Expanding choice with video therapy

Giving people a choice of ways they can access mental health treatment is important. If someone is able to participate in therapy in the way that best suits them, the more engaged they’ll be in the process, and the more effective the treatment is likely to be. That’s why since April 2021 we’ve been offering online video CBT in certain areas of the UK, with the aim of offering it as an option alongside typed therapy.

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There are many advantages to typed therapy, but video therapy offers a different experience that may appeal to some people depending on their learning style, personality and the difficulties they’re seeking help for.

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Video has the edge when it comes to picking up on non-verbal communication and body language. You and the therapist can both express yourself physically and facially as well as verbally, and watch each other’s reactions. For some people, being able to see the therapist nodding when they understand and making facial expressions that indicate empathy, for instance, will be important for building trust and rapport.

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However, the anonymity of typed therapy will help others to open up more easily and honestly, by making them feel less self-conscious and inhibited. There are also fewer tech and practical things to think about: you don’t have to worry about a slow connection or whether the camera is positioned correctly, for example.

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Writing also gives people the chance to pause and consider what they want to say, instead of rushing their answers. They might feel less ‘put on the spot’ and under pressure to respond than if someone was looking at them expectantly.

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But some people simply don’t like typing, or find it easier to express their thoughts when they’re speaking – without the distraction of worrying about typos or how to word things. In this case, they’d probably get more out of video-based sessions.

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For someone who learns best in a visual way, the ability to share and work collaboratively on worksheets and diagrams in video sessions is likely to be an advantage. This includes the drawing out of formulations – a key part of CBT which involves mapping out the ‘vicious cycle’ that’s at the centre of most people’s difficulties.

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While techniques such as exposure and behavioural experiments are highly effective when they’re applied in typed therapy, video makes it possible to do these live, with the therapist watching the patient out in the ‘real world’. For instance, someone who has social anxiety and is afraid that everyone is looking at them might agree to do a behavioural experiment in a café. The therapist will be able to observe the experiment first hand, and discuss what’s happening with the patient in real time.

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It’s important to emphasise that whether it’s typed, video or face-to-face, the content and structure of your CBT treatment will be the same. Whichever approach you choose, the therapy process will focus on your emotions, thoughts, feelings and behaviours, and figuring out how they’re linked, to better understand your difficulties and how to address theme.

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When we have therapy, we tend not to remember everything that’s discussed or covered in the sessions. If you come to ieso for CBT you’ll have a record of each session; with typed therapy this will be a written transcript, while if you have video appointments you’ll be able to access an audio file. You can read over or listen back to these whenever you like to consolidate what you’ve learned, and review them if you experience similar difficulties in the future. This cements one of the central ideas of CBT: helping you to become your own therapist.

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You can find out more about how CBT works here.