MMN 025: Distance Counseling – with Jef Gazley

On this episode of the Make a Mental Note podcast, Jef Gazley, a psychotherapist and Distance Credentialed Counselor (D.C.C.) discusses issues and strategies in counseling people from a distance (e.g., videocounseling, e-mail). Give it a listen and find out why this episode is worthy of a mental note!

Jef Gazley interview (click on Jef’s name to listen to interview)

Mental Notes:

* Modern forms of distance counseling have been around since the 1990s. The suicide hotline, which has been around since the 1960s, was one of the earliest forms of distance counseling.

* Early on critics denounced distance counseling because of inferior technology (e.g., videocounseling was not available so the therapist could not pick up on non-verbal cues of client).

* Figuring out what a client needs and tailoring it to them is important. The therapist must judge whether distance counseling – or a certain type of distance counseling – is appropriate. If not, then they should make a referral to another therapist for in-person counseling.

* Some clients may not be appropriate for distance counseling (e.g., psychotic).

* Clients who are appropriate for/benefit most from distance counseling: good verbal skills; good technological skills; ability to craft a sentence in a clear way; no characterological issues; highly mobile person.

* Advantages of distance counseling: flexibility, cost effectiveness, loss of disinhibition due to quasi-anonymity.

* Providing distance counseling services sometimes involves learning how to use other senses if one sense (e.g., vision) cannot be used due to the particular type of modality that is used to deliver services (e.g., e-mail; phone).

* Texting is in inadequate way to have a conversation with a client.

* In recent years, research has demonstrated that distance counseling is as effective as in-person counseling. Psychiatrists at mental health centers are using video to do med checks with clients while psychotherapists use video, e-mail and phone to provide counseling services to clients.

* Some EAP programs in Canada pay for distance counseling services.

* Issues that are discussed in distance counseling are similar to those that are discussed in in-person counseling (e.g., relationship problems, depression, anxiety).

* Many problems are rooted in the early life of the client. Obtaining a thorough social history provides a context for clients’ problems.

* Identifying feelings by reading clients’ e-mails – when clients are asked to go into detail about their thoughts and feelings they essentially make diary/journal-type entries and write things that go beyond what they would normally write in a logical/objective way.

* Helping people experience therapeutic success in distance counseling is no different than what a therapist would do in in-person counseling. The goal is still the same – to understand where client is coming from, what is the issue and its origin, and aligning with client/establishing a partnership with client.

* In many cases, clients who seek distance counseling stick around for 1 – 5 counseling sessions and then move on (i.e., counseling is short-term).

* Challenges in providing distance counseling services – based on guidelines/best practices for distance counseling it is best not to work with psychotic clients. It can be challenging to work with suicidal clients using distance counseling, but if the therapist has training and experience (e.g., suicide hotline) then it is possible to work with such clients using this modality.

* It is important to be trained in distance counseling prior to providing distance counseling services.

* Check with licensure board to determine if there are rules and regulations with regard to providing distance counseling services.

Mental Notes Takeaway:

* Distance counseling is an alternative method of providing counseling services to clients. Clients who require flexible scheduling of counseling sessions due to travel or time constraints appreciate distance counseling and clients that can’t access in-person counseling because they live to far away from a mental health center also benefit from these services. Clients that seem to be most appropriate for distance counseling are those with good verbal and technological skills and do not have serious problems like personality disorders or psychosis.

Check It Out:

* Jef Gazley’s web page: http://www.asktheinternettherapist.com

* Jef’s phone number: 866-998-0560

* ReadyMinds no longer provides training in distance counseling. However, interested therapists may go here for available training options: http://www.cce-global.org/Credentialing/DCC/Training

 



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