Firstly, let’s be clear about what I mean by ‘online therapy sessions’. I am talking about using conferencing technology like Zoom or Skype so you and your client can chat and interact just as you would if you met up in real life. This is not the same as the video equivalent of a CD or download that is prerecorded and generic. There’s a place for that, but it’s not what we’re talking about here. (To learn more about making that sort of video, check out our blog on the topic, LINK).
Is online hypnotherapy as effective as working face to face?
I couldn’t find any studies that looked at
hypnotherapy specifically, but there are some that look at video conferencing
for other talking therapies (usually CBT) and the evidence is quite heartening.
A study in 2014 for example (Nordgren et al) found that internet-based CBT was ‘an
effective and cost-effective treatment for primary care patients with anxiety
disorders with or without comorbidities’ [1] and, in 2018, Andrews et al said
that ‘Computer therapy for anxiety and depression disorders is effective,
acceptable and practical health care’. [2]
What are the benefits of online therapy?
- It’s easier for your client to access your
services if they live in a remote area, if they suffer from a condition like
anxiety which makes it difficult to leave the house, or have access issues such
as a wheelchair.
- Some clients may feel more secure in their
own homes.
- Privacy – clients never bump into people
they know in your waiting room, and can’t be seen coming and going from your
clinic.
- Travel time and costs are reduced for both
you and your client.
- The overheads for you are less than hiring
a room.
- There are fewer personal safety issues for
the therapist, for example, if you work from home you don’t have to give clients
your address.
- You can open up your practice to a larger
geographical area – this might be especially useful if you have a niche market.
What are the drawbacks of online therapy?
- The technology – if either you or your
client is unfamiliar with it or has a poor internet connection, or if it goes
wrong (freezing, cutting out, etc).
- Privacy – making sure that clients are not
overheard or interrupted at their end, and also that your connection is secure
and GDPR compliant.
- Some clients may prefer face to face – Berle
et al (2015) cited a survey that said 92% of primary care patients were
interested in face-to-face interventions but only 48% in internet treatment. Of
course, that was pre-COVID, and many people are now much more familiar with and
comfortable using online conferencing platforms. [3]
- It’s not as easy to read non-verbal communication
cues, especially if your client is using a small screen like a phone.
- You might have to adapt some of your
techniques, for example, if you regularly use an Elman induction you can’t do
the hand drop.
- Professional insurance may be more
expensive if you want to take International clients.
- You may have to deal with multiple sets of laws and regulations about hypnotherapy if you take International clients.
Working online effectively
Even if you don't want to take your practice 100% online, there's no reason you can't offer it as an option to those clients who do want it. Here are our top tips for doing so effectively.
- Send clear instructions to your client about
how to prepare for the session; not just the tech, but also being in a safe and
comfortable place where they won’t be interrupted or overheard.
- Make sure your insurance covers you.
- Arrange a way to take payment if clients
usually pay at the appointment. Make it clear to clients when and how payment
should be made.
- Agree before you start the hypnosis what
will happen if you get cut off. It is also wise to agree that if they don’t
hear your voice for five minutes, they bring themselves out of trance feeling
wonderful and contact you. Repeat this as an instruction after they are in
trance.
- Zoom is widely considered more reliable and
secure than Skype or Facetime but if you or the client prefer, you can use any platform you choose.
- Make sure you are familiar with the
technology, so using it doesn’t distract you from your client. Arrange some
practice sessions with friends and family before using it with clients.
- Switch off automatic background tasks on
your PC and theirs, e.g. emails, updates, virus scans which can make noises and
interrupt the connection.
- Check the technology is working before you
start!
- Headsets can be better than desk
microphones as they cut out more background noise.
- Have the client use a laptop or iPad which
is propped on a desk or table; if they are holding it they may drop it when
they go into trance and you’ll lose sight of them.
- If you want to use background music, it needs to be playing through the meeting and not being picked up by your mic. Have a look at https://support.movegb.com/how-to-play-music-over-your-live-stream-on-zoom for advice on how to do this.
It’s also wise to check over your T&C
or contract before working online. I would recommend adding the following
provisions, but you might be able to think of others.
- If we are working online, you
accept that levels of confidentiality may be affected by factors that
are beyond my control, for example, the actions or failures of the
platform provider (usually Zoom).
- If we are working online, you accept that
it is your responsibility to ensure that you are not interrupted or overheard
by others at your end of the connection.
- If we are working online, you agree that we are working under the jurisdiction of the laws and regulations in force in England and Wales. (or of course, substitute the country you work from).
References
[1] Nordgren, L.B., Hedman, E., Etienne,
J., Bodin, J., Kadowaki, Å., Eriksson, S., Lindkvist, E., Andersson, G. and
Carlbring, P. (2014). Effectiveness and cost-effectiveness of individually
tailored Internet-delivered cognitive behavior therapy for anxiety disorders
in a primary care population: A randomized controlled trial. Behaviour
Research and Therapy, 59, pp.1–11.
[2] Andrews, G., Basu, A., Cuijpers, P.,
Craske, M.G., McEvoy, P., English, C.L., and Newby, J.M. (2018). Computer
therapy for the anxiety and depression disorders is effective, acceptable, and
practical health care: An updated meta-analysis. Journal of Anxiety
Disorders, [online] 55, pp.70–78. Available at: https://www.sciencedirect.com/science/article/pii/S0887618517304474#bib0045.
[Accessed 7.12.20]
[3] Berle, D., Starcevic, V., Milicevic,
D., Hannan, A., Dale, E., Brakoulias, V. and Viswasam, K. (2014). Do Patients
Prefer Face-to-Face or Internet-Based Therapy? Psychotherapy and
Psychosomatics, 84(1), pp.61–62.
Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer.
She is the author of
Their Worlds, Your Words and has co-written the
Hypnotherapy Handbook,
both of which are available from Amazon. Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi accredited hypnotherapy practitioner training, taster days and foundation levels.
CPD Expert - accredited CPD and other therapy training (online and workshops options), expert and qualified hypnotherapy supervision
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