This document summarizes online counseling for anxiety and stress management. It discusses how online counseling can be conducted asynchronously or synchronously using tools like email, chat, or video conferencing. It notes the benefits of increased access and convenience but also the limitations of a lack of in-person cues. The document also outlines ethical, legal, and practical considerations like confidentiality, licensure, and identifying clients. Finally, it proposes a technology plan using CBT and stress management techniques over Skype to help clients identify stressors, improve coping skills, and reduce distress.

1. Online Counseling: Anxiety and
Stress Management
Stephanie Encarnacion

2. What is online counseling?
 Online counseling is characterized by counseling performed through means
of technology and internet-assisted tools such as: email, chat, and video
conferencing, to name a few.
 Consists of asynchronous or synchronous communication
 It has not only shown to have many benefits, responses to concerns, and
various platforms, but has also been proven to be efficacious in helping to
alleviate distress

3. Asynchronous & Synchronous
Communication
 Synchronous communication refers to the counselor and client
communicating or conducting sessions in the “here-and-now”
time
 This can be done through video chat or instant messaging
 This type of counseling requires a scheduled session in which the
counselor and client can come to an agreement to meet
 two should also come to agreement as to whether
videoconferences or chat messaging is preferred
 Using synchronous counseling, especially video chat for example,
can provide a sort of “mock” session of a f2f office setting
 Using chat messaging can also allow for instant communication
between the counselor and client. While this platform does not
provide the same opportunity of body language, facial
expressions, and tone of voice, emoticons and punctuations can
be used in place to express emotions
 Asynchronous communication is performed at any convenience to
the client and therapist
 Both parties can reply or inquire at their own time
 Encourages clients to be thoughtful in their responses and relieves
the pressure of having to give an answer without delay
 It should be kept in mind however, that the more constant
communication there is between the two would help to create a
better therapeutic relationship

4. Benefits  & Limitations 
 Benefits
 Convenience: perfect alternative for those who may not
have any offices in their near location. It is also helpful for
prospective clients who have busy lives and are constantly
working and traveling.
 Increased access: increased access for those who would not
be able to attend f2f counseling otherwise. This can include
clients who are physically disabled or even a person with
severe agoraphobia for example.
 Disinhibition: clients feel more comfortable in disclosing
personal information
 Recordability: ability to record and save sessions. Being able
to look back on conversations you are able to do a couple of
things. One, it helps to refresh your memory of what was
discussed. Two, the client can go back and review any
helpful tools given by the counselor. And third, it can help to
keep track of the progress being made and where the
patient started
 Limitations
 Lack of f2f cues: When these cues are missing in a
conversation, it is more difficult to determine the meanings
and/or emotions being evoked. This leaves the counselor in
the position to “guess” what the client means.
Unfortunately this may involve making judgments or
portraying transference towards the other person. As the
client and counselor continue to have sessions, the
counselor will begin to learn about him/her, pick up on
feelings, and may learn to better understand him/her
 Delayed reaction: Longer delays in response may put a
damper on treatment because it does not remain consistent
(as f2f counseling does)
 Anonymity: It is important for therapists to know the
identity of an online client because of issues of safety and to
avoid getting involved in dual relationships. In the case of an
emergency, such as the client planning to harm themselves
or others, the therapist must be able to reach the client.

5. Ethical, Practical, Legal Implications
 Confidentiality: When taking part of
web communication, clinicians should
make the client aware of these
potential risk factors as well. However,
there are some precautions that a
clinician can take. They can protect
themselves by downloading
encryption software, which can help
increase privacy or they can use an
online counseling platform that
already has more security. Password
protection and the use of firewall can
also be helpful
 Another legal implication that is
enforced is state licensure laws. A
therapist can only provide services in
the state in which they are licensed.
The counselor’s insurance is also only
viable in his/her licensed state.
Although this limitation exists,
counselors are able to acquire their
license in other states as well. This can
allow counselors to gain a larger client
base, although these licenses may take
time to obtain
 Must know client’s identity in case of
an emergency

6. Tech Plan for Anxiety &
Stress
 “Find balance and take control of your
life!”
Name: Taking it Easy
Population: Adolescents and Adults 17+
older that are struggling with stress
management and/or anxiety
Recommendations: CBT & Stress
management
•

7. Goals
Identify what causes stress/anxiety
Change the way you deal with stress/anxiety
Time management/scheduling
Learn about meditation/relaxation techniques
Decrease client's distress
Increase coping skills
Allow client to gain control of their life
Collaborate with clients to create goals that best suits their needs

8. Setting
 Sessions will take through synchronous communication
 Because CBT and stress management are more effective through hands on
work, we will meet via. Skype for a one hour session
 Frequency of sessions will be individualized according to client distress
 Clients may feel free to email any questions or concerns outside of
treatment sessions

9. Legal, Ethical, & Practical Implications
 Confidentiality and privacy is a high priority and you may put your mind at
ease that we will be on a private secure network and that no one else will
have access to your information or our conversations. Everything is locked
with a password and firewall is installed as well.
 Unfortunately, I am only able to counsel those in the New York State area
 To ensure the safety of all clients, clients must fill out and sign a contract
that identifies their personal information such as: Name, Address, Phone
Number, Emergency contact information, etc. before treatment is started.
Your information will not be shared and will be kept confidential. It will only
be used in the case of an emergency

10. Hardware & Software
 Sessions will be held via Skype
 You will need:
 A computer/laptop
 Access to Internet
 Web cam (some are built into the computer)
 Functioning microphone
 We will also be using email to further communicate
 Clients will watch/have access to videos, sound, and whiteboard for psychoeducation and further aid in the
client’s treatment and understanding of their symptoms