Q. I’ve been working with a client in my face-to-face practice who is going to be overseas for a number of months. He has asked me if we can continue our counselling together online, using Skype. He is going to a location where there are unlikely to be counsellors offering individual private counselling and I would also like to maintain our therapeutic relationship, especially as he will probably choose to continue when he returns. I often use Skype with family and friends to keep in touch and I’m happy using the technology. He tells me he is familiar with Skype too. Should I go ahead?
There are a number of questions to ask yourself when thinking about whether or not this is a good idea for you and your client and whether it is, in fact, serving his best interests to offer to work with him online in this way. These questions are complex and cannot be answered within the scope of a simple ‘q and a’ page, but here are some of the things you should consider:
Do you know what the legal position is concerning the delivery of online therapy within the jurisdiction of the country where your client will be living? This is complex and varies across the world.
Are you aware that Skype is not considered secure for the delivery of online therapy and that there are other software providers who can offer a more secure and appropriate platform for this kind of work?
Does your insurance company cover you for online work and for work with client who are overseas?
Are you aware of the conditions under which your client will be speaking to you from his computer or laptop (will he be at home/at work/in an internet café etc?). Are you aware of the need for special boundaries to be explored in order to provide safe and ethical counselling online?
Are you aware of the phenomenon of ‘Online Disinhibition’ and how this might impact on your existing therapeutic communication and relationship?
And there are many more considerations like this! Do explore the resources on this site and consider what you might need to know before embarking on something like this. If you are still interested, would you be prepared to undergo training?