Is on-line therapy poor practice?

[CalvinC]

Hi all

The (gay) therapist I used to see once a month went on extended leave before covid; and then the hospital-based center in which he worked changed its mandate to short-term treatments only. Since the therapy was through the hospital it was free. (In Canada, normally, psychiatrists are covered but not therapists, eg, MSWs, unless they operate through hospitals as part of a clinic.)

Anyway, I got another therapist (not gay) and I had to pay him (which I could afford), and I saw him exclusively on-line. We focused on my OCD, which is his professional focus. HIV never really came into the picture.

I like him, but I was looking forward to the day when we could go back to in-person. The governments here have lifted most covid restrictions. But my therapist said awhile back that he was never going back to in-person. I just confirmed this with him and decided to stop seeing him, and I told him why (ie, that I think I'm happier with in-person).

What I really wanted to say was that I think on-line intense care, such as psychotherapy, is not real care. Of course, it is not for me to make decisions for him; but I can't believe that I'm the only one who feels this way. I have a feeling he likes on-line because it's more efficient, eg, no having people coming and going, no renting an office.

I told him that when I'm in-person I feel more exposed and thus more challenged and thus I get more out of therapy, even when it becomes painful. With on-line, it's like social media: you can just comment randomly and leave and no one can hold you to account because, well, you can click off.

Has anyone encountered a similar situation with care-givers, or even other forms of connecting?

Cal

[leatherman]

I feel similar to you, with zoom meetings and virtual doctor appts. I feel less personally connected via the screen and often disconnected from meetings. Underneath is a whole list of issues: do I look ok? are the people on the other end watching my "every" reaction? Can they hear me? is my sound level too low or too high? It's certainly better than text messages but without a decent accessible PC or phone and a great connection on both ends of the call sometimes it's worse than texting.

Next after considering your post and my thoughts, I turned to thinking about the people on the other side of the vid feed. (it's a Pisces thing for me. trying to channel what the other person is thinking) As a patient or as a consumer representation (for various ryan white committees), I don't regularly do vid meetings while the doctor and/or state employees at the meetings do regularly vid as part of their job, especially during and after covid lockdowns. For those people, I would imagine that being able to do virtual meetings has become common place  and probably an easy method for their work (less office traffic, less travel, less costs, the ability to interact with more people daily than if travel or in-person were necessary.)

So while I can understand how doctors, et al  are more comfortable with and more apt to use virtual meetings, it's just....ugh. One more way our lives are being depersonalized. I couldn't imagine being stuck with this kind of communication when talking with a therapist, I hardly want to talk to my HIV doctor this way, and I'm an easy patient with next to no issues.

I hope you can find someone to speak to in person (not only qualified but affordable too)

[CalvinC]

I had to laugh, sadly, at what you listed as issues. These are *exactly* what I feel too. I'm a decent looking guy, but on line and in pictures I look like ugh. I don't know why, but I guess I am just not photogenic. I bought the best lighting stuff for on-line classes I teach, but I still look ugh. Of course, the way one looks isn't everything; but I just don't feel "present."

Oddly enough, for the on-line classes I taught, students were REALLY participatory in the chats. And I thought, of course they are, it's an extension of social media. And it was great. And now in person classes and.... and it's same ol' same ol'. So I guess Zoom can have its upsides.

But again, for professional care, no. You just don't get the nuance. And rankling around in the back of my brain is a memory of once doing phone sex; and it was fine, I guess, until the end, when we were "done" and then....and then you hang up. For some reason, zoom reminds me of that. Leaves you momentarily connected -- until you aren't.

But yes, I suppose my therapist likes the efficiency. (His main constituency, he told me, is actually students! haha!) Oh well. I shall keep on keeping on.

[harleymc]

ive had therapy with a chatbot.  Worked ok for me,  im not suggesting that its for everyone nor all conditions.

[Jim Allen]

ive had therapy with a chatbot.  Worked ok for me,  im not suggesting that its for everyone nor all conditions.

Agree, I also suspect online works well for some, but others will do better with face-to-face support.