A qualitative investigation into the online counselling relationship: To meet or not to meet, that is the question

Abstract

Background and aim: Online counselling, as a psychotherapeutic approach, provokes debate amongst practitioners and researchers concerning its efficacy and validity. This reflexive study extends existing research into the nature of the online counselling relationship when it is conducted asynchronously (by email) and explores the possibility this approach may facilitate both online and face-to-face therapeutic engagement. Method: Semi-structured interviews were conducted electronically with ten former email counselling clients of a university counselling service and six counsellors delivering email counselling in other higher education settings, to explore, in depth, their experiences of the online therapeutic relationship and its impact on the counselling process and outcomes. These were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Four areas of focus emerged relating to: (1) the importance of the structure and processes involved; (2) their impact on thinking and feeling; (3) their impact on self and relationships (within and outside counselling), and (4) changes that followed email counselling. Having 'time to think' within the asynchronous exchanges, the anonymity and disinhibition afforded by the online medium, the creation of transitional space and the rich use of metaphor, visualisation and imagery all contributed to a sense of empowerment and relational depth for individuals who might have otherwise avoided seeking help. This led to positive change in many cases and for some, facilitated subsequent face-to-face counselling. Implications: The findings support the provision of counselling and therapy online and particularly its integration within existing face-to-face services.

The future of online therapy

“…Dunn, 2012;Fenichel et al, 2002;Rochlen, Zack, & Speyer, 2004). Many professionals oppose e-therapy on the basis that it is impossible to surmount the limitations of distance (e.g., Lester, 2006;Wells, Mitchell, Finkelhor, & Becker-Blease, 2007).…”

Informal Use of Information and Communication Technology: Adjunct to Traditional Face-to-Face Social Work Practice

“…Employing screenings, assessments and informed consent, Formal Online ICTs consider the acceptability and fit of each client (employing evidence-informed strategies based on individual needs and goals), and simultaneously strive for accessibility, anonymity and/or confidentiality (Gilbert 2011;Rummell and Joyce 2010). Research has almost exclusively studied Formal Online ICTs, examining effectiveness (Dunn 2012;Gilat and Reshef 2015) and identifying clinical, ethical and legal implications (Amichai-Hamburger et al 2014;Haberstroh et al 2014;Hall and McGraw 2014;Johnson 2014).…”

Desenvolvimento de protocolos para acompanhamento de psicoterapia pela Internet

“…Uma observação interessante é a de que os pacientes que participarem desse estudo não sabiam que receberiam a psicoterapia via Skype e, mesmo assim, aderiram ao tratamento, apesar de não estarem na faixa etária daqueles indivíduos que tipicamente estão familiarizados com a tecnologia (Dunn, 2012). Esse achado indica que adultos de diferentes idades que buscam tratamento psicoterápico e aceitam utilizar a tecnologia podem se beneficiar da psicoterapia psicanalítica via videoconferência.…”