Counselling via Skype? This sounds promising, especially for people who would otherwise hardly be able or willing to go to a therapist. Whether eating disorders, depression or tinnitus: Counselling via Skype offers advantages over the classic couch. But there are also limits.
The demand for therapy sessions that patients can conduct comfortably from home is high. There are various reasons for this: If mobility is reduced due to accident, illness or old age, home sessions make therapy easier for the customer. In addition, going to a counsellor is not always an easy step. Video telephoning (Skype) from home can make it easier to get started with the therapy. Another advantage is the flexibility of online counselling by Skype. The customer saves time and can determine the place from where he would like to conduct the conversation.
In many respects, counselling via Skype is hardly different from traditional face-to-face counselling for both therapists and patients: Both appear punctually at the same time. The session is limited in time. Many therapists make sure that they always Skype from the same place, so that the patient has the same image in front of him, similar to when he comes to the practice. The same attention is paid to clothing and order as in regular counselling sessions. Just as the chairs in the practice are set to the feel-good distance, the therapist can also enlarge or reduce the Skype image so that the correct distance is created.
The similarities that Skype therapy has with traditional face-to-face therapy are often surprising. For example, the regularity and punctuality of appointments is just as important for patients as it is for traditional counselling. "Skype patients" are just as insecure with irregularities as patients, who come to the practice for therapy. The narration of dreams can sometimes be as close as the real presence of the patient. It is possible that the therapist and the patient can also come into a state of closeness via Skype - especially with dream stories.
Skype is the most sympathetic for many therapists, because one is not bound to any subscription and many patients have Skype at their disposal anyway. You don't have to set up anything special and you don't have to transfer money to an intermediary service.
For anxiety disorders just as successfully as face-to-face therapy
Social phobia is one of the three most common disorders of the psyche. Who suffers from it, experiences torments, if he must mingle among humans. The voice trembles, the hands flutter, the heart beats up to the neck, the body is soaking wet. In addition, there is a growing anxiety that everyone immediately notices how miserable one feels. Experts promise that suffering is easy to treat. But for many of those affected this is a small consolation. The inhibition threshold to knock on the therapist's door and describe the needs seems too high for them. Many therefore do without help. Some therapists develop therapies based on the Internet precisely in order to reach those people. And indeed: In a recent study, three out of ten respondents stated that they would not have visited a therapist without the Internet. Another three out of ten want to use online treatment as a first step in order to perhaps start a conventional therapy later.
Online therapies show high success rates for almost all anxiety disorders. Studies have shown that 60 percent of patients were cured. Help via the Internet is therefore just as effective as face-to-face therapy. The prerequisite is that patients talk to a therapist on a regular basis, for example once a week. Therapist-accompanied offers, in which the treatment steps are determined, are therefore highly recommended. They are typically based on cognitive behavioural therapy. Patients learn to change their own habits: They get used to certain behaviour patterns again. The approach is also effective for sleep problems and obsessive-compulsive disorders.
Limits of Skype Counselling
But online therapies via Skype cannot do everything: Crisis interventions are impossible. This is the reason why people with severe depression, psychoses or acute suicidal thoughts are still dependent on outpatient help or clinics.
In addition, Skype counselling does not transport all non-verbal signals, although they would be important for a comprehensive diagnosis. Also limited are therapy effects that result from physical presence and proximity in a room. In psychotherapy and psychoanalysis, patients sometimes experience severe psychological pain. An effective factor in psychoanalysis here is the presence: The pain is processed by the analyst - in a way that is not yet measurable or fully understood - so that the patient's pain can subside after a while. This psychotherapeutic effect is attenuated with Skype counselling.
Skype counselling is a very good alternative. Especially for patients who are very busy at work or who live abroad. Often it is also a preliminary stage, an introduction to face-to-face counselling. Skype counselling shows in many areas a comparable effectiveness to traditional face-to-face counselling. Skype counselling is not suitable for crisis interventions (people with severe depression, psychoses or acute suicidal thoughts). Although non-verbal signals and physical presence seem to be weakened, Skype can often achieve an amazing degree of connectedness and closeness.