"I had virtual therapy – this is what it’s really like"

Isabella Silvers
Photo credit: Alice Cowling

From Cosmopolitan

It’s a typical Thursday afternoon; I’m chatting to Jane* about my job, my (lack of) dating life and how this pandemic is amping up my anxiety. Just like the last time we spoke, Jane listened to everything I had to talk about before jumping in with advice. I always feel better after I talk to her.

But Jane isn’t a good friend or a colleague who's always happy to lend an ear – she’s a trained counsellor and we’re 20 minutes deep into an online therapy session. After two video chats and despite never having met in person, Jane knows more about me than some of my closest friends. She knows about the grief I’ve experienced, the guilt over my family relationships and that I think everyone hates me pretty much 24/7. So, how did I get here?

In the midst of a global pandemic, it’s no surprise that online therapy is experiencing somewhat of a boom. With the order to stay at home, we’ve needed to find new ways to look after ourselves, with everything from HIIT classes (hello Joe Wicks) to counselling moving online.

But it’s not just coronavirus that’s seen us seek therapy via URL instead of IRL. With packed social schedules, weekly pilates, Bumble dates that never amount to anything and countless side hustles, self-care can often slip to the bottom of our priorities list.

Now, with just the tap of an app, you can access the same therapy you’d have to wait months for on the overstretched NHS (one in four people in the UK experience mental health difficulties every single year). But can connecting over a phone ever really be as effective as sitting face-to-face?

The answer is, well, maybe. According to Dr. Lucy Tinning (BSc, PgDip, DClinPsy), “Some people feel more relaxed in their own space, allowing them to speak more openly about their challenges. I have numerous clients who find it threatening to be emotional in a face-to-face setting, so online therapy works well for them”.

However, Oliver Chittenden, founder of mental health and wellbeing platform Head Talks, feels that face-to-face therapy can be more impactful, because certain important aspects of the client-therapist relationship simply can’t be replicated when going digital. “The benefits of being in the same room as your counsellor, sharing body language and a sense of mutual ground can’t necessarily be mimicked virtually,” he says.

Photo credit: FANGYIFEI - Getty Images

For many, it’s the practical benefits of online therapy that may make the difference. “Moving therapy online is beneficial for people with physical limitations that may prevent them travelling or who live in remote areas,” explains therapist Sharnade George, founder of Culture Minds Therapy. “It’s also more convenient for people to schedule appointments from the comfort of their own home without a busy schedule,” she adds, “as long as you can find a safe space to speak openly.”

Log on, get it off your chest

Having had Cognitive Behavioural Therapy (CBT) and face-to-face counselling before to deal with grief, depression and anxiety, I’m curious to see how online therapy compares. I sign up to Babylon Health to book an appointment, and am presented with a handful of CBT practitioners, therapists and counsellors, all with a picture and bio.

Being able to pick who I might feel most comfortable with is one added bonus over the NHS, who are usually too overwhelmed (through no fault of their own) to offer anything other than a several month-long waiting list. Finding three slots, I confirm my appointments and wait for my first call.

However, it seems that virtual therapy - while easier to book - is also easier to forget... Despite adding reminders to my calendar and receiving a few calls from the therapist, I manage to sleep through my first 7am appointment. Hardly ideal, especially at £59 per pay-as-you-go appointment. Without the commute to remind you to, you know, actually go to therapy, it can be easy for an appointment to slip your mind.

So, after my false start, I try again. This time I actually do make it to my appointment... but there’s a glitch with the app and I can’t see my counsellor, Jane. While she can see me, I have to settle for spending our therapy appointment staring at the app home screen, which is… weird. However, not being able to see myself means I stop worrying about whether or not Jane will judge how unkempt I look. Swings and roundabouts.

I’m nervous that this session is going to resurface old issues, but it’s definitely less anxiety-inducing waiting for a call in the comfort of my bedroom rather than clutching my coat in a waiting room. When the phone does ring, Jane checks off some safety questions, such as asking me to confirm my name and date of birth, then dives straight in.

We have an easy conversation, and I’m soon opening up about how I never validate my own emotions and what this pandemic could be triggering in me. So far, so good - I’m keen to try a few more sessions to see if this was a one-off or whether virtual therapy could be a revelation for me.

After Jane says goodbye and wishes me a good rest of the day, I reflect on our session. In face-to-face therapy, the two things I hated most were seeing my therapist sneaking a look at the clock whilst I was talking and that feeling of being turfed back out into the real world when the session was over, tears still wet on my cheeks. Virtually, however, there was none of that. Jane could see the time at the top of her screen without looking away, and I had all the space I needed to pull myself back together – and reflect on our conversation – after a session. But how could it compare as a long-term solution?

In it for the long haul?

I book another appointment with Jane. Waking up at 9am, bleary-eyed, I realise our appointment was at 7am. I’ve slept through yet another therapy session. I open the Babylon Health app, select Jane’s picture and search her diary for the next available appointment. Once I pick my slot for a few day’s time, it’s booked in two taps. I am not proud of myself.

When I do pick up for my second therapy session with Jane, I’m able to see her face this time, which makes the appointment slightly less unnerving. She’s as friendly as her voice sounded and as cool as her bio picture looked, with dip-dyed pink, purple and peach hair.

I’d been feeling particularly anxious that week, with a brain fog I just couldn’t shake. We speak about what could be causing this, and Jane leaves me with some coping strategies, including mantras, breathing exercises and journaling ideas, that I can take forward after our session has ended. With the app, I’m also able to check back to see notes on my session if I need a reminder of what we discussed, something you can’t do so easily with in-person therapy.

Photo credit: damircudic - Getty Images

One cause for my frantic brain is constantly feeling like I should be productive and trying to multitask, but thankfully I’m able to fully focus on my session, ignoring the work emails and Zoom calls pinging away on my laptop in the background. Note to self: put laptop in a separate room next time.

The yawn threatens to engulf my face. For my third and final session, I have to wake up bright and early. The session is at 7am. While the waiting lists for virtual therapy might not be as long as the NHS ones, daytime appointments do get booked up pretty quickly (especially if you’re looking to book with a specific therapist), meaning you could find yourself speaking to somebody at an unusual hour (Babylon has appointments from 7am to 11pm).

Today I wanted to try a different therapist to see whether a new approach could elicit some new personal learnings, so I’m speaking to Nia*. While it’s business up top (clean teeth, ponytailed hair, t-shirt on), it’s still very much bedtime from the waist down (hello flowery PJ bottoms and sitting cosily in bed).

We start our call, and Nia asks what I want to talk about today. For some reason, I’m feeling quite emotional, but I decide to be brave and jump into a topic I don’t discuss a lot. Tucked away in my room, I’m thankfully not worried about any family members walking in during this very vulnerable chat, so I feel comfortable opening up to Nia.

It was scary and I felt my stomach drop as I opened my mouth to talk, but the screen barrier between us somehow made it easier. For me, knowing she could only see my face and not my body language gave an added sense of freedom. For Nia, she probably wished she could see more of my body language on screen to give me the therapy I needed.

So, was online therapy helpful for me? The fact that my therapy commute was reduced to a walk up the stairs was fantastic – and I imagine that’ll still hold true when we eventually do resume our 'normal' busy schedules.

Virtual therapy could also be a great option for those who struggle with travelling – as Dr Lucy explains, it offers a solid interim option for everything from CBT to treating eating disorders while NHS waiting lists continue to grow, only falling short for immediate suicide assistance and psychosis. "Both of these concerns need a more urgent and personal intervention, as for someone feeling suicidal or suffering from a psychotic episode, accessing therapy through a screen could exacerbate their symptoms and distress."

Being in my own bedroom also felt a lot more comfortable than crying in a therapist’s office, and while it wasn’t always easy to snap up an appointment for the next day, waiting a week is a lot shorter than the four month wait I had for NHS counselling.

However, at £59 a session, private therapy isn’t accessible to everyone. For full transparency, I received these sessions free of charge so I could try it out and share my experience, otherwise those missed alarms would have set me back nearly £120. Yikes. But if you can afford it, paying for therapy could help to take the pressure off the NHS – which can only be a good thing, both for your mental health and the overstretched services they offer.

We’ve taken birthday parties, business meetings and workout classes online, so why not therapy? For me, it works. It could for you too.

*Names have been changed.

For more information about Babylon Health visit the website.

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