Themes – July 2014 : Online versus face-to-face coaching/ therapy


1. Comparing online therapy/coaching with face-to-face.

An experimental study that was conducted in the University of Zurich (2013) compared face-to-face with online psychotherapy through pre-structured written tasks. 62 patients were randomly assigned to one of the two conditions and the findings demonstrated that online therapy was an effective mode of psychotherapy.

Our community´s discussion which was stimulated by this report highlighted several advantages and disadvantages of the two modes – distance and face to face – of therapy/counselling/coaching. According to members of our community, technology offers several advantages. Firstly, members referred to the practical advantages that technology brings in coaching/counselling/ therapy:

  • “It bridges geographical distance”
  • “It is useful for following up on homework”
  • It helps to “get over barriers like time problems and travelling”
  • It offers the possibility to keep a record of sessions.
  • It offers the advantage of using technology between face-to-face sessions,  as “with technology you can support habit formation more efficiently than if you must wait until next session and discover that nothing happened”.

Secondly, aside from practical benefits, members mentioned advantages concerning the quality of distance coaching/therapy:

  • Distance coaching enables a strong focus on the language used, thereby avoiding visual distractions as it is often the case during face-to-face communication. In other words, distance coaching helps to focus attention to what is said, and prevents “an overload of information” that coaches have when all sensory cues are available.
  • For some clients and particularly those “who are familiar with technology”, distance communication is the preferred mode: “for some people it was the very distance that enabled them to communicate about their issue in a way that they would not have been able to do in a face to face session”.

On the other hand, members also considered the drawbacks of distance coaching/therapy:

  • Online therapy is not appropriate for everyone, rather the suitability of technology for therapy sessions is subjective and situational. Quoting one of the members:  “We need to be aware of ‘what works for whom, when and why’.”
  • Physical presence is essential for deeper personal issues, as all senses are needed to “pick up complex emotions”.According to one member´s experience: “…it is fully possible to have a person in front of you who says one thing but you sense there is something else going on”. 
  •  Rapport building as it was implied in the discussion, is difficult online. Thus, members suggested that before transferring the coaching/therapy online there must be a “platform” first.Quoting one of our members: “I still find a lot of benefit from a face-to-face induction session to set the ground rules and to build the rapport.”
  • Other drawbacks, specifically concerned text-based communication:
    • a) Text-based communication tends to be slower than face to face.
    • b)Emails and text-chat are not appropriate media for expressing feelings, showing empathy and understanding clients´ emotional states. Quoting one member: “Writing is a way of ordering your thoughts that is rather shallow and requires a lot of a person who is not used to writing, slow at typing or don’t have an exact vocabulary for emotions. You will both build fantasies and intellectualize as a way to fill in missing pieces.”
    • c)In written communication words can´t be taken back. As one member shared:  “when I’m speaking with a client, any mistakes are relatively easy to recover from – in fact recovery can often be done in the moment. The opposite is the case when committing something to writing – mistakes can be almost impossible to recover from, online work trades flexibility in wording for rigour”

Moreover, with regard to the above mentioned research study that stimulated the discussion, some members felt that the findings should be interpreted with caution. According to members of our community, moderate depression is relatively easy to treat and thus, the findings of this study – that online therapy may be as effective as face to face –  should not be generalized to online therapy for all cases. As one member argued: “there is definitely room for caution regarding the evidence – for instance minor depression is one of the easiest things to treat so cannot be used to prove that technology works as a medium generally”.

For further reading on this topic, members shared references to research studies, peer-reviewed journal articles and other relevant resources:

  • References to studies indicating similar impact and therapeutic alliance ratings between online and face-to-face clients:
    • An Exploratory Study of Client Perceptions of Internet Counseling and the Therapeutic Alliance – Todd Leibert James Archer Jr. Joe Munson Grady York published in Journal of Mental Health Counseling ,Volume 28/Number 1/January 2006/Pages 69–83
    • Using the Internet to provide cognitive behaviour therapy, Gerhard Andersson , published in Behaviour Research and Therapy 47 (2009) 175–180
    • An investigation of session impact and alliance in internet based psychotherapy: Preliminary results, D’ARCY J. REYNOLDS, JR1, WILLIAM B. STILES1, & JOHN M. GROHOL2, published in Counselling and Psychotherapy Research, September 2006; 6(3): 164168

 

2. The new sub-groups of the LinkedIn community: “E-coaching: A dialogue between researchers and practitioners”

The LinkedIn group: “E-coaching: A dialogue between researchers and practitioners”  now has 2 new sub-groups:

in addition to the existing ones:

The main aim of the sub-groups is to discuss best practices and experiences of existing and potential users and to answer questions about the specific tools the groups are focusing on.

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