Friday, November 28, 2014

The Good and Bad of Video Therapy

There are many benefits to video- or distance-therapies, but also some drawbacks. This article discusses a few.

The Good


Video-based philosophical counseling solves several practical problems for both the philosopher and the dialog partner:


  • No need for an expensive physical office. It is nice to have a quiet, private office, but the reality is that these are quite expensive. When a client pays for counseling, he is not only paying for the counselor's time, but all of the other costs associated with the service. Video-based meetings avoid such costs.
  • No need to travel, find parking, etc. The client does have to pay for gas, find parking and deal with all of the hassle associated with a physical office visit, saving a lot of time (and often some frustration).
  • Allows for limited visual communication. Some researchers suggest that the majority of our communication is non-verbal. Indeed, some modes of psychotherapy are based primarily upon discerning and interpreting non-verbal cues almost exclusively. Though this isn't critical for philosophical counseling, seeing the dialog-partner's face is an important part of the relationship and dialog. An in person meeting is better in this regard, but video is better than telephone, e-mail, and such.
  • Diminishes the chance of dual relationships. It is difficult to have a productive therapy relationship with someone if you also have another relationship with them; family, friend, student, employee, etc. The client often discloses things to a therapist that could substantially complicate these other relationships. This is less an issue in philosophical counseling, where our realm is ideas and the relationship is not so much one of therapist to patient but a friendly discussion among equals. However, the reality remains that it can complicate or be complicated by another relational dimension dimension between the participants. Video discussions don't really avoid this issue, except that it allows you to easily choose a discussion partner with whom you have no other relationship, and likely never will. That is, you can select a philosophical counselor in another town, state, country or continent!


The Bad


Video communications are better than many other modes of communication (or none at all), but there are also difficulties:


  • Technology Confusion. Some people find the technology confusing or lack the necessary equipment. These days, however, most computers and almost all smart phones come equipped with cameras, microphones and software necessary to video-chat.
  • No private office. This is also listed, above, as a good thing, but sometimes it is helpful for the client to be able to get away from noise and distraction in his or her home to talk. In my own home it can be hard to find a quiet corner to work, think, or just have some uninterrupted rest.
  • Bad Connections. Connection quality can vary substantially, and sometimes be a distraction to the conversation. Sometimes just a phone conversation is better -- less distracting -- than a bad video connection.
  • Disconnects. It can be upsetting to the client to be disconnected without notice. Participants should be aware that we will never deliberately disconnect from them except in the event of an emergency or if they have become abusive. Apart from that, any disconnect was just a technical problem and we can usually reconnect in a few seconds.
  • "My eyes are up here." We like to look at people -- usually their face or eyes -- when they are talking. There are sometimes some cultural differences here (or so I'm told), but in my experience most people seem to associate eye-contact with attentive listening. However, due to the location of the camera on most devices, it often appears that we are looking slightly downward. (We try to remember to look at the camera, and not the picture.) To address this we actually hand-made a special teleprompter-like camera setup to solve this problem and create a better experience for the client.

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