Virtual counselling

Sounds like a dream, counselling without even having to leave the house, talking about embarrassing things without the other person seeing you blush. But is it all it's cracked up to be?

Telephone and internet counselling are becoming more easily available, but they may suit some people better than others. Some of these treatments are also controversial.

Over the phone

• Telephone counselling can be used on its own, or alongside face-to-face counselling.
• It can be used to help people who are in remote areas, or who cannot easily get to centres due to ill-health or mobility difficulties.
• If there is a long waiting list for other therapies, tele-health may be a useful way to keep in touch and provide reassurance.
• Telephone therapy trials have included counselling, cognitive behaviour
• therapy, reminders to take medication, follow-ups after hospital discharge, and even hypnotherapy.
• It seems to be effective in helping people with mild to moderate depression, especially in the early stages of treatment.
• People with severe communication difficulties, or with poor motivation, may not benefit.

Over the internet

• Therapies may be given by email, using videoconferencing, on message boards, or using a live chat facility.
• May be suitable for people who move around a lot with their work, or for people who prefer to write emails instead of talking face-to-face.
• Lack of non-verbal clues such as facial expression or other body language may make it difficult for the therapist to work out how the client is really feeling.
• If the therapist is unable to hear the client's voice, they might miss changes in tone, so may not realise the client is anxious, depressed, or agitated.
• It's easy to misunderstand what people are trying to say when they communicate via email. A joke can look like an insult, for example.
• There can be a long period of time between sending an email and getting a response.
• Avoid therapists who don't use their real name, and who don't give you full details about their qualifications or memberships of professional bodies.
• Think about your privacy: use secure sites, and password-protect your email. Remember that message boards are not necessarily private.