Online, F2F or Phone?

There were few positives around COVID but it did change how you can access therapy. Therapists had to work online to continue supporting clients and a whole new way of counselling developed.

To help you understand the options and perhaps decide which is best for you, in this article I look at the three main ways of using counselling. I work across all three - sometimes clients use only one, sometimes they mix and match depending on what suits them or is going on in their lives. It is entirely about what works for them. Alongside my face to face training I am certified as an online and phone counsellor.

Below are the most common modes of therapy. There are many others - walking and talking therapy is increasingly popular.

Whichever mode you choose, they are all about a ‘safe space’ with strict rules on confidentiality.

Face To Face

In person, face-to-face counselling is the ‘classic’ mode of counselling pioneered by Freud. Therapists no longer use couches but the principles are the same. The counselling room is literally a ‘safe space’ to talk and explore experience.

Generally there are two comfortable chairs, arranged opposite each other but likely at an angle so that you can easily look away from the counsellor if you want to.

Face-to-face counselling can involve a lot of non-verbal communication for both counsellor and client. It can be adapted to suit clients who experience neuro-diversity issues.

Online

Online therapy generally means sessions conducted by a video conferencing platform like Zoom. It makes therapy more convenient and also more accessible for those who do not or cannot leave their homes.

The therapist will ensure the space is ‘safe’ for both - for example that you can’t be overheard or that nobody else is in the room. A counsellor who is trained in online work recognises the specific circumstances of online work and how they impact the work.

Online can suit clients for practical reasons or because they feel uncomfortable being in the same room as someone else. It can also be useful if you dislike eye contact or experience neurodiversity challenges. The counsellor can adapt the experience to suit neuro-diversity.

Phone

Phone counselling is more established than online. The Samaritans have been using a form of phone therapy for many years. It requires a particular approach by the counsellor, who must be very tuned to tone and silence, but can also be a very intense and personal type of relationship. Phone counselling can be preferred by clients who feel uncomfortable being in the room with someone else or do not want to make eye contact.

Which is best?

The mode of counselling you choose will be the one you feel most comfortable with. As a counsellor, I may ask you to tell me about your choice so that we can be transparent between us. But I won’t question your choice. I may highlight the strengths and weaknesses of each mode so you’re aware of them. But it is your choice.

How does therapy work?

If you’re new to therapy, or perhaps it’s been a while since you saw a counsellor, you may wonder what it is all about. Since Freud kicked off the whole psychodynamic analysis process over 100 years ago, lots of words have been devoted to how counselling works.

I can only tell you how I work and how it has worked for me. I’ve put this article together to provide a quick introduction to how I think therapy works. I believe it is based on four principles.

The Therapeutic Relationship

The relationship you develop with your counsellor is likely to be quite different to any other relationship in your life. It is based on the counsellor offering a genuine lack of judgement - whatever you say, goes - and empathy. That’s quite different from sympathy - empathy means trying to understanding your experience from your point of view.

A therapist won’t wait for you to finish speaking before telling you about their experiences that they think might be similar. They won’t judge you. They may share a little of themselves but the focus is entirely on you.

A good therapeutic relationship creates the trust and honesty needed to explore how you feel. It is the rock, the gateway on which change can occur.

Self Awareness

Freud talked a lot about the conscious and the unconscious. What he meant was that by increasing our awareness of who we are and how we ‘work’ we can begin to take more control over our lives. This can be difficult. That’s why the therapeutic relationship is important - it provides a safe place to explore this awareness.

Choices & Control

Greater awareness enables us to understand our lives and the choices available to us. It enables us to consider and have the courage to make different choices. To take more control if we need to. That can be over our feelings and emotions as well as relationships and life paths.

Self Acceptance

Experiencing a relationship where another person simply accepts us as we are, without judgement, can enable us to do the same for ourselves. By developing greater self acceptance, of accepting who we are as we are, can be an important step to improving mental health. It is about believing ‘I am good enough.’ You may still want to change and evolve, but if your starting point is that you are not broken, faulty or flawed then change and evolution begins from a much stronger and healthier place.

Do I Really Need therapy?

You may be asking yourself this question right now. Perhaps it was on your mind before you started looking into therapy. It’s a common and very reasonable question.

If you’re trying to answer it, the first question to ask yourself might be: why am I asking it?

It might be because you don’t think that what you want to talk about in therapy merits talking about. Maybe you see other people with ‘worse’ problems. It is always possible to find people who look like they’re facing harder things than you. That shouldn’t affect your decision. The key issue is how your life issues are affecting you. If they are destabilising you, affecting your mood or causing you anxiety, low mood, stress or a multitude of other emotional and health consequences, then therapy is there for you.

Perhaps you are asking the question because you’ve coped with your experiences up to now. Some days are bad, some days not so good, some are actually ok; quite often they’re ‘copable.’ We all develop ways to ‘survive’, to manage the impact of our experiences. But perhaps life is about more than merely ‘coping,’ of surviving. Perhaps you’re ready to embrace a different way.

I know from my own experience of starting therapy that it can feel frightening or scary to make that step. Wondering if therapy is right for you can be a natural response to that feeling. I am glad I made that step, because it was a step that put me at the heart of it - that valued what I need and want.

The question may also be about whether it is the right time for you to start therapy. Therapy is a commitment, a process of exploration. A good therapist will help you stay safe, will be alongside you on the process. But it can still be difficult.

If you’re not sure about this, most therapists - me included - offer a free, introductory, informal chat where you can explore it. Your therapist will help you develop a sense of whether you are ready to start. It’s also worth remembering that therapy is not a bus you cannot get off - while it is always good to commit once you’ve made the step, you’re free to step off any time.

Therapy is for everyone who is struggling in whatever way. There is no hierarchy of struggle. It is purely about how your life and your experience is affecting you.

To answer the question ‘do I need therapy?’ here’s my take: if you are struggling and it is affecting your life, your emotions or your health, therapy is there to help.

If you’re grappling with this question, you’ve made the first step by reading this. If it’s not the right time for you, I wish you well. If it is, you can contact me or use the various directories from BACP, NCPS, Counselling Directory and Psychology Today to reach out to a counsellor. Whatever you choose to do will be the right choice for you, right now.