2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
"Online psychotherapy is a profonation," some will say. But where are the roots of this belief?
Every day people write to me with a request for advice, but most of those who applied disappear without a trace when they learn about how this work is happening. Why? Because many people know about online counseling only by hearsay and often rely on the opinion of experts who did not find themselves in this story and once and for all closed the topic with the postulate - "online psychotherapy is evil." In this article I will tell you how it all began and what was the point of online psychological counseling in the post-Soviet space. And I will also write my TOP misconceptions about psychotherapy on the net.
And there were forums first
We will skip the stage when the Internet was on cards, at night or in an Internet cafe, since a more or less adequate format for consulting opportunities came only with the advent of specialized forums. We eagerly downloaded books in the Ichtik library and "looked into the mouths" of the masters of psychology who consulted on the net. Until we figured out what's what and why.
Both now and then there was certainly a certain percentage of specialists who wanted to help for the sake of help. But in most cases, in addition to the questioner, the consultations were attended by: "masters of psychology" who collected information for dissertations and lectures, shared their best practices; "novice psychologists" who learned from masters, imitating them or honing oppositional politics; "experienced" - consultants who had nothing to do with psychology, but really wanted to give advice, because they themselves (or the sister of their second cousin's husband's niece) were in a similar situation and "know what it is."
The client, in turn, received anonymity and consultation, considering his issue from different positions - a plus. The main drawback was that it was stretched out in time (the answer to 1 question could be expected from 2 days to a week) and it was difficult to filter information, weed out scientific knowledge from the personal opinions of beginners and experienced ones. It was certainly a help, but it was not possible to call it therapy in any way. The first step for a better analysis was to go to correspondence by mail (i.e. you read who answers you and how, chose a specialist to work with your case and then communicate with him face-to-face - you get the answer to 24 hours faster and you don't need to filter anything). But even then, one of the popular topics of discussion among psychologists was the topic of how to evaluate such work. For the number of words? For the number of questions answered? How long do you spend describing? Or if you want to charge a full hourly rate, how many emails should you send to a client per week? etc. Those who got used to this method and began to work like this, after a long time could not get rid of the habit of "reading letters from clients" from morning to night and at 1 hour of consultation to fit the entire possible range of questions and answers, because … without timely feedback, specialists are used to insuring themselves from all sides. Of course, this could not but affect the list of minuses that were forgotten, but settled in the heads of many. The benefits of such interaction are still questionable for both parties, but experience.
And schoolchildren created ICQ
The Internet pager did not reach us soon, but this greatly facilitated the essence of the dialogue, which now took place in the "here and now" mode without delays and witnesses, with a greater ability to respond adequately to the request. But the lack of visual support has become a new obstacle. Psychologists still objected - it is difficult for the therapist to guess whether the client is telling the truth or not, and in general what non-verbal signals his body sends, how he actually reacts to certain questions and answers, there is resistance and defenses, and is there a person behind whom he gives himself away, etc. Even in consultation by phone, the voice and intonation could give more than any messenger with its emoticons. Internet counseling is evil and profonation - once again the ethical committees decided and the only objection was that if a person really needs feedback, then the effect of therapy has already taken place (otherwise there would not have been a helpline in crisis services, etc.). Time passed, but the attitude of many remained at this level of development of the issue.
And the last word was Skype
We write Skype conditionally, because today any messenger with video communication allows us to provide this kind of consulting. On the one hand, such work became a challenge - an imitation of a real therapeutic session. On the other hand, an unexpected flurry of psychopathology and banal human dishonesty fell upon specialists, which forced once again to reconsider the form of such interaction.
To date, there are many studies on how that full-fledged psychotherapy online is not inferior in quality to face-to-face meetings … This became possible precisely due to the fact that the specialists made every effort, partly in the fact that they transferred all the rules of face-to-face counseling (setting) to the network. It worked. If earlier European insurance companies categorically refused to pay for "Skype therapy", now many admit consulting in the format of coaching or a short course of "behavioral modeling" (CBT). Even in the options of limiting the use of techniques due to the lack of physical presence (ie "I cannot use this technique at a distance"), therapists began to include in contracts the concept of assistants and "confidants", people who can help the client if necessary " on his side."
As a result, online counseling has become not only competently structured and effective, but also made it possible for people who previously could not visit a therapist for a number of organizational and psychological reasons (ranging from time constraints, long distance, language barrier and ending directly with the fact that new opportunities have opened up for people with mental disorders and borderline people, people who have special difficulties in establishing contact directly and people who seek special confidentiality if their problem affects part of their medical disorders).
But in post-Soviet thinking, everything worked out as always) We want to use the technologies of the future, relying on the experience of 15 years ago. After all, in fact now:
1 - researchers have a lot of material for research and opportunities for creating a high-quality sample. Today it is 100 times more difficult to meet a "maestro" at a forum than before.
2 - aspiring psychotherapists receive information from online archives and practice under supervision.
3 - social networks and other marketing platforms have made it possible for faster and better self-promotion.
And then we returned to the origins that in psychotherapy, it is not the quantity and quality of meetings that is paid for, but the specialist's time. And on the Internet, more and more customers began to receive answers with the meaning: "I understand you, I support you, you really want to change something - here is my phone number, the price is" average market "". Of course, this does not mean that all charitable projects and volunteers suddenly disappeared. But the question began to be formulated differently - if you want to work, this is work, if you want to inquire - get articles, videos and thesis answers.
From here, I summarize the TOP misconceptions that we have not yet finally said goodbye to regarding online work.
1 - online counseling is just a semblance of real counseling, therefore, everything is not so serious, meaningful and responsible.
In fact, as I wrote above, research has shown that online counseling is not inferior to face-to-face counseling. The percentage of unsatisfactory consultations lies precisely in the fact that clients, in addition to such work as serious, violate the setting - they miss meetings, do not complete agreed tasks, are distracted in the process or go on air in front of someone, from public places, etc.
2 - a serious problem cannot be worked out on the network
This misconception stems from the differences in the methods used. If the therapist practices hypnotherapy, a body-oriented approach and directions in which "physical" contact is important - this remark is true. However, most psychotherapeutic areas are based on a behavioral and analytical basis, which does not have any obstacles if the client decides to work on his request.
3 - the cost of working online should be minimal
This logically proceeds from the first two delusions, if such work is frivolous and superficial, then we pay frivolously and superficially. At the same time, as I wrote above, it was the application of the full-time setting (rules) to online therapy that helped bring it to a real effective level.
Moreover, since expats are more interested in online therapy, they also tend to choose the lowest price. However, in the rules of therapy, the price is formed not by where and how the psychotherapist lives, but by what price and significance the client puts into his work.
If a psychotherapy session costs like 1-2 packs of cigarettes, a short taxi ride or a trip to McDonald's, then the value of the work done is leveled to an ordinary trip, a cup of coffee, and so on. Psychotherapy is a process of qualitative change that does not occur within the patterns of the past. Personally, on the contrary, I have a question regarding the qualifications of a psychologist, who assesses his work in 4 trips by public transport.
4 - the illusion of simplicity - online therapy as an express method
"I watched the video on the net, everything is very simple there - a clever psychologist, an elementary method, you just need to consult in order to insert your problem into this formula." As I wrote in another article, anxious thinking very often refers to our experience of safety - childhood. In it, one way or another, we all believe in the existence of magic and magic. In essence, psychotherapy is the method that helps a person to grow up psychologically. As long as we believe in the existence of a magic pill, we will be disappointed again and again - in the form, in the method, in the specialist, etc. Any articles and videos are just acquaintance and general information - this is necessary and important, but this does not solve customer request.
5 - online psychotherapy is not safe. There are 2 points here.
a) these are doubts about complete confidentiality.
On the one hand, some of the messengers are "tapped by the special services." As a person who often works on the border between mental norm and pathology, it is always important for me to understand whether the client really thinks that his person is so important for the special services? After all, those who really matter know about it more than any of us)
On the other hand, it is impossible to know if someone else hears you on the other side. In addition, to use headphones with a microphone, there is a concept of trust, without which you cannot go far in psychotherapy. What is the point of having information that can no longer be applied in any way without cashing out a violation of ethics and just human dishonesty?
b) during the session, a crisis / attack / hysteria may occur.
For 17 years of full-time work, I have never come across such a case. But theoretically, a crisis can happen always and everywhere, so for those who really doubt it is important to just talk with the psychotherapist the topic of "confidant".
Thus, the answer to the original question "is online counseling a profonation" can be given as follows:
In modern conditions, if a person takes this work seriously and invests in it as well as in full-time, the result will be unambiguous, which has been proven by the research. If a person considers online consulting something not so serious and worthwhile, he will receive an appropriate result. And this applies equally to both the client and the specialist himself.
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