How does email therapy stack up against tradition face-to-face counseling?
“I thought I was the super student as everyone else did - always getting high grades, good fun on a night out, a decent part-time job - but the ever-building exam pressure during my degree really took its toll. I developed an eating disorder halfway through my final year and had frequent panic attacks.”
Anna, a Geography graduate from a top London university, eventually sought help from the student support services weeks before her all-important exams. “I didn't have the time to see a counsellor in person, so I was offered counselling by email. For me, it was the most convenient way to deal with my anxiety and eating problems.”
Anna's treatment involved a seven-email exchange with a university counsellor. She was given practical strategies to cope with exam stress and an understanding of the thinking patterns associated with bulimia. “I couldn't believe how accurately my counsellor could express how I was feeling in an email,” she says. “My eating hasn't quite returned to normal yet, but the key thing was I was more relaxed going into the exams and came out with a degree.”
Hard Times
Anna's story is among many of students experiencing mental health problems at college or university. An independent study by The Times in 2007 found that the number of students seeking counselling at Bristol University had increased by 29% in a five-year period, and that British universities are having to spend £30 million a year to treat a range of psychological issues, from substance misuse, depression and exam anxiety, to eating disorders and bullying.
Email counselling, as in Anna's case, is emerging as an accessible and cost-effective alternative to traditional therapies. Several UK universities - including Sunderland, Warwick, Edinburgh, Cardiff, Portsmouth and Manchester - now offer counselling by email, sometimes free of charge, as part of their support services. For students unable or unwilling to access face-to-face services, the option to communicate via email with a psychologist is an attractive one.
“Students and young adults are naturally comfortable talking about their thoughts and feelings online, so it makes sense to offer email as a way to engage in counselling conversations,” says Professor Stephen Palmer, Chair of the online counselling working group. “It's also an easier way to receive professional advice and support in between studying and socialising.”
There are any number of circumstances where email therapy might be the more suitable option for a busy student. Plymouth University's counselling team encourages those who are away from university on a work or field trip, experiencing an illness or disability that makes it difficult to attend in person, or has an irregular schedule, to consider counselling by email.
For many undergraduates, the university experience can be an understandably challenging one. “At this key stage of life, students are searching for their identity,” says Debbie Johnson, acting director of the Student Counselling Service at Bristol University. “Many students come to university with expectations of how it's going to be and they become anxious when they're not having a good time.”
Common Sense
Email counseling is one way of helping those experiencing difficulties to look at the bigger picture. “Just to appreciate that life is full of highs and lows, and that other people are going through the same thing, can be reassuring,” says Phillip Hodson, a spokesman for the British Association for Counseling and Psychotherapy. “It's important for students to know that there is a difference between feeling very low and being clinically depressed.”
He explains that dealing with exam stress by email, for example, could take a straightforward approach. “The counselor might simply encourage the student to appreciate that passing or failing exams is not a life-or-death situation. It's more about imparting wisdom, facts and common sense than using special tricks of the psychological trade.”
Mr Hodson believes that email counseling comes into its own as a way to help male students in particular. “It has the potential to connect with young men who are notoriously unwilling to sit on a therapist's couch. You simply wouldn't reach them any other way.” The Samaritans, which launched its own email support service in December 2002 and receives an average of 300 emails a day, noted in a research study that a third of young men between 18 and 24 would rather use email to talk about their problems.
Potential Pitfalls
Despite such advantages, some practitioners caution against branding email counseling as a replacement for face-to-face therapy. Professor Palmer says: “Counseling online comes with its own challenges, and the therapist and client need to be aware of some of the possible difficulties they may encounter.” Universities are beginning to recognise the unique nature of treating students in this way; Warwick University assures its students that all counselors are professionally trained with a specific, additional qualification in email counseling.
