Online counselling: How effective is it and is it for you?

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While online counselling or teletherapy has steadily been growing in popularity, the ongoing pandemic has also accelerated its growth now that most of the world has been stuck indoors.

For those seeking mental health care and considering the service, there could be a few niggling questions: “Is it really effective, and how does it compare to face-to-face meetings? Does it work for everyone?”

We speak to Lynette Seow, COO of local start-up and virtual therapy platform Safe Space and Matt Oon, founder of social enterprise Acceset, which offers text-based therapy for youths, on how online counselling has progressed, its benefits and limitations, and who it’s best suited for.

How has digital therapy evolved throughout the years?

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As with telemedicine, healthcare, and even veterinary services, online mental health care has also grown rapidly over the last few years, and especially with the ongoing pandemic.

“A 2015 WHO survey revealed that 29 per cent of 15,000 mHealth apps focused on mental health. With Covid-19, this trend has accelerated. Taking the US as a bellwether, telepsychology work from psychologists jumped from 7.07 per cent to 85.53 per cent since the pandemic, with 67.32 per cent of mental health professionals conducting their work through online means exclusively,” says Lynette.

“Over the years, we see a greater diversity of digital mental health solutions,” says Matt.

“These range from self-service apps that require no human interactions (e.g. journaling apps and chatbot solutions), virtual therapy solutions that allow client and therapist to interact online, and blended solutions such as Acceset, which marries both approaches and allows users to access trained community support or professional help based on one’s needs.”

Virtues and effectiveness

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The immediate benefit of digital therapy would be improved access to mental healthcare.

“With technology, clients can have a session with our therapists from anywhere that’s comfortable for them and also access therapists who might not even be in the same country, but who have the expertise to help them get better. This reduces the barrier for people to seek help, as well as makes it easier for them to continue and complete their course of treatment until they get better,” Lynette notes.

“In terms of efficacy, there have been numerous validated studies showing that digital therapy has been able to significantly reduce depressive and anxiety symptoms, especially in mild to moderate cases. Randomised controlled trials have shown that therapist-supported, internet-based interventions can have similar efficacy rates as face-to-face interventions, and may even have higher long-term benefits.”

How does it compare to traditional in-person therapy?

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For those looking to try out therapy for the first time, digital therapy often reduces the barrier.

 “Especially if they’re concerned about privacy, it’s less intimidating to turn on a video call from wherever they’re comfortable and have a session instead of going down to a therapist’s office if they’re concerned about being seen by their friends or colleagues,” shares Lynette.

Limitations

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It does come with its limitations, with counsellors unable to zone in on physical cues.

Jia Ying says, “Unlike offline therapy, a therapist is unable to observe full-body cues such as finger tapping or leg shaking as they can only observe the client’s facial expressions and their tone of voice. However, more schools have been incorporating counselling via a video call as part of their curriculum and our therapists are constantly upskilling themselves in terms of how to conduct effective online sessions.”

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Matt agrees: “In-person therapy is a real-time synchronous activity between the clients and therapist in the same physical environment. Therapists are able to tap non-verbal cues not available on digital platforms and leverage on their clinical experience to establish a therapeutic alliance with clients and help to facilitate their healing and recovery.”

Then there’s also the concern of data protection and cyber safety.

Lynette advises, “In choosing an appropriate digital therapy platform, one should also be aware that there are strict data protection and cybersecurity policies in place to ensure strict client confidentiality.”

Who is or isn't suited for digital counselling?

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“Since Covid-19, many people, even seniors, have become more familiar with video conferencing and have adapted to be able to have effective conversations online. As long as you have access to a stable internet connection, digital counselling could be worth a try,” Lynette tells us.

But on the other hand, some may not be able to find a quiet and private space for themselves to have a video counselling session. “For instance, there could be constant distractions with other people around at home. In that case, it may be more appropriate to book an in-person session at the therapist’s location to ensure that they are able to have that safe space to share their thoughts openly.”

According to Matt, users seeking ongoing community support may benefit from using Acceset’s text-based therapy while those facing chronic or toxic stress that may undermine daily functioning would benefit most from in-person therapy.

“For users who may need professional therapy but are not ready yet, they may find text-based therapy beneficial as an interim measure,” he shares. “It gives them time and space to process their experiences and verify their need for help. Also, it helps therapists serving as moderators to know their prospective client’s needs in a digital setting before transiting to in-person when one is ready for professional help.”

What does a session look like?

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Through Acceset’s digital letter-writing platform, youths can reach out to trained, anonymous confidantes who will reply to their letters, and these will also be vetted by a moderator.

As for Safe Space, clients can book an appointment through the website, where they’ll be prompted to fill a short questionnaire. A real-time matching algorithm will then recommend the top four therapists whose expertise most aligns with their needs.

Lynette says, “The client still has full liberty to select any other therapist from our full list, but the recommendation helps simplify the decision-making process. Based on the therapist’s availability, the client can then book an open time slot. This has been very effective and most of our clients continue their subsequent sessions with the first therapist they have been recommended.”

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This article was first published in The Singapore Women's Weekly.