When I began my journey into the world of professional counseling, I never would have imagined that 15 years later, I would be providing mental health services via an online platform. Back in the day this was unheard of, but today it is an integral part of the way that I provide services to my clients. One of the number one questions that I’m asked in my online counseling practice is “how is online counseling different from face to face counseling?”
There are quite a few differences between face to face counseling and online counseling, but at the center of both is the therapeutic alliance.
There are many pros and cons to online counseling. Counseling platforms like Betterhelp and TalkSpace provide clients with 24 hour access to Licensed Mental Health Professionals; however, some clients take 2
4 hour access quite literally. This idea of around the clock access creates the illusion that clients will get immediate responses from licensed professionals and that’s not practical for a number of reasons. I’ve had several experiences with clients who write me back to back messages expecting immediate responses even when I’m in an active session with another client, sleeping, or engaging in self care. I try to be as open with my clients about the limitations of around the clock counselor access and most are understanding; however, the way certain platforms are marketed it can be a bit misleading. My number one con related to online counseling is the fact that it can teach clients to rely too heavily on their clinicians fostering a certain level of dependency.
As an online therapist, I attempt to empower my client by joining with them to learn about their problem areas and educating and equipping them with the necessary tools to solve their own problems. For me this is no different than the counseling service that I would provide with a face to face client. I truly enjoy being a counselor, it’s not what I do, it’s who I am. After each session I give my clients homework assignments that I typically follow-up with them with at the midpoint between sessions or the following week during the next session depending on what their engagement level is. Some clients have been in traditional counseling sessions before and prefer to only speak with me during live sessions, while other’s take advantage of mid week check ins and like to process through things in a back and forth text/e-mail format. Overall I think that online counseling is overall a positive addition to the counseling work. Below I’ve created a list of some of the pros and cons of this particular medium.
Pros
1. Online counseling provides access to services to people with non-traditional schedules.
2. Online counseling provides access to counseling for people who lack access to reliable transportation.
3. Online counseling provides access to clients who live in rural areas where there are limited counseling resources
4. Online counseling allows people to speak with a counselor via several mediums to include messaging, live chat/instant messages, phone, and video sessions.
5. Most online counseling platforms do not have a waiting list, which means you’re typically paired with a counselor within 24 hours.
6. Online counseling can be done from nearly anywhere within your home state.
7. Online counseling provides some form of anonymity which allows many clients to feel more comfortable sharing information about sensitive areas in their lives.
Cons
1. Online counseling can teach clients to rely too heavily on their clinicians fostering a certain level of dependency.
2. Online counseling is asynchronous, which means that the counselor and client are not always online at the same time when exchanging messages.
3. Online counseling is not appropriate for individuals who are suicidal, homicidal, or experiencing active hallucinations or other forms of psychosis.
4. Online counseling is not appropriate for individuals who are actively experiencing alcohol or drug withdrawal.
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