Professionals use telephone counseling—a lot. In a recent survey of American Psychological Association (APA) member psychologists, 98% affirmed that they have provided counseling services over the phone. And 69% responded that they currently provide psychotherapy by phone, at least on occasion.
Similarly, a survey of psychiatrists found that 45% use the telephone as an adjunct to face-to-face (FTF) sessions, and 19% use it as their primary medium for providing treatment. Also, research has found that for some medical practices up to 70% of problems are handled solely by telephone. In my own research study (published in the Journal of Mental Health Counseling) of 841 mental health professionals, 73% reported using telephone counseling.
Such data irrefutably shows that the use of the telephone in the delivery of mental health services is nearly universal, and this doesn’t even include para-counseling services, such as those provided through radio or television call-in programs.
There are several ways online counseling is provided. These methods include (1) email counseling, (2) text-chat counseling, and (3) videoconference counseling.
Computer Mediated Communication
Computer mediated communication (CMC) is a fancy way of saying “talking to someone through a computer,” and without it online counseling—the online part, anyway—would be limited to an online version of bibliotherapy. That is, without CMC, a person suffering from depression could find a website and read about depression, or watch a video on depression recovery, but back and forth dialogue between client and counselor would not be possible. Therefore, having at least a basic understanding of CMC will help us immensely as we begin to discuss online counseling.
CMC is commonplace for persons with Internet access, especially younger Internet users who use CMC to be part of online communities, and to connect emotionally with others. There are two basic types of CMC, asynchronous communication and synchronous communication.
Asynchronous communication is a conversation that is not in ‘real-time’. This means there is a significant time-delay between the period when one person makes a statement, and when another person responds. This is nothing new. Mailing letters back and forth with a friend is an example of asynchronous communication. A friend of mine participates in asynchronous communication when she uses a camcorder to record video-messages from her and her daughter, and then emails the file to her husband, who is overseas. On the Internet, asynchronous communication is very common and takes the form of email, discussion board forums, and bulletin boards.
Synchronous communication is a conversation in ‘real-time’. This means that two or more persons receive and immediately respond to each other’s dialogue. We are all experienced with synchronous communication—every in-person conversation we have ever had has been synchronous, as has every telephone conversation. Videoconference would also be an example of synchronous communication, as would text-chat.
Email counseling is a method of online counseling that comes with great flexibility for counselors and clients. First, it is a ‘low-tech’ method of online communication that
virtually any person with basic computer skills can use without additional technical training. Also, it makes counseling extremely convenient because (1) the counselor and client never need to meet in a certain place and (2) they never need to meet at a certain time. A client can write a counselor at any hour—even if the counselor is busy, or not working, or fast asleep! The counselor then has (usually negotiated to be) 24-48 hours to provide a well thought through response.
With Text-chat counseling, client and counselor meet in a secure ‘chat room’ for counseling. Since text-chat counseling is in real time, it closely emulates in-person dialogue. The emotion-rich back- and-forth between counselor and client can feel very similar to an in-person discussion, especially when both users are well acquainted with the modality. Also, like email counseling, text-chat counseling is relatively low tech. That is, it is not complicated to use a text-chat program for it has basically the same functionality as the Microsoft Word program I am using to type right now.
However, text-chat counseling is not as flexible as email counseling. Even though client and counselor do not meet at the same place, they do need to be available at the same time for a counseling session. To some, this is a limitation of the text-chat modality.
Finally, Videoconference counseling is the online counseling method that most closely resembles an in- person encounter. With videoconference counseling, both the counselor and client are able to view each other, usually from the shoulder-level up, by use of an Internet video camera (i.e., webcam) or cell phone camera. Both parties are able to communicate verbally back-and-forth in real time. The experience is so true to life, many persons who use videoconference say they “forget” the person they are talking to is not there “in-person” with them.
However, there are some exceptions to the videoconference experience. If only one person has a microphone, that person might speak, while the other person might type. If only one person has a webcam, one person will be visible but not the other. And perhaps the most interesting variety of videoconference counseling is video-email, which is when two persons communicate using audio and video, but the conversation does not take place in real time.
Online counseling is very convenient for counselors and for clients. It can help people overcome barriers and seek out help.
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