online and don’t want to do anymore ‘on screen’. The issue of privacy and being interrupted by family members can be difficult as well. In person therapy allows for a neutral location, a safe space for the client to share private information away from everyday life.

In person therapy has always been considered as preferable and certainly this was the case before Covid, but now this is shifting and we are learning that online therapy is also a valid option.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

Loneliness and CBT

Enhancing the Positive Self 

Is that a fact or an opinion? 

As we come out of lockdown, will a number of us be feeling socially anxious?

New Year’s Resolutions

Filed Under: Mental Health, Psychotherapy, Rebecca Mead Tagged With: CBT Therapy, Online Counselling, Onlinetherapy

May 23, 2022 by BHP 2 Comments

The Limitations of Online Therapy

Online psychotherapy is not a new concept; it was around before the pandemic and successfully used as a medium for delivering psychotherapy, counselling and coaching. However, what is new is how nearly all of us were obliged to work online to maintain continuity of sessions for our patients and clients during lockdown and how ubiquitous it remains. It is clearly here to stay but does that mean that in-person psychotherapy is a thing of the past?

Online psychotherapy brings with it some advantages over seeing a psychotherapist ‘in the flesh’ such as:

  • Access to a wider pool of clinicians;
  • Less time consuming as no travel is required;
  • Some people may find it easier to ‘open-up’ online rather than in person.

Like many psychotherapists, during the pandemic I had to abruptly move my whole practice online and together with my clients adapt to virtual sessions. Now at the tail-end of the pandemic the world is a different place and yet I have found that the vast majority of my clients have of their own volition decide to return to in-person sessions. I have explored this with them and below is a synthesis of some of the limitations of online psychotherapy and why, I believe, it will never replace in-person face-to-face sessions.

Psychotherapy is a body to body communication

Though often referred to a ‘talking therapy’ psychotherapy is much more a ‘listening therapy’ and the clinician is trained to listen in a very particular way – to what the client says as well as how they say it.

More than half of our communication is non-verbal and is a combination of tone and delivery in conjunction with body language. With online therapy much of the latter is lost due to the limitations of what can be seen on screen. But there is another reason why it gets lost – online psychotherapy is ever so slightly ‘out of synch’. It is almost imperceptible (most of the time) but there is a slight lag between the delivery of the sound and the delivery of the image which makes for a disconnect between the spoken and unspoken. And whilst almost imperceptible to the conscious mind, it gets registered by the emotional system.

Psychotherapy as re-parenting

Everyone who crosses the threshold of a psychotherapist’s consulting room is bringing with them unresolved experiences and patterns from their childhood. Many of the patterns are laid down in the formative years of bonding and dictate our attachment style. And because they were laid down between birth and around 2 years of age, they are non-verbal (and unconscious).

Psychotherapy is about working with these patterns – often referred to as ‘working in the transference’ – to understand how the client ‘does’ relationships; in this sense it is a process of re-pare helping the client to feel safer and more secure in relationships and in expressing boundaries.

The transitional space – travelling to therapy

Travelling to sessions in person can be time consuming and with today’s fuel prices, expensive. However, the travelling aspect has an important psychological function as it operates as a transitional space between the ordinary world and the unique world of introspective psychotherapy.

In online sessions I have often found that clients can be distracted as they have literally just ‘left work’ and entered my virtual consulting room – they have no given themselves time to make the journey to psychotherapy and it can then often take a significant part of the sessions for them to arrive.

Likewise, I have had clients who have scheduled work meetings immediately after their online therapy which can act as a powerful prohibitor to allowing themselves to ‘be in therapy’ as “I don’t want to get upset because I have a meeting with my boss”.

Lastly, when clients visit my consulting room in person, I am responsible for most of the physical boundaries. Clients know where they will be sitting, where the furniture will be positioned and this will remain the same week after week – it is part of be providing a consistent experience. Seeing a psychotherapist from home may mean that the space feels less safe with other members of the family in the same home or just simply having daily distractions around such as a picture of the family on the desk next to the monitor.

Psychotherapy is about making contact

Starting psychotherapy in any realm can feel like a daunting prospect. Coming into a consulting room, which is the domain of the psychotherapist, is a brave step.

Clients have often sat on my couch and mused or fretted about what to talk about. I generally sit in silence as they try and find their words as, to me, what they say is often less important than why they are telling me. If a client tells me anything they are telling me something about themselves that they feel is important and that they want me to see as important – often we need to figure out together why it is important but we generally get there in the end.

Therefore, psychotherapy is about ‘coming into contact with another’ – taking a risk to be seen and heard. Whilst this can be achieved to some extent online, nothing can be a substitute for in person contact where two bodies are in the same room and in communication and contact with each other.

Until we start raising babies and infants over virtual connections and can do so successfully – which is neither desirable nor remotely possible due to our physiological and psychological make-up – face-to-pace in person psychotherapy is not going anywhere.

 

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.

 

Further reading by Mark Vahrmeyer –

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Parental Alienation and the impact on children

Filed Under: Mark Vahrmeyer, Mental Health, Psychotherapy Tagged With: Online Counselling, Onlinetherapy, Psychotherapy

August 17, 2020 by BHP Leave a Comment

Taking therapy ‘online’

When Covid-19 started spreading, I didn’t instantly move away from working with people directly in the room.  Up until that point I had only provided limited online sessions, usually when people moved away from the area or travelled for work.  I was slightly apprehensive about that as an option.  However, as things continued and lockdown measures were looming, I decided to only offer online sessions, and of course it got to a point where this was all we were able to do.

As lockdown measures have eased there has been lots of discussion (and concern) amongst Clinical Psychologists regarding at what point is it ‘safe’ to return to working with people in the same room again.  As I write this, in early July, I do not feel that it is quite time yet, which is to do with a variety of factors.  One factor that is informing this decision is that I am actually (surprisingly) finding online working ok.  In fact more than ok.  There are of course some disadvantages, and it has taken some getting used to.  However, in terms of the feedback from my clients and the reflections I have made myself, I feel that online working is a very viable option.

Over this lockdown period, I have completed work with clients who I have solely worked online with and therefore will never meet in person.  If online working weren’t an option, these clients, instead of having completed a course of therapy, would still be waiting.  I reflected today on how online working doesn’t necessarily have to impact negatively on the therapeutic relationship, as perhaps I had previously anticipated that it would.  The therapeutic relationship is of utmost importance to me:  it is essential that people are able to foster a good therapeutic relationship with their therapist, and this has been proved to be essential in determining whether work is effective.  I have learnt that it has been possible to foster some really strong therapeutic relationships with clients through online working.

In some instances, online therapy might actually be easier for some people, as clients may feel more comfortable and relaxed in their own surroundings rather than in a clinic space.  This may mean that people feel more able to open up and allow themselves to be more vulnerable than they previously might have done.  It may even be about practical factors; people may find it easier to engage in therapy when there are competing demands on time as it can take just an hour out of the day when no travel time is required.

Of course, online options are not going to suit everyone.  For some people accessing therapy via an online platform will not be comfortable or even possible.  However, I am keen that once I am again in a position to offer ‘in room’ therapy again, that I will continue to offer online sessions to those who might want it, or indeed a combination of the both.  For anyone who is considering therapy, but unsure whether they feel online therapy is for them, I would encourage them to get in touch.  I offer a free 15 minute consultation, which can be conducted online in order to get a ‘feel’ for how online therapy might work.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

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Filed Under: Mental Health, Psychotherapy, Relationships Tagged With: Mental Health, Online Counselling, Onlinetherapy

March 28, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Making the Most of your Online Therapy Sessions

During the recent challenges brought about by Covid-19, we all had to make significant changes to our lives and adapt quickly to a new reality. This is also true for therapists and clients who shifted quickly from the safety and familiarity of their consulting rooms to video or telephone meetings. I would like to acknowledge the impact of these changes on both clients and therapists on a separate blog. But first, to help remove some of the anxiety of involved in this transition I want to outline how you can make the most of your online therapy sessions.

  1. Spend some time setting up

Although most of us are familiar with video technology in our personal and professional lives, meeting online for therapy requires some preparation. Not just in terms of tech but also allowing a psychological transition into the therapy space, especially if you are shifting from a different activity in your home.

Give some thought to the room you wish to use, making sure that it is private and quiet, and that you will be sitting comfortably for the duration of the session. Make sure your devices are fully charged or plugged in and well positioned, so that you can see and hear your therapist well. Preferably wear headphones for a better sound quality and experience. Have a phone available in case one of you encounter issues with your tech and need to continue your session over the phone.

Finally, make sure the lighting in the room is positioned so you can also be seen well. Seeing and hearing you well will enable your therapist to ‘tune in’ much better to you, reading nuances in your facial expressions and tone of voice.

  1. Avoid all distractions

Make sure your notifications are switched off and all distractions are put away, such as work and study materials. Most therapy rooms are deliberately thoughtfully furnished in order to offer a calming, comfortable and uncluttered environment.  Ideally try to replicate this in your home where possible. If you live with others, schedule your session at a time when no one will hear or interrupt you.

  1. Communication queues

Psychotherapy and counselling usually take place face to face because it important for both the client and therapist to be able to communicate well with one another. This communication is largely non-verbal and often ‘felt’ rather than spoken. Video can be an additional of barrier to communication, despite advances in technology and video quality. Therefore, it is important that both client and therapist flag up missed queues or gaps in connection as it can be the case with delays or frozen images. Voice any frustrations you are experiencing in relation to this and work with your therapist to try and improve them where possible.

  1. Transitioning into and out of your appointment

As in number 1., give yourself space before and after your session. The travel journey to and from a meeting can help with processing, reflecting and thinking. In the absence of this, allow yourself some quiet time before and after your therapy session. Dealing with difficult emotions and discussing sensitive topics can leave us feeling vulnerable for a little while. If you are using your therapy to work on relationship difficulties with someone you live with, engaging with them straight after your appointment might not be a good idea. Go for a walk, take a bath, or just ask for some quiet time on your own. Equally, moving from a therapy session straight into dealing with work emails might not be such a good plan.

  1. Remember the positives

With Covid-19, we have moved our face to face meetings online because of circumstance rather than out of choice. However, people have been offering online therapy for quite a few years now. Although my preference remains meeting people in person, I am beginning to appreciate some of the advantages of online working. For instance, it is nice to be able to use headsets and adjust the volume if I can’t hear someone well. Because I no longer need to travel to and from work, I now have more time to do things I used to have no time for. It has also given me much more flexibility to see clients at times I previously couldn’t. There are advantages and disadvantages of working at home and working online. It will take us sometime to get used to our new reality. If we can’t change our new predicament, we may as well make the most of it!

 

Sam Jahara is a Psychotherapist and Supervisor in private practice working with individuals and couples. She is also the co-founder of Brighton and Hove Psychotherapy, a multi-approach clinic, offering Psychotherapy, Psychology and Counselling to all client groups, both face-to-face and online.

 

Further reading by Sam Jahara

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Leaving the Family

Psychotherapy and the climate crisis

Psychotherapy can change your life – but you may not want it to

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Psychotherapy, Sam Jahara Tagged With: anxiety, Covid-19, Onlinetherapy

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