Top Ten Tips for Online Working for therapists


Due to the Coronavirus many counsellors are, with some reluctance, turning to working online to support their clients though this anxiety-provoking time. Normally I would have recommended doing some online therapy training as it’s a different skill set and has professional, ethical and legal requirements that need to be understood. But many therapists are now facing the dilemma of needing to do something – to offer to work in ways they have never done before and may not be entirely comfortable with, and the wish to continue support clients and keep their practice open.

I qualified in online therapy with Online Counselling Services and Training (OCST), and I am a member of the Association of Counselling and Therapy Online (ACTO), who can provide a list of online therapists if you do need to refer clients at the moment. Online Events has more information and training on working online.

Below is a list of Top Ten Tips, considerations and practical suggestions for online working. It is not comprehensive, but it will hopefully provide a little support for anyone just starting out with online working.

  1. Check with your insurance that you are covered to offer online working.
  2. There is lots of new guidance currently being produced about online working including BACP guidelines for online working.
  3. Ensure that you have online security in place and register with the ICO.
  4. Online working includes webcam but also voice/phone, Instant messenger (IM) and email. Check with clients if they are comfortable with working online. Not all clients can or will want to. For clients who cannot find a confidential space to do webcam work, I am offering chat / IM or a combination of webcam and IM. I am currently offering weekly 15-minute calls to check in, connect and support with those clients.
  5. Clients may feel more or less connected to you online than face-to-face. Be aware of disinhibition, where they share more online than they would feel comfortable in person.
  6. You may need to amend your counselling agreement to reflect online working and recontract with your client.
  7. Therapists are usually responsible for setting up their room, but this has now changed. I sit in my usual chair in my counselling room and so my laptop is opposite me in a space that the client would normally occupy in person. Clients have said that they feel comforted by this – seeing me in my room, and this familiarity helps to ground them and feel more comfortable with this new way of working. Clients also invite you into their space so there is something about acknowledging this and the feeling of equality in this. I learn a bit more about my client’s physical world too.
  8. I send guidelines on online therapy to clients before we meet so they can prepare for their session. It includes information about the online platform we will be using usually Zoom, how to access it, what happens if technology fails, and outlining a plan B. I also suggest that clients turn on their pc / laptop at least 15 mins before the session so any updates that need to run won’t delay the session. I also suggest they make sure their space is private, to ensure it is confidential, they have a drink, headphones if required, are warm enough and have their diary to hand. Some clients use their cars if their home is not suitable for a private conversation. Some clients may use a mobile so I request that they have it landscape as it means I can see them better. I do not use Skype or WhatsApp as these are usually used with friends and family and therefore can feel less professional and boundaried for therapy. Mainly I use Zoom and Vsee because they are safer and have better security.
  9. There may be misunderstandings in online therapy due to the lack of personal cues. I usually rely on my felt sense in face-to-face work so online I tend to ask more questions to clarify my understanding. I also try to communicate more than I would in person, my experience of the session as it evolves.
  10. Practice, and practice some more with peers if you have not worked online before. Clients deserve to feel held and well supported and if we are struggling with technology this can be stressful for everyone. Having a plan B if technology fails, which at times of high demand is likely, can help you to remain calm and feel in control.

If anyone has any questions about the move to online therapy, please drop me an email