Psychotherapy by telephone

Sat Oct 25 17:38:02 CDT 2008

Thank you Adam for the clarifications!  I have to say that learning  
to use Skype myself has been a lesson in internet communication that  
the Chinese have taught me.  And there is an element of "presence"  
due to fact that it is real time communication.  I blow kisses and I  
ask the interpreter to give my client a hug so that helps too.

I will be starting a Skype supervision group for my Level 3 trainees  
in Nanjing after I meet with them next week and I will let you know  
how that goes too.

Tele, Kate
On Oct 25, 2008, at 11:01 AM, Adam Blatner wrote:

> 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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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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