Online Therapy Hope Rehab
by Doug
We Can Help Where Ever You Are
Why Would You Consider Online Counselling?
Back in 2012, I was a first year student studying for a degree in Humanistic Counselling Practice at The University of Nottingham in the UK. I was bright eyed, bushy tailed and ready to soak up as much knowledge as I could.
On one occasion our class of about 12 students were sat in a process group along with two of our tutors when a peer asked if there were any elements of the course where we would look at online counselling?
I’m a little embarressed to say that I dismissed the idea of online counselling with a little bit of a sneer, looking down my nose and thinking that there is no way that online counselling could ever be as effective as Face to Face sessions, so why would you even consider it?
I think my prejudice came from my own experience of having been in a counselling relationship and being convinced that face to face was the only viable form of therapy and maybe a little fear that the idea of online was out of my comfort zone as well.
Turns out I was entirely wrong in this belief and thankfully my opinions have shifted 180 degrees. Which is just as well given the current Covid-19 situation and all my counselling work is currently being done online.
However, it wasn’t the current situation that prompted me to start working online.
My Experience of Online Counselling
Over the years, I’ve been completing my CPD hours and can in contact with several people talking about the effectiveness of working online. Then, about three years ago, I had the opportunity to move to Asia to work in a residential treatment centre for people with addiction problems.
In my rush to get on the plane, I hadn’t given much thought to my supervision needs. I just assumed that I would find someone locally and that would be fine. As it turned out this wasn’t the case. The nearest available supervisors were over 90 minutes drive away and that was in good traffic conditions. This wasn’t a viable option.
Left with a choice of having no supervision at all, at least a four hour round trip including my session or contacting my old supervisior and having sessions online, there wasn’t really a choice. So, for the last 3 years I’ve been having supervision in this way and as a client, I have found it to be just as effective as our previous face to face sessions.
But What about Online Sessions as the Therapist?
During the first 18 months working in Asia I had been asked many times by clients if I worked in private practice as well and if they could continue to engage with me once they left treatment. For various reasons, which included being a little fearful of running sessions online and whether we would be able to reach the same kind of relational depth, I had always declined.
Then along came that one client, the one that gets under your skin, who you find yourself thinking about on an evening when your was trying to watch something interesting on Netflix.
This client was very willing and did some execellent work while in treatment but it was very obvious that they were going to need ongoing support for the foreseeable future.
When they broched the subject I relented and agreed to continue sessions. This was about two weeks before their leaving date and we arranged a session for 2 weeks after they left treatment.
Over the next four weeks I watched as many YouTube clips as I could find & spent a lot of time on Google Scholar trying to learn as much as I could about the mechanics of online counselling. After all, I have a Level 6 degree from a Russel Group University, how hard could it be?
Effective Online Counselling
Turns out it wasn’t that hard to transfer online, but I did make quite a few mistakes in the early days.
From having a client who was trying to look after a 2 year old toddler during our sessions, or another who called me almost every day, sometimes twice when I’d told them to ring if they needed me.
Most of my mistakes were to do with bounaries. What we could expect from each other and how we approached the sessions. Thankfully this has been ironed out through the contracting phase where I advise what is acceptable, what isn’t and what they can expect from me and what I expect from them. In exactly the same way as with face to face sessions.
Some of the things I’ve learned to include in the contracting are to do with the mechanics of working online, these include:
- Requesting that the client be on there own in a quite space, that they ask others in their environment not to disturb them during this period.
- Informing clients that although we will do our best to ensure that technical problems don’t occur they always do. (e.g. They will recieve calls during session, this will put you on hold & pause the video link, at some point the signal will drop and the device will have to reconnect).
- Be aware that you may have to ask clients to repeat themselves due to an unstable audio connection.
- If things get too difficult to carry on the session you may have to rearrange the session for a later date.
The good news is Hope Rehab Thailand is accepting international clients again. Thailand is prioritizing medical tourism visitors for licensed facilities like Hope. The first step is to get in touch, and we will start your medical visa application. If you require immediate help, we suggest online counselling by one of the therapeutic team. Some of our Counsellors offer independent online professional counselling and coaching. On the next page you can select a counsellor of your choice.
In my experience if you discuss these issues with clients before they happen they are far more resilient and able to cope when they do.
Therapists also have to recognise that these incidents will occur and not get frustrated by them. On one occasion when working with a client their device kept pausing, I started taking these issues personaly, as a reflection of my worth as a therapist in being unable to create a safe consistant space.
When this had happend for about the sixth or seventh time in fifteen minute, I mouthed a stream of unapproriately congruent explitives. Only to hear a little chuckle in my headphones before my client asked “getting a little frustrated are we?”. Not my finest moment but a very good lesson was learned. Just because you can’t see them doesn’t mean they can’t see you.
Online Counselling Works
I’ve never found the therapy itself to be a struggle or our ability to develop a therapeutic relationship any more challenging than in the face to face environment.
Initially I was nervous whether online counselling would be applicable to working with clients in addiction. I really needn’t have worried. Yes, there are additional issues that we have to be aware of. Do they attend support meetings, what kind of support network do they have around them, do they need to create one, do they have a sponsor, are they using or not, if not how long have they not used for, are they detoxing, what is their substance of choice, are they taking any medication, prescribed or otherwise, do they have any mental health diagnosis, any issues in regards to self-harm or suicide attempts, these are some of the more obvious questions that need to be asked.
If you would like to book an online session with Doug or one of our other counsellors, please click here to visit our online therapy page.
Really not unlike the usual process of an initial consultation session, just with a few more questions. Again it’s also about setting boundaries, letting people know that if they attend a session under the influence they will not be seen. It really isn’t difficult to pick up on whether someone has been using or not.
Personally I devote nearly the entire consultation session to finding out as much as I can in regards to their life today, their using, their motivation to change and what they want from the sessions and whether working together would be right for them and whether or not I would be the right person to help them.
Ultimately, at it’s core, counselling and psychotherapy is about the relationship between the counsellor and the client. This is just as true for online therapy as it is for face to face therapy, it is also true for both addicted and non addicted clients.
If you would like to book an online session with Doug or one of our other counsellors, please click here to visit our online therapy page.
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