I am fully aware that many clinicians in my field who use Skype as a medium to do therapy. I have chosen not to use this medium with a few exceptions—they are only if I already have a therapeutic alliance with the client and they are not available to come in for a session due to illness or away for a brief time. Otherwise, I want to see my client face to face, eyeball to eyeball to appreciate the full experience of their need and desire. Skype does not allow this full experience because I can’t calibrate with the body language that usually tells me more than what my client may be saying in words. It doesn’t offer me the opportunity to see the changes in skin color, breathing, eye movements and more. To really know the full picture of what a person or couple is experiencing I have to be fully present. Skyping limits my ability to evaluate and assess properly.
There are times when something is better than nothing, so skyping can be of some value, however the client will be short changed in what I have to offer when in person. It’s like a virtuoso violinist playing a substitute violin because his Stradivarius was not available. Most expert violinists would not even consider playing without their instrument. The same is true for an expert golfer who wants to play with the clubs he knows will give him the best chance to win. There are countless examples I could list, but the point is to give my clients the best of me whenever possible. Skyping limits my abilities to do so.
I would never consider making a living from using Skype as my main medium for communication any more than I would texting or emailing. Granted there are many times I use both, however it is only conditional, for instance when there is a need to change an appointment date or time or if there is information necessary to transmit prior or after a session. Texting is the most brilliant way to misinterpret and misunderstand. In therapy, this can never be afforded.
The most important ingredient in creating and maintaining a strong therapeutic alliance and effecting positive change is if the client feels safe and secure with the therapist. He/she must feel that their therapist truly cares about them and their welfare. All the methodologies and modalities don’t mean a thing if the therapist doesn’t exude genuine care and concern for their client. This can never be achieved using Skyping alone. Sometimes giving a hug does more than the best techniques developed over the years. If the client can have both then it’s a bonanza! This can only be accomplished when a therapist is fully present.
Over the past forty years I have acquired a multitude of trainings. Each are equally important and effective. The art is to know when to use them. It’s not unlike a golfer who has a lot of golf clubs in his golf bag. If he only had one club, he’s play a shitty game of golf. It’s his choice of which club to pull out depending on the shot he wants to make. Therapy is no different. The modality only works when the therapist and clients are face to face. Skyping is like putting a band aid on a hemorrhage. There’s nothing as good as the old-fashioned way of sitting across from the person who needs your total attention and presence. This is what I always want to offer!