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In-person or vitrual therapy?

Therapy Room VS Online Room

Factors favouring online psychotherapy:

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  • Remote place of residence 

  • Fewer mental health practitioners in rural areas and inconvenience to follow therapy due to long distance

  • Stigma and anonymity, "I do not want to be seen entering a therapist's office. It is a personal need to be kept for myself." 

  • ​Reduced free time

  • Mobility issues due to physical limitations 

  • Extreme social anxiety symptomatology that would discourage the patient from engaging in therapy in-person. 

None of the above should prevent us from starting or continuing psychotherapy when we need it.​

 Benefits of Virtual Psychotherapy 

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·  no need for transportation,

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·  immediate and easy access to the session from our personal space,

·  greater schedule flexibility,

·  direct communication with our therapist even at times of crisis (e.g. hospitalisation, quarantine, limited mobility), which would otherwise abruptly interrupt our meetings or prevent us from seeking psychological support,

·  reduction of anxiety and gradual familiarization with our therapist and/or group members.

Framework defferentiations in face-to-face and online sessions

When conducting in-person sessions, we are seated in armchairs facing each other, while in some cases I may be seated behind my desk.
In  case of in-person group therapy, we are seated in a circle.

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Conversely, during online individual or group sessions we are virtually connected facing eachother through our screens. 
 

Privacy and confidentiality, both necessary to develop a sense of trust in the therapeutic dyad or group, are ensured regardless of the sessions' environment (live or virtual).  We aim to cultivate a sense of proximity and non-verbal communication, while promoting the acknowledgment, expression, respect and preservation of boundaries between us.

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All the above can be achieved not only in face-to-face but also in online psychotherapy.​

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Challenges in online psychotherapy

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Privacy assurance |

The assurance of privacy and confidentiality in online sessions is a  responsibility of both the therapist and the patient. The patient needs to make sure there will be no interruptions by other members of the family and that she feels comfortable enough being connected online from her personal space. 

In online sessions, we often ask the patient if she is alone and comfortable enough to express herself from the place  where she is connected. This discussion may shed light to the patient's relationship with her cohabitants (parents, siblings, partner, friends, etc.), the respect of other on her personal space and time, or existential issues about loneliness.

 

interference by exogenous factors |

Our attention may be distracted more easily during online sessions. In order to stay focused it is important to avoid interruptions by phone calls, emails or visitors.

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Technical issues of connectivity |
There are times  we need to manage our feelings of loss, loneliness, disconnection and anxiety after an unexpected, out of our control interruption during a session, such as technical difficulties, loss of internet connection, or power outage.

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​​Bodiless environment (?) |

Nonverbal communication is differentiated during online psychotherapy. The therapist and the patient only perceive each other visually and still partially, as they can mainly see each other's face and not the rest of the body.

Posture changes are likely to slip our attention through the camera, while on the other hand we can better see each other’s facial expressions and come in more direct contact with the emotions communicated.

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Additional issues to be faced during online group therapy |

During an online self-awareness group, our responsibility for ensured privacy, such as connecting from an area that is not accessible to third parties during the session, depicts not only our respect for our personal therapeutic work, but also for the other group members.

Any changes or difficulties we may encounter due to the online operation of the group sessions should be thoroughly discussed not only with the therapist/therapists, but with all the members of the group. We should express our feelings and thoughts about this shared experience and discover new ways to connect with each other and manage the new circumstances.
 

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