Skype therapy in English vs. in-person therapy in a second language
February 6, 2018 10:16 PM   Subscribe

Looking for guidance about whether to do therapy via Skype in English (my native language) or in-person therapy in a language in which I am generally proficient but not fluent.

I live in a second-tier city in a non-English-speaking country, and English-speaking therapy is not available here. My mental health and functioning have gone off a cliff since relocating last year, and therapy is urgently needed before things get worse. I'm currently trying to decide whether to pursue therapy online via Skype with a US-based practitioner or in-person in the local language. Both these options seem to have pros and cons: the in-person aspect seems quite important to the therapeutic relationship, but on the other hand I've noticed that the emotional impact of words doesn't feel as strong when I'm speaking in the local language. I would love to hear any personal experiences from MeFites who have done therapy under either of these circumstances: was it actually useful? Are there ways to compensate for these disadvantages?

I should also mention that after doing some internet research, I feel my possible issues include trauma/CPTSD, social anxiety, general anxiety, depression, and maladaptive coping styles that may be a part of NPD or BPD. I am not interested in therapy that is mainly CBT-based as I found this to be unhelpful when I tried it previously.
posted by anonymous to Health & Fitness (9 answers total) 3 users marked this as a favorite
I wonder if Talkspace is a good solution for you. Haven't tried it myself. Good luck.
posted by mdonley at 1:14 AM on February 7, 2018

I see a therapist in a language I speak well but am not native in, one of the reasons it works is that my therapist speaks some English, so if I ever can't think of a word, I can say it in English. Do you think this would be the case where you are? I also make notes before the meetings if there are things I want to discuss that I'm not too familiar with the vocabulary.
posted by ellieBOA at 2:49 AM on February 7, 2018

Consider how you are with people in-person vs Skype/google hangout, etc., and if being online-only may factor in for how you show up. Some people carry off online well, while others connect better with the immediacy of in-person. We communicate with more than our spoken languages.
posted by childofTethys at 5:58 AM on February 7, 2018

I don't think there's a single answer for this question. For one, there are licensing and insurance issues. In the US, licensing is by state so I am not licensed to do therapy via skype to people in other states (forget other countries). (I'm a therapist but not yours.)

Depending on the kind of therapy you need/want, having a relationship (therapy is a relationship) with someone who doesn't speak your native language will feel differently to you than with someone who speaks your native language. If one of your issues is feeling isolated, this will play out in the therapy. If, on the contrary, your issues are around feeling invaded or enmeshed with others (e.g. family) it may feel safer to you to have the distance of a foreign language.
posted by Obscure Reference at 6:38 AM on February 7, 2018

I have done this - (a specific kind of) talk therapy via Skype, over a year. Worked fine for me. I developed a trusting relationship with the person. The therapy accomplished a great deal for me. YMMV - a lot depends on how easy it is to get a setup where you will be alone and undisturbed while on computer for the duration of the session, how good your internet connection is, etc.
posted by Ziggy500 at 6:43 AM on February 7, 2018

Aside from language, I would also consider if cultural differences will come into play with a local therapist.

A local therapist might be an advantage if your problems relate to adjusting to local customs.

On the other hand, a US therapist might be more in tune with your cultural background and how it affects you.
posted by duoshao at 7:58 AM on February 7, 2018

I have just done a few "transition" Skype therapy sessions with my (existing) therapist after moving country. I didn't find those to be very different to seeing her in person, but I've known her for yeeeaars so that may help. I'm also not very emotional. Crying over Skype might be weird.

That said, I would find it difficult to do therapy in another language. (Funnily enough, English is my third language, but it's my "emotional" language I've done all my therapy work in and if I try to explain these things in a different language, I really struggle.)
posted by ClarissaWAM at 11:05 AM on February 7, 2018

Prior to finding my therapist through InkBlot, I shared your concern that in-person consultation was crucial to the therapeutic process. But it's not. In my experience, Skype interface has not interfered with my ability to develop a strong, deep relationship with my therapist. On the contrary, the convenience of being able to have sessions from the comfort and privacy of my home has made the experience all the more accessible.
posted by wjfitzy at 7:26 PM on February 7, 2018

Somebody familiar with culture shock might not be a bad idea. Expatriating can suck.
posted by Che boludo! at 8:51 PM on May 18, 2018

« Older Insomnia and work pressure and getting through the...   |   Epub/Mobi/Pdf reader Newer »
This thread is closed to new comments.