Paz Holguín: "Online sessions are more comfortable for the client".

Psychologist Paz Holguín talks to us about the efficacy and effectiveness of online therapy.

The Internet is a virtual environment that has opened the door to services that we would never have been able to conceive of just a few years ago, and yet which are rapidly becoming popular. The field of psychotherapy is no stranger to this reality, and an example of this is the way in which online therapy has become a perfectly normalized and appreciated modality of psychological intervention by both patients and mental health professionals.

However, those who are considering seeing a psychologist often have doubts as to whether online psychotherapy offers them a level of effectiveness comparable to "classic" face-to-face sessions with the psychologist. with the psychologist. To help solve these kinds of doubts, we interviewed psychologist Paz Holguín, who has been combining face-to-face care with online care via video call for some time.

Interview with Paz Holguín: the effectiveness of online therapy

Paz Holguín is a psychologist specialized in psychotherapeutic care to people of all ages, and attends both in her office in Las Rozas de Madrid and online, a modality increasingly used and popular. In this interview he talks to us about the peculiarities of this latest form of therapy that takes advantage of the potential of the Internet.

What are the distinctive features of online therapy?

For the people who access the therapeutic service, the distinctive characteristics of an online process have to do with situational aspects, mobility and adaptation of schedules. The online therapy allows the process to be carried out without the need to travel to the consultation, this means a saving in time for the client, thus being able to access a greater possibility of finding time and access to have the therapeutic session.

Another feature that distinguishes it, perhaps the main one, is that it requires a device with Internet connection, a stable connection and a place where the person can be quiet and have no possible interruptions.

For therapists, it also requires equipment that can provide a connection and suitable conditions for the session to run with a "technical" normality, and as for the preparation and process of sessions, it requires the adaptation of some tools and the search for new ones.

What myths and erroneous beliefs about online psychotherapy and its effectiveness do you think are most widespread?

Here we must also distinguish between those that are created in the clients and in the therapists themselves. Among the former is the idea that the fact of not being face to face, in the same room, means that they will not be able to build trust, that the therapist is not as attentive or that the Internet is too cold, that emotions or messages do not arrive well, or that by the fact of having to travel to the consultation, the attention will be better.

The reality is that even if it is via Internet, it is still a relationship, the only thing that cannot happen is physical contact, something that does not happen in face-to-face consultations either. On the other hand, trust in a therapist does not depend on whether there is a screen or not, it depends on how safe he/she makes you feel and that safety goes beyond the screen because it depends on what you say, how you say it and how careful you feel with the therapist. Regarding the myth that it is cold, emotions do not only send their information through the verbal message, the body, the voice, the energy that is created is perceived.

Therapists have some limiting beliefs, such as considering that the therapeutic alliance does not occur, or does not occur in the same way, that the client's commitment is limited, that methodologies are limited, etc.

The reality is that there are studies that show very little variability in the therapeutic alliance generated in online or face-to-face therapy. We must find a way to adapt our idea of therapeutic sessions to make them as effective as possible and this means adapting our tools. I believe that it is part of our job to advance and adapt to the needs of society and it is time to take advantage of the tools that technology offers us to do so.

What are the types of psychological treatment in which there is more scientific evidence that online therapy is effective?

According to the latest studies, online cognitive behavioral therapy has had good results in the treatment of anxiety and depression, also with adolescents there are publications of studies from around the world that defend the effectiveness of online therapy in terms of emotional management. Treatment with EMDR, Gestalt therapy, narrative therapy, NLP or systemic therapy have also obtained good results.

How does using a digital communication channel affect the ability to establish a therapeutic relationship?

Well, logically there is the factor that the technical part does not fail, that it is not cut, that it is heard and seen well.... All this can influence the person in front of us to feel listened to, understood and cared for.

But in reality, if we analyze what are the defining characteristics of establishing a therapeutic relationship we will see that we can get it online, unconditional acceptance, the goals and the means to reach them do not differ because there is a screen in between.

And how does it affect the way patients engage with the therapy process without discontinuing it after a few sessions?

I don't really think it has a major effect, what, in part, generates the engagement is progress and effectiveness, although it may be that the environment in which the session takes place does exert an influence in which the therapist has less control.

If the person has interruptions or is unable to speak honestly for fear that someone may overhear, it is likely that there will be a time when he or she will want to interrupt the process either to come in person or to stop.

As a psychologist, what do you think are the most positive aspects of online therapy, or the features that add to its potential compared to face-to-face sessions?

Actually, the biggest benefit I find is the possibility of choosing the therapist of my choice without having to take into account whether or not he/she is in my location, just having the device with Internet access is enough.

I think that online sessions are more comfortable for the client because it means that there is no travel, saving time and money, and you can do it in a place that is safe and quiet, but, in terms of effectiveness, there are no studies that show that online therapy is less effective than face-to-face therapy.