What is the first online psychotherapy session like?

Increasingly, online psychotherapy is emerging as the favorite option of many clients and patients who welcome the advantages of this modality of psychological intervention.

This is not surprising, given that the freedom it provides and the ease with which the psychologist's office can be accessed via the Internet they are factors from which many benefit. The limitations of time and space do not have to weigh us down when it comes to accessing psychotherapy services.

However, it is frequent that the idea of ​​attending therapy through the Internet is somewhat confusing for those who consider opting for this option and are not very familiar with the options provided by the remote format supported by the new technologies of the interconnection. Let's see, then, what the first online therapy session is like.

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This is how the first online psychotherapy session begins

At first, what distinguishes online psychotherapy from face-to-face is minimal. The making of contact between the therapist and the patient is fundamentally the same in both cases, since currently most of the first steps when establishing communication occurs on the Internet, either through the psychologist's website or through a directory of psychologists. It is, in short, an email message or a phone call.

From there, the professional can raise the possibility of online or face-to-face therapy, or it may also be the case that the potential patient expresses the intention to use only the online format.

In any case, it should not always be borne in mind that even if care is to be received online, the service will be provided by a health professional clearly identified by name, surname and collegiate number, not by a computer program or by a virtual interface unrelated to any component human.

Miguel Angel Rizaldos, an expert in online therapy with more than 25 years of experience and one of the pioneers in the use of this modality in Spain, points out that this modality of therapy is subject to the same quality standards as face-to-face care in physical consultation, and the same psychologists who can attend through Internet are trained to practice face to face- The type of service is the same, and only the medium in which it is provided changes.

At the same time that the day and time of the first online psychological therapy session are established, the patient you receive simple instructions to know what to do to start the session, which will take place by video conferencing.

Exploring the problem

Once the connection is initiated, both the professional and the patient have on their computer screens a live image of what the other person's webcam captures, which points to the face: both the image and the sound.

Videoconferencing is the basis of online therapy, as it offers a context in which both parties can share elements of verbal communication as non-verbal, and also gives the possibility of sharing audiovisual content in real time (which can be useful in various phases of the therapy).

In the first minutes of starting what can technically be considered the first online psychotherapy session, the formal presentations are made. This phase is intended to create a communication flow in which patients feel comfortable. Then the patient, invited by the professional, explains what he is looking for or what his problem is.

This explanation does not have to be very prepared, and can be relatively spontaneous and improvised, as later patient and therapist will negotiate goal setting a lot more concrete.

In any case, it is important to note that these explanations are not given "on camera", since the session It takes place not looking at the camera (which would be uncomfortable for many people, but looking at the therapist. The online format itself is designed to be an interaction very similar to what would occur if you were both in the same room.

On the other hand, despite the fact that in this phase of therapy the patient has a lot of information about the case and the therapist does not have it yet, the latter usually intervenes frequently to help the patient to structure their explanations. If necessary, the patient can share videos or photos to provide more information about her case, as long as these documents do not violate the privacy of other people.

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A remote but not impersonal session

Most of this first video conference session, which usually lasts less than an hour, is dedicated to the patient explaining and communicating their concerns and aspirations related to the problem or need to be addressed.

The professional acts as a guide to make these explanations go towards one or another area of ​​life, but he does not give orders or abruptly interrupt the other person without giving the opportunity to continue explaining. Miguel Ángel Rizaldos points out that the fact that there is a screen in between is in no case an excuse to offer a more treatment distant and impersonal to the patient, but a resource to be used to allow a type of communication that better fits with the availability of both parties.

Of course, psychologists adopt a professional role and do not try to pose as friends of the patient, but that it does not mean that they are not empathetic and close, or that they make relevant decisions in a totally relevant way unilateral. The creation of consensual therapeutic commitments is always sought, that allow to advance the therapy. Thus, the first online therapy session ends pointing towards the objectives of the next session, in which a recapitulation of what has been put in common in the first and delves into the proposals to start walking towards the objectives fixed.

Bibliographic references:

• Zack, Jason; Stricker, George (2004). Kraus, Ron, ed. Online counseling: a handbook for mental health professionals. Amsterdam: Academic.
• Zelvin, E. (2004). Online Counseling Skills Part I: Treatment Strategies and Skills for Conducting Counseling Online. Academic Press.