Psychotherapy by telephone

Sat Oct 25 10:01:49 CDT 2008

Dear Kate and all, a couple of points to build on your good work:
    1. Lots of folks are less electronically sophisticated and don't know what Skype is. It's an internet program with a built in capacity to work from a camera taking your picture (as moving video) and the other person has one, too, so that you see each other's face and it's closer to being there. You can pick up more nonverbal communications and respond. There are still a few elements missing, such as the actual presence of the other, but the point is that modern computer work has made it more possible than a decade ago to feel that we are in touch, at least for one-to-one. Perhaps even some skype conference call shots are possible, I don't know. 

     2. f2f  this acronym means face to face. I had to puzzle it out.

   3. Kate, glad you're getting good feedback. You deserve it. And that you'll go to Rome, I hope. Many encouragements! 

Warmly, Adam
  ----- Original Message ----- 
  From: Dr Kate Hudgins 
  To: Haim Weinberg 
  Cc: Rosa Cukier ; Adam Blatner ; iagp-psychodrama at yahoogroups.com 
  Sent: Saturday, October 25, 2008 3:35 AM
  Subject: Re: [IAGP:PSYCHODRAMA] Psychotherapy by telephone

  Dear Rosa

  I too hope I am not too late to answer your question.  Hello Haim, nice to see you in Japan!

  I have been doing internet therapy for the past few months with a client in China where I am now.  I see her f2f when I am here and then each week we meet by Skype.com.   She is in her office and I am in my home office and we can see each other in real time.  We start out with some talking and get a contract for the session and then I set up an action sequence with her.  I have to work through an interpreter but I have found that the session is really almost if not as good as f2f.    we did weekly sessions for two months and then I came over here again and it was amazing how much change has happened during that two months.  She is much improved even though she has a very severe trauma history and a dx of complex PTSD.  

  IAGP in Japan was great and I have been talked into trying to come to Rome.  I hope to see you there.  Kate

  On Oct 14, 2008, at 8:14 PM, Haim Weinberg wrote:

    Dear Rosa.
    I hope it is not too late to answer your question about psychotherapy by
    phone or Internet. At first I thought that I have nothing to contribute to
    this discussion, because you asked specifically about psychodrama, but then
    I had second thoughts that maybe it will be helpful if I share with you my
    experience and thoughts about therapy over the phone or the Internet in
    general.
    In Israel, where I come from, therapy by phone is very rare, but in the USA,
    where I moved lately, it is quite common. I guess that the reasons are the
    vast distances of that country (just as in Brazil) and the fact that people
    move and relocate a lot. So when you start f2f therapy and later move to
    another state - you can still continue the sessions with your therapist by
    phone.
    A few patients that I have been seeing in Israel wanted to continue the
    sessions by phone when I moved to the US. We established a procedure with
    very clear boundaries (a quiet room, no interruptions, fixed time, etc.),
    and I was surprised how well it went. I think that the fact that we had a
    long term previous connection, helped a lot, and when I came for vacations
    to Israel (once in 6 months), we always met f2f.
    An example of an event that showed me how powerful such a session can still
    be was when a patient told me on the phone: "you cannot see my face right
    now, but I have tears in my eyes following our talk".
    I am sure that there are papers about phone therapy, but I cannot recall one
    right now. I do recall a lecture in a conference about phone therapy with a
    patient that was in prison.
    I think that psychodrama presents a challenge over the phone, but I am sure
    it can be overcome. I know of attempts to do groups on the phone: At the
    AGPA (American Group Psychotherapy Association) annual meetings, there are
    usually two days pre-congress workshops (called Institutes). Some of them
    continue for two successive years with the same participants and group
    leaders. Lately, two group leaders started such a two year group, and
    suggested a monthly phone session with the members in between the bi-annual
    meetings.
    Regarding the Internet, the situation is more complicated and involves
    confidentiality, ethical and law dilemmas. There is an association that
    deals with these issues called "the International Society for Mental Health
    Online (ISMHO) ***http://www.ismho.org *with suggested principles of doing
    therapy online http://www.ismho.org/builder/?p=page&id=214, and articles
    about cases http://www.ismho.org/builder//?p=page&id=201.
    Today, even very conservative psychoanalysts understand that online therapy
    is possible. Glen Gabbard, a very famous and respectful psychoanalyst,
    published a paper about using email during a regular psychoanalysis.
    I hope this helps,
    Haim Weinberg

    On Mon, Aug 4, 2008 at 4:08 PM, Rosa Cukier <rosacukier at uol.com.br> wrote:

    > Hy Adam and coleagues
    >
    > I need some help around the issue of psychotherapy delivered by telephone
    > or internet.
    > a.. Do you know any reference of Moreno talking about delivering therapy by
    > telephone?
    > b.. Is there any article about psychodrama by telephone?
    > c.. Is it permitted by APAS law of ettics?
    > Thank you very much, it is a new subject in Brazil and I think that in USA
    > and Europe it is more discussed than here.
    >
    > [Non-text portions of this message have been removed]
    >
    > 
    >

    -- 
    Haim Weinberg, PhD
    www.group-psychotherapy.com

    [Non-text portions of this message have been removed]

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  Kate Hudgins, Ph.D., TEP

  Clinical Psychologist
  Director of Training
  Therapeutic Spiral International, LLC
  ww.therapeuticspiral.org
  drkatetsi at mac.com

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