Online Therapy 
Training to work online

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Training to work online

From time to time, we find ourselves attracted to new approaches to our work as therapists. Or perhaps we may not choose an approach for ourselves, but find that it chooses us, for example when an organisation or workplace setting requires us to embrace a new and different way of working. This may take us outside of our comfort zone and require that we learn a variety of new skills, administratively as well as therapeutically. Sometimes a change in circumstances may lead us to consider alternative ways of delivering therapy, perhaps as a result of physical constraints, changing client requirements or possibly relocation to a new geographical area.

When such situations arise, we usually engage in a variety of activities to familiarise ourselves with new ways of working. We explore the relevant literature, research and ideas available online. We may contact colleagues who already use these approaches and with whom we can engage and collaborate. We almost always seek training opportunities to extend our knowledge and increase our understanding of new techniques so that we continue to offer competence and integrity to our clients.

Choosing to offer therapy online involves embracing a plethora of new ideas, experiences and challenges. Surprisingly, if you search online directories and individual practitioners’ websites, you will find that increasing numbers of counsellors and psychotherapists are offering online therapy without demonstrating any concrete evidence that they have taken any of the steps mentioned above to prepare themselves appropriately, despite the recommendations and guidelines set out by the professional bodies. It may be that you have already started working online, or perhaps are you still considering working in this way?

I invite you to take a moment or two to consider the following questions:

How would you define and convey ’presence’; in an online meeting?

Which aspect of their ego do you think a client is likely to present when meeting a therapist online?

How is identity conveyed online, especially if the client chooses an ‘unseen’ communication approach (ie text-based)?

What is the place of fantasy in the online therapeutic engagement?

What difference does it make when contact is asynchronous/synchronous?

What is the ‘disinhibition effect’?

What is the ‘black-hole effect’?

How are appropriate boundaries established in online work and conveyed to clients?  

What additional steps should be taken by both counsellor and client to ensure confidentiality?

What is encryption and what other precautions are essential to ensure security for both counsellor and client?

Are there some clients for whom online work is not suitable?

What is the legal position if a client is overseas?

This is just a sample of the questions I might pose; there are many more that I could add!  

How many can you answer with confidence?  

As an online therapist, I reflect on all of these questions daily in the course of my work.   I would not be able to address any of them effectively without my initial specialist training and if I didn’t spend considerable time updating my skills and knowledge through ongoing CPD and networking, in addition to my supervision with a trained and highly experienced online therapist.  The technological world changes and develops at a frightening pace!

We read a lot about the potential dangers and problems that are emerging as a result of living in a technological age, as well as the amazing advances and new possibilities that arise.  It is essential that we recognise our responsibilities as practitioners to ensure that we are as informed and aware as we can be of the implications of embracing technology within our practice, if we are to maintain an ethical and professional approach to our work.

Suggestions for finding effective online therapy training and further information:

A number of training organisations have been awarding certificates and diplomas (involving supervised and guided experiential practice), as well as offering CPD opportunities for some considerable time now and there are a number of books and websites where further information about working online can be found.  These organisations are committed to keeping up with the rapid speed of change and informing and guiding therapists appropriately.  Some specialist software providers (whose numbers are growing) now offer training modules as part of the package they supply to subscribers.  Does yours?  The Association for Counselling and Therapy Online (ACTO) recognises and endorses a number of training providers and further information is available on their website:

Guidelines for online counselling and psychotherapy, containing information about useful contacts for training, are available to BACP members via the members section of the website .  

Suggested reading (a small sample):

Anthony K & Merz Nagel D (2010) Therapy Online (a practical guide) London: Sage Books

Evans J (2009) Online Counselling and Guidance Skills: A Practical Resource for Trainees and Practitioners London: Sage

Jones G and Stokes A (2009) Online Counselling: A handbook for Practitioners Basingstoke: Palgrave Macmillan

Weitz, P (Ed) (2014) Psychotherapy 2.0: Where Psychotherapy and Technology Meet London: Karnac Books