While most people traditionally think of therapy as involving two comfortable chairs in a fairly cozy office, psychotherapy has been offered many different ways for decades (e.g. phone therapy and even therapy by email). Over the last few years, we have seen an increased interest in video based therapy. Using software similar to Facetime or Skype, online therapy or internet based counselling is an alternative method of traditional therapy that enables one the opportunity to meet with a mental health care provider even if you are far away or when your time is limited and you want to sneak in a session during a break from your daily demands.
While video based therapies also open up the opportunity to see professionals from a larger geographic region, it is important to recognize that much of the work provided over this medium must be provided by an individual registered provincially to work in Ontario. This means that you are generally restricted to Ontario-based psychotherapists and psychologists. This can also mean that moving out of the province may make it difficult for your local therapist to service you from afar. This restriction is not in place in all regions, so you should certainly discuss with your treatment provider whether this is an option for you.
I am often asked if I think the same level of connection can be cultivated in an online session versus an in person one. I would say that video based sessions are essentially 90% the same. Whenever possible, I prefer to have at least one in person session with a client before offering to switch to online support. This allows us some time to get to know each other and build a strong rapport with all of the context of in person. Perhaps there is something special about sharing the space with your therapist or having increased presence to allow the conversation to deepen. However, for many people the alternative of online support is more feasible and therefore more helpful than getting no support at all. Differences between online and in-person care may vary from person to person, and some might even find that they are more easily able to open when discussing concerns from the comfort of their own space. For individuals that struggle to get out of the house due to mobility issues, phobias, transportation barriers, or child/elederly care responsibilities this alternative avenue for support may be essential.
Because this form of support is becoming more commonly available at clinics across the world, it is now easier to continue therapeutic relationships despite life changes instead of having to start over with someone new. This online opportunity also opens up many avenues for individuals in rural communities to access qualified support that may not be available close by or may be limited by a local clinician’s areas of expertise. Furthermore, clinics are starting to offer online structured module based psychotherapy where clients complete educational pre-recorded videos and readings, complete homework and are monitored by a therapist. These might be more suited towards individuals who are not as comfortable opening up, looking for something structured and have limited financial funds to pursue long term options.
While video therapy may not be for everyone, it has become an increasingly available and research-supported method of intervention. If you find getting to session a challenge, why not consider talking to your support team about including some video based work.
While deciding to engage in therapy can feel like a big decision, it is not the only challenge one may face prior to sitting down in the therapist’s office. A common question we hear from clients is a lack of direction when “shopping” for a therapist or therapeutic approach that is the right fit for both themselves and their area of concern.
While it may sometimes feel overwhelming, seeking a better understanding of what approach will be the best fit for you does not have to be especially difficult.
Seeking Treatments that are Evidence Based
Accessing an evidence-based approach to psychotherapy means that the techniques being applied in treatment are supported through research and have been found effective in reducing symptoms for people with a particular type of concern. There may be a variety of different options available that meet your needs, but not every “validated” approach will be the right fit for you or your particular area of difficulty.
Not all domains of therapy are easy to study in controlled research trials, meaning that not all therapy orientations receive the “evidenced based” seal of approval. Styles of therapy that are not evidenced based are not necessarily ineffective, but a practice modality that is at least informed by this research is ideal.
You will generally find that many therapists use an eclectic approach to treatment, meaning they borrow strategies from a variety of different therapeutic modalities and incorporate them into your care in an individualized manner. This is very common because it allows the therapist to choose a combination of techniques that seem right for you, rather than trying to fit you to a specific mold. What is most important is that the therapist is trained in each of these different approaches.
What if the fit doesn’t feel right?
As a client, you have every right to change your mind with regards to your consent to treatment and can stop treatment/therapy at any time. Consent should be an ongoing and collaborative process. Perhaps you try out a therapist and agree to a treatment plan, but later find that things are not moving the way you would like. It is certainly within your right to discontinue care at any time and transition to a new treatment provider, though you may also find you benefit greatly from communicating your concerns with your therapist and seeing if they use that feedback to further shape the collaborative process to meet your needs. Lastly, it is important to give it more than just a session or two before you assess fit. Keep in mind that the therapist only has the information you have provided to get things started and sometimes we need a few sessions to obtain a fuller understanding of your needs. So, give it a chance, but also recognize if your needs are not being met and consider moving on if that seems to be a hurdle you cannot cross.
Often, the demands we face at work go well beyond getting things off our task and to-do list. These demands can begin to weigh on us and consequently add a lot of stress to your plate. Stressors can come from may relate to management of the workplace, one’s workload, or difficulties with co-workers or employees. Consider the example of a team member or leader becoming aware of imbalances in how a peer or employee is pulling their weight at the office. Your first instinct likely will not be to have the person fired, but you will undoubtedly recognize that the employee needs some feedback in order to recognize that a change is needed. This is a pretty common experience, one that is even more complicated if you work with friends or family members and do not want to ruin the relationship by being critical.
We can all probably relate to the discomfort of having these sorts of difficult conversations. You may even see the similarities to situations that are not professional related. Maybe you notice that one sibling is not helping out as much with care of your aging parents. Indeed, we all experience some sort of conflict in our lives where productivity and responsibility conflict with our relationships.
Before initiating a difficult conversation, it is important to start with a period of honest reflection, with the intention of widening your perspective to alternative explanations for the experience. Next, we must move towards an open and collaborative dialogue where both sides can have an opportunity to feel heard.
Managing a conversation where there is a need to be assertive while simultaneously attempting to minimize conflict is difficult. There are some guidelines, however, that can certainly help navigate these sorts of difficult conversations:
Have you ever had a situation where these tips might have come in handy?
While work generally is not a day full of fun and games, it should also not be an environment that completely drains you of your emotional resources. When the balance is off, assess, discuss, and act. It is quite likely that you are not the only one feeling the imbalance and we may find their are allies all around us looking to get things back on track.
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Anyone can get stuck. We face problems, we know they are there, but we feel at a loss on how to move forward. Sometimes the best path forward is to have a structured way to consider and tackle the concerns we are experiencing in our lives. Marsha Linehan, the creator of Dialectical Behavior Therapy, discusses four options that can be applied to any challenging problem. These four options provide a good path to clear one’s mind and help clarify a direction when one feels utterly stuck in a difficult situation.
So the next time you feel stuck and upset ask yourself what it would look like to employ each of these four options and then decide which option will be most satisfying for you and the desired result. You may not be able to solve the problem, but you might be able to avoid staying miserable.
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Jessica is a member of the clinical wellness and learning support team at FLEX Psychology. Jessica started Wellness Wednesday out of a desire to provide further opportunities for her clients to extend their wellness journey to all avenues of their life. You can learn more about Jessica by clicking here or by learning more about her and the clinical team at FLEX Psychology by clicking here.