Telephone and video communication have made remote communication with a psychologist accessible to many. But can it be considered psychotherapy?
Lyudmila is 35 years old. Having received the rights and leaving a little more than a year, she had an accident. And although she was almost not hurt, she could not bring herself to drive again. Skype helped her: in a few weeks of online communication with a psychotherapist, Lyudmila managed to overcome her fear. “I can’t say that everything went off without a hitch,” she says. “At first, I was not comfortable driving. But thanks to the psychotherapist, I became a very careful and responsible driver.”
Psychologists on the Web
“IN THE CLIENT, HIS “INTERNAL” PSYCHOTHERAPIST CAN WAKE UP, AND THEN THE PERSON BEGINS TO SOLVE HIS PROBLEMS HIMSELF”
Communication with a psychologist or psychotherapist via telephone and other telecommunication channels is called «telepsychotherapy»: this term is officially accepted by the American Psychological Association (APA)*. But if the phone is used mainly as a means of communicating with clients in a crisis (“helpline”) or in hard-to-reach places, video conferencing technologies and the Skype service have forced people to talk about real remote therapy. Which often gives an effect comparable to «live» communication**. This, in particular, applies to depression, post-traumatic disorders, anxiety. Psychologists are actively mastering the global network. Breakthrough.com, one of the largest online therapy portals in the United States, attracted 900 specialists — psychotherapists, psychologists and coaches — in the first two years of operation. However, there are critics — primarily psychoanalysts. Each side has its own arguments.
Pros and cons
The main disadvantage of skype-consulting is that it is remote. Even the best camera does not convey all the nuances of facial expressions, and even the “body language”, gestures, often remain behind the scenes. Meanwhile, all this is very important in psychotherapeutic work. Just as the interior, lighting and even the smell in the office are important. There are also purely technical problems. Skype crashes from time to time: the picture is split, the voice “croaks”, or the connection is completely cut off, which does not contribute to solving therapeutic problems. In psychotherapy, direct eye contact is extremely important, and achieving it on Skype is more difficult than it seems, due to the fact that you have to choose whether to look at the monitor or into the camera. And finally, in online communication, no one guarantees protection from hackers, and our revelations can become the property of the entire Internet.
The advantages are also quite obvious: you can communicate with your therapist at any time and from anywhere in the world. By the way, remote therapy often becomes a continuation of the “live” one, if the client (or therapist) has to move, and they are not ready to sacrifice the established relationship. Moreover, sometimes treatment at a distance is faster: “Body language does not work in a telephone conversation, and we open up more easily, because we do not need to try to impress or defend ourselves!” explains psychologist John Reiter.
However, apart from convenience, there are no serious reasons to prefer remote therapy to personal meetings. Moreover, many methods are not applicable online. “In Skype, it is impossible to imagine body-oriented work or psychoanalysis, constellations, psychodrama, Gestalt therapy, systemic family psychotherapy,” explains psychotherapist Alexander Orlov. – However, I am sure that Skype is suitable for both short-term psychological counseling and deeper and longer work. It is likely that my point of view is due to the method that I use. As a client-centered psychotherapist, I do not use any techniques and techniques in my work that go beyond the psychotherapeutic conversation as such. Therefore, the possibilities of Skype suit me quite well. And although the debate about distance therapy continues, one thing is already clear: skype counseling provides real psychological support, alleviates suffering, and helps you feel better. And we can, if we wish, take advantage of this opportunity.
* American Psychological Association, apa.org
** Journal of Aggression, Maltreatment & Trauma, 2011, vol. 20, № 3.