How to go about Online Counselling?
Some Practical Guidelines
Sahaya G. Selvam
Background
The situation created by COVID-19 is difficult for most people. Internet and online services have filled the gap in social distancing. Online teaching and learning have become the new norm.
COVID-19 induced lockdown might create increased need for psychological help for some people, while reducing the possibility for physical sessions. Therefore, there could be more regulated possibility for online counselling and therapy sessions.
The guidelines here refer to some practical hints on how to go about online counselling sessions. Remember, all regular norms of ethics and code of conduct proper to counselling and therapy will apply: confidentiality being a primary concern. These guidelines are not meant to offer alternative code of conduct to any existing norms offered by governments or professional bodies.
Remote Preparation
Familiarise yourself with the common online platforms. The common platforms are: Skype, WhatsApp, Zoom. Each of them has its advantages and disadvantages. Zoom is very flexible, and ideal for group-therapy and one-on-one sessions; it allows sharing of files or screens instantaneously. However, recently there have been some cases of hacking by external persons in Zoom when the session is still in progress. But this should be controlled on one-on-one sessions. WhatsApp is very straightforward and easy to use, but can be used only on a smart phone. Zoom and Skype could be used from a PC/laptop.
Prior to the Session
The initial contact with the client could be through an email, or a phone-call, or a WhatsApp message, or through a referral. In the course of that exchange, confirm the following elements:
- modestly introduce yourself: clearly stating your qualifications, your specific approach, if you are a registered counsellor, etc. In an online situation, since the counsellor and the client do not meet in person, face to face, there could be issues with trust. These have to be cushioned by a careful self-introduction and politeness.
- Reason out with the client why online counselling may be the most suitable method in this context (For example, due to COVI-19 lockdown). Agree on your charges, if any, and how the payment may be made.
- Before the actual session(s) begins, as part of getting an informed consent: Ask participant if they are alright with the online arrangement. Ask them which platform are they familiar with and comfortable with – Skype, Whatsapp, Zoom? Would they want only an audio counselling or video counselling?
- Agree on the duration of a normal session. Remind them about punctuality.
After these logistics and requirements are worked out, give them an opportunity to make a choice and get back to you – confirming the informed consent. You might want them to write a form with some guidelines and ask them consent to it. Once they agree to be on the session with you, agree on the date, time, and platform for the first session. Sent links if need be or share specific contacts.
During the Session
Be punctual as agreed for the session. Allow a few minutes for cross-checking the internet connections, camera, microphone, etc. Have an alternative source of internet in case the normal one is weak, or happens to fail.
Be relatively well-dressed for the session. Don’t be too casual in your appearance, this could give room for the session to become too casual ending up in a conversation rather than a counselling session.
Make sure, that you appear well on the camera without your head being cut-off or with a poor lighting or a strong back-lighting. Cut out extraneous noise from environment and family members. Be sensitive to details to make the session pleasant for the client. If the client is not handling the equipment well, be polite and instruct softly without much fuss.
Note that you might only see the face of the client in a video-session. Therefore, pay attention to their facial expressions including movement of facial muscles to understand the non-verbal communication. Do not make any embarrassing remarks about their appearance. Be gender-sensitive and culture-sensitive.
Before the session begins, enquire if they are alone and if they are free to speak openly to you. You may move around your camera to show them that you are alone in your location and that everything they say is confidential. Assure them also that you are not recording the session, and if they share any paper or photo online then it is deleted from your computer after the session – unless mutually agreed upon otherwise.
During the session, be sensitive to give verbal and non-verbal feedback. In a virtual context you might have to be extra sensitive about feedback. In a pure audio session, you might have to exaggerate the “Mm…Mm…” responses assuring them that you are around and you are listening. Right proportion is important, without exaggerations or prolonged silence. Even in video-sessions, you might have to be conscious of your own body language to keep them in communication.
Remember the usual guidelines relevant for any counselling.
- Keep the questions open-ended.
- Avoid too many questions, not to give them an impression of a police-enquiry.
- Give a variety of listening feedback: body-language, paraphrasing, mirroring of final phrases, open-ended questions.
- Keep the pace of the session suitable for the personality of the individual: not too fast nor too slow; when a client is talking too much know how you would help them focus; when they are not speaking enough know how you would elicit some detailed descriptions;
- Focus on processing of thoughts and emotions rather than direct solutions.
- Focus on the interaction between their feelings, their thoughts and their behaviour.
- Focus on what their heart wants. Clarify and uphold what they desire most for themselves.
- Keep advice and personal sharing to the minimum.
- Time your session. Towards the end of the session try to focus, and arrive at a resolution, and a way-forward. Remember, free Zoom account allows only 40 minutes of session.
Towards the End of the Session
As you conclude the session, try to evaluate logistics of the session with the client – if they were comfortable with the medium used; and do they have any suggestions.
Agree on the number of sessions and the details for the next session.
For Further Reading:
APA Guidelines for Telepsychology
https://www.apa.org/practice/guidelines/telepsychology
Putting the Guidelines into Practice
https://www.apa.org/monitor/2017/05/ce-corner
Kenya Ministry of Health, Standard Operating Procedures (SOPs) for Counsellors and Psychologists