Tuesday, March 4, 2014

Accessibility and Flexibility: The Work of Reach Psychology Counselling

Online Counselling offers the opportunity to reach out to individuals who might find it too difficult to step into a clinic room or office. Therapy Market Counselling psychologist Ruth Hare has developed a friendly and accessible online service that provides the flexibility people require. Here she shares some of the principles behind her online and email counselling packages.

Ruth, you’ve indicated that you want to make counselling stigma free for people. How do you encourage clients who are reluctant to share their experiences or those who are experiencing shame around what has been happening in their lives?

Whilst ensuring a professional service, I’m fairly relaxed and promote myself as the friendly face of psychology – as much as I’m reluctant to have my photograph taken, my website is full of pictures of me so people can get their own sense of who I am.   Regardless of whether it’s face-to-face or online, the first contact with me is free which removes the pressure and I encourage clients to check me out and decide if I’m right for them.

I also tend to put myself in places clients will have no issue walking into – one of my ‘clinics’ is in a private meeting room within a local library for example.  I find people are more at ease if they can browse the shelves whilst waiting rather than sitting in a clinical environment.

It’s always been said that I have the knack for putting people at ease and that, with some empathic reflections early on which draw on resilience and survival, clients tend to open up and quickly learn that nothing is taboo with me. 

Counselling Psychology in the Education Sector

You also work as a consultant in the education sector. In what ways has your background in working as a psychologist with educators and parents contributed to your skills in counselling psychology?

There is huge interplay between the two.  Traditionally, psychologists have been tasked to ‘fix’ children and young people by only working with the pupil.  Utilising systemic thinking and exploring factors which maintain issues (such as parental issues or staff-pupil dynamics) has drawn significantly on my counselling psychology skills.  When seeing individuals for therapeutic work, I’m now all the more mindful of the impact of external issues and hypothesise about this in my formulations routinely.  Offering educators the opportunity of training, supervision, consultation and reflection empowers them to support troubled young people themselves.

Can you say a bit about your experience with teacher stress and your interest in the well-being of teachers? What draws you to this practice area?

I am struck by the enormity of the pressures teachers face today and the breath of their role.  The referrals I receive for young people in mainstream schools are complex, challenging and the issues are often already significant and embedded even by their early teens.  Teachers and support staff have very little training on the emotional demands of their job, and there is no culture of supervision within education like there is in healthcare, counselling or psychology.  I have found that by supporting staff to reflect and understand their own drives, needs and challenges it’s led them to develop deeper empathy and a greater capacity to think about the young people they are teaching.

(Find out more about stress and burnout in professional life at Therapy Market)

The Benefits of Email Counselling

Why did you decide to start offering your services online? What do you see as the benefit of online practice and email counselling?

Online practice sits well within the ethos of Reach Psychology  – it’s the ultimate in accessible counselling and removes all the barriers which location, clinic or the issue itself could generate.  I’m interested in combining the areas I’ve already mentioned – promoting the service to those in the education sector particularly – a place where staff can discuss pupil issues but also safely acknowledge their own work or home stressors.

You have developed a novel range of packages for email counselling – Reach 1, Reach 6 and Reach more - as well as the ‘This is Awkward’ consultation service. Do you find that online clients prefer the clarity of knowing in advance the service inclusion they will receive?

I am of course flexible in how long clients wish to work with me but I find that on a practical level it’s easier for clients to budget this way, and it’s helpful for me to anticipate capacity this way too.  I think it’s especially important for both parties to have a basic expectation of how much correspondence there is going to be, especially in email exchanges – I would respond differently if I was only expecting to reply once to someone than I would if I know we’ve got six opportunities to explore themes.

Would you mind giving some examples of the kinds of ‘awkward’ situations your email clients might raise with you?

I feel passionate about the Mind and Rethink ‘Time To Change’ concept – the idea that there should be greater discussions about emotional wellbeing and mental health.  However, in my experience what stops people is not their concern or stigma per se, but usually not knowing how to start the conversation or what to say back when the going gets tough.  The situations people typically talk to me about usually start with them saying “My friend…” , “My husband…” , “My daughter…” and they then describe a behaviour they are worried about: “drinks too much”, “works too late”, “doesn’t eat properly”, “becomes incredibly rude”, “hasn’t been themselves for weeks” , “seems depressed”.  I invite them to think more about the situation with me and support them to begin, and sometimes to sustain, a meaningful conversation with someone they care about.

Do you only provide email consultations or are you available for webcam sessions as well?

I enjoy using email primarily as well as live text chat using Skype instant messenger.  I occasionally use webcam but find it limits us to specific times where as email and live chat epitomises the flexibility of the approach.

If you were to give one piece of advice to another counsellor or therapist just starting out working online, what would it be?

I’d remind people that some of the benefits of this way of working also generate things you need to be mindful of and explore in supervision.  Once clients have opened up, I find the pace is often much quicker than face to face.  Inferring tone is also a challenge for both sides but with a transparent, open and approach with suggests interest, care and a motivation to understand, this is more than manageable.

Find out more about Ruth Hare at Therapy Market.

If you are interested in being featured as a practitioner, take a look at the why to sign up for professionals at Therapy Market.

Saturday, January 25, 2014

6 Tips for Starting your Online Therapy or Coaching Practice

Woman looking at computer screen
Starting out as an online coach or therapist? Here are 6 of the best tips about how to get your practice up and running quickly and efficiently!

#1. You are your product, so show who you are

When you are building your practice and developing your website, keep in mind that your prospective clients will want to research you before they book a session. They need to see you both as a professional and a human being, so forget those animated videos and robotic voices. Attracting clients is about trust and you can't build trust through complete anonymity. This doesn't mean you have to divulge all your personal secrets online, it just means that your website and Internet presence should reflect who you are, what you do and why you do it. Including at least one photograph of yourself is a good idea as is sharing your background and membership of professional associations. Don't be afraid to be yourself.


#2. Download Skype (or another Voice over Internet programme)

There are a few different software programmes you can use for webcam and voice over Internet, but Skype is the most well-known. Skype is free to use computer to computer and free to download. And you can even choose to purchase a Skype online number to keep your office mobile or a premium account that will give you access to group video (great for working with couples). Once you have installed Skype, practise using it with family or friends. Being comfortable with a webcam and creating a good impression is just as important online as it is if you were meeting clients face to face. Since its takeover by Microsoft, Skype is upgraded regularly. So once you have installed Skype, make sure you have the latest software upgrade.


#3. Set up a Paypal account (or another online payment service)

You want to get paid don't you? Paypal is one of the most well-known and trusted of all the payment systems. It's really easy to set up and start using it almost immediately. Of course you could choose to have payments made directly to your bank account, but using an online payment system is another way to develop trust with your clients because they know they can make a complaint if things go wrong. These e-commerce solutions do take a small fee, but it is comparable to what the credit card companies charge and worth paying for the extra business you will receive.


#4. Create your social media presence especially Twitter and Facebook

If you are counselling or coaching online you need to have a presence as a counsellor or coach online as well. A Twitter account and Facebook page are great starting points and a must-have for any online therapist or Internet coach who is serious about social marketing. Therapy Market regularly re-tweets our members tweets so we can help raise your profile too. Instagram and Pinterest are visual social platforms that are also becoming more popular. And if you are willing to show even more of yourself and feel comfortable being in video, you can't beat Youtube. It will really give prospective clients an idea of who you are!


#5. Join Therapy Market and be seen in the best UK advertising for therapists, coaches and counsellors

Therapy Market specialises in promoting online practitioners. If you want to boost your profile online through a counselling or coaching directory, Therapy Market should be your number 1 choice. A one-off annual payment secures a place in the advertising directory that you can modify and add to whenever you like. It's good value and will ensure you are seen among the most eminent of the UK coaching and counselling professionals. Look after yourself as a therapist with a listing that will help you attract more clients.


#6. Write about your coaching or therapeutic practice online

Most clients who want to see you online will find you online, not in printed ads. The future is virtual, so the more content about yourself and your counselling and coaching practice that can be found online, the better. Keep in mind that it should be quality content and specific to your niche as a therapist or coach. Avoid trying to be everything to everyone, you are swimming in a very big sea now. Focus on what you do best and how you stand out from other counselling and coaching professionals due to the Long Tail Effect. Having a blog and regularly posting updates is one of the best ways you can market yourself and much cheaper than google ads or paying someone in India to do your SEO for you.

Sunday, December 15, 2013

Online Psychology for Communication and Coping with Cultural Issues. An Interview with Judith Zur.

Clinical psychologist Judith Zur offers international online therapy and life coaching specializing in trauma and inter-cultural relations. We interviewed her about the application of online therapy to cultural issues and geographic isolation.

Judith, can you say a little about yourself and background including what brought you to work as a therapist and life coach? What aspects of your character and personality do you bring to this work?

I am a British American clinical psychologist, family therapist, social anthropologist and life coach who has lived many years in the UK, Mexico and the USA. My personal background has made me more aware, sensitive and empathic towards people's plights, suffering and difficulties in communication and coping (among other issues). This subsequently led me to choose my profession as a therapist and life coach.  The relevant aspects of my character include true interest in people, their family histories and dynamics, caring and the belief in peoples' ability to overcome hardship, to change and to make better choices.

What are the advantages of online therapy and coaching that have you offering these services to people in different parts of the world?

Online therapy allows me to offer therapy to people all over the world without them having to travel to a consultation room. It allows me to be of help to people for whom traditional therapy is inaccessible. It also allows some people to be more open when they are physically close. People can feel more comfortable about disclosing aspects of their lives when they are in their own environment and space. For some people time is an issue so being able to access therapy without spending extra time for transport and travel to and from sessions makes therapy possible for them.

You specialize in trauma, inter-cultural relations and working with refugees. In terms of these specific areas, what do you think are the benefits of working online?

Finding someone who specialises in these areas is not easy so working online makes me accessible in distant places around the world. The benefits of working online are also that I am able to work with people who are facing challenges associated with the forced or voluntary relocation to a new culture. There are also benefits from working with a therapist from a similar cultural background as the client and or one who places a high value on knowing the culture of all clients.

Can you give some examples of who might be your typical online clients?

Some typical clients are:
  • People who want coaching on a specific short-term issue, which is problem, focused, task oriented and builds on people's resources. 
  • People who seek therapy and are wishing to resolve more deep-seated problems whether as individuals, couple or families.  
  • Individuals who speak English or Spanish and as well as families who speak both languages and want to be coached or receive therapy in their mother tongue. 
  • Those who would like their issues to be understood from within their cultural context or bi cultural families for whom some of their issues revolve around their difference in culture.
Do you have a preference for working online, for example, via email or web-cam or voice-only technology? Is there particular software you prefer and, if so, why?

My preference is working via web cam where I can be seen and also see body language, facial expressions and generally feel less distance between the client and myself. This is the closest one can get to face-to-face contact without actually sharing a room. However I have also worked using voice only, chatting and email and am not opposed to working in this way.

What advice would you give to clients who are unsure about whether an online therapy or life-coaching appointment is right for them?

If possible I would suggest that they try both options and in this way discover which process suits them better.

How do you think online therapy and counselling should be promoted in Britain and around the world?

I think we need to make clear what these processes involve and offer positive feedback from both types of approaches.

Take a look at Judith’s page on Therapy Market if you would like more information about her services. And you can sign up here to become a Therapy Market coach, counsellor or therapist.

Friday, December 6, 2013

Self-care for Online Therapists and Internet Coaches: Win-Win for Counsellors and Clients

Psychologists, psychiatrists, nurses, social workers and counsellors are heavy users of mental health services, often themselves suffering from anxiety or other conditions like depression. Self-care is particularly important in our profession, to avoid burnout, compassion fatigue and the unintended consequences of working with troubling situations. What can working online as a counsellor, therapist or coach contribute towards maintaining good mental health?

We’ve all heard of vicarious trauma (VT), the consequences of therapists not taking enough care of themselves while working with traumatised people. It’s a combination of exhaustion and absence of support or coping strategies and perhaps one’s own history of trauma interacting with our clients traumatic stories, the work setting and the specific nature of therapy or counselling work. No one wants to succumb to VT, which is why it is crucial that healthcare practitioners take precautions.

Although working online with clients is no protection in itself against vicarious trauma, it can offer an alternative way of practising to ease the burden of work related hours and add variety to lighten the pressures of everyday practice. Many private counsellors, coaches and therapists on Therapy Market do both in-person (‘face to face’ counselling) as well as online therapy and find this a more satisfying mix than just seeing client after client in a consulting room. Other health professionals blend in other activities such as writing or teaching, running workshops or training, offering supervision or even public speaking so as to ensure their workload is not all client contact hours.

The advantages of replacing some face to face client hours with online hours include less travel time and even more time at home. For many therapists and coaches, getting to work is an effort in itself and a loss of valuable private time. There is also the advantage of working when it suits you. Many clients prefer not having to travel to appointments and the opportunity to attend online coaching or therapy can make their lives easier and less stressful as well. The benefits of internet based therapy practice include more time for personal relationships and happier clients, particularly those who appreciate a choice of online sessions and face to face consultations.

There’s no doubt that online counselling or coaching can make more time for yourself and contribute to the sense of professional boundaries that you have with your clients, if that is what you are seeking. Taking on some online therapy clients can be a proactive way to reduce the stress associated with getting to work or the worry about having enough clients through your clinic room door. Supervision is still important of course, but offering your services online can be a positive way to job satisfaction and effectiveness.

If you think working online could make a difference to your self-care as a coach or therapist, register now at www.TherapyMarket.co.uk . For a low annual fee you can be part of Britain's best directory of online counsellors, coaches and therapists.

Saturday, August 17, 2013

The Long Tail and Marketing for Online Therapy or Coaching

Ever wondered about the best way to use the Internet to promote online counselling or therapy services?

The wonderful thing about the world wide web is that it allows anyone anywhere to find obscure or specialised services. Now how your website works is quite easy to understanding if you are a face to face counsellor in Manchester offering Mindfulness sessions. Or an EFT therapist in Eastbourne. The geographic location is key. But what if you are an online coach or therapist and the whole world is your market? How do you get seen?

This is where Chris Anderson’s theory ofthe Long Tail is important. The Long Tail refers to the phenomenon that, when people are offered choice, they will go for diversity in addition to the most popular items available. It means our culture is shifting from mass markets to niches. And it is the Internet that makes it possible for people to find specialised and unique services in ways that was not possible previously.

What does this mean for counselling, therapy and coaching? It means that as an online practitioner, your capacity to connect with your best clients depends on what you offer and how. But more specifically, it means moving away from being a generalist to being a specialist AND letting people know you are available for online counselling whether that be over webcam, email, chat or the old fashioned phone.

With the Internet, you don’t need a geographic base for people to find you. And your online practice must reflect this if you want to reach clients. An added benefit of the Long Tail is that you don’t have to stop at offering counselling sessions. Imagine people all over the world are Googling their problems and difficulties. They might be interested in your real-time sessions or in email counselling but they might also want to read what you have written or do your courses. You can sell other things through your website than just your time. You can even sell advertising if you want. Just remember that the Internet loves specialists.

Therapy Market is a site that promotes online coaches, therapists and counsellors. We retweet your Tweets (if they are good) and push your Facebook posts. Join Therapy Market today to increase exposure to your online practice and get more clients.

Monday, July 15, 2013

Cyber Counselling and Online Therapy: Pioneering a Virtual Future for Social Work

How does a social worker turned mental health counsellor and gay mens therapist find his way into webcam counselling? Here's a story from Ash Rehn, one of the Therapy Market practitioners, about commencing as an online therapist.

For the past 4 years I’ve been delivering counselling and talk therapy over the Internet. A typical day might involve discussing homophobia in Hong Kong over webcam, composing an email on Mindfulness for a client in Manchester and chatting around communication with a couple in Capetown. When people hear I have an online private practice they usually have many questions. This is the story of my transition to cyber counselling.

It started with enrolling in a masters degree at Stockholm University and planning a move to Sweden. My partner was Swedish and this was the opportunity to live there. Excited by the challenges of exploring a different culture and learning a new language, I had one reservation: how would I support myself in a country where English was not the primary language?

My Sydney based counselling practice had been quite successful. So when someone suggested working over webcam with existing clients, it seemed a better option than pulling beers at an expat waterhole in Stockholm. Anyone who has set up privately will recognise my reluctance to give up that investment of time and energy. I already had a website and background in telephone counselling but there was steep learning curve ahead.

Marketing was probably my biggest challenge. The Medicare rebate is not available for online consultations and my Aussie clients quickly dropped off. After a year of trial and error I realised advertising as an Internet counsellor was pointless. By the time they decide on counselling, most people expect to be sitting in a room with a stranger. I had to find a way to pop up when prospective clients were still Googling their problems.

The web gives you a global client base. That might sound advantageous but if you want to be found, you need to stand out. I threw myself into learning about ‘search engine optimization’, blogging and specialising in niche concerns. Now most of my work is with gay men on issues of coming out or mid-life and men generally around sexual matters and pornography use. Shame presents a high threshold for anyone seeking help, which makes these issues ideal for addressing at a distance.

Web counselling doesn’t suit everyone but up against in-person services it’s like the proverbial apples and oranges comparison. Many of my clients simply would not meet face to face due to the value they put on their privacy, their relative geographic isolation or travel time. It’s also been suggested that Internet counselling poses greater risks to confidentiality or client safety. Certainly some subjects are not suitable for a solo practitioner working over the net but hopefully we all work with reflexivity. Online counsellors also require supervision, ongoing professional development and ethical standards. And there are the usual business factors like getting paid and insurance. The way our services are delivered might be different but the professional considerations are similar.

The biggest surprise has been the level of interest from other social workers and psychologists. I started offering fee-for-service mentoring and also provide supervision online. When the time comes to relocate, I will continue online as well. I see the future of online therapy as about growing specialist knowledge and a sophisticated skills-base. Being available online makes us more accessible and offers choice. I’m looking forward to the future.
Ash Rehn is a Therapy Market online practitioner. Take a look at his page on Therapy Market if you are interested in making an appointment.

This article first appeared in a slightly altered form in the 2013 winter edition of the AASW National Bulletin.

Saturday, June 29, 2013

Email Counselling and the Disinhibition Effect: An Interview with Psychologist Caroline Macrory

Psychologist Caroline Macrory is a Therapy Market practitioner offering therapy via email. Email counselling and therapy is becoming more and more popular as a way of engaging with a counsellor. We asked Caroline about her clients and approach and why she decided to offer written word therapy.


Caroline, you offer written word therapy through email. What inspired you to specialise in this written approach to therapy?

During my work as a therapist, I discovered that traditional one-to-one therapy doesn’t work for everyone. I spent many years seeing clients who had experienced trauma and abuse and who struggled to withstand the intensity of a one-on-one therapy situation; I travelled out to rural and regional areas to see people who had no access to other services closer to home; I also saw people with speech or communication difficulties, who found it difficult to express themselves effectively by talking. As a result, I became more and more interested in alternative therapies and exploring ways of supporting people using different techniques and approaches.

I have been drawn to writing since a young age, and journalling has undoubtedly helped me through some difficult periods in my life. So once I became aware of the evidence base that demonstrates the healing power of writing, I was hooked.

My colleague and founding partner, Jenna Mayhew, had experienced similar limitations in traditional therapeutic approaches and also shared my passion for writing. It made sense to us to develop a therapy service where people could be supported and empowered to experience the many benefits of writing from the comfort of their own home. 

Therapy over the Internet and web counselling is becoming increasingly popular. What do you see are the advantages of a text-based approach to therapy?

There are a number of practical benefits to online therapy, for example it is convenient, more affordable and you can do it whenever and from wherever you like. You also avoid waiting rooms, public transport and all the other irritations that accompany attending appointments in person.

There are significant emotional benefits as well. Being online can be empowering, and will often lead to you being able to express yourself more openly and honestly. Researchers call this the ‘disinhibition effect’ and it means that you are likely to be more confident in exploring aspects of your self and identity when online. Being open and honest is crucial for effective therapy, so this is a real plus.

Is it just therapy you offer by email, or do you provide counselling and coaching as well?

Our service is person-centred, meaning that we believe people have a significant capacity for self-understanding, self-healing and personal growth. As such, whilst providing structure, guidance and suggestions in our correspondence, we also aim to support empowerment, and we work from the assumption that the individual needs to maintain control over the therapeutic process at all times.

Counselling and psychotherapy are often used interchangeably, although they are different. Counselling is usually focused on one problem, whilst psychotherapy is for longer-term emotional problems. We use the term ‘therapy’ to cover both of these approaches.

Jenna and myself trained as psychologists, meaning that we can offer both counselling and psychotherapy. We will determine the needs of each client on an individual basis and respond accordingly. There may also be an element of coaching in our approach, although we don’t practice this as a pure modality.

Who are your typical clients and what kinds of concerns do they write to you about?

The wonderful thing about writing is that anyone and everyone can benefit from it. Although our service may have particular appeal to certain people, for example those who find traditional therapeutic approaches uncomfortable or those who find it easier to communicate by writing than face-to-face, we don’t have a ‘typical’ client.

Clients come from a range of backgrounds and write to us about a whole host of of issues, ranging from a recurring dream they have been having to a relationship breakdown or a general feeling of being ‘lost’ in the world.

How many times can clients write to you? Is there a minimum number of emails they can send or a maximum time period you will work with people for?

Clients can write to us as a one-off or on an on-going basis. As with face-to-face therapy, people are likely to experience an increased rapport with the therapist over time, along with a steady progression of their self-development through writing, therefore it is encouraged that clients do write more than once. However, there is no minimum or maximum time period for engagement. 

As with all therapists, we will use our clinical judgement if we feel a client is no longer benefitting from the service or if we think a different type of therapy might be helpful. However, we will never turn a client away as long as they feel they are gaining something from the service and we feel it’s the right support for them.

What kinds of issues or problems interest you most as a therapist? Do you have any special areas of expertise to offer those interested in written word therapy?

A traumatic experience is one that overwhelms an individual’s ability to cope and inhibits their ability to integrate the emotions related to that experience. It can have a lasting negative impact on their lives.

I have worked extensively with people who have experienced trauma of one kind or another. As such, I am particularly interested in supporting people to work through these experiences. James Pennebaker’s original and groundbreaking research into writing focused on people writing about traumatic and emotional events and the results were remarkable.

I certainly believe that where a person has been subjected to an overwhelming experience and is unable to talk about it, writing about it (as long as they are ready) can bridge that gap and begin to make the traumatic event more coherent and subsequently more manageable.

What advice would you have for other therapists thinking about branching out into online therapy or even written word therapy by email?

Online therapy is a powerful tool that is becoming more and more popular. However, it is essential for therapists to be aware of the potential drawbacks to this approach. Most importantly, when individuals reveal their deepest and most painful or emotional secrets when no one is physically present, this can leave them feeling vulnerable and alone. Online therapists need to be aware of this and ensure they provide an appropriate level of support and advice. They also need to be aware of the many legal and ethical requirements of working online.

Finally, what do you think is the future for online therapy in the UK?

It is becoming evident that computers and online environments can have profound implications for therapeutic support. People are becoming more familiar with computers and more comfortable interacting in online environments, and this has become a part of daily life in modern societies.
Online therapy can be extremely effective, and it is also cost-effective and convenient. It makes therapy available to many people who have previously been unable to access it, due to location, time or financial restrictions. It has great potential for reaching out to people who are in need of support, yet are unable to see a therapist face-to-face.

Take a look at Caroline's page on Therapy Market if you would like more information about her services.

If you are interested in becoming a Therapy Market practitioner, you can join Therapy Market or visit www.TherapyMarket.co.uk to find out more.