2.3 Assessing counsellors’ competence for online working

As Fiona Ballantine-Dykes suggested in her welcome message, a critical ethical requirement for all counsellors who are moving to working online with clients is to assess their competence to do so: in other words, are you able to work safely and effectively with clients online? It is important to discuss this with your supervisor.

Activity 6 explores this further.

Activity 6: Working online with clients

Timing: Allow approximately 20 minutes

Listen to this extract of a conversation between online counselling specialist Sarah Worley James and Sally Brown, editor of BACP magazine Therapy Today, as they discuss how counsellors should decide about working online with clients.

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Transcript

SALLY BROWN:
So how do we assess which clients are OK to work online? Obviously, as I said earlier, it’s extraordinary circumstances at the moment, and I think a lot of our members are in a position where they don’t want to work online, but they want to support their clients. And this is the option that’s open to them, is to complete the work online so they can continue with work for the clients.
And so a lot of the members, they’ve established a therapeutic relationship with the client that you’re working with. And they’re also very experienced therapists. So from that point of view, they are taking their knowledge about how to hold the client safely in difficult times.
They’re taking that and they’re translating that to, admittedly, a new medium. But one in which they’re working with a client who they know – they’ve established a relationship with. But also, the client is also aware that these are extraordinary circumstances.
SARAH WORLEY-JAMES:
Absolutely.
SALLY BROWN:
And I think those factors need to be taken into consideration. I hear what you’re saying about the importance of training. But I guess my concern is: you said most courses are 80 learning hours. We’re in an emergency situation; therapists need to support their clients now. They don’t need to say, ‘OK, well, I hear you’re in crisis, but can you just hang on for the next six weeks while I do this 80-hour training course and then we’ll pick up?’ OK, I’m being a devil’s advocate here –
SARAH WORLEY-JAMES:
Absolutely.
SALLY BROWN:
– I’m wondering what you have to say to members who will say to you – and they will say this – which is, ‘I’m experienced, I know how to hold the client, I have a therapeutic relationship with this client. The client knows that it’s extraordinary circumstances. But maybe when we move our work online, there may be some teething problems and some hitches, but we’re prepared to work through them. In that circumstance, are you then still saying to me it’s not safe to do this?’
SARAH WORLEY-JAMES:
What I’m very conscious of is, absolutely, we need to be flexible while being very considerate of those ethical considerations. Thinking about our own competencies, as you said – our experience level, our familiarity with technology. So what I’m conscious of is, there’s a balance there between being flexible while not feeling, perhaps pressured, to work in a way that feels uncomfortable. And also taking that time to work out with the client what’s going to work for them. What kind of support might they need?
So for example, I’ve had a session this week with somebody who’s normally face-to-face, and we had a webcam session. And obviously what most people would be thinking, well, that’s as close as you can get to you’re actually seeing somebody. But of course there was a lot we talked about in terms of how it felt for that client to not be in the room they’re normally in, which feels very safe for them. ‘Being suddenly at home with other people in the house, am I going to be overheard? Part of my issues that I'm working on are these relationship issues, and actually that person's in the next room. I'm not sure how – I'm feeling inhibited to work as fully.’
So there will be significant changes to be discussed and worked through. Some clients might feel ‘No, this is fine, I‘m not overheard. It feels a bit odd being in my own home when I’m normally in the therapy room.’ And you can work through it, but it might be quite a lot of discussion. Other clients might find they try that and go ‘No, it just doesn’t feel comfortable enough.’
So what you can also be thinking about is, ‘Well, what other ways can I support my clients at this time? Rather than it being therapy, do I want to offer them checking-in support sessions? Focusing on their coping strategies, focusing on how are they maintaining support connecting to their support network. What other online support websites, apps, might they want to start connecting to in order to build a broader range of support around them during this time?’
So it’s thinking more widely beyond from counsellor to counselling sessions. Is that actually appropriate for that client at this point? Is that what they want?
End transcript
 
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Sally argues that counsellors and psychotherapists should – in the emergency context of coronavirus – not be discouraged from working online with existing clients if those counsellors fall into which of the following categories?

a. 

The counsellor is already working with the client.


b. 

The counsellor is struggling financially due to coronavirus.


c. 

The counsellor is being told by supervisors that this is what they need to do.


d. 

The counsellor is experienced.


e. 

The counsellor does not want to abandon clients in a time of national emergency.


f. 

The counsellor has an established therapy relationship with the client.


The correct answers are a, d and f.

Discussion

Abandoning clients is of course ethically wrong (although risk related to abandoning clients must be balanced with the potential risk related to working in a new way) – but this was not mentioned by Sally in this extract. The negative financial impact of coronavirus on counsellors and psychotherapists, as well as counselling organisations, is unknown at the time of publication (April 2020), but it is likely to be huge. However, ethically the decision to work online at this time must be driven by the client’s needs, rather than those of the counsellor or organisation.

What does Sarah suggest that anyone moving their work with clients online needs to consider?

a. 

‘Do I have password-protected Wi-Fi?’


b. 

‘What is my level of competence?’


c. 

‘Do I have a private space at home that I can work in?’


d. 

‘How familiar am I with technology?’


e. 

‘What is my experience level?’


f. 

‘How can I securely process online payments?’


g. 

‘Will my online practice meet ethical requirements?’


The correct answers are b, d, e and g.

Discussion

The practical aspects of providing counselling online are of course important, but Sarah suggests that the core factors that should drive any decision about engaging in online counselling are ethics and competence.

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2.2 GDPR, contracting and insurance

2.4 Assessing (existing) client appropriateness for online counselling