Psychologist Online. Pros And Cons - Quality Of Life, Society

Psychological assistance cannot remain aloof from the changes that are taking place in society. People are becoming more mobile and more and more distant from each other. Now it is in the order of things when a psychologist and a client live not only in different countries, but also on different continents

It is not surprising that today, in addition to the "classic" version, when the therapist and the client are in the same room, there are many "distant" versions when various technical means are used to provide psychological assistance: telephone, skype, all types of network communication, including assistance in chats in written mode.

Quite exotic cases are not excluded, so your humble servant once had to shoot a panic attack using SMS correspondence.

Tell me, how do we sit down?

Even a hundred years ago, the founders of psychotherapy in all seriousness discussed how the psychotherapist and the client should be located in the office, and they found different options for "seating", and sometimes "spreading out". Let us remind you that orthodox psychoanalysts still put the client on the famous “couch”, and they themselves sit at its head so that the client does not see them.

Gestaltists and Rogerians prefer to sit opposite each other on chairs, art therapists can crawl with a client on the floor, play in a sandpit, dance or paint while sitting at a table

I am already silent about therapeutic horse riding or swimming with dolphins. So even without the Internet, the variety of interaction options is off scale. And underneath all this is a serious theoretical basis for understanding how the interaction should be carried out, how the client and the therapist should behave and who the therapist should be for the client.

Telephone operators

The first successful attempts to provide psychological assistance remotely are associated with the emergence of "helplines". The birthday of telephone psychological help is considered November 2, 1954, when the Anglican priest Chad Wara, having learned that there are three suicides a day in London, left his parishioners a phone with permission to call him at any time of the day. Within a few weeks, he had to involve volunteers on duty to satisfy everyone who wanted to pour out their hearts.

The advantages of such assistance are the ability to receive it almost around the clock, anonymity of treatment, free of charge, and the absence of time and thematic restrictions

Most helplines have a “consultant never hangs up first” rule.

Helplines quickly gained worldwide popularity, including the territory of the USSR. It is worth recalling that the author of the first (1994) manual in Eastern Europe on the theory and practice of telephone counseling was the well-known Odessa psychologist Alexander Mokhovikov.

Internet

Before the advent of the Internet, telephone counseling was the only form of “remote” psychological assistance. As the quality of Internet communication improved, so did the opportunities for online psychologist assistance. One of the first types was skype, later social networks and numerous instant messengers were pulled up, the quality of communication in which is improving every month.

Consulting on sites

Consulting on all kinds of professional psychological sites is also rapidly developing. The trick of this direction is that the client has the opportunity to check the qualifications of a psychologist at one or two free "trial" meetings with different therapists, who, moreover, also place a lot of useful psychological information on the resource for advertising purposes.

Virtual programs-psychotherapists

The most recent direction is the development of computer programs for psychotherapists. This idea arose in America as an attempt to help combatants who are reluctant to seek psychological help "in real life", but agree to communicate with an individual assistant program.

Considering that overseas psychological, as well as medical, assistance is increasingly provided "according to protocols," then developing a standard algorithm for psychological assistance in trauma does not seem such a difficult task.

New questions

Today there are many questions to which there are no unequivocal answers, no clear recommendations. The use of different means of communication influences the nature of the interaction between the client and the therapist. And sometimes in a radical way. Whichever component of the therapeutic interaction is taken, that one undergoes significant changes.

I would venture to say that “absence of joint presence” in one room is not the most problematic moment in “distant” forms of counseling

After all, a video or audio communication session also presupposes the simultaneous presence of the client and the psychologist online. Much more questions arise in connection with the new opportunities that users have on the Internet. For example, when the dialogue between the therapist and the client can be "spaced out in time" and both participants have the opportunity to reflect on their responses. Or when both have the opportunity to make an audio or video recording of the meeting or re-read the text of the consultation saved in the chat.

Customer opinion

At the client level, as always, it comes down to individual options and preferences. What becomes an indisputable plus for one client is a minus for another. And this is not surprising. I asked several people who have experience of client work in "distant" formats to share their impressions. That's what came out of it.

3 cons of online work according to clients

• 1. Usually the consultation takes place at home. And a consultation with a psychologist is something unusual, out of the ordinary, an event either very scary or long-awaited. It does not fit with the house where you are every day.
• 2. It hinders the fact that there is no road. The road there helps to tune in, and back - to lay inside a new experience. And so the session ends, and in two minutes you are already looking into the eyes of your family. In addition, the possibility that family members can interfere is straining, it is difficult to concentrate on the conversation.
• 3. The client does not see the therapist at all. His feet, his fingers, his shoulders. Only a severed head with a well-controlled voice. Also, the picture is often of poor quality. As a result, it is very difficult to understand the reaction and believe it, most of the non-verbal messages are lost. The client looks at a screen, an artificial surface, a fake, he can remove the connector - and everything will disappear! As a result, the client may feel rejected by this form of organizing the meeting.

3 advantages of online work according to clients

• 1. This kind of work is the least stressful. Because no one looks at you, you don't think about how you look. The result is the effect of a Catholic “confessional” and there is an opportunity to concentrate as much as possible on oneself. For those who are prone to introspection, this form of work is more preferable than face-to-face meetings.
• 2. Attracts also the maximum level of anonymity. Not only does no one see you, in addition, you can work under any nickname or from a specially created account.
• 3. In written forms, it is very attractive to take a pause for reflection, to answer not immediately, to re-read what is written. It is convenient that you save time on the road, and that you can work at the most convenient time for you. This is especially important for people with a flexible work schedule and for those who are often on business trips.

Ambulance

On my own behalf, I can add that the opportunity to get psychological help almost anywhere in the world where there is an Internet connection is very valuable. This is especially important for cases of emergency assistance, when the client does not need, for example, to wait until he can get out of some exotic "corner" into the vastness of civilization.

The author has been able to provide assistance to clients who are at ski resorts, exotic islands, airports, and not always at the "accepted" time of day in a decent psychotherapeutic society. This possibility is especially important in a situation of suicidal risk or an acute reaction to traumatic events.

Technical matters

A significant part of the complaints about distant assistance is directly related to the quality of video and audio communication, which made much to be desired five years ago. It is clear that even now all sorts of technical problems may arise, starting with a periodic interruption of communication. But today, in the presence of a good Internet, they do not happen much more often than, for example, the lack of light in the consulting room or repairs carried out next to the psychologist's office.

Economic issues

By the way, globalization provides new opportunities to reduce the cost of psychological assistance. There are therapists who work remotely with monolingual clients in rich countries. The benefit is mutual - for clients it is much cheaper than in the country of residence, and for the therapist the fee is higher than in his economically not most prosperous country.

There are other benefits as well. The range of convenient working hours is significantly expanded, and the psychologist does not need to rent a room for consultation. I suspect that a certain percentage of criticism of “distant” types of counseling is directly related to financial competitive advantages.

Equivalence paradox

Today, even supporters of the "classics" use "combined options" - when, for example, the main work is carried out in "full-time" mode, and if the client leaves or for some reason cannot be personally present, they go online. In this case, the client can send written self-reports about his health and "caught up" with his insights.

There is a growing body of scientific research that confirms the effectiveness of almost all types of psychotherapy. In fact, there is a constant expansion of "genres" of psychological assistance

It seems that the "paradox of equivalence" of psychotherapeutic assistance, discovered several decades ago, the essence of which boils down to the fact that different types of psychotherapy lead to approximately the same results, is expanding before our eyes to various information "channels" of interaction between the client and the therapist. The decisive factor, as always, will be how well a particular type of assistance suits a particular client and a particular specialist.

So the slogan of modern psychotherapeutic assistance can be formulated simply: "More approaches - good and different!"

Read also:

• Is it time to see a psychotherapist? Self-test checklist
• Psychologist or friend? Part 1. Six rules and three whales of friendship
• Psychologist or friend? Part 2. Can friendly support replace psychological help
• And talk? Pros and cons of online consultation