Online Therapy – Breaking Down Barriers for Quality Care

The COVID-19 health crisis has placed many people, whether directly affected by the virus or not, in situations of psychological vulnerability. Many have found themselves seeking psychological help, often forced to do so online.

Before this extreme situation we have all experienced, online psychological therapy was uncommon. It was primarily for those with significant personal, intra- or interpersonal circumstances that made it difficult to attend in-person psychotherapy sessions. However, like many other services, this modality has now become normalized.

So, if I can choose, is online therapy recommended?

Adapting to change is challenging, at least initially. This is especially true in a profession where we strive to create a warm, safe, and trust-based environment. Psychologists are trained to operate in the physical interpersonal space, leveraging all the richness it provides.

Therefore, as a psychologist (and this is only my personal opinion), I will always say that to ensure the best quality of the therapeutic bond and relationship, it is more advisable to conduct sessions in person. The sense of safety, stability, and acceptance is more intense when the client and professional physically share the same space and can also interact non-verbally: what is not said, the changes in atmosphere when sensitive topics arise, the nuances in the patient’s mood, light-hearted and humorous moments, or even defensive and transfer mechanisms are usually more perceptible and enriching in person.

Nevertheless, as we have experienced firsthand, this is not always possible. We can all find ourselves in circumstances related to time, distance, difficult schedules, or purely physical and psychological impediments… or even a pandemic.

For these reasons, it is essential for me to offer the possibility of starting or continuing therapeutic work remotely via video call, Skype, or Google Hangouts.

In theory, the process is the same: an initial assessment of the problem, feedback on the information gathered relevant to the case, jointly setting treatment goals, and using therapeutic techniques adaptable to the online format.

In practice, logistical difficulties that may arise, such as when doing practical exercises or using paper-based support, are easily solvable if there is a strong alliance and motivation for change. The user’s attitude and comfort with using the computer and video call programs greatly influence the success and long-term maintenance of the results.

But there are also specific guidelines that an online psychotherapist should provide:

• Clear and reliable information to the user about service aspects: characteristics of the work method and session development, limitations of the online format for intervention or evaluation, schedules, prices and payment methods, and the professional’s training, qualifications, and authorization, among others.

• Professionalism and quality of interventions, supported by adherence to the Ethical Code of Psychology and constant updating of psychotherapeutic knowledge and practices.

• Informed consent, where, as in the in-person format, no data or personal information can be collected without the user’s explicit consent, and users must be informed if such data will be archived or shared with other professionals for therapeutic or research purposes.

• Privacy. The entire therapeutic relationship must comply with the principle of confidentiality, and the professional must ensure the privacy of the data provided by the user.

With all this, I encourage anyone interested to ask for more information and give it a try, as the most important thing initially is to feel comfortable with your psychotherapist.

"I believe the greatest gift

I can receive

from someone is to be seen by them,

heard by them.

The greatest gift I can give

is to see, hear, understand,

and touch another person.

When this is done,

I feel that contact has been made."

– Virginia Satir

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Bibliography

• Aguayo, L. V. (2003). El consejo psicológico a través de Internet: Datos de una experiencia institucional. Apuntes de Psicología, 21(1), 4-18.