How the Role of the Psychologist Is Changing: Online Psychotherapy
How the Role of the Psychologist Is Changing: Online Psychotherapy
In a world where access to online services is becoming increasingly widespread and information circulates faster and faster, the role of the psychologist is also changing. Traditionally imagined as a mental health professional who welcomes patients into their office, few people know that psychologists are also adapting by using new online psychological counseling platforms to reach more and more users connected to the web.
What is meant by online psychological counseling?
Online psychological counseling is a remote intervention designed to support a person in a moment of crisis, while going through an acute condition of distress, or it can be used as support for personal growth. Sometimes it is not possible to consult a professional quickly because of difficulties in reaching the office, or obstacles arise due to shyness; in these cases, online psychological counseling becomes a concrete option for help.
Behind an online consultation, in fact, there is a trained psychotherapist who responds to the request by providing targeted help. Through professional tools such as listening, empathy, and a solution-oriented approach, the psychologist can operate even in contexts different from the classic in-office setting.
Among the methods used by psychologists when providing online psychological counseling are:
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Counseling via email: using e-mail becomes a way to share personal experiences and reorganize one’s thoughts. It is generally used as the first contact between the psychologist and the client;
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Counseling via chat: platforms such as Facebook Messenger allow real-time communication, again facilitating a first contact between psychologist and client. The purpose is to frame the request for help and provide the best path to address the problem;
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Counseling via videoconference: in this case, Skype is most commonly used. For audio/video exchanges between psychologist and client, a computer, a webcam, and a stable internet connection are needed. Video counseling, which can then be followed by further online sessions to address the issue, can be just as effective as a first in-person session at a psychologist’s office.
Research on the effectiveness of online psychological counseling
Online counseling is widely used in English-speaking countries, where online services have been created within national health systems to provide access to psychological support for those unable to attend an in-person consultation.
This approach is also spreading in Italy, despite the skepticism of some professionals who believe that online counseling lacks the ability to fully convey and interpret non-verbal and paraverbal cues (tone of voice, timbre, rhythm, etc.) via video. Limitations also concern the difficulties some users may have with technology.
Nevertheless, online psychological interventions—often referred to in the scientific literature as internet-delivered or web-based—have been the subject of numerous studies over the past two decades. These studies have validated their effectiveness in a wide range of clinical contexts. Today, there is extensive evidence supporting their use, not only for their efficacy and cost-effectiveness (at least equal to traditional in-person therapy), but also for their ability to provide easier and broader access to care, making them advantageous in terms of compliance.
To give an idea of their application in different clinical contexts, studies have been conducted on the treatment of eating disorders [2], obsessive-compulsive disorder [3], panic attacks [4,5,6,7], post-traumatic stress disorder [8], as well as the treatment of victims of abuse, grief [9], and addictions [10]. Internet-mediated therapeutic interventions have also proven effective for disorders such as depression [11] and even couples therapy [12], where the online format has helped overcome resistance to attending sessions together in person.
For this reason, many psychologists have brought their expertise online, courageously responding to the demand for greater accessibility to psychological care through technology. The role of the psychologist evolves along with other human activities, becoming closer to people by breaking down the barriers that would otherwise prevent access to psychological services.
The 3 benefits of online psychological counseling
When we talk about the benefits of online psychological counseling, we are referring to a potential that deserves more attention and awareness from users who wish to access psychological services on the web. Online counseling offers three main benefits:
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Accessibility: for people with limited mobility, difficulties in accessing mental health services, or those living abroad for work or personal reasons, online counseling provides the opportunity to ask for help without feeling “alone” in facing an important life change.
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Overcoming stigma: online services help to overcome the social stigma, still rooted in our society, that psychologists are only for the “mentally ill.” In reality, psychologists support people who want to overcome moments of crisis and achieve well-being by learning strategies to improve their lives. Online counseling allows those who might feel inhibited by cultural biases to freely and confidently seek professional support.
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Telepresence: modern videoconferencing platforms offer the possibility of creating a space that feels almost physical in the encounter between psychologist and client—an experience often referred to as “telepresence.”
Conclusions on a world “psycho-logically more technological”
Although technological tools can be a valuable support in accessing many services, including psychological counseling, we must remember that every tool carries risks. Internet addiction, for example, has been discussed for years as one of the consequences of excessive technology use in our lives.
Today, almost everyone owns a smartphone. While years ago computer use was confined to time spent at home, technology now follows us everywhere. For individuals suffering from internet addiction, face-to-face treatment is still recommended. However, it is undeniable that the advantages of technology are numerous in terms of costs, time, and benefits. Among these, online psychological counseling holds great potential for reaching a wide audience and responding promptly to diverse needs.
Bibliography
Rogers MA, Lemmen K, Kramer R, Mann J, Chopra V. Internet-Delivered Health Interventions That Work: Systematic Review of Meta-Analyses and Evaluation of Website Availability. J Med Internet Res. 2017 Mar 24;19(3):e90
ter Huurne ED, de Haan HA, Postel MG, van der Palen J, VanDerNagel JE, DeJong CA. Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial. J Med Internet Res. 2015 Jun 18;17(6):e152.
Lenhard F, Ssegonja R, Andersson E, Feldman I, Rück C, Mataix-Cols D, Serlachius E. Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial. BMJ Open. 2017 May 17;7(5):e015246
Richards J, Klein B, Carlbring P. Internet-based treatment for panic disorder. Cogn Behav Ther. 2003;32(3):125-35.
Klein B, Richards JC, Austin DW. Efficacy of internet therapy for panic disorder. J Behav Ther Exp Psychiatry. 2006 Sep;37(3):213-38.
Kiropoulos LA, Klein B, Austin DW, Gilson K, Pier C, Mitchell J, Ciechomski L. Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? J Anxiety Disord. 2008 Dec;22(8):1273-84.
Wims E, Titov N, Andrews G, Choi I. Clinician-assisted Internet-based treatment is effective for panic: A randomized controlled trial. Aust N Z J Psychiatry. 2010 Jul;44(7):599-607
Internet-based interventions for posttraumatic stress: A meta-analysis of randomized controlled trials. Kuester A, Niemeyer H, Knaevelsrud C. Clin Psychol Rev. 2016 Feb;43:1-16
Kersting A, Dölemeyer R, Steinig J, Walter F, Kroker K, Baust K, Wagner B. Psychother Psychosom. 2013;82(6):372-81. Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial.
Spijkerman R1, Roek MA, Vermulst A, Lemmers L, Huiberts A, Engels RC. Effectiveness of a web-based brief alcohol intervention and added value of normative feedback in reducing underage drinking: a randomized controlled trial. J Med Internet Res. 2010 Dec 19;12(5):e65.
Perini S, Titov N, Andrews G. Clinician-assisted Internet-based treatment is effective for depression: randomized controlled trial. Aust N Z J Psychiatry. 2009 Jun;43(6):571-8.
Cicila LN1, Georgia EJ1, Doss BD1. Incorporating Internet-based Interventions into Couple Therapy: Available Resources and Recommended Uses. Aust N Z J Fam Ther. 2014 Dec;35(4):414-430.
