Presenting issues Best practice
What does research tell us about the experience of remote counselling for both clients and therapists – and what is still unknown? Jeannette Roddy , Naomi Moller , Wayne Full and Andreas Vossler share their findings Online therapy: what we know now
I t is nearly three years since lockdown measures against the transmission of COVID-19 were eased across the UK and we could return to in-person counselling. Since that time we have continued to adjust to a new normal in terms of counselling provision, one in which remote counselling via video platforms is now typically part of a standard service and private practice o ff er. Yet while the pandemic spurred on both research and practice in remote therapy, we would argue that the profession is still learning about remote delivery, with much as yet unknown. According to meta-analytic reviews of pre-pandemic research, remote therapy is as e ff ective as in-person. 1 A study comparing pre-pandemic in-person therapy to remote work during the pandemic found some improvements in symptoms of anxiety and depression, and no worsening of outcomes, for more than 5,000 clients who completed IAPT (now NHS Talking Therapies) therapy. 2 A similar study also found no di ff erence, except that recovery seemed to be faster in remote therapy. 3 Yet we still don’t really know how outcomes compare when people are free to choose between remote and in-person therapy, or if these fi ndings hold true for all presenting issues or client groups. We also don’t know from this type of research whether practitioners have to work di ff erently online in order to get those ‘as good as in person’ results. There has been a lot of research on how practitioners experienced the switch to remote provision but not, as yet, much research on the client experience. Much of
enough data for a 50-minute weekly video session. Alternatively, remote counselling might actually help some populations access counselling who were unable to do so before – for example, people with chronic illness and disability. This has always been a key rationale for remote therapy, yet there is limited research evidence to support this. While there is much that we do not know, it is also worth considering what we do know from the published research. We, the authors, have conducted one of the largest online qualitative studies ever. Taking place during the pandemic, 590 therapists responded to a qualitative online survey, providing more than 130,000 written words. This allowed a detailed exploration into counsellors’ lived experiences, both positive and negative, of online working, given the relatively new experience of online working to many therapists. 5 A second project completed a literature review of therapists’ experiences of video therapy both prior to and during the pandemic, and provided further insight into therapist views of online working. 6 We also interviewed Marianne Guthzeit, Clinical Lead, and Nicola Arceri, Deputy Clinical Lead, of Sunderland Counselling Service, to explore the reality of video
the work that has been done is focused on the experience of a forced shift to remote working. For example, one study that interviewed clients who had gone back to in-person working post-pandemic found that they mostly saw the online therapy as ‘less than’. 4 However, there is not enough research so far to suggest that we should encourage clients to opt for in-person if online is more convenient for them. Although video counselling is increasingly part of a standard service o ff er, we would also argue that services lack an empirical basis on which to decide whether there are some clients who should never/always be o ff ered remote counselling. Additionally, hybrid counselling, where a client might usually work in person but occasionally online, is under-researched – is a ‘whatever suits’ approach good enough? Whether video counselling is inclusive is another signi fi cantly under-researched area, yet counsellors have an ethical imperative to think about the inclusivity of their practice, including their remote practice. It seems likely that video counselling may be less accessible to some populations due to digital exclusion, including issues such as not having an internet-enabled device or not having
‘While the pandemic spurred on both research and practice in remote therapy, we would argue that the profession is still learning about remote delivery, with much as yet unknown’
DECEMBER 2022/JANUARY 2023 25 MAY 2024
THERAPY TODAY
Made with FlippingBook Online newsletter maker