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counselling in a general counselling environment from a service perspective. While the service suggests online working is the next preferred option after in-person work, only fi ve per cent of clients in this service chose video therapy, with more opting for telephone. Looking at our di ff erent pieces of research, we identi fi ed areas of commonality and di ff erence, which we share below. Areas of commonality Digital know-how : There was clear recognition of the challenges of internet working for those who were less familiar with computers, apps and the internet. Clear information sheets were needed for clients to make them aware of how the therapy would take place, what sort of arrangements might be required at home such as a private, safe space, free from interruptions from family members, and voice-based apps such as Alexa, as well as covering technical issues such as client technical understanding, or any software that needed to be downloaded. Simple and straightforward instructions can be very helpful in supporting clients into an online environment. However, these are still not generally available and would bene fi t from development. Client and counsellor safety : There was general agreement that some clients may be less suitable for online working, such as those with suicidal ideation and intent, living with an abuser, or experiencing trauma. However, the views expressed were diverse, from those preferring risk management, to those wanting to mandate in-person sessions only. There is evidence to support both perspectives, but further research is needed to help establish reasonable boundaries. It was also noted that clients who potentially posed a risk to a counsellor in person could be seen remotely, ensuring client and counsellor safety.
¢ Online Counselling: advancing your knowledge (DGXS001) is a 25-hour course developed in partnership with BACP that equips counsellors, psychotherapists and trainees to advance their skills in delivering effective and safe video and phone- based counselling. www.open.ac.uk/courses/short- courses/dgxs001
understand why this might be a problem for the work, even when guidance had been provided. This is perhaps something to be addressed through discussion in therapy, rather than rigid implementation of policy. Financial benefits : There was general agreement that there were cost bene fi ts to counsellors, organisations and clients with online working through the reduction in travel time. Working online also meant that more clients could be seen, as services were no longer limited by the number of counselling rooms available, potentially also increasing access to therapy. Areas of difference Technical experiences : The literature recorded di ffi culties in working with internet connections that dropped, delays in transmission, unclear pictures or sound and the impact on the therapeutic relationship. However, the service provider talked about fi nding the right platform and using a specially designed encrypted system, which was designed to meet the needs of their service. It is possible that since the pandemic internet provision has become more reliable and faster, improving the experience of both clients and therapists. Research to de fi ne an acceptable standard for the technical provision of online working would be useful. ¢ Online counselling: getting started (DGXS002) is a 25-hour course on how to set up and provide safe and effective remote counselling via video and/or phone, and how to navigate technology, data protection and contracting challenges as well as explore ethical practices. It aligns with BACP’s Online and Phone Therapy competence framework. www.open.ac.uk/courses/short- courses/dgxs002
Digital deprivation : As noted above there can be di ffi culties for some people in accessing online services. In some cases a remote telephone session may be easier to manage, but this may come with limitations on what the therapist can pick up during a call, if untrained or inexperienced in telephone counselling. Client benefit : The potential bene fi ts for seeing people who were unable to leave their home due to mental and/or physical health issues were seen as a signi fi cant improvement on in-person-only services. Client behaviour : There were many examples given of clients not adhering to the guidance around preparing for sessions, such as allowing interruptions from family members, taking the session with other people present, or while undertaking domestic tasks. Even when noted and raised with the client, the client did not always
‘Simple and straightforward instructions can be very helpful in supporting clients into an online environment. However, these are still not generally available and would benefit from development’
THERAPY TODAY 26 MAY 2024
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