Remote psychological therapy is not a modern invention. At the beginning of the 20th century, Sigmund Freud wrote letters to his patients, through which he generated almost the same sensations as in a personal visit, according to his biographers, and it was not unusual for him to analyze their dreams and unconscious impulses, offering guidelines to them.
Later, in the 1960s, psychotherapists began using the telephone to help their patients, especially in moments of crisis. A little later, in 1972, a group of psychologists from UCLA and Stanford conducted the first simulated psychotherapy sessions through connected computers.
In the early 1990s, when the World Wide Web became public, mental health professionals began creating websites offering psychological information, and some began receiving requests for help. This is how online guidance services were born, first through email and then through chats.
With the spread of the Internet, instant messaging services and video calling platforms, online psychological therapy has expanded its reach, increasingly resembling an in-person session.
What is online therapy exactly?
Currently, different terms are used to refer to psychological interventions through the Internet, from online therapy and telepsychology to cybertherapy or e-therapy. However, the American Psychological Association (APA) includes them under the concept of “telepsychological interventions,” which includes all those psychological services that use technology to allow non-face-to-face communication.
Therefore, it includes both guidance using the telephone, email or chats and treatment through video calls or mobile applications. However, it is worth clarifying that online therapy is not a psychological trend or approach but just a new way of communicating with patients.
Of course, due to the characteristics of the technology, the psychologist must adapt some of his evaluation and diagnostic instruments, as well as the intervention procedures and his communication skills, but basically he uses the same methods and techniques as in face-to-face therapy.
The main objective of Telepsychology is to facilitate access to mental health services, which is why it focuses primarily on people who need psychological help but who, for various reasons, cannot attend the consultation in person.
How is online psychological therapy used?
Psychologists can use technology in different ways in their clinical practice, applying both the asynchronous modality (via email or recorded audio) and the synchronous version to maintain contact in real time.
• Receive psychological therapy. The possibility of seeing patients through video calling platforms has greatly opened the range of options for telepsychological interventions, facilitating communication, so that today you can receive a complete psychotherapy treatment over the Internet, without the need to ask for in-person appointments.
• Complement face-to-face treatment. Many psychologists use technology to complement in-person treatment, especially when the patient cannot attend the consultation in person. This alternative allows you to increase the frequency of sessions without disturbing your daily life too much or interviewing other relevant people in your immediate context who cannot go to the psychologist. It will also allow you to receive tasks and guidelines, as well as psychological resources or reminders comfortably on your devices, which can improve therapeutic adherence.
• Conduct an initial evaluation. The effectiveness of psychotherapy depends, among other factors, on the bond you establish with the psychologist. Online resources are becoming a valuable tool in choosing a therapist. Carrying out the first online session, which is generally free or at a reduced cost, will allow you to determine if you feel comfortable with the psychologist while the professional can evaluate your case and decide if he or she is qualified to care for you.
• Follow up on face-to-face therapy. When psychological treatment is coming to an end and it is only necessary to carry out specific sessions to check your progress and ensure that you do not suffer setbacks, online psychological therapy is a particularly effective and comfortable resource. In fact, it allows for a more complete and prolonged follow-up over time that guarantees the consolidation of the results.
• Receive advice. Current technology is also useful for delivering brief psychological interventions aimed at providing specific counselling, typically via video calls or using messaging services and email. You can appeal this option when you need help to solve a specific problem, whether in your relationship, with your children, at work, or to overcome the death of a loved one.
• Support for serious psychological problems. Currently there are also the so-called “red lines”, telephone numbers through which people with suicidal ideation or other mental disorders who need help in critical moments are assisted. In addition, you can use online evaluation programs for the detection and prevention of suicide risk.
Online therapy is as effective as in-person therapy
In recent years, several studies have been carried out that show that online psychotherapy is as effective as in-person sessions. A meta-analysis carried out at McMaster University that included 17 studies on cognitive-behavioral therapy, concluded that it is just as effective for depression as the in-person modality, but much more convenient for patients.
Another review conducted at The Scarborough Hospital in Toronto found that online psychotherapy significantly reduces anxiety symptoms, particularly panic disorder. It was also significantly effective in treating post-traumatic stress disorder and specific phobias.
Researchers from the Karolinska Institute went a step further to analyze the effectiveness of long-term online psychological therapy. After evaluating 14 studies that involved more than 900 participants for an average of three years, they found that the average duration of online treatments was between 8 and 15 weeks, a relatively short period of time in psychotherapy.
In addition, they confirmed a 50% reduction in symptoms of panic disorder, social anxiety, depression, stress, obsessive-compulsive disorder, generalized anxiety, compulsive gambling and chronic fatigue. And best of all, these results were maintained in the long term.
Therefore, the belief that online therapy is not as effective as in-person therapy is simply a myth. Thanks to video calls, practically the only difference between online and in-person psychological therapy is the communication channel. Instead of speaking in front of the psychologist in the same room, you will do so through a screen.
Is online psychotherapy the most suitable option for you?
Current technology allows the verbal and extraverbal information exchanged to be received quite clearly, so details relevant to treatment are not lost, which is one of the main concerns of many patients.
It is true that at first online psychological therapy may seem more “violent” if you are not used to using technology, but the psychologist will quickly establish a bond that makes you feel more comfortable and calm.
In fact, online sessions are not “cold”. An experienced professional will be able to establish a warm and trusting relationship even through a screen. Furthermore, one of the main advantages of this modality is that you can find English-speaking psychologists who not only share your language but also your cultural references when you are in a foreign country.
In general, the effectiveness of psychological therapy does not depend on the place where it is carried out, nor on the channel used for its application, but on your commitment to following the guidelines indicated by the professional and, of course, the skills of the psychologist, hiso r her qualifications and experience.
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