Online therapy – the third wave?

Matt-ButlerTherapy purists will, no doubt, protest but it must be said that online therapy has many potential benefits over the traditional face-to-face mode. From the client’s perspective you can undertake psychotherapy from the comfort of your own home at a time and price to suit. Clients have the opportunity to browse potential therapists, check their prices and professional profiles, check recommendations and therapist availability. Therapists can access clients drawn to the platform from anywhere in the world going well beyond their usual geographical boundaries and benefit from the promotional activities of the site as whole.

But beyond the relatively obvious benefits of convenience, choice and comfort, online therapy also holds some unforseen benefits relating to the efficacy of psychotherapy. For example, this mode means that users – clients and therapists – potentially have access to a verbatim record of sessions. This means that learning can be enhanced as clients can look back over the content of sessions thereby reinforcing therapeutic insights. Professionals also gain by having the same record – obviating the need to keep separate notes – also useful for supervision on which to base their own learning and service improvement (see, for example, Godleski et al 2012; Wagner et al 2013).

ProvenTherapyThe first wave of therapy in mental health centred on the industrial model – asylum based ‘care’, haphazard and largely non-therapeutic. Psychotherapies and drugs improved the situation from the 1950’s on and the most recent advancements have been in well evidenced therapies such as those used in IAPT (Improving Access to Psychological Therapies) services in the UK National Health Service (see: Layard ”The Depression Report” 2006). Such therapies are a major advancement in treatment for anxiety and depression but are still largely delivered in a traditional health service delivery model – i.e. professional centric rather than client centric.

Online therapy offers a third wave of therapy delivery in mental health which puts the client at the centre of the model. The development of apps and other approaches such as email therapy means therapeutic interventions can be carried out remotely ‘in vivo‘, for example undertaking behavioural experiments or graded exposure. With such potential flexibility we argue that it is increasingly hard to see traditional delivery models remaining so centrally relevant, indeed as society becomes ever more internet centric it is likely that where they can, clients will vote with their feet seeking therapy online first.

Another manifestation of the digital revolution? We think so when it seems like only a short time ago it would have been hard to imagine something like counselling and psychotherapy to be so well suited to digitisation.


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