I’m not only old, I’m also old-school in some ways. So when we were first considering offering intensive trauma-focused psychotherapy online, I was opposed. I did not want to compromise the quality of our work, and I believed that doing therapy online would be substandard. But I was wrong.
I didn’t find out I was wrong until the pandemic hit a couple of years ago, and it became high-risk for therapist and client to be in the same room. Being old school, the first thing I did is look for the evidence. As it turns out, there’s quite a lot of research on psychotherapy via video-conference, with three primary findings:
- Conducting psychotherapy via video-conference increases access to therapy, for those who would find it difficult to get to the therapist’s office for whatever reason.
- Comparing therapy in the same room to therapy via video-conference, there is no difference in outcomes. In study after study.
- Even faced with that finding, many therapists don’t believe it, and continue to insist that being in the same room is better!
Okay, I was one of those therapists, I found it hard to believe, too. I was still convinced that too much would be lost in the translation when my client wasn’t in the room with me. But people needed treatment and they weren’t coming in to the office, so we went for it.
And it worked! More than worked, it went really well. Of course, research findings are averaged out from large numbers of people, whereas each individual case is unique. We found that many of our clients actually preferred working online, for the convenience of not having to travel to our office, and the sense of comfort and safety they experienced by doing therapy while in their own space. On the other hand, on occasion a client did not have a suitable space in their home for doing online therapy, or was already so “zoomed out” that they found it difficult to stay focused. Overall, though, our experience has been positive. We’ve become confident that – consistent with the research – online therapy works about the same as in-the-room therapy, with some individual variation.
One gap in the research I reviewed a couple of years ago was the lack of studies specific to trauma-focused psychotherapy. However, a number of recent studies have found – consistent with our own experience – that EMDR works quite well online, including when provided in the intensive format.
Even when the pandemic blows over, we will continue to offer the option of doing intensives online, because now we know that doing therapy via video-conference is not just a second-rate alternative; it’s a top-level option. And while the pandemic is raging? It’s good to know that you can both stay safe and get your treatment done.