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Winter 2009/10 | Vol 13 No 2

Focus

Being there

How one therapist and her client connect online

 

These two stories convey an important message: Therapy is about communication and connection. As the tools of communication evolve to meet the demands of the 21st century, what stands firm in the therapy process is the therapeutic alliance that lies at its heart. CrossCurrents asked Dawn Schell, a counsellor with Therapy Online, and her client Kathy to write about how they experience “being there” in therapy, despite having only met once.

Kathy

I met Dawn in 2008 when she led a weekend retreat. Dawn and I had a natural rapport, so I was excited to start online counselling with her, focusing on my anxieties about raising a son with bipolar disorder. I had experienced face-to-face counselling and knew how important it was to develop a strong alliance with the therapist. I was curious to see how we would develop this connection online, with 100 kilometres separating us.

Dawn works for an online counselling company whose web site clearly outlines the counselling process. It was wonderful to be able to write to Dawn whenever I wanted. I know that journal writing can be therapeutic, but I have never been able to stick with it.

I’m amazed at the sense of “being there” that Dawn creates. When we are in a session, she always welcomes me into the “room,” and I feel her presence as she invites me to sit beside her. She develops a sense of natural conversation by inserting comments beside my remarks, often identifying feelings and empathizing with my experiences and thoughts. She tells me how she feels, for example “[sad],” or she describes herself as “[smiling].” She writes “hmmm” to indicate her thought process.

Online counselling helps to clarify my own thought process. I can rethink and rewrite my comments. I couldn’t do that in face-to-face counselling. I can reread Dawn’s comments, which are often profound and moving. I can respond whenever and however I wish. I can even print out the sessions to reflect on. In the past, when I left an in-person session with a therapist, I often felt better, but I couldn’t always recall exactly what we talked about.

In looking back at some previous sessions with Dawn, I realize how often I don’t answer her questions in subsequent sessions. I do consider responses to her questions, but I don’t feel that I have to answer them, nor does she pester me for answers. In this way, I feel that I have more control over what we discuss, and I like that. This process has allowed me to have more responsibility for my healing. Dawn has always responded to my questions or requests for more information. It has been delightful to receive e-mails from her that simply list websites she thinks might interest me. That makes me feel like she really cares.

I find online counselling to be more helpful than face-to-face. It can happen anytime, any place. I encourage other counsellors to consider it. Perhaps a one-time meeting would be helpful, but if you can provide a clear description online of your areas of expertise, your values and beliefs, clients will have a good sense of who you are. When Dawn describes the room she is in, when she describes her feelings in response to my comments, when her empathy comes through loud and clear, this fosters a natural, positive relationship. Online, no one is looking at you, at your hands, at your clothes. These superficialities are removed and a more authentic experience is possible. That’s what I have with Dawn.

Dawn

I couldn’t help but smile when I read Kathy’s e-mail describing a difficult situation with her son. I was smiling because, even in the midst of the frustration that clearly came through in her message, she could write about the situation with humour. It was a moment in our therapeutic relationship where I felt like I was in the room with Kathy, although she was sitting at her computer at home, and I at mine in my office. Like countless other moments in our therapy, this one reinforced my amazement at being able to feel such a natural rapport with a client I was “seeing” as an online counsellor.

I have never met most of my clients in person. Since I met Kathy that one time and she asked me to do online counselling with her, I had more background information than I usually do with online clients. That was a bonus in establishing our rapport in therapy. I could visualize her, hear her voice, picture her smile. But that physical presence isn’t necessary.

When I first heard about online counselling I didn’t think it would be possible to build a strong connection with clients without being physically present together. How could I translate the counselling skills I had developed over 19 years into a therapeutic relationship that relied purely on text to communicate and connect? How could I be “present” with clients in a meaningful way online? Yet, here I am, four years later, doing it, and it seems to work. For me and for Kathy.

At first, it was difficult to translate onto a computer screen what I do every day in person as a counsellor. It was awkward and seemed unnatural to have to stop and think about what I was doing, my facial expression, what my tone of voice would sound like in person – and how I would convey that to clients purely in writing. Then I thought back to my early days of counsellor training (flash back to Simon Fraser University in British Columbia in 1984). It was awkward then too. So I had to remind myself to be patient and to practice, practice, practice.

I had to learn how to translate the physical components of counselling skills – my voice, my body language – to my fingers. I had to learn how to provide clients with as much context as possible – describing my surroundings and conveying my gestures, facial expression and tone of voice in a natural way. Mastering these techniques takes time and can feel artificial at first, but these are rich nuances key to creating an online environment that captures the complexities of expression in face-to-face work.

A part of the ongoing therapeutic process with Kathy (and all my clients) is that I ask questions, I never assume, I ask for clarification. Not different from face-to-face counselling, really.

Still, I know from experience that online is not the format for everyone. But I do know – and Kathy tells me – that it is possible to build a strong therapeutic relationship online [not that I’m biased ... grinning].