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Loss and Survival: a lesson in why training is crucial

Research report into the experiences of psychoanalytic psychotherapists working online highlights the importance of training for all therapists working online

Understanding the impacts of the period of lockdown during the COVID-19 pandemic is of undoubted importance, providing crucial insights into how future health emergencies can be managed.

It is therefore welcome to see research published on the subject, including this project that explored the experiences of psychoanalytic psychotherapists based in the UK during the first period of lockdown.

The research findings

The findings of the research study concluded that the psychotherapists primary concerns focused on loss and survival, with sub-themes relating to holding the frame, worries over a loss of security and safety, challenged analytic technique and altered relationship dynamics.

However, what is disappointing about the research article is that it barely mentions the importance or relevance of training.

Why is training for working online critically important?

Training and CPD provide each of us with the knowledge, the skills and expertise which ensures that our clients receive the best possible care – and also offers safeguards to ourselves as working practitioners. Working online is no different.

Those who have pioneered the work of online therapy have much to give to all those who are considering working online, whether on a long-term basis or in situations where it is necessary, such as during the recent pandemic.

Innovators in the development of online therapy have really given thought to the processes, frame, disinhibition effect, transference/counter-transference issues etc that can occur or change once therapy transfers online.

Furthermore, there is a real risk if you do not undertake any training, as you are likely to be working outside your set of competencies.

BACP guidance

It is consequently surprising that the thought of actually training to work online did not arise during the project, as each of the issues raised in the study are covered in training courses which would have been available to all at the start of the pandemic.

Indeed, the BACP has produced excellent guidance which strongly recommends training for working online.  It highlights the challenges of changing the method or medium of communication within the therapeutic relationship, for both practitioners and their clients. For example, it cites the fact that online relationships of all kinds are qualitatively different from those held in a physical space. The document recommends that practitioners think carefully about what is needed to ensure that they become competent in this new way of working. Training and preparation are vital ingredients to achieving this successful evolution into a new way of working.

The benefits of a supervisor

As a practising online counsellor, I have seen at first hand the benefits of training and the important role of a supervisor. Supervisory support furthermore reduces the risk of isolation and can guide those working online to access the tools and information, increase their skills and improve the effectiveness of the techniques applied. In addition, supervision must be online e-supervision, by an experienced practitioner who understands the differences to face-to-face work.

Training and research are key

At ACTO, we passionately believe in the importance of high levels of training across all the modalities, and to transform our individual modalities.

Training builds knowledge, skills and understanding. This process also encourages us to use research data to assess efficacy and the appropriateness of different approaches.

Let us hope that in the coming years, all those working within the mental health professions can benefit from good quality training; reducing the feelings of loss and survival and enabling them to thrive.

About the Author 

Kiren Sweetman is a person-centred counsellor and registered member of the British Association for Counselling and Psychotherapy (BACP). Kiren is also a director of ACTO.

Research study article

Taylor, L. Kegerreis, Rohleder, P. (2022). Loss and Survival: Experiences of Psychoanalytic Psychotherapists Working Remotely During the COVID-19 Pandemic. British Journal of Psychotherapy. 27 November 2022. https://onlinelibrary.wiley.com/doi/full/10.1111/bjp.12800. [Last accessed 06.12.2022].

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Counselling Online In A Pandemic World – Emma West

Emma West

We are proud to present the blog post that won the blog competition.

There’s no doubt that those trained in online counselling were ahead of the curve when we entered the eerie world of Covid-19 lockdown.  

Suddenly face to face counsellors were struggling with the practicalities of working online – “What’s Zoom?”, “How will my clients pay?”, “What’s online disinhibition?”….  

On top of sorting the practicalities they were also having to embrace the possibility that online counselling is actually just as valid, and effective, as face to face work, if not more so for some people.

But there was no time for prolonged smugness on my part because when lockdown kicked in the private online practice I’d been building up took off and I had clients coming at me via ACTO, E-therapy, Psychology Today, and word of mouth too.

Whilst previously I’d always had space for new clients I was now in the new territory of working out how many clients I could feasibly ‘see’ each week.  

It was actually quite a tricky conundrum because initially I found that a lot of people just wanted one session – they wanted to know that it wasn’t just them that was struggling, they wanted to hear that other people were finding things difficult too.  The issues of control, loss of routine, uncertainty, unpredictability abounded, but once their experience had been normalised they were happy to go it alone once more.

Some turned into OAAT [one at a time] clients, with weeks and sometimes months between sessions.  They seemed to appreciate the ability to be able to reach out whenever they needed to.

There were also a number of people who grasped the opportunity of being at home and the flexibility of their working arrangements to give counselling a go – with threats of a mental health ‘epidemic’ hitting the headlines counselling was becoming even more acceptable, and online counselling was their only option.

Many were new to the idea of counselling so initial work was often around managing expectations – what did they think counselling was – advice vs finding their own answers vs a magic wand?!

So how can counsellors adapt in this brave new world?

  1. Decide what platform to use [then stick with it but review periodically]: 

At the start of lockdown there was a LOT of online chat about trying to find the ‘perfect’ online counselling platform.  I found myself getting very caught up in this, with fears of getting it ‘wrong’ and that eternal counsellor bugbear of not being ‘good enough’.  In the end I decided to put all the security I could in place and used Zoom.

  1. Decide how many clients you can work with [then learn to say no]:  

With clients coming at me from all directions I learnt to recognise when I had reached capacity.  It wasn’t easy turning people away but I would try to signpost them.  I knew this would mean I could work effectively with the clients I had, and practice self care too.

  1. Sell yourself:  

When face to face counsellors ‘moved’ online the competition for clients skyrocketed.  I found that when I updated my various profiles to say I had already done specialist online counselling training and had been practising solely as an online counsellor pre-lockdown that the number of enquiries I received increased.  How can you make yourself stand out from the crowd?

  1. Be flexible:   

I realise that many counsellors need to know they have a regular income stream and this usually means seeing clients weekly on the same day at the same time.  

I found that offering one-off, fortnightly, OAAT sessions and not stipulating that I’d need to see clients on the same day/time, enabled me to corner a market in terms of offering a flexible service to those who needed that flexibility.  To be honest it was a bit of a gamble but strangely it works, and I’ve had a steady stream of bookings over the months.

  1. Seek peer supervision [as well as your regular supervision]:  

Coincidently I set up a peer supervision arrangement with another ACTO member at the end of 2019.  Having those monthly meetings together with online peer support through Facebook has been invaluable – it can be a lonely world counselling online.  NB Pick your Facebook groups wisely and unjoin those that leave you feeling stressed and/or unsupported.

  1. Normalise:  

I think it is vital to normalise clients responses to the pandemic.  Feeling anxious or low about potential threats to our health and the ever-changing limitations imposed upon us is perfectly normal.  The big question is how can we effectively support clients to adjust, manage, and move forward?

7. Don’t claim to be Harry Potter.

Emma West

Accredited Counsellor MBACP: 

www.emmawestcounselling.co.uk

www.motabilitylifestyle.co.uk

http://emmabowler.blogspot.co.uk

www.accessibleguide.co.uk

www.bbc.co.uk/ouch/writers/emmabowler.shtml

@FourFootTall

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It’s time to rethink the norms and face the new realities

ACTO patron Anne Stokes and champion of online therapy is challenging our profession to think differently

Over the years many of you will have heard of, listened to presentations at conferences, read books or articles by or indeed spoken to Anne Stokes. Anne is a passionate advocate of online counselling and psychotherapy and a practitioner of online work since the late 1990’s. Earlier this year, we were delighted when Anne accepted our invitation to become a patron of ACTO in recognition of her service to the profession.

Last month, you may have read about our plans to refresh our organisation for the challenges which lay ahead, as the online community grows to accommodate the environment, we now work in.

In July, I therefore invited Anne to give a presentation to the ACTO Board. Anne’s experience in the field of online psychotherapy and counselling is immense. Her book Online Supervision (Psychotherapy 2.0) is undoubtedly a must-read text for all online practitioners.  I wanted to give Anne the opportunity of challenging our organisation to embrace the new opportunities and help us to overcome the hurdles presented following the global pandemic. Since March, we have experienced significant membership growth in ACTO and of course thousands of psychotherapists and counsellors have migrated from face-to-face sessions to meeting with clients online.

I thought I would share one of the key points that Anne made: –

“The COVID-19 pandemic feels like it is a real watershed moment for the online counselling and therapy profession, turning our world upside down.

“In recent years, the number of therapists practising online has increased significantly. However, since March these numbers have grown exponentially. Many practitioners are now working online – because they have to. We need to respond to that, bringing people into our online community.

“For example, how are we going to ensure a consistently high quality of service to clients as those offering counselling and therapy online increases substantially? We must reach out to training providers and encourage people who may do things differently, whilst maintaining our ethical standards and values.”

Many of us have been working online for a period of time. Sometimes – given our enthusiasm and passion for online working – it can be difficult to understand the steep learning curve and issues facing other therapists who are new to this form of working. Our response must be inclusive and positive: supporting practitioners and those in the field of training, with the key objective of raising standards and ensuring the quality of our work.  

Anne’s contribution is timely. We have recently set ourselves new goals and aspirations to raise standards and encourage discussion and debate, as we welcome more members into our online community. Anne is encouraging us to do more – and to rethink how we do it.

Inspiring words. And words which we will translate into action.

Thank you, Anne.

Adrian M Rhodes

Chair, ACTO

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