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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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As demand for online therapy grows, self-care has never been so important

ACTO members Jan Stiff and Sarah Worley-James offer some practical advice to therapists and counsellors coping with increased workloads and the complexities of added stress caused by moving from providing face to face to online therapy

Recently we shared to our Facebook page an article written by a therapist, Katerina, who is coming to terms with the significant increase in demand for moving to providing online therapy initiated by the recent COVID pandemic.

The issues raised in the article are of course extremely pertinent ones at this time. So, we thought we would share some of our observations, and some suggestions for online therapists and counsellors to help them with their own self-care.

Firstly it is good to see a blog published on this matter – and one which is openly spoken about. After all, like our clients, we too are human beings struggling with the myriad ways that the COVID-19 pandemic is affecting us personally, as well as professionally.

Let us now consider some of the points made by Katerina – and offer our thoughts.

  • The power of online therapy to enable a new kind of creativity, safety and emotional intimacy.

That sense of “power” that can be interesting for some but equally disarming and frightening for therapists without appropriate training, experience and online supervision.

  • The importance of therapists having their own space set aside for online therapy

Coping with everyday things such as eating and sleeping can be difficult if this is the same space that you undertake your online therapy.

The inappropriateness of not having a sacred space – set aside for online therapy – a space that is safe and confidential and that can be “walked away from” as if locking the office door –  can pose a challenge which then impinges negatively on a therapists life and personal space.

  • The feeling that our profession is not getting any recognition or support

This is a concern for many of us in the profession; comments have been made that therapists have been “forced” to provide online therapy. The increasing effects of COVID and what therapist have “had” to endure (they feel they have had little choice in most cases and need to continue to work to bring in money) are concerning – and is deserving of further debate.

  • Not having an opportunity to say goodbye to clients as a result of end of face-to-face contact

Again, the need for training and appropriate supervision comes to mind here – and the option for therapists to acknowledge that moving to providing online therapy might not be an option that they want to move towards. During support sessions for face to face therapists “forced” to move to working online  – mainly school counsellors – one message I [Jan] shared was that they knew the client best and they knew what they needed.

Also they, as that clients therapist had the autonomy to communicate their concerns with either the schools, training bodies or professional bodies to say that they did not feel competent to practice online if they did not feel it was benefiting their clients. For instance, many were “forced” to provide telephone support because that was deemed “safer” but of course, the lack of ability to make visual assessments caused great concern for some therapists – understandably so.

Within support sessions and teaching we share the following as a way of assessing your needs as a therapist, working online and face to face – it can highlight areas of concern that a therapist, especially one practicing online, might not be aware of.

 

Building resilience 

Research has shown that vicarious trauma within therapists is related to workload and support. Of course individual therapist resilience is also a part of this.

We love this and therapists that it has been have shared with have sometimes been left in awe with how this highlights individual self-care needs, blind spots and issues leading to burnout.

This website has some great info:

https://proqol.org/Home_Page.php

 

Fun activities are important too!

And finally there are some simple things too. Fun activities which can help us all to relax away from our work.

Finding those small moments in the day to take care of ourselves.

That cup of tea sipped whilst listening to relaxing music, a few minutes to colour in a colouring book, do a jigsaw, cook something new.  Encouragement to focus on noticing those small actions that give a message ‘I’m worth taking care of’.  Focusing on gaining a balance, which may look very different to the pre lockdown one, while appropriate to life right now.

All of these may help.

Jan Stiff, online counsellor and supervisor

Sarah Worley-James, online counsellor and supervisor

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ACTO board messages Announcements Blog

Looking for an exciting new opportunity?

Looking for an exciting new opportunity?

The world of online counselling and psychotherapy is changing – and you can help to shape it by joining our team of directors on the ACTO Board

ACTO is always on the look-out for talent and energy to join the Board of Directors. In recent months, our profession has seen significant changes with the huge growth in the practice of online psychotherapy and counselling. We are keen to support that development by broadening our team with new directors.

There are opportunities for members to join our Board as ‘Directors without portfolio’; however we are particularly in need of expertise in the following areas:-

A Director of Training – to help us:

  • improve our training standards;
  • support our Training Organisations;
  • encourage other online training organisations to join the ACTO family.

A Director for Inclusivity/Diversity, to:

  • help us decide what this director should be called!
  • champion issues of inclusion and diversity within ACTO;
  • disseminate awareness and understanding of inclusion and diversity in online work.

An International Director (or deputy)

  • this is a passion of our Chair – but he hasn’t sufficient time to manage it fully:
  • to bring the long-awaited International Directory to fruition, to develop and manage it;
  • to link in with the international organisations devoted to online work;
  • to develop a network of ACTO ‘chapters’ around the world.

If you are interested, please contact the Chair of ACTO at:  chair@ACTO-org.uk for an informal chat.

Adrian M Rhodes

Chair, ACTO

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New ACTO Chair aims to raise the standards of online therapy

June 2020 blog Raising Standards
It is easy to do therapy online; but it is difficult to do therapy online well,

Raising standards and making ACTO the go-to place for online counselling and psychotherapy. Those are the two principal goals of ACTO’s new Chair, Adrian Rhodes, who leads the volunteer Board of Directors with representatives from across the profession. And for Adrian, the new role comes at a time of fundamental change as the world adjusts to life during the Covid-19 pandemic, necessitating innovative ways of working for counsellors and psychotherapists.

The lockdown and the introduction of social distancing measures have resulted in a massive increase in the numbers of psychotherapists and counsellors seeking to work online. Earlier this year, ACTO responded by publishing security and privacy guidance for practitioners providing online therapy. However, further work is needed as practitioners and services adapt to the technology and ways of engaging with their clients.

Adrian, who qualified as a psychotherapist in the 1980s, worked as a psychotherapist in the NHS and is also an Honorary Canon in the Church of England, believes that the growth in practitioners and services working online is a positive response to the crisis; however, it offers fresh challenges too, to ensure that a high standard of quality is provided. As Chair, Adrian is committed to leading the organisation in this exciting, albeit challenging, new phase of its history.

ACTO is a body with a clear objective: to support counsellors and psychotherapists who work online. With 15 years’ experience, we believe that this knowledge and expertise is invaluable at the current time.

Clearly, the landscape that practitioners and training providers operate in has been transformed since the start of the pandemic. Since March, many psychotherapists and counsellors have started to work online, some with limited experience and training.  The need to equip our colleagues with the right skills and expertise is therefore urgent. It is easy to do therapy online; but it is difficult to do therapy online well.

ACTO priorities

To make these transformative changes, ACTO will build up its repository of resources and knowledge around online therapy. Furthermore, as an organisation we will drive up standards of practice and training, provide information about working internationally and improve access to key research.

The goal: for ACTO to be the ‘go-to’ place for discussion and debate for psychotherapists and counsellors.

ACTO provides a range of services to its members, including a directory for therapists and supervisors, forums for practitioners to discuss relevant issues and access to digital tools.

If you would like to enquire about joining ACTO or find out more regarding our work, please go to the ACTO website or get in touch.

Adrian M. Rhodes

Chair, ACTO

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