36. 互联网咨询

互联网咨询

在上一章中，我们要求你考虑成为电话咨询师（TC）或面对面咨询师哪个更难。在本章中，我们介绍另一个选项：互联网（在线）咨询。互联网咨询与电话咨询和面对面咨询相比如何？这个问题的答案相当复杂，部分原因是互联网咨询本身的复杂性。这种复杂性的一部分来自在线咨询环境的不断变化性质——它相对较新且发展迅速。其中一个持续增长的方面是现在可用的多种互联网咨询模式。

互联网咨询的模式

对于选择在线寻求咨询支持的人来说，有许多选项可供选择。在这里，我们将讨论范围限制在个人咨询；然而，我们确实承认还有许多其他咨询支持选项，包括团体咨询和支持小组、自助、心理教育或书目疗法、结构化项目等。对于感兴趣的读者，我们在《青少年咨询：年轻人的主动方法》（2015年）一书中简要探讨了这些选项，特别是在利用技术支持年轻人的背景下。

电子邮件、实时聊天、视频会议和虚拟平台都可以用于建立远程咨询关系。

我们在表36.1中列出了个人互联网咨询的不同选项，以及目前在线可用的这些模式的一些示例。或许你有兴趣探索提供的示例，以了解在线咨询是如何呈现和交付的。互联网咨询可以通过以下方式提供：

电子邮件
实时聊天
视频会议
虚拟环境。

电子邮件

表36.1 互联网咨询的模式 306

咨询模式示例

电子邮件

澳大利亚母乳喂养协会（breastfeeding.asn.au）为哺乳母亲提供电子邮件和电话咨询支持。
beyondblue（beyondblue.org.au）提供焦虑和抑郁的电子邮件咨询。它还提供电话和聊天咨询。
蝴蝶基金会（thebutterflyfoundation.org.au）通过电子邮件咨询为患有饮食障碍的个人提供支持。他们还提供电话和聊天咨询。

实时聊天

咨询在线（counsellingonline.org.au）通过聊天和电话提供药物和酒精咨询。
eheadspace（eheadspace.org.au）为年轻人提供聊天咨询。除了电话咨询外，它还设有面对面咨询中心。
儿童热线（www.kidshelp.com.au）为年轻人提供聊天咨询。它还提供电话和电子邮件咨询。

视频会议

人类潜能中心（cfhp.com.au）通过Skype提供咨询支持。它还提供面对面咨询。
Psynaptic心理学咨询（ppccounselling.com）是一家在线咨询服务，通过WebEx视频会议系统（webex.com.au）提供支持。
USC远程医疗（usctelehealth.com）是一家美国的在线咨询服务，开发了一套专门用于在线咨询的视频会议系统。

虚拟环境

德克萨斯大学大脑健康中心（brainhealth.utdallas.edu）开发了一个专门用于在线咨询的虚拟世界。
Reaction Grid（ReactionGrid.com）和InWorld Solutions（inWorldSolutions.com）是提供虚拟世界开发服务的公司，这些虚拟世界可以用作在线咨询的平台。
第二人生（secondlife.com）是一个商业可用的虚拟世界，已被咨询师用作在线咨询的平台。

通过分享电子邮件建立咨询关系是一种方式。这可能仅限于一次交流，也可能发展成多次电子邮件交流。就像电话咨询一样，使用电子邮件进行沟通时，咨询师的工作可能会很具挑战性，因为没有视觉线索。正如我们在第35章中讨论的，缺乏视觉线索使得识别一个人的表现、感受和对咨询师的反应变得困难。此外，语音线索如语调、节奏和叙述中的停顿也缺失，这可能会增加误解寻求帮助者所表达的感受和想法的潜在风险。有许多方法可以使感受和想法更加明确，例如使用不同的字体、格式、缩写词、表情符号和标点符号。我们将在本章后面详细探讨这些技术的使用。

虽然缺乏视觉和语音线索确实给咨询师带来了挑战，但也存在潜在的优势。许多发现面对面分享太具挑战性的人可能会发现电子邮件提供的匿名性减少了抑制，因此能够披露更多信息。还存在权力不平衡的减少，使寻求帮助的人在咨询过程中有更多的控制感。虽然这可以支持披露，但也有可能导致寻求帮助的人突然结束咨询关系。因此，咨询师必须努力与每个人互动，防止他们提前退出。简单地不再发送另一封电子邮件或终止聊天会话是非常容易的。

实时聊天

尽管通过电子邮件连接是异步的（即回复之间有时间间隔），实时聊天，顾名思义，是同步的。这在某些方面比电子邮件通信更具优势，因为你可以获得更多即时的信息：例如，一个人回复中的停顿可能为咨询师提供线索，表明该人需要反思的信息或难以分享的内容。在其他方面，通过互联网聊天可能更具挑战性，因为咨询师没有太多时间来反思和形成他们的回应。咨询师仍然缺乏视觉和语音线索。使用视频会议技术可以在一定程度上减少这种缺乏线索的情况。

视频会议

在某些方面，通过视频消息服务（如Skype）进行咨询比电话咨询更像面对面咨询，因为咨询师可以获得更多的视觉线索。咨询师和寻求帮助的人也可以通过语音而不是文字进行交流。这对那些不太适应使用基于文本的在线方法的人是一个很好的选择。视频会议的一个缺点是可能出现技术问题；在会话中途被切断肯定不利于治疗过程！另一个担忧是视频通话的安全性。显然，寻求帮助的人和咨询师都希望避免未经授权访问他们的会话。

虚拟环境

互联网咨询的一个不太常见但日益增长的选项是在虚拟环境中会面。在这种情况下，寻求帮助的人和咨询师由他们自行选择的虚拟形象代表。这些虚拟形象随后在一个虚拟环境中“见面”，并通过文本或语音（使用麦克风）进行交流。虚拟环境可以是从一个虚拟咨询室到海滩、雨林，甚至是一个完全想象的环境。尽管视觉线索再次丢失，但虚拟形象的选择为咨询师提供了关于个体自我形象的视觉线索。讨论一个人选择的虚拟形象可能会揭示对他们自我认知的重要见解。在此，我们鼓励咨询师避免投射假设，特别是负面假设，关于寻求帮助的人。例如，你如何看待与一个恶魔形象进行咨询关系？这会引发哪些想法和感受？如果你愿意与一个恶魔形象互动，你觉得哪种虚拟形象会让你感到挑战？根据沟通方式的不同，虚拟会话中可能存在或不存在语音线索。对虚拟环境中咨询感兴趣的读者可以阅读Nagel和Anthony（2011）的文章《虚拟形象疗法》。

你会注意到表36.1中许多服务提供多种互联网咨询模式，有时还会提供电话和面对面的方式。这种模式和方法的混合非常常见。提供多种互联网、电话和面对面咨询支持有什么优势？有哪些劣势？

互联网咨询对咨询师和寻求帮助者的适用性

互联网咨询的独特性质要求咨询师和寻求帮助者具备特定的技能和特征。因此，我们认为并不是所有的咨询师和个人都适合在线工作。我们在表36.2中列出了一些问题，供咨询师和寻求帮助者在开始互联网咨询之前考虑。表36.2中的问题涵盖了以下技能和特征：

咨询微技能
计算机技能
个人特征
问题表现

咨询微技能

在考虑通过互联网提供支持之前，咨询师需要熟练掌握本书第2至4部分描述的咨询微技能。我们将在互联网咨询过程的部分详细讨论这些微技能如何应用。在这里，我们想更广泛地关注面对面咨询和互联网咨询之间的差异。至少，当使用视频会议时，一些视觉线索会丢失，这不仅使咨询师更难准确理解一个人的呈现问题和相关感受，也更难向他们传达自己的存在、共情和关心。当使用基于文本的模式时，这种效果会加剧，因为视觉和语音线索都会丢失。因此，咨询师必须非常擅长将面对面咨询的微技能适应到在线环境中，以建立有效的和支持性的咨询关系。

计算机技能

对于咨询师和寻求帮助的人来说，在开始互联网咨询之前，熟悉计算机并了解在线交流是非常重要的。还需要具备所需的技术。你可能需要考虑你的计算机规格、视频、麦克风、耳机、互联网连接以及在这些组件之一发生故障时的技术支持。最后，熟悉网络文化也很重要；例如，人们如何在线互动以及虚拟环境是如何被感知的。重要的是要认识到，对于许多互联网用户来说，他们的虚拟生活，包括在线形成的关係，是非常真实的。你能想到咨询师或考虑互联网咨询的个人还需要哪些其他计算机技能和要求吗？

个人特征

作为互联网咨询师，最重要的个人特征可能是灵活性。寻求在线支持的个人可能是因为他们难以获得传统的面对面支持，而传统支持通常受限于工作日。你对在非工作时间工作有何看法？有些人可能会要求临时会话。事实上，表36.1中列出的一些服务就是这样提供的支持。你认为这合适吗？如果有人临时请求支持，你会如何回应？另一个你可能需要灵活应对的领域是互联网支持的模式。你愿意提供多种模式还是更倾向于坚持一种模式？对于这些问题，没有正确或错误的答案——这取决于咨询师愿意提供的内容。然而，我们鼓励任何潜在的互联网咨询师从一开始就坦诚地说明他们如何提供服务。你可以通过提供关于你的可用时间、支持模式、人们何时以及多久可以期待回复以及你如何收费的易于访问和全面的信息来实现这一点。对于寻求互联网咨询支持的个人，还有什么其他信息是重要的？

呈现问题

就像面对面咨询一样，咨询师应在自己的能力范围内实践，并在不确定是否适合与某个特定个体或呈现问题合作时寻求督导。更具体地说，互联网咨询的适用性对于一些人来说受到质疑。例如，为选择保持匿名的人提供适当的危机支持可能具有挑战性。如果他们仅提供电子邮件地址作为联系方式，如何确保他们的安全？本章的伦理考虑部分提供了一些想法。其他可能不适合在线支持的群体包括那些经历严重心理健康问题和需要药物治疗的人，例如经历精神病或严重抑郁和焦虑的人。这并不意味着互联网咨询不能进行，但可能需要将寻求帮助的人与适当的面对面支持联系起来。

互联网咨询过程

一旦确定了你和寻求支持者的适用性，如何进行在线支持？这可能很复杂，取决于许多因素。你是打算提供短期还是长期支持？你是否更倾向于坚持一种模式，还是愿意通过多种模式（电子邮件、聊天、视频会议、面对面、电话）提供咨询？显然，支持的方式及所需技能会有所不同。然而，图16.1（见第135页）中展示的咨询过程可以作为互联网咨询的框架。正如第35章所强调的那样，不是所有的咨询关系都会完全遵循这些阶段，但了解咨询过程中的步骤，包括何时跟随求助者的引领以及何时引导过程以满足其表达的需求，是有帮助的。

表36.2 在进行互联网咨询前需要考虑的问题

咨询师的问题	寻求帮助者的问题
我是否有经验并且在面对面咨询中感觉舒适？	寻求帮助的人是否需要面对面支持？
我是否熟练使用面对面咨询的微技能？	寻求帮助的人是否经历严重的心理健康问题，如严重抑郁/焦虑或精神病，或需要监测的药物？
我是否知道如何将这些技能适应到在线环境中？	他们是否需要危机支持？
我是否熟悉网络文化？
我是否灵活？我的生活方式或工作安排是否允许灵活性？
我是否舒适通过文本在线交流？或通过麦克风？
我是否具备计算机素养？
我是否有使用所需技术的条件？

准备

与面对面咨询类似，咨询过程也可以作为互联网咨询的框架。

在进行任何形式的咨询之前，做好充分的准备非常重要，以便能够尽可能高效地提供支持。如果你自己也需要支持，就很难有效地帮助他人！我们在上一章提出了四个建议，用于准备电话咨询，这些同样适用于准备互联网咨询。我们再次列出了这些建议。还有哪些其他方式可以帮助你准备互联网咨询？

与你的督导讨论你自己的问题。
通过告诉同事这些想法的存在来管理你的侵入性想法。
根据你的精神信仰使用放松、冥想或祈祷。
参与体育锻炼。

加入

与电话咨询一样，网上咨询师与寻求帮助的人建立联系的时间比面对面咨询要短得多。一个人只需快速点击鼠标或干脆不回邮件就可以结束会话。正如前面提到的，由于视觉和语言线索的减少或完全缺失，建立这种联系也可能具有挑战性。在加入过程中特别重要的微技能是反思和释义。这两种微技能在互联网咨询中尤为重要，因为需要更多的澄清来补偿视觉和语言线索的缺失。没有伴随语调和肢体语言的情感背景，很容易误解书面陈述。如果你不确定，可能还需要使用更多直接的问题来确认一个人的情绪或隐含的想法。接下来我们将更详细地讨论在线提问的使用。

除了与寻求帮助的人建立联系外，网上咨询师在加入阶段还有其他几个目标。在初始互联网咨询会话的早期获得适当的信息有助于确定一个人的身份，以便后续跟进。信息收集有助于筛选和评估，以确定互联网是否是寻求帮助的人合适的模式。咨询师还可能在加入阶段进行合同签订和设定基本规则。最好在第一次会话前讨论互联网咨询特有的伦理问题，或向寻求帮助的人提供相关信息，以便他们可以做出是否继续在线咨询的知情选择。我们将在本章后面更详细地讨论伦理问题。实现这些目标需要技巧，以便在合适的时间以理解的方式引入它们。你不想用一系列封闭性问题压垮对方！

本章知识点阐述

进一步阐述知识点

互联网咨询

1. 引言

2. 互联网咨询的模式

2.1 多样化的选项

对于选择在线寻求咨询支持的人来说，有许多选项可供选择。在这里，我们将讨论范围限制在个人咨询；然而，我们确实承认还有许多其他咨询支持选项，包括：

团体咨询和支持小组：通过在线平台组织的团体活动，提供集体支持。
自助：提供自我帮助资源，如文章、视频和工具。
心理教育或书目疗法：提供心理健康知识和书籍推荐。
结构化项目：提供有计划的课程和活动，帮助用户逐步改善心理健康。

对于感兴趣的读者，我们在《青少年咨询：年轻人的主动方法》（2015年）一书中简要探讨了这些选项，特别是在利用技术支持年轻人的背景下。

2.2 不同的咨询模式

电子邮件：通过电子邮件进行咨询，可以提供异步的交流方式，方便用户在自己的时间安排内进行沟通。
实时聊天：通过在线聊天工具进行实时交流，提供即时反馈和支持。
视频会议：通过视频会议软件进行面对面的在线咨询，提供更接近面对面咨询的体验。
虚拟环境：通过虚拟平台进行咨询，如虚拟现实（VR）技术，提供沉浸式的咨询体验。

3. 互联网咨询的优势与挑战

3.1 优势

便利性：用户可以在任何地点、任何时间进行咨询，不受地理和时间的限制。
隐私保护：在线咨询可以提供更高的隐私保护，减少用户的尴尬感。
多样性：多种咨询模式可以满足不同用户的需求。

3.2 挑战

技术问题：网络连接不稳定、设备故障等问题可能影响咨询的效果。
非语言信息缺失：与电话咨询类似，互联网咨询也缺乏非语言信息，增加了理解和沟通的难度。
安全性：保护用户数据的安全性和隐私是一个重要问题，需要严格的措施。

4. 互联网咨询的应用场景

个人咨询：一对一的在线咨询，解决个人的心理问题。
团体咨询：通过在线平台组织的团体活动，提供集体支持。
心理健康教育：提供心理健康知识和资源，帮助用户自我管理。
特殊人群支持：为特定群体（如青少年、老年人、残障人士）提供定制化的支持服务。

5. 未来展望

随着技术的发展，互联网咨询将会变得更加成熟和多样化。虚拟现实（VR）、人工智能（AI）等新技术的应用将进一步丰富咨询的形式和内容，提高咨询的效率和效果。同时，也需要不断优化技术和流程，确保在线咨询的安全性和有效性。

总结

互联网咨询作为一种新兴的咨询形式，具有便利性、隐私保护和多样性的优势，但也面临着技术问题、非语言信息缺失和安全性等挑战。通过多种咨询模式的应用，互联网咨询可以满足不同用户的需求，提供个性化的支持和服务。未来，随着技术的发展，互联网咨询将更加成熟和多样化，为用户提供更高质量的咨询服务。

进一步阐述知识点

咨询模式示例

1. 电子邮件

电子邮件是一种常见的在线咨询方式，适用于多种情境。以下是几个具体的例子：

澳大利亚母乳喂养协会（breastfeeding.asn.au）为哺乳母亲提供电子邮件和电话咨询支持，帮助她们解决母乳喂养过程中遇到的问题。
beyondblue（beyondblue.org.au）提供焦虑和抑郁的电子邮件咨询，同时也提供电话和聊天咨询，帮助人们应对心理健康问题。
蝴蝶基金会（thebutterflyfoundation.org.au）通过电子邮件咨询为患有饮食障碍的个人提供支持，他们还提供电话和聊天咨询，帮助患者克服饮食障碍。

2. 实时聊天

实时聊天是一种即时的在线咨询方式，适合需要快速响应的情境。以下是几个具体的例子：

咨询在线（counsellingonline.org.au）通过聊天和电话提供药物和酒精咨询，帮助用户应对成瘾问题。
eheadspace（eheadspace.org.au）为年轻人提供聊天咨询，除了电话咨询外，还设有面对面咨询中心，为青少年提供全面的支持。
儿童热线（www.kidshelp.com.au）为年轻人提供聊天咨询，同时也提供电话和电子邮件咨询，帮助青少年解决各种问题。

3. 视频会议

视频会议是一种接近面对面的在线咨询方式，适用于需要更多互动的情境。以下是几个具体的例子：

人类潜能中心（cfhp.com.au）通过Skype提供咨询支持，同时也提供面对面咨询，帮助用户实现个人成长。
Psynaptic心理学咨询（ppccounselling.com）是一家在线咨询服务，通过WebEx视频会议系统提供支持，帮助用户解决心理健康问题。
USC远程医疗（usctelehealth.com）是一家美国的在线咨询服务，开发了一套专门用于在线咨询的视频会议系统，为用户提供专业的心理支持。

4. 虚拟环境

虚拟环境是一种创新的在线咨询方式，适用于需要沉浸式体验的情境。以下是几个具体的例子：

德克萨斯大学大脑健康中心（brainhealth.utdallas.edu）开发了一个专门用于在线咨询的虚拟世界，帮助用户进行心理治疗。
Reaction Grid（ReactionGrid.com）和InWorld Solutions（inWorldSolutions.com）是提供虚拟世界开发服务的公司，这些虚拟世界可以用作在线咨询的平台。
第二人生（secondlife.com）是一个商业可用的虚拟世界，已被咨询师用作在线咨询的平台，提供沉浸式的心理支持。

5. 电子邮件咨询的特点

5.1 优点

匿名性：许多发现面对面分享太具挑战性的人可能会发现电子邮件提供的匿名性减少了抑制，因此能够披露更多信息。
控制感：还存在权力不平衡的减少，使寻求帮助的人在咨询过程中有更多的控制感。

5.2 挑战

误解风险：缺乏视觉和语音线索可能导致误解，增加沟通的难度。
突然结束：虽然匿名性和控制感可以支持披露，但也有可能导致寻求帮助的人突然结束咨询关系。因此，咨询师必须努力与每个人互动，防止他们提前退出。简单地不再发送另一封电子邮件或终止聊天会话是非常容易的。

6. 提高沟通效果的方法

为了减少误解的风险，可以采用以下几种方法：

使用不同的字体和格式：通过加粗、斜体、下划线等格式，强调关键信息。
使用缩写词和表情符号：如“LOL”（大笑）、“:)”（微笑）等，传达情感。
使用标点符号：通过问号、感叹号等标点符号，表达语气和情感。

总结

电子邮件咨询作为一种在线咨询方式，具有匿名性和控制感的优势，但也面临缺乏视觉和语音线索的挑战。通过采用不同的字体、格式、缩写词、表情符号和标点符号，可以提高沟通的明确性和效果。咨询师需要努力与每位用户建立联系，防止他们提前退出咨询关系。通过多种在线咨询模式的应用，可以满足不同用户的需求，提供个性化的支持和服务。未来，随着技术的发展，在线咨询将更加成熟和多样化，为用户提供更高质量的咨询服务。

进一步阐述知识点

实时聊天

1. 优势

即时信息：实时聊天是同步的，可以即时获取对方的反馈，这在某些情况下比电子邮件更有优势。例如，一个人回复中的停顿可能为咨询师提供线索，表明该人需要反思的信息或难以分享的内容。
互动性强：实时聊天可以提供更直接的互动，有助于建立更紧密的咨询关系。

2. 挑战

时间压力：咨询师没有太多时间来反思和形成他们的回应，这可能增加工作的难度。
缺乏视觉和语音线索：尽管可以通过视频会议技术部分弥补，但实时聊天仍然缺乏视觉和语音线索，这可能增加误解的风险。

视频会议

1. 优势

视觉线索：通过视频会议，咨询师可以获得更多的视觉线索，这有助于更好地理解对方的情绪和状态。
语音交流：咨询师和寻求帮助的人可以通过语音而不是文字进行交流，这对于不适应基于文本的在线方法的人是一个很好的选择。

2. 挑战

技术问题：视频会议可能会出现技术问题，如中途被切断，这会影响治疗过程。
安全性：视频通话的安全性也是一个重要的问题，需要确保会话不被未经授权的人访问。

虚拟环境

1. 优势

个性化体验：虚拟环境可以提供从虚拟咨询室到海滩、雨林，甚至完全想象的环境，为用户带来个性化的体验。
视觉线索：虚拟形象的选择为咨询师提供了关于个体自我形象的视觉线索，有助于更好地理解个体的自我认知。

2. 挑战

虚拟形象的影响：选择的虚拟形象可能会影响咨询过程。咨询师需要避免投射负面假设，特别是关于寻求帮助的人的假设。
语音线索：根据沟通方式的不同，虚拟会话中可能存在或不存在语音线索，这可能影响沟通的效果。

提供多种咨询模式的优势与劣势

1. 优势

灵活性：提供多种咨询模式可以满足不同用户的需求，增加咨询的灵活性。
综合支持：结合互联网、电话和面对面的咨询方式，可以提供更全面的支持，提高咨询效果。

2. 劣势

技术复杂性：提供多种咨询模式可能会增加技术复杂性，需要更多的技术支持和维护。
资源分配：需要合理分配资源，确保每种模式都能得到有效支持。

互联网咨询对咨询师和寻求帮助者的适用性

1. 必备技能和特征

咨询微技能：咨询师需要具备基本的咨询技能，如倾听、共情和反馈。
计算机技能：咨询师和寻求帮助者需要具备基本的计算机操作能力，以顺利使用各种在线咨询工具。
个人特征：咨询师和寻求帮助者需要具备开放、耐心和适应性强的个人特征。
问题表现：咨询师需要评估寻求帮助者的问题是否适合通过互联网咨询解决。

2. 适用性评估

咨询师：咨询师在开始互联网咨询之前，需要评估自己的技能和特征是否适合在线工作。
寻求帮助者：寻求帮助者需要评估自己是否适合通过互联网咨询解决问题，是否能适应在线交流的方式。

总结

互联网咨询作为一种新兴的咨询方式，具有即时信息、互动性强、视觉线索丰富等优势，但也面临时间压力、技术问题、安全性和虚拟形象影响等挑战。提供多种咨询模式可以增加灵活性和综合支持，但也需要处理技术复杂性和资源分配问题。咨询师和寻求帮助者需要具备特定的技能和特征，才能有效开展互联网咨询。通过评估和准备，可以确保互联网咨询的质量和效果。未来，随着技术的发展，互联网咨询将更加成熟和多样化，为用户提供更高质量的咨询服务。

进一步阐述知识点

咨询微技能

1. 技能的重要性

在考虑通过互联网提供支持之前，咨询师需要熟练掌握本书第2至4部分描述的咨询微技能。这些微技能包括但不限于：

倾听：有效地倾听对方的陈述，理解其核心问题和感受。
共情：设身处地地理解对方的情感和经历。
反馈：给予适当的反馈，确认对方的感受和观点。
提问：提出开放式和封闭式问题，引导对方深入思考。
解释：清晰地解释概念和建议，帮助对方理解。

2. 面对面与互联网咨询的差异

视觉线索的缺失：视频会议时，部分视觉线索会丢失，这使得咨询师更难准确理解对方的呈现问题和相关感受。
文本模式的挑战：当使用基于文本的模式时，视觉和语音线索都会丢失，这进一步增加了沟通的难度。
适应性要求：咨询师必须非常擅长将面对面咨询的微技能适应到在线环境中，以建立有效的和支持性的咨询关系。

计算机技能

1. 技术要求

计算机素养：咨询师和寻求帮助的人都需要具备基本的计算机操作能力，熟悉在线交流工具。
硬件要求：需要考虑计算机规格、视频、麦克风、耳机、互联网连接等硬件条件。
技术支持：在这些组件之一发生故障时，需要有技术支持来解决问题。

2. 网络文化

在线互动：熟悉人们如何在线互动，了解虚拟环境的感知方式。
虚拟生活的现实性：认识到对于许多互联网用户来说，他们的虚拟生活，包括在线形成的关係，是非常真实的。

3. 其他计算机技能和要求

网络安全：确保咨询过程中的信息安全，防止未经授权的访问。
软件使用：熟练使用视频会议软件、聊天工具等在线咨询工具。

个人特征

1. 灵活性

工作时间：互联网咨询可能需要在非工作时间进行，咨询师需要具备灵活性。
临时会话：有些寻求帮助的人可能会要求临时会话，咨询师需要准备好随时响应。
支持模式：咨询师可能需要提供多种支持模式，如电子邮件、实时聊天、视频会议等，或者选择专注于一种模式。

2. 透明度

服务说明：咨询师需要从一开始就坦诚地说明他们如何提供服务，包括可用时间、支持模式、回复时间和收费标准。
信息提供：提供易于访问和全面的信息，帮助寻求帮助的人了解咨询过程和期望。

3. 其他重要信息

隐私政策：明确告知咨询过程中的隐私保护措施。
紧急情况：提供紧急联系方式，以便在必要时提供及时支持。
用户反馈：鼓励用户提供反馈，不断改进服务质量。

总结

互联网咨询作为一种新兴的咨询方式，要求咨询师具备特定的技能和特征。咨询师需要熟练掌握咨询微技能，并将其适应到在线环境中。同时，咨询师和寻求帮助者都需要具备基本的计算机操作能力和网络文化素养。灵活性和透明度是互联网咨询师的重要特征，能够有效建立信任和支持性的咨询关系。通过提供全面和透明的服务信息，可以确保互联网咨询的质量和效果。未来，随着技术的发展，互联网咨询将更加成熟和多样化，为用户提供更高质量的咨询服务。

进一步阐述知识点

呈现问题

1. 专业能力与督导

专业能力：咨询师应在自己的能力范围内实践，确保能够胜任所面对的呈现问题。
督导：在不确定是否适合与某个特定个体或呈现问题合作时，应寻求督导的意见，以确保提供专业的支持。

2. 互联网咨询的适用性

匿名性：为选择保持匿名的人提供适当的危机支持可能具有挑战性。如果他们仅提供电子邮件地址作为联系方式，确保他们的安全需要特别注意。本章的伦理考虑部分提供了一些想法，如建立紧急联系机制、提供心理急救指导等。
严重心理健康问题：一些经历严重心理健康问题和需要药物治疗的人可能不适合在线支持，例如经历精神病或严重抑郁和焦虑的人。这并不意味着互联网咨询不能进行，但可能需要将寻求帮助的人与适当的面对面支持联系起来，以确保他们的安全和治疗效果。

互联网咨询过程

1. 适用性评估

个人评估：咨询师和寻求帮助者都需要评估自己的适用性。咨询师需要确定自己是否具备必要的技能和灵活性，寻求帮助者需要确定自己是否适合在线支持。
支持模式：咨询师需要决定提供短期还是长期支持，是否愿意通过多种模式（电子邮件、聊天、视频会议、面对面、电话）提供咨询。不同的支持模式需要不同的技能和资源。

2. 咨询过程框架

咨询过程：图16.1（见第135页）中展示的咨询过程可以作为互联网咨询的框架。虽然不是所有的咨询关系都会完全遵循这些阶段，但了解咨询过程中的步骤，包括何时跟随求助者的引领以及何时引导过程以满足其表达的需求，是有帮助的。
灵活性：咨询师需要具备灵活性，根据求助者的需要调整咨询方式和内容。

3. 适用性评估的具体问题

咨询师的问题

经验与舒适度：我是否有经验并且在面对面咨询中感觉舒适？
微技能：我是否熟练使用面对面咨询的微技能？
适应性：我是否知道如何将这些技能适应到在线环境中？
网络文化：我是否熟悉网络文化？
灵活性：我是否灵活？我的生活方式或工作安排是否允许灵活性？
技术能力：我是否舒适通过文本在线交流？或通过麦克风？我是否具备计算机素养？我是否有使用所需技术的条件？

寻求帮助者的问题

面对面需求：寻求帮助的人是否需要面对面支持？
心理健康状况：寻求帮助的人是否经历严重的心理健康问题，如严重抑郁/焦虑或精神病，或需要监测的药物？
危机支持：他们是否需要危机支持？

总结

互联网咨询作为一种新兴的咨询方式，要求咨询师具备特定的技能和特征。咨询师应在自己的能力范围内实践，并在不确定时寻求督导。互联网咨询的适用性对于一些人来说受到质疑，特别是那些需要紧急支持和严重心理健康问题的人。咨询师需要评估自己的适用性，并决定提供短期还是长期支持，以及是否愿意通过多种模式提供咨询。图16.1中展示的咨询过程可以作为互联网咨询的框架，帮助咨询师了解咨询过程中的步骤。通过评估和准备，可以确保互联网咨询的质量和效果。未来，随着技术的发展，互联网咨询将更加成熟和多样化，为用户提供更高质量的咨询服务。

进一步阐述知识点

准备

1. 类似框架

与面对面咨询类似，咨询过程也可以作为互联网咨询的框架。这意味着无论是在面对面还是在线环境中，咨询的基本步骤和原则都是相似的。

2. 重要性

在进行任何形式的咨询之前，做好充分的准备非常重要，以便能够尽可能高效地提供支持。如果你自己也需要支持，就很难有效地帮助他人。这包括心理准备、情感准备和技术准备。

3. 具体建议

与督导讨论问题：与你的督导讨论你自己的问题，可以帮助你更好地管理自己的情绪和压力。
管理侵入性想法：通过告诉同事这些想法的存在来管理你的侵入性想法，可以减轻这些想法对你的影响。
放松和冥想：根据你的精神信仰使用放松、冥想或祈祷，可以帮助你保持平静和专注。
参与体育锻炼：体育锻炼可以释放压力，提高你的整体健康水平。

4. 其他准备方式

技术测试：确保你的设备和网络连接正常，避免技术问题影响咨询效果。
熟悉平台：提前熟悉你将使用的在线咨询平台，了解其功能和操作方式。
心理准备：调整心态，保持积极和开放的态度，准备好应对各种情况。

加入

1. 时间限制

与电话咨询一样，网上咨询师与寻求帮助的人建立联系的时间比面对面咨询要短得多。一个人只需快速点击鼠标或干脆不回邮件就可以结束会话。因此，迅速建立信任和联系至关重要。

2. 挑战

由于视觉和语言线索的减少或完全缺失，建立这种联系也可能具有挑战性。这需要咨询师具备更高的沟通技巧和敏感度。

3. 重要微技能

反思：通过重述和总结对方的话，帮助对方感受到被理解和关注。
释义：用自己的话重新表述对方的观点，确保理解的准确性。

4. 额外技巧

澄清：由于缺乏视觉和语言线索，需要更多的澄清来确保理解的准确性。
直接提问：使用更多直接的问题来确认一个人的情绪或隐含的想法，避免误解。

5. 其他目标

信息收集：在初始互联网咨询会话的早期获得适当的信息，有助于确定一个人的身份，以便后续跟进。
筛选和评估：信息收集有助于筛选和评估，以确定互联网是否是寻求帮助的人合适的模式。
合同签订：在加入阶段进行合同签订和设定基本规则，明确双方的权利和义务。
伦理问题：在第一次会话前讨论互联网咨询特有的伦理问题，或向寻求帮助的人提供相关信息，以便他们可以做出是否继续在线咨询的知情选择。

6. 技巧要求

时机：在合适的时间引入这些目标，避免一次性提出过多问题或要求，给对方带来压力。
理解方式：以理解和支持的方式引入这些目标，建立信任和良好的咨询关系。

总结

互联网咨询作为一种新兴的咨询方式，要求咨询师在准备和加入阶段具备特定的技能和策略。做好充分的准备可以帮助咨询师在心理、情感和技术上都处于最佳状态。在加入阶段，迅速建立信任和联系至关重要，特别是在缺乏视觉和语言线索的情况下。通过运用反思和释义等微技能，以及适时的澄清和直接提问，可以有效提高咨询的效果。此外，信息收集、筛选评估、合同签订和伦理问题的讨论也是加入阶段的重要目标。实现这些目标需要技巧，以确保在合适的时间以理解的方式引入它们。通过这些准备工作，可以确保互联网咨询的质量和效果。未来，随着技术的发展，互联网咨询将更加成熟和多样化，为用户提供更高质量的咨询服务。

36 Internet counselling In the last chapter we asked you to consider whether it would be harder to be a TC or a face-to-face counsellor. In this chapter we introduce another option: internet (online} counselling. How does internet counselling compare to telephone counselling and face-to-face counselling? The answer to this question is, we feel, quite complex due to the complexity of internet counselling itself. Part of this complexity comes from the ever-changing nature of the online counselling environment — it is relatively new and growing fast. One aspect that continues to grow is the many different modes of internet counselling now available.

MODES OF INTERNET COUNSELLING There are many options available for people who choose to seek counselling support online. Here, we limit our discussion to individual counselling; however, we do acknowledge that there are many more counselling support options available including group counselling and support groups, self-help, psychoeducation or bibliotherapy, structured programs and more. For interested read el’s, we have briefly explored these options in the context of using technology to support young people in our book Counselling Adolescents: The Proactive Approach for Young People (2015).

Email real-time chat, video conferencing and virtual platforms can all be used to develop a distance counselling relationship

We have listed the different options available for individual internet counselling in Table 36.1, along with some examples of these modes that are currently available online. Perhaps you would like to explore the examples provided to get a sense of how counselling is presented and delivered online. Internet counselling can be provided via: 1 email 2 real-time chat 3 video conferencing 4 virtual settings.

Table 36.1 Modes of internet counselling 306

MODE OF COUNSELLINGEXAMPLES Email- The Australian Breastfeeding Association (breastfeeding.asn.au) provides email and telephone counselling support for breastfeeding mothers.

beyondblue (beyondblue.org.au) provides email counselling for anxiety and depression. It also offers telephone and chat counselling.
The Butterfly Foundation (thebutterflyfoundation.org.au) provides support via email counselling for individuals with eating disorders. They also offer telephone and chat counselling. Real-time chat- Counselling Online (counsellingonline.org.au) provides drug and alcohol counselling via chat and telephone.
eheadspace (eheadspace.org.au) provides chat counselling for young people. In addition to telephone counselling, it also has face-to-face counselling centres.
Kids Helpline (www.kidshelp.com.au) provides chat counselling for young people. It also offers telephone and email counselling. Video conferencing■ The Centre for Human Potential (cfhp.com.au) provides counselling support via Skype. It also offers face-to-face counselling. -- Psynaptic Psychology Counselling (ppccounselling.com) is an online counselling service providing support via the WebEx video conferencing system (webex.com.au).
USC Telehealth (usctelehealth.com) is a US-based online counselling service which has developed a video conferencing system spec fically for online counselling. Virtual settings- The Center for Brain Health at the University of Texas (brainhealth.utdallas.edu) has developed a virtual world specifically for online counselling.
Reaction Grid (ReactionGrid.com) and InWorld Solutions (inWorldSolutions.com) are companies that can be hired to develop virtual worlds that can be used as platforms for online counselling.
Second Life (secondlife.com) is a commercially available virtual world that has been used by counsellors as a platform for online counselling.

One way to establish a counselling relationship over the internet is by sharing emails. This may be limited to a single exchange or develop into multiple email exchanges. Just as with telephone counselling, the counsellor s job can be challenging when using email to communicate as visual cues are not available. As we discussed in Chapter 35, a lack of visual cues can make it difficult to identify a person’s presentation, feelings and response to the counsellor. In addition, verbal cues such as tone of voice, pace and breaks or pauses in a person’s narrative are also missing, which may increase the potential for misunderstanding the feelings and thoughts expressed by the person seeking help. There are many ways to make feelings and thoughts more explicit, such as the use of different fonts, formats, acronyms, emoticons and punctuation. We will explore the use of these techniques in more detail later in this chapter.

While the lack of visual and verbal cues do present challenges for die counsellor, there are potential advantages. Many individuals who find sharing face to face too challenging may find the anonymity afforded by email disinhibiting, and therefore be able to disclose more information. 1 here also exists a decreased power imbalance, providing the person seeking help with a greater sense of control over the counselling process. While this can support disclosure, there is also the possibility that the person will exercise this power to end the counselling relationship quite abruptly. Consequently, the counsellor has to work hard to engage with each individual and prevent them from early withdrawal. It is very easy to simply not send another email or to discontinue a chat session.

REAL-TIME CHAT While connecting via email is asynchronous (that is, there is a gap between replies), real-time chat, as its name implies, is synchronous. This can present an advantage over email communication as you do receive more information: for example, breaks or pauses in a person’s reply may provide the counsellor with clues as to information the person needs to reflect on or is finding difficult to share. In other ways, chatting over the internet can be more challenging as the counsellor does not get as much time to reflect on and form their response. 3 here also remains a lack of visual and verbal cues for the counsellor to draw on. This lack of cues may be minimised to some degree using video conferencing technology7.

VIDEO CONFERENCING In some ways, counselling via a video messaging service, such as Skype, is more like face-to-face counselling than telephone counselling, in that the counsellor has access to more visual cues. The counsellor and the person seeking help can also communicate verbally, rather than via text. This can be a good option for people who are not as comfortable using online text-based approaches. One disadvantage of video conferencing is the potential for technical difficulties; being cut off mid session certainly isn’t helpful to the therapeutic process! Another concern is the security of video-calling. Clearly, both the person seeking help and the counsellor want to avoid unauthorised access to their sessions.

VIRTUAL SETTINGS A less common, but growing, option for internet counselling is to meet in a virtual environment. In this instance, the person seeking help and the counsellor are represented online by avatars of their own choosing. The avatars then ‘meet m a virtual setting and communicate either by text or verbally, using a microphone, lhe virtual setting could be anything from a virtual counselling room to a beach, a rainforest or even a completely imaginary environment. While visual cues are again lost, the choice of avatar does provide the counsellor with a visual clue as to the individual’s self image. Discussing a person’s choice of avatar may reveal important insights for both them and the counsellor about the person’s view of self. In saying this, we would encourage the counsellor to guard against projecting assumptions, particularly negative ones, about the person seeking help. How, for example, would you feel about engaging in a counselling relationship with a demon? What thoughts and feelings would this evoke? If you are comfortable engaging with a demon avatar, what type of avatar do you think you would find challenging? Depending on the mode of communication, verbal cues may or may not be present in a virtual session. Readers interested in finding out more about counselling in a virtual environment may like to read the article on avatar therapy by Nagel and Anthony (2011). You will notice in Table 36.1 that many services offer multiple modes of internet counselling, and sometimes telephone and face-to-face approaches are also offered alongside online modes. This mixing of modes and approaches is very common. What could be some advantages to offering counselling support via multiple internet, telephone and face-to-face approaches? What are some disadvantages?

SUITABILITY OF INTERNET COUNSELLING FOR THE COUNSELLOR AND PERSON SEEKING HELP l he unique nature of internet counselling requires specific skills and characteristics from both counsellor and the person seeking help. As such, we would suggest that not all counsellors and individuals are suited to online work. We list a number of questions in Table 36.2 to consider for both the counsellor and the person seeking help before commencing internet counselling. The questions in fable 36.2 cover the following skills and characteristics: 1 counselling micro-skills 2 computer skills 3 personal characteristics 4 presenting issues.

COUNSELLING MICRO-SKILLS Before considering the commencement of support over the internet, the counsellor needs to be well-practised in the counselling micro-skills described throughout Parts 2 to 4 of this book. We will discuss in more detail how these micro-skills apply in the section on the internet counselling process. Here, we would like to focus on the differences between face-to-face and internet counselling more generally. At the ver}" least, some level of visual cues is lost when using video conferencing, therefore making it not only more challenging for the counsellor to accurately understand a person’s presenting concerns and related feelings but also to relay their presence, empathy and concern to them. This effect can be increased when using text-based modes, as both visual and verbal cues are lost. Therefore, the counsellor must be ver}" skilled in adapting their face-to-face counselling micro-skills to the online environment in order to build an effective and supportive counselling relationship.

COMPUTER SKILLS It is important for both the counsellor and the person seeking help to be computer literate and familiar with communicating online before commencing internet counselling. It is also essential to have the required technology. You may need to consider your computer specifications, video, microphone, headphones, internet connection and access to technology support m case of a failure in any one of these components. Finally, it is important to be familiar with cyber-culture; for example, how people interact online and how the virtual environment is perceived. It is important to recognise that for many internet users, their virtual life, including the relationships formed online, are very real. Gan you think of any other computer skills and requirements that would be useful for a counsellor or individual who is considering internet counselling?

It is important for an internet counsellor to be well-practised in using micro-skills face to face

PERSONAL CHARACTERISTICS Perhaps the most important personal characteristic to have as an internet counsellor is flexibility. Individuals who seek support online may do so because they find it difficult to access traditional face-to-face support, which is often restricted to the working day. How would you feel about working after-hours? Some individuals may also request impromptu sessions. Indeed, this is how some of the services listed in fable 36.1 offer support. Do you feel this is appropriate? How would you respond to an impromptu request for support from someone? Another area you may have to be flexible in is the mode of internet support. Are you happy to offer multiple modes or would you prefer to stick with one? I here is no right or wrong answer for many of these questions — it depends on what the counsellor is comfortable offering. However, we would encourage any potential internet counsellors to be upfront from the start about how they offer services. You could achieve this by having accessible and comprehensive information about your availability, mode of support, how often and when people can expect responses and how you charge for services. What other information would be important to provide to individuals seeking internet counselling support?

PRESENTING ISSUES As with face-to-face counselling, it is important to practise within your area of competence and to seek supervision if you are unsure about working with a particular individual or presenting issue. More specifically, the suitability of internet counselling has been questioned for a number of people. For example, it can be challenging to provide appropriate crisis support for a person who chooses to remain anonymous. If they only provide their email address as a means of contact, how do you ensure their safety? Some ideas are provided in the ethical considerations section of this chapter. Other groups potentially not suited for online support are those experiencing severe mental health challenges and those requiring medication, for example, individuals experiencing psychosis or severe depression and anxiety. This doesn’t mean that internet counselling cannot occur, but it may be necessary to also link the person seeking help with appropriate face-to-face support. It can be challenging to provide appropriate crisis support over the internet

THE INTERNET COUNSELLING PROCESS Once you have determined your suitability and that of the person seeking support, how do you go about engaging in online support? Again, this can be complicated and depends on many factors. Do you intend to offer short- or long-term support? Would you prefer to stick with one mode or are you happy to offer counselling via mixed modes (email, chat, video conferencing, face-to-face, telephone)? Clearly, how support is offered and, therefore, the skills required, will vary. However, the counselling process as presented in Figure 16.1 (see page 135) can be useful as a framework for internet counselling. It is important to recognise, as highlighted in Chapter 35, that not all counselling relationships will follow these stages exactly, but it can be helpful to recognise the steps involved in the counselling process, including when to follow the person’s lead and when to guide the process to meet the person’s expressed need.

Table 36.2 Questions to consider before engaging in internet counselling 310 Questions for the counsellorAm 1 experienced and do 1 feel comfortable counselling in a face-to-face setting? Am 1 well-practised in using counselling micro-skills in a face-to-face setting? Do 1 know how to adapt these skills to the online environment? Am 1 familiar with cyber-culture? Am 1 flexible? Does my lifestyle or work schedule allow for flexibility? Questions for the counsellor and the person seeking supportAm 1 comfortable communicating online via text? Or via a microphone? Am I computer literate? Do 1 have access to the required technology? Questions for the person seeking supportDoes the person seeking help require face-to-face support? Is the person seeking support experiencing severe mental health challenges, such as severe depression/ anxiety or psychosis, or do they require medication that needs monitoring? Are they in need of crisis support?

PREPARATION A similar counselling process can be used as a framework for both face-to-face and internet counselling

Before you engage in any form of counselling, it is important to prepare yourself so you can be as effective as possible. It is difficult to support someone else if you are feeling in need of support yourself! We have made four suggestions m the previous chapter for preparing for telephone counselling, which can also be used to prepare for internet counselling. We have listed these ideas again for you below. What other ways would be helpful for preparing for internet counselling? 1 Talk through your own problems with your supervisor. 2 Own your intruding thoughts by telling a colleague that they exist. 3 Use relaxation, meditation or prayer, depending on your spiritual orientation. 4 Engage in physical exercise.

JOINING As with telephone counselling, an online counsellor doesn’t have as long to connect with the person seeking help compared to face-to-face counselling. It is veiy easy for an individual to end the session with a quick click of the mouse or simply not to return an email. As highlighted before, forming this connection can also be challenging in light of the decrease in, or complete absence of, visual and verbal cues. Micro-skills particularly important when joining with the person seeking help are reflection and paraphrasing. These two micro-skills are perhaps even more essential in internet counselling as there is a need for more clarification to compensate for the loss of visual and verbal cues. It can be much easier to misinterpret a written statement without the accompanying tone of voice and body language that provide an emotional context. You may also need to use more direct questioning to confirm a person’s emotion or implied thoughts if you are unsure. We discuss the use of questioning online in more detail next.

In addition to connecting with the person seeking help, there are also a number of other goals for the online counsellor when joining with the individual. Obtaining appropriate information early in an initial internet counselling session is helpful for determining the person’s identity so that follow-up is possible. Information gathering allows for screening and assessment to determine whether the internet is an appropriate mode for the person seeking help. Counsellors may also engage in contracting and setting ground rules during the joining phase. It is a good idea to discuss ethical concerns specific to internet counselling, or to provide information about these to the person seeking help prior to the first session, so that they can make an informed choice about whether to continue online counselling. We discuss ethical concerns in more depth later in this chapter. Achieving these goals requires skill in order to introduce them at the right time and in an understanding way. You don’t want to overwhelm the person with a barrage of closed questions!

ACTIVE LISTENING As in the joining phase, reflection and paraphrasing are two important micro-skills during the active listening stage in order to show the person seeking help that they are being heard and understood. To support this process, clarification by using questions may be required. However, questions need to be approached with care. Have you ever been the recipient of an abrupt question via email or chat? How did it make you feel? It is very easy to come across as more harsh than intended online without the softening effect of visual and verbal cues. Therefore, much more care must be taken when introducing and wording a question. Another important micro- skill, especially when using chat, is the use of minimal encouragers to show that you are still listening. You could, for example, type ‘Hmmm ...’ or ‘1 see’. How else could you let the person seeking help know that you are still listening? Due to the increase in the potential for misinterpretation and miscommunication, it is also important for the counsellor to monitor judgements, assumptions, interpretations and projections throughout this process of active listening. How might you remind yourself to identify the development of any negative projections? The lack of visual and verbal cues can also lead to an increased sense of privacy or anonymity for an individual. This can have the advantage of increasing disclosure via what is known at the disinhibition effect. The disinhibition effect can also, however, increase transference and counter-transference; this is certainly something to be aware of so that you are able to reflect on its possible presence and respond accordingly.

EMPHASIS ON EMOTIONS Just as content can be misunderstood when communicating online, so can emotions. How do you usually identify others’ emotions? While people will explicidy state their emotions, counsellors usually draw on the visual and verbal cues of the person seeking help to identify their emotions, cues which are reduced or missing in the case of internet counselling. This can be particularly’ significant when a person’s expressed feelings don’t match the emotion evident via their visual and verbal cues. When you are unsure of an individual’s emotional state, it could be helpful to provide a tentative interpretation by reflecting and seeking clarification with a carefully worded question. Apart from the use of feeling words, there are many ways that individuals may7 express their emotions via text. For example, many people make use of emoticons (smiley faces) and acronyuns for feelings or other expressions. Table 36.3 has some examples of emoticons and acronyms (both feelings and more general abbreviations) commonly’ used in written communication via the internet. A more comprehensive list can be found at PC.net under the ‘Online slang’ and ‘Emoticon’ tabs. Formatting and punctuation can also be used to convey7 feeling through text, for example, using bold, capital letters or exclamation marks can be used to increase the intensity’ of an emotion.

Table 36.3 Examples of commonly used acronyms and emoticons EXAMPLESMEANINGS AcronymsAFK BBS bf cya gf LOL ROFL SOS thxAway From Keyboard Be Back Soon Boyfriend See You Girlfriend Laugh Out Loud Rolling On the Floor Laughing Someone Over Shoulder Thanks Emoticonsor f XD or =

( or :( or =( :_( or :'( =/ Xd O.oHappy Laughing Sad Crying Mad Angry Confused ^different Surprised :O

Pitch of voice can also be represented by formatting. For example, individuals may use different fonts, colour, bolding, exclamation marks, capitals, repeated letters (sooooo ...) and so on. The pace of a person’s narrative can also be implied by aspects of the text. An unpunctuated block of text which contains changes in subject matter without pause or time for reflection suggests a fast pace which may imply a sense of urgency or anxiety. In contrast, an email with minimum content may imply a slower pace that could reflect a person’s difficulty disclosing information or putting their thoughts and feelings into words. A little more information about pace is available when using chat, as you get a sense of any pauses or breaks in the dialogue with the person seeking help. These breaks could be equivalent to breaks in eye contact in face-to-face counselling, or suggest that the person has difficulty sharing certain information. Other clues to an individual’s emotional state include layout, presentation, sty le, and the avatar or symbol chosen by the person to represent themselves.

There are many ways to express feelings online including feeling words, emoticons, acronyms, font, formatting and style

We feel it is important to note that many of the market's for emotion could be affected by many factors other than emotional state, such as gender, culture, disability, faith, family of origin, Current situation or circumstances at the time of writing, or the social and economic context. This brings us back to our initial suggestion of asking for clarification if you are unsure of an individual’s emotions.

EMPHASIS ON THOUGHTS Due to the use of text to communicate via most online modes, internet counselling is well-suited to word-based therapies, such as Rational Emotive Behaviour Therapy (Chapter 20), Narrative Therapy (Chapters 13 and 21) and the use of metaphor (Chapter 11). What other word-based therapy could be successfully adapted to internet counselling?

EMPHASIS ON BEHAVIOUR As with an emphasis on thoughts, when working with a person to support behaviour change, word-based therapies or strategies can work well online. Some skills to consider include confrontation (Chapter 19), Motivational Interviewing (Chapter 29) and solution-focused (Chapter 22) approaches. As we discussed earlier, more care is required when introducing and wording confrontation statements and questions online.

CLOSURE As a session or counselling relationship is coming to a close, it can be useful to draw on summary skills in order to outline the session and prepare an individual for closure. Preparing someone for closure is particularly important as there is an increased risk of the person terminating internet counselling prematurely, compared to face-to-face counselling. 1 he process of closure as described in Chapter 35 can also be useful in bringing an internet counselling session to an end. Depending on the needs of the person seeking help, it may also be necessary to make appropriate referral options available during the closure stage of internet counselling. When, for example, might it be necessary to refer a person to face-to-face counselling? Alternatively, you may like to provide the individual with follow-up options. However, when providing follow-up options it is important to set clear post-counselling boundaries, as the borders between personal and professional can be lessened online, as we discuss in more detail below. As with any form of counselling, it is important for the counsellor to debrief regularly with other counsellors or their supervisor. Debriefing helps the counsellor to release emotions experienced as a result of their counselling work, thereby protecting against burnout and ensuring they remain effective. We discuss the debrief process in more detail in Chapter 35 and other self-care strategies to manage burnout in Chapter 42.

ETHICAL CONSIDERATIONS While we do cover ethical concerns in Chapter 40, we feel it is important to end this chapter by discussing some of the ethical considerations that are unique to the online environment. Drawing on your own personal experience of using the internet, what are some potential ethical concerns that come to mind regarding online counselling? How might you proactively address these concerns? In the coming discussion we draw on the guidelines produced by the Australian Psychological Society (APS, 2011) for using technology in counselling. A number of organisations also exist to support and provide resources for professionals practising online including the International Society for Mental Health Online (ismho.org), the Association for Counselling and Therapy Online (vvww.acto-uk.org) and the Online Therapy institute (onlinetherapyinstitute.com).

COUNSELLOR EXPERTISE Providing counselling over the internet presents a number of unique ethical considerations

As we noted earlier in this chapter, it is important for counsellors to first be well-practised in face-to-face counselling before moving into internet counselling. Once face-to-face micro-skills are well- developed, counsellors can then look at adapting their skills to the online environment. Internet counsellors also need to increase their knowledge and understanding about working online, including the current research into adapting counselling skills and strategies to the internet, it is important for internet counsellors to become familiar with any relevant legal and registration requirements. Is it, for example, OK to offer counselling to people who reside outside your registration area? Counsellors may develop their skills and knowledge through training and supervision.

CONFIDENTIALITY During the informed consent process, it is important to highlight the way that confidentiality7 could be limited by using the internet. In particular, it is important to share how the individual’s privacy^ is being protected from unauthorised access. This might include how their electronic data and information are stored and backed up, and what security measures are used, such as password protection and data encryption. Guidance or ideas may also have to be shared with the person seeking help regarding protecting the privacy of their counselling session, for example, password protection and not forwarding on personal information to others.

BOUNDARIES The internet is used extensively for developing personal relationships; therefore, there is an increased need to protect professional boundaries. One way to maintain boundaries is to highlight them before commencing an online counselling relationship. Some questions to consider include: • How quickly and often will you reply to emails? • How long will chat sessions run for? • Will you schedule sessions or reply to emails after-hours? • Will you offer impromptu sessions at a person’s request, or only pre-scheduled sessions? Maintaining your professional boundaries can also be made easier by using professional language.

Learning summary There are a growing number of modes available for internet counselling, including email, real-time chat, video conferencing and virtual settings. Before engaging in internet counselling, counsellors need to consider their Suitability with respect to micro-skills, computer skills and their personal characteristics. It is also important for counsellors to consider the suitability of the person seeking help regarding their computer skills and presenting issue. While each counselling relationship is unique, the process of internet counselling can follow the same stages as face-to-face counselling, including preparation, joining, active listening, emphasis on emotions, emphasis on thoughts, emphasis on behaviour, and closure. All counselling micro-skills are important in internet counselling, however, they may need to be adapted. Internet counsellors may have to seek clarification more frequently, word their questions and confrontations more carefully, and make more use of reflection, paraphrasing and written minimal encouragers. There are a number of unique ethical considerations when using internet counselling. Guidelines produced by the APS encourage counsellors to consider implications with respect to counsellor expertise, informed consent confidentiality and professional boundaries.

References and further reading Australian Psychological Society (APS) 2011, Guidelines for Providing Psychological Services and Products I 'sing the Internet and Telecommunications Technologies, APS, Melbourne. Evans, J. 2009, Online Goan selling and Guidance Skills: A Practical Resource for Trainees and Practitioners, SAC IE, London. Geldard, K., Geldard, D. & Yin Foo, K. 2015, Counselling Adolescents: The Proactive Approach for Young People, 4th cdn, SAGE, London. Kraus, K., Stricker, G. & Speyer, C. 201 1, Online Counseling: A Handbook for Mental Health Professionals, 2nd edn, Elsevier Academic Press, London. Nagel, D.M. & Anthony, K. 201 L ‘Avatar Therapy’, The Gapa Quarterly, Issue 3, 6—9.

PART 7 PROFESSIONAL ISSUES In this, the final part of the book, we focus on professional issues of which every counsellor needs to be aware. We consider the counselling environment, keeping records, cultural issues, confidentiality and other ethical issues, counsellor training and the need for supervision and looking after yourself, faking these issues into account is essential for maintaining our effectiveness as counsellors.