Starting a therapeutic process – what we commonly know as “going to see a psychologist” – is a very important decision. Some people take that step easily, smoothly, and without too much thought. Others need to think about it for a while, sometimes for years, before overcoming their own obstacles and deciding to knock on their therapist’s door.
There are so many reasons that a person may consider obstacles when starting therapy as a person. This is what, in psychological terms, is often called “resistance”. Many times you don’t have to look for very convoluted explanations for these resistances: a person may be perfectly willing to start a therapy but not have enough money to pay for it, or he may have enough money but not the time, or he doesn’t know any therapist close to his home, or he is not the right one for the situation he wants to deal with.
Leaving aside these “logistical” issues, we find another important field of resistance that we could consider more symbolic, conceptual or, not to make things complicated, purely psychological. I do want to go to the psychologist because I know I need help but I already went once and it didn’t work out or I didn’t feel good, so I’m afraid of having that feeling again. I do want to go to the psychologist but I’m afraid to pay attention to certain parts of myself, I don’t want to go deep into my discomfort. I do need to feel better but I don’t trust any professional to help me with that.
Online therapy can be a solution for those who have little time or live far from a specialist psychologist in their particular caseSometimes -much often than it seems- there is a combination of both types: we make logistical excuses (I don’t have time, I don’t have money, I don’t know any reliable psychologist) not to admit that the most important resistance is of another type (the idea of getting to work with my problems, conflicts, pain, etc. is beyond me but I make the excuse that I will do it, that when I have money, when I have time, when I get worse and have no choice…).
It is in this context, perfectly legitimate and common, is where online therapy is of great help to neutralize many of the resistances that a person may encounter when taking the step and starting a therapy. Conducting psychotherapy through an app is an activity that is increasingly present in our society, where many people give more and more importance to their psychological health, many people find resistance to go to the psychologist through traditional channels and many people use new technologies to meet an increasing number of needs. This is the format of ifeel, a platform formed by certified psychologists, trained in a wide variety of theoretical models and trained to care for their patients through new technologies. In fact, ifeel has created the app for online therapy best valued by users in this sector, which clearly places it as a powerful example of the already known as eHealth, the result of the combination of the Internet, new information and communication technologies and services aimed at improving people’s health and which the World Health Organization considers among its strategic priorities. The incorporation of this type of resources to health care and promotion, in this case psychological, is not only a behaviour (doing therapy through the Internet) or a method (using the Internet as a tool to do therapy) but also an attitude and it is this attitude that guides the daily work of the whole ifeel team.
Online therapy is as valid as the conventional, face-to-face scenario, to carry out an effective, comfortable and useful process for the patient. In ifeel all users are attended by a psychologist who is in charge of knowing their goals, needs and expectations for the therapy. Once the demand of the person has been examined, it may be necessary to discard him/her as a potential user of the therapy service if the circumstances of the case indicate that it is appropriate to attend to him/her in person. On other occasions, this first psychologist, called the guide psychologist, is responsible for selecting the most appropriate platform therapist for the case in question. The aim is for the patient to be treated by a professional with specific training and sufficient experience in cases such as yours. Therapist and patient get in touch within the platform created by ifeel and continue the therapy process through a chat in which they can communicate from Monday to Friday or through weekly sessions by videoconference.
In this way, online therapy appears to be the optimal option for many people, whether it is their first time in therapy or if they want to resume their “personal development” process some time after their previous experience with a psychologist.
First of all, online therapy is a useful alternative for those who cannot afford face-to-face therapy. Although it doesn’t always have to be this way, the online format tends to lower the costs of face-to-face care, in fact, it can be up to 50% cheaper than face-to-face. In addition, online therapy breaks down the physical barriers of those who do not have a psychologist on hand, especially those who live in areas far from urban centres or who live abroad and need to communicate in their own language in order to conduct their therapy.
Let’s think about people who live in towns. Perhaps they do have a psychologist who can assist them but to do so in an environment where everyone knows each other, or where they go to meet their therapist on multiple occasions unrelated to therapy, makes the person concerned inhibited from going to that consultation because of shame or a sense of lack of privacy. It’s not so much that their therapist will spread their story, but that their neighbors and family members can easily know that they are coming to therapy. There are people for whom a total level of privacy is important.
Sometimes the problem is not that everyone finds out, but that there is not a place to go directly, except by making heavy trips that are a tremendous deterrent to those who are not sufficiently motivated to start therapy. Sometimes these people live in populations that are very remote, for example in a mountain area, or far from the nearest city, where perhaps there is no psychologist or there is one but it is not the most appropriate for their case.
Let us also think, for example, of young people who are on Erasmus, which is a rather intense and stressful experience in many ways and which puts a person’s mental health to much greater test than one might imagine. These young people may be enjoying their experience abroad but may also be psychologically overwhelmed. When this is the case, it is very difficult for them to go to a therapist in their own language and at an affordable price, unless they use a platform such as ifeel, which avoids travel, has an affordable cost for a large sector of the population and avoids the problems that sometimes arise from making appointments thanks to its chat therapy mode, in which it is not necessary to coincide with a specific time in order to exchange messages every day.
These and other advantages are also applicable to all those people who, without being exactly students, have a similar geographical circumstance: that is, people who are already living abroad and need to be attended by a psychologist in their same language and cultural environment or who are about to leave and still do not want to extend the start of their therapeutic process any further. If the problem is that they have not yet left but will soon, thanks to platforms like ifeel that is no longer a problem. First of all because they don’t have to start a therapy now that they will interrupt later when they leave, nor do they have to wait until they are settled in their new country to start their online therapy: they can start now and continue it comfortably once they are in their new environment. Thanks to online therapy, distance and time are no longer a problem.
On the other hand, it is important to bear in mind that in the world of face-to-face therapy the structure is often reduced to the patient-therapist binomial, with no one else around. In contrast, at ifeel neither one nor the other are alone in this way. On the contrary, behind the patients and therapists of ifeel there is a whole team, both technical and psychological, to support them not only in the technical incidents that may arise with the app but also to be able to replace the therapist in a short time and without difficulty if, for some reason, the therapist cannot continue with the case, or if he finds some difficulty in the process that he needs to supervise quickly with other professionals.
Chat therapy allows for daily communication with the therapist, while video conferencing sessions bring the benefits of face-to-face contact without having to travelOn the other hand, we must not lose sight of the fact that psychotherapy is a profound human encounter, normally prolonged in time. This encounter gives rise to what is known as the therapeutic relationship, which is the human framework in which the therapy takes place, hence it is considered its main tool, or method. Many people fear that this relationship cannot take place through an online format, as they consider that the screen of a mobile device or a computer, or communication through chat rather than face to face will result in cold or superficial contact. This is not an outlandish thought, but the experience of hundreds of people who have taken the step to carry out an online therapy shows us that if the therapist is the right one for the case and the involvement of the patient is enough, the therapeutic relationship and, therefore, help and change can take place perfectly even if the two people are not physically present in the same room.
The physical presence, voice, touch and immediacy of the interaction are aspects that promote the establishment of a bond of warmth, security and involvement between two people. But they are not everything. We can be in front of a therapist, physically, hearing their voice, seeing their expressions, receiving their answers immediately to our words… and feel that we are in front of someone who does not understand us, who does not listen to us, who is cold or unpleasant or who, for some reason, is not able to provide us with the confidence we need.
The attitude, the tone that a therapist is able to impress in the interaction with his patient, is not manifested only through his face and his voice. Through a chat where therapist and patient exchange written messages every day, the psychologist can be perfectly warm, firm and involved, even if his voice and image are not present. On the other hand, a face-to-face session through a video call is perfectly valid to feel the presence of the therapist even if the distance is miles.
Once this reflection has been made, the only thing left to do is to overcome these resistances – which sometimes come from ignorance or prejudice – and give oneself the opportunity to receive help through a format that, although not the most conventional, may be the most appropriate for the current circumstances of the person in question. Taking the step can be difficult but most of the time it is worth it: 95% of our users say that their emotional well-being has improved after their therapy with ifeel and they are very satisfied with the fact that they made the decision to start it.
Online therapy at ifeel basically takes place in writing through a chat or through video conference sessions. In addition, it can be started on the same day that the information is requested, without waiting several days until the therapist has an opening.
In the chat mode, the patient can always write to his or her therapist, knowing that the therapist will answer at least once a day from Monday to Friday with all the guidelines and comments that should be transmitted that day. They are not connected at the same time, which allows them to write, add content and review the contents already exchanged in a relaxed way and whenever they want, without the pressure of a schedule or knowing that the other person is on the other side of the screen waiting for an answer.
Another advantage of the chat mode is that the patient can express what is happening to him/her at the moment it happens, without having to “save it” for the next appointment scheduled with the psychologist. Therefore, it allows for fluid and continuous communication between patient and therapist throughout the week without being excessive for either, and with the comfort of not having to coincide in a specific space of their respective agendas.
In the videoconference modality, patient and therapist have a weekly session, as is also usual in face-to-face therapy. This format has the advantage of offering a more direct and time-focused interaction, ideal for those patients who need to perceive in a more visual or immediate way the presence of their therapist. In contrast to face-to-face sessions, in online sessions the patient is usually at home, a place that can provide security and where they can express themselves freely.
Neither of the two modalities is better than the other, since both offer important advantages to patients. Some people opt for the chat mode because of the convenience (not only do you not have to travel, but you do not have to make an appointment) and also because of the nature of the written contact, since – due to their personal circumstances – facing a face-to-face interaction with their therapist makes them ashamed or afraid, and they need a greater level of distance. It should be borne in mind that some topics are more difficult to deal with than others, even taboo topics, and being able to address them without having another person in front of you at the same time or without the need to show your face, voice or real name (but an alias chosen by them) allows the patient to express himself or herself more candidly. Other users choose the video call mode because they need an immediate response from their therapist and require the presence of the therapist -even if it is through a screen- to be able to link to him or her more solidly.
