Online psychotherapy: when is it effective?

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Online psychological counseling: FAQ

Contacting a psychologist online is no longer something exotic or forced. The technologies of communication on the Internet are developing – and in parallel with them, the possibilities of using all these technologies for psychological assistance appear.

If five years ago a potential client, having met an offer to consult online, would rather have doubted, now he simply clarifies the nuances. I also want to write about them in this article – answering the most frequently asked questions.

In my answers, I draw on research data, my own experience, and the experience of colleagues who practice online.

1. Is online psychological help effective?

Yes, online help is effective. This is evidenced by scientific research and numerous special cases described by practitioners. The studies were very versatile, this is both an assessment of the results of online therapy, and its comparison with the classic options for help.

At the same time, a fairly wide range of problems and diseases was considered: from anxiety and eating disorders to family conflicts. Detailed results of these studies are freely available on the Internet (for example, at

In short, 90% of those who applied for help via the Internet believe that it helped them. Separate studies comparing the effects of face-to-face and online work have shown that they are on the same level.

We can also talk about the successful application of various methods in counseling in the network: from cognitive-behavioral and gestalt therapy to psychoanalysis. Apparently, the question is not which method works best online, but whether a specialist can adapt his professional skills to such a format of work.

2. With what problems does it make sense to contact a psychologist online, and what is not worth it?

At the moment, strictly speaking, the contraindication to online therapy is the same as to psychotherapy in general – namely, the presence of a condition requiring other, urgent care (psychosis or an extremely serious somatic condition).

Online therapy is in demand for panic and other anxiety disorders, depression, family problems, sexual dysfunctions, psychosomatic diseases, as well as for a wide range of psychological problems (self-doubt, communication difficulties, etc.).

In particular, in my online practice, appeals about anxiety, depression and psychosomatic problems prevail.

3. Is online help just Skype consultation, or are there other options?

At the moment, several options are possible. I write about “this moment” because new technologies promise us (mental health professionals) absolutely amazing possibilities in the future – for example, the use of virtual reality and specialized applications in Internet psychotherapy.

So, the options for working today:

  • video consultation mode (using Skype, Viber, Messenger, Oovoo and other programs). This is the closest way to the traditional way of working, since the face-to-face mode is preserved. However, it is more demanding on the quality of communication (although with the development of networks, this nuance is becoming less important).
  • voice consultation (using any programs that allow you to make calls). In my practice, this option is used, as a rule, in three cases – unstable Internet (for example, on the road), the client’s preference not to show his appearance, or the technical inability to use the camera. According to my observations, the effectiveness of this method of work is not inferior to the video format, provided that the client is able to express his thoughts clearly enough and perceive information “by ear” (with a predominant auditory system of perception).
  • chatting in real time (the so-called synchronous correspondence) – usually carried out in instant text messaging programs (Skype, Viber, etc.) or social networks. In my practice, this format is in demand by clients who cannot completely retire for a sufficient time (young mothers; people working on a rotational basis, etc.), as well as by those who have slow internet. Since part of the consultation time is spent on typing, this problem is usually solved by lengthening the session time (I allocate 90 minutes for a chat consultation, instead of the usual 60).
  • asynchronous correspondence – in chat or via emails.

Correspondence therapy (scribotherapy) is generally the very first option for remote psychological assistance. It has existed for more than 100 years, if we consider the publication of G. Oppenheim’s psychotherapeutic letters in 1908 as the date of its origin.

Before the advent of special programs for communication on the network, he remained one of the leading (along with telephone consulting). Asynchronous communication, chat or e-mail, is convenient for those who cannot allocate enough time for a session or generally prefer written communication. As a rule, it contains the client’s question, the answer and the recommendations of the psychologist.

In addition to each of the above forms, working in the network makes it possible to: apply a homework system (for example, using services such as a “personal account”); use psychological testing online; orient the client to independent searches / obtaining information on specialized resources.

4. Do online psychologists work with married couples or groups?

Consulting a couple on the Internet is certainly more difficult than working with one client, however, and it is now quite possible and effective. There is already enough of this practice, which made it possible to adjust the techniques and methods of work for this format.

Basically, the consultation takes place in video format via Skype or similar programs. Group work is more common. We use webinars, online courses, closed groups in social networks with the possibility of group discussions on the “wall” of the group.

More and more systems provide the ability to use video conferencing in a group (for example, Google Hangouts, Skype, ooVoo).

5. What do you need to be able to work with a psychologist remotely?

Contrary to popular belief, anyone can use web therapy, even not the most active Internet user. In my practice, for example, there were cases when a person who was not familiar with the Internet at all became a client, in this case either relatives helped, or the client himself simply contacted me by phone.

The only requirement in the case of online therapy is the availability of the Internet, the necessary programs and minimal skills in using them. For example, to work in text format – the ability to type quickly enough.

6. Which specialist can advise online?

Real life shows that not every professional who is successful in full-time work is also successful when working on the Internet. At the moment, there are no professional standards for working as an online consultant.

There are models of requirements for the practical skills and qualities of a psychologist who works with clients using the Internet; you can read more about them in the works of V.Yu. Menovshchikov (President of the Federation of Online Psychologists-Consultants).

In my opinion, for effective work online, the most important are:

  • extensive experience of personal and professional communication on the network;
  • experience of undergoing personal therapy in an online format (at least in the mode of individual consultations);
  • the ability to equally effectively perceive visual and auditory information;
  • very good user skills, understanding of the nuances of the program (settings, etc.), fast typing, text analysis, etc.

And, of course, the belief in the possibility and effectiveness of online therapy.

7. How do you pay for the services of a psychologist online?

Payment for consultation when working online is made before the session, at the moment this is the only way to guarantee a professional that he will receive a reward for his work.

Here the question may arise, does the payment guarantee that the consultation will take place? If you have chosen an adequate specialist (more on this below), then he will not risk his reputation and deceive clients. The cost of the consultation, as usual, is negotiated in advance.

In the professional environment, there are still several opinions – should an online consultation cost less than a face-to-face consultation? Some of my colleagues believe that this is justified by reducing the cost of renting an office and travel.

The other part (including myself) is that online consultation has a number of features, due to which it cannot be cheaper than face-to-face consultation – a higher level of mental stress on the part of the therapist in order to get the most information on the channels currently possible and be ready for technical surprises, the need for computer contact.

In terms of preparation for the consultation and analysis of the client’s homework, full-time and online work are comparable. Payment is usually made by transfer to a bank account, bank card, paypal, webmoney, etc.

8. What if you didn’t like working online?

Of course, when working online, there is a risk that the format of distance communication itself “will not work.”
To solve this problem, there are two options: demo consultations, short preliminary consultations, after which the client can agree on a full consultation, or the “time for making a final decision” system, which I use, for example, when at the first, already paid, consultation the client has 30 minutes to decide if this option is suitable. If not, the payment is returned to him, in full.

9. What if technical problems arise during the consultation?

Of course, online therapy is dependent on the quality of the Internet and the work of technology. To be on the safe side, additional communication channels are usually discussed. For example, if a problem occurs with a computer, a smartphone is used; if the connection has deteriorated and the video format is not possible, we will nevertheless end the consultation with the help of chat correspondence or a voice call. Naturally, communication failures during the consultation are compensated by additional time.

10. Now there are a huge number of specialists in the network offering online help, how to choose?

A specialist who positions himself as an online consultant, as a rule, is actively “represented” on the Web. These are publications on professional portals, and communication on specialized forums, and pages in various social networks, etc.

Use the search engine to see specialist publications and interviews. Pay attention to basic education, not just a line in an advertisement, but a photo of diplomas, and the university that issued them.

It’s the same with certificates. Any self-respecting specialist presents this information in the public domain.

The second step is to get acquainted with his work experience, this information can be obtained from the published resume or requested. But it is up to you to decide how you feel about the reviews of strangers about working with a particular specialist, but do not forget about the fake reviews widespread on the Internet.

Category: Online psychotherapy


About the Author ()

I’ve hurt myself while trying to help myself more than you can imagine, that’s why I want to scientifically analyze every popular self-help technique and ‘method’ there is.