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Does online therapy work for mental wellness?
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Reach out: Getting help for mental health support is now more accessible with the increasing number of online counseling services. (Unsplash/Sergey Zolkin) (Unsplash/Sergey Zolkin)
Can a major problem like mental health be treated through a screen?
Getting help for mental health support is now more accessible than ever with the increasing number of online or virtual counseling services. The concept is a straightforward one: The patient usually pays for a session upfront before scheduling an appointment at their most convenient time.
While the current state of online counseling does provide practical benefits, some maintain that mental health problems are meant to be solved in the traditional way, which means face-to-face with in-person sessions.
Comfort zone
Heralda "Sasa" Savira, a master's degree student in psychology at Airlangga University, said online counseling certainly had its own benefits and drawbacks both for the therapist and the client, just like most internet-based services today.
"Being an online psychologist has its pros and cons [...] For example, one of the pros to online counseling is that clients feel more comfortable because they are home," said the psychology student.
As a result, clients become easily more open when they are in their comfort zone.
"Counseling purely depends on whether the client wants to be open [about the problem]. Whatever the situation, it is the psychologists' responsibility to coax them into opening up," she added, emphasizing that all counseling should be client-centered.
Sasa said that online sessions were also beneficial in the way that they could "cut [the client's] expenses because a client does not need to travel to the psychologist's office and can save time".
Ivana Maretta, a 22-year-old recent graduate from Surabaya, East Java, is a major believer in the benefits of online therapies, being a frequent user of the alternative herself.
"When it comes to a personal session with therapists, I believe that it is much easier to access as the patient does not have to line up to get their needs being met," Ivana said. "Virtual therapy is actually convenient."
While she agrees with the espoused benefits of online sessions, Ivana also believes that certain things can only be done through in-person sessions.
"A patient may have some triggers that need to be directly taken care of [through an offline meeting]," she said.
On top of that, internet issues may occur during the session, which could hinder the therapy's objective.
Meanwhile, according to Fath Fatheya, a 30-year-old adult clinical psychologist associate at Tiga Generasi (Three Generation) Psychology Bureau in Jakarta, the problem with online therapies lies in the fact that a psychologist cannot fully observe the clients' circumstances during the session.
"In terms of the psychotherapy itself, I don't have any difficulty building an emotional connection with clients [with online sessions]. However, you can only observe so much through a screen," said Fatheya, who received her master's of psychology from the University of Indonesia. "Observations can be done thoroughly [through] offline meetings. In comparison, [you can] only [observe] the upper half of the client's body during online meetings."
Fatheya, who has been actively practicing psychology sessions since 2018, often notices that her clients are bothered by privacy concerns during their sessions. When this happens, patients cannot freely consult with her, potentially rendering the entire session ineffective.
"Some clients feel they lack the privacy [to consult freely], so they purposely do the consultation in their car, in a quiet cafe, in the backyard and so on," she explained.
"It is different when it's an offline meeting. [The conversation] between a psychologist and the client is guaranteed kept safe in that particular room. It's also not rare that clients want to talk [directly with their therapist] rather than having to speak out loud and be heard by [people in] their surrounding."
In addition, while the psychologist knows how each session should go, the patient might not know what they are supposed to do during one. For example, underaged clients understand so little about their underlying mental problems when they go to a psychologist.
This issue is exacerbated when a consultation is done through a computer screen. Children will not be able to address the problems if not guided by the psychologist, and the psychologist doesn't even know if the child client is genuinely paying attention to them. On the other hand, this kind of session should be done without any interference from the parents.
"For me, online counseling is not meant for every case and age," said Sasa. "Theoretically, online counseling is OK, but for running tests and particular disorders, it is still not adequate."
Sasa also explained that online test results done for psychological purposes were likely to be biased or invalid as participants might be "cheating or finding some help on the internet".
Better than nothing
Some clients conceded to Fatheya that the online alternative had particularly helped them in terms of accessibility. Rather than having to drive to main cities merely to receive psychological treatment, they can just receive help at home.
"The ease of accessibility [that online therapies offer] allows more clients in remote or far areas [to seek help], that is the excellence of online counseling or therapy," said Fatheya.
"Some of my Indonesian clients living abroad also benefit [from online therapies] because in some cases, [...] clients feel more comfortable and understood by psychologists coming from the same cultural background."
However, some techniques that psychologists often employ might not be practical online. For example, Fatheya finds it harder to instruct patients to relax or wind down during online sessions.
Sasa, meanwhile, believes that psychological first aid is appropriate online, especially for people with mild disorders such as insomnia, stress or detachment issues.
On the other hand, Sasa recommends patients with "severe disorders like autism, ADHD [attention deficit hyperactive disorder] and others that require clinical tests" to schedule in-person meetings with their counselors whenever possible.
Yet even in high-risk cases where clients should ideally get offline treatment, Fatheya affirms that online therapy might be a viable alternative.
"Though the most ideal [solution] would be to get offline guidance [for these kinds of patients], they might also benefit from the ease of online counseling, which is better than not having any guidance at all."
