Advantages of Face-to-Face Therapy
Over the course of the Covid-19 pandemic, we saw a shift from in-person to online interactions in almost every sector, from businesses and schools to exercise classes and quiz nights! There have been so many benefits of this online shift which has allowed us to stay connected from a distance and stay productive from home. Particularly in the world of CBT therapy and counselling, video calling has enabled the delivery of talking therapies amidst social distancing restrictions. Despite scepticism, such online therapy has been shown to maintain effectiveness in treating some issues, for example the use of online CBT for depressive and anxiety related disorders [1].
However, as we are now past the limitations and restrictions of the pandemic, many private practitioners such as CBT therapists, psychologists and counsellors may be weighing up the option of staying online or returning to face-to-face CBT therapy and counselling. This decision is of course a matter of personal preference as well as accessibility to a private therapy space. Although we have seen the many benefits to online therapy, we cannot dismiss the advantages face-to-face therapy maintains, and the reasons why private practitioners should not shy away from returning to the traditional style of face-to-face delivery.
1. Providing a safe space for clients
Some clients may not have a private space at home in which they can comfortably disclose personal information. If the individual lives with other people, including family or friends, it can be difficult to find somewhere private to have a video call without other people hearing. This not only raises issues of confidentiality but also means that the client may not be able to discuss certain personal issues in fear of being overheard. Furthermore, having a therapy space away from home not only allows the client time to sit on the content of the sessions when travelling to and from the practice, but also gives the practitioner a separate working space to go over their notes and prepare for their next session. This is an aspect that, although can be done following an online session, becomes an additional part of the therapy process.
2. Nonverbal communication
This is a very important part of any social interaction [2]. There are many cues that can be hidden when speaking on via video call as opposed to being in the same room. For example, posture and hand gestures may not be fully visible on camera. These are both reliable indicators of how a client is feeling, and whether they are comfortable or hesitating to disclose some information. The true meaning of a communication can be revealed through non-verbal cues such as these, with clinical studies revealing the extent to which body language can actually contradict verbal communications [3]. Furthermore, eye contact is easily avoided during a video call. Eye contact is not only a useful way to connect with clients by demonstrating active listening and genuine interest [4] but can also be an indicator of whether the client is uncomfortable or anxious with the subject being discussed. In order to gain such information that would otherwise be clear from body language, more time is required in the session to ask more questions and obtain a fuller understanding of what the client is conveying.
3. Personal relationship development
For a lot of people, having a conversation face-to-face is much more personal than conversing online. From a therapy perspective, sitting in the same room as your client can help to create a meaningful connection which can lead to more trust, positive disclosure and investment from the client. Furthermore, research has shown that contact with others can reduce levels of cortisol (the hormone related to stress) in the nervous system [5]. Almost half of all depressed adults have raised cortisol levels, and it has been found that low levels of face-to-face contact can double levels of depression [6]. This is another example of the importance of real-life interaction, particularly in a therapy scenario.
4. No technical difficulties
Although sometimes interruptions are unavoidable, face-to-face therapy eliminates the possibility of technical difficulties obstructing a session. Whether it is connection issues or device malfunctions, meeting online is susceptible to the possibility of such disruptions. This can cause scheduling issues if the session gets cut off and needs to be rearranged but can also disturb the flow of conversation and potentially deter the client from continuing where they left off, meaning some important points may be missed. Furthermore, meeting online may raise issues of data protection depending on the virtual platform being used. Meeting in a private therapy room ensures that everything remains in that room, and there is much lower risk of a data breach.
5. Credibility
Therapy seekers may be stuck between opting for an online therapy service and an in-person practice. Offering in person CBT therapy or counselling not only puts a face to your service but provides you with a sense of credibility and validity as opposed to a client talking to an unknown source online. Additionally, once a stable client-therapist relationship has been developed, there is still an opportunity to have online sessions where necessary.
6. Direct support
Although online CBT therapy for anxiety and depression has been shown to be effective [7], some types of therapy require more than a virtual conversation. Additionally, for more severe cases of some mental health conditions, the individual may require a more intense and direct form of therapy. Making extra time to come to therapy sessions, away from home and everyday stressors, can also be a helpful tool or outcome in the therapy as well as encouraging self-care as part of the therapy process.
References:
5. Hart, S. (2008). Brain, Attachment, Personality: An Introduction to Neuroaffective Development. London: Karnac https://doi.org/10.4324/9780429472541
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