Disadvantages of Online Counseling: Where the Format Reaches Its Limits

Online counseling reaches its limits when more is needed than just a good connection. The room matters: If you have to expect that someone is listening in, or if you constantly have your own image in view, you’ll speak differently. If your own image bothers you, the phone carries the conversation better than the camera; if others are listening in, only a private place or a different time helps. Even the video window itself can become a limit: Anyone who easily cuts off distressing conversations closes it with a click, more easily than a door. For video treatment, the Federal Chamber of Psychotherapists cites precisely this pattern as a reason to weigh the merits of the format on a case-by-case basis; the same consideration applies to counseling.

If the Connection Is Lost

The connection will also drop at some point; it’s bound to happen. It’s good to have this arranged in advance: the phone as a second channel and a clear agreement on who calls back. In my experience, the physical presence of another person in the room provides more information and more support than any video connection, and those who are feeling particularly unstable right now benefit most from having someone there in person.

Crises and Emergencies

In acute crises, in cases of danger to yourself, or when close psychiatric care is needed, online counseling is not sufficient. In case of immediate danger to you or others, the emergency number in Germany is 112, and abroad it is the local emergency number. The Telephone Counseling Service (TelefonSeelsorge) is there for a confidential conversation, at 0800 1110111, 0800 1110222, or 116 123, day and night, free of charge and anonymous. In Germany, 116117 arranges medical help outside practice hours. This is not an overreaction.