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Before the advent of telephone/skype counselling, physical presence in the counselling room would have been deemed essential to achieve a successful therapy outcome. Now, however, as people spend increasing amounts of time online the counselling profession has needed to adapt in order to meet the demands for a more diverse range of counselling services delivery.

Skype counselling is by its very nature not face to face counselling in the same room. Clients and therapists do not occupy the same physical space but they do communicate synchronously i.e. the therapist and client are engaging in a therapy session with one another in real time.
Today, Skype and other online platforms for counselling are mainstream and are more and more the preferred medium of the young seeking therapy and of service users of Employee Assistance Schemes (EAPs) so should more counsellors/ therapists be offering this method of delivering their services to clients?
I have been offering skype as an option to my clients since around 2004. Client issues are varied but often relate to anxiety around work/life balance issues, problems at work, being overwhelmed by events in their lives, bereavement, relationship and health issues but also include more deep seated issues requiring long term therapy.

I have Skype counselled clients who I have never personally met. One particular client in SE Asia has been HIV positive since 2005 and was a referral.
In terms of technical issues associated with Skype, the most common problem I experience is a break in the connection or a poor quality sound connection. The advantages however far outweigh the disadvantages. I can speak to clients in their own homes or in their cars or wherever is convenient for them, in different time zones to my own and from the comfort of my own home. It brings certain individuals to therapy that could not physically attend sessions, particularly the elderly or those with no access to transport.

Disadvantages in addition to technical issues can include Interruptions by family if they are at home. Children may stick their heads in the door, someone may knock, the phone may ring.

These possibilities are something I discuss with the client at the beginning of our first Skype therapy session or free 30 minute consultation as they can be potentially damaging to our relationship if not addressed.

Some therapists have argued that one cannot create a meaningful therapeutic relationship with a client when using Skype and that the non verbal cue aspects (lack of full body

visibility cues such as for example body posture) are compromised as the full body cannot necessarily be seen, but I have not experienced these problems.
In terms of contracting I have devised a Skype contract which I send to clients and which they usually sign with an electronic signature. The contract is not that much different to a standard counselling contract but is amended slightly to fit with the Skype platform.
If you think having Skype available as an option would make it easier for you to enter into therapy I would be happy to hear from you and arrange a 30 minute free consultation.

Jan MerrillsJan has a practice in Stratford Upon Avon and can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. or by phone 07807466174

Jan Merrills LL.B P.G.Dip Counselling and Integrative Psychotherapy

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