Contrary to what you might think (and I was concerned about), on-line therapy is working very well, according to the studies. There’s something about frequent texting, combined with optional video and audio, that seems to bring people closer and invite the sharing of confidences.
It allows my clients and me to leave notes for each other in the chat room, as well as to see each other and talk in real time. So for the client, it’s contacting their therapist as often as they want, 24/7, without having to get dressed and travel to the therapist’s office.
You might think that this keeps the therapist chained to the computer, but it doesn’t. While my clients can text me at 3 a.m., I won’t read it until 9 a.m., and that’s fine with them (and me!). When they read my response in the morning, they may opt to take some time to think about what they want to say next, maybe an hour or even a day or two. It doesn’t matter - the office is always open, although I’m not always in it. I do have office hours, of which my clients are aware, that are totally flexible, so I can accommodate everyone.
This works out well for the client who doesn’t have a therapist nearby, or wants complete anonymity (fake names are fine), or can’t afford face-to-face therapy. The only drawback, for both the therapist and the client, is that without visual cues, text messages can occasionally be misunderstood, so it becomes important to ask questions such as, “What did you mean by that?” I consider it excellent training for developing communication skills, which is what therapy is largely about.
Would I use an on-line therapist, myself? Absolutely! I would want to start with video, because I put great store by visual information, and then use the texting for ongoing back-up. But the video is not required, and people who are video-shy just avoid it.