Online therapy is not perfect, but has its benefits

Psychotherapy over Zoom may not be a panacea, but it has been a boon during Covid-19 lockdowns (Therapy via Zoom should make mental healthcare available for all – it hasn’t, 3 August). I am an integrative psychotherapist and shied away from e-therapy in all forms, as it contravened my idea of the therapeutic frame within which I practised – rich with warmth and empathic relating.

With lockdown, I rapidly trained in online etiquette, contracting, indemnity, and safety and security. Zoom security was helpfully improved early in 2020. Could I be therapeutic digitally?

Only one existing client withdrew.

I arranged my room with the computer across the arms of the client’s chair so the view of me, as therapist, was unchanged. Fortuitously, this put the client’s image where they would have been if present. This was a crucial factor, and I realised that I had settled into online therapy when I offered a tissue box to a weeping patient through the computer screen. I had become at ease with Zoom as a medium. I was an online therapist.

The challenges are different – if a client does not have a safe place from which to engage in therapy it will not work. I am sad when this happens, as I normally provide that safety for them. Privacy is also crucial. I have been challenged to deliver therapeutic help to clients in cars and vans, in the park, in bedrooms, and with poor visibility both ways. Though not ideal, the time efficiency of turnaround between clients is beneficial, as is not travelling to see a therapist, for the client. It has been a great experience, enabling clients to access a scarce resource on their own terms. We changed to function safely in

the pandemic. The positives of Zoom therapy are here to stay. I envisage maintaining a hybrid practice.Dr Chantal MeystreIntegrative psychotherapist

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