Autism at work: the missing workforce

Why are so many autistic people missing
from the world of work? Rachael Klug explores the reasons that lie behind the exclusion and suggests ways both for organisations to become an ‘autism friendly’ employer, and for workplace therapists to better support our neurodivergent clients.

It was with a heavy heart that I read recently that only 22% of adults diagnosed with autism are in some kind of regular employment.1 I was saddened but not surprised as it brought home to me the stark reality of how difficult it can be for autistic people just to get a foot on the employment ladder. I’m writing this article as an autistic person, a mother of three young autistic adults, as well as a therapist who specialises in working with neurodivergent clients. It’s something that touches me personally and professionally, and I’m left with a sense of sadness at the number of autistic people who routinely have their opportunities to aspire, and progress, curtailed simply because they are excluded from the workforce.

Facts and figures
According to the Office for National Statistics (ONS) 2 ,332,600 people were diagnosed with autism in the UK in 2021. This means that over 250,000 autistic people were without regular
employment. If we compare the employment rates of 80% of non-disabled people and 47% of disabled people, it is an even more worrying picture, as autistic people had the highest rates of unemployment out of all disabled groups. 2 The ONS found that out of all categories of disablement including hearing impairments, breathing problems, diabetes, heart problems, severe learning difficulties and mental health issues – that autistic people had the lowest rates of employment. 2 While a resounding 77% of unemployed autistic adults say they want to be employed, 3 just a mere 16% are in full-time employment out of the 22% that are employed.1 Too many people remain undiagnosed or are on lengthy waiting lists for an autism assessment, which means they are left out entirely left out of these employment figures.

This is taking place at a time when the UK is experiencing serious labour shortages, and ONS data reveal that almost a third of UK businesses are struggling to recruit staff. 4 This backdrop begs the questions: ‘Why are so many autistic people not engaged in employment?’ and, ‘What does it mean for the therapy profession and how we respond?’ In this article, I explore these questions and share my reflections, which draw on both my personal and professional experiences of navigating the world through the lens of autism, with a focus on how our education system, the world of work and the wider therapy profession respond to people with autism.

What is autism?
Autism is a spectrum condition and affects people in different ways. While it is not entirely clear what causes it, recent research points to strong genetic factors which shape how the brain develops. 5 As an autistic person, you may or may not identify as disabled, but for me and in this piece, it refers to the impediments we autists face socially, culturally and in our lived environments. Like all people, autistic people have their own strengths and weaknesses, but it is usually diagnosed by looking at three key areas – social communication and interaction, repetitive behaviour and sensory issues.

What happens at school?
Too many of our autistic children are required to attend schools where they are expected to fit in and conform to environments that are just not suitable for them. Sensory overwhelm in noisy
classrooms, long school days without breaks, and the social pressure to fit in with peers can leave a toxic legacy of trauma in many cases. If we add in the likelihood that autistic pupils will
experience severe bullying due to ‘being different’, inflicting wounds of deep shame, with increased levels of anxiety and isolation, it’s inevitable that it all takes its toll. 6

Seeing themselves to blame, they turn their frustrations and emotional pain onto themselves, with the terrifying consequences of high levels of self-harming and suicidality in this group of young people. A recent workshop for the Anna Freud Centre, reported that between 11 and 15% of all
patients at risk of attempting suicide are autistic and that 41.4% of people who died by suicide may be autistic.7 If you consider that 1% of the population is autistic, these suicide rates underline just how deadly isolation and stigmatisation are for the autistic community. 6 This all leads to too many young autists leaving school having been failed by the school system itself. Researchers at University College London published a study of 500 autistic students, and found that a staggering 43% of these students were persistently absent from school. 8 The same study also found that the chances of missing school were almost 100% when the students attended a mainstream school rather than a specialist school.

This study underscores the contention voiced here that autistic young people are being let down by the school system. In my practice, I see autistic young people who are left so physically and mentally wounded from school experiences that they are unable to seek regular employment, at least for some years while they recover. So, what does this physical and mental wounding look like for autistic people?

Masking and lack of support
Exhaustion arising from what is known as ‘masking’ can be intense, and can combine with a liturgy of physical ailments, from IBS to intense periods for young women, to migraines that all add up to a high risk of autistic burn out. Young autists learn to mask to try to hide their autistic traits in a desperate attempt to try to fit in, as well as to avoid the stigma of being seen as ‘weird’ or ‘the oddball’. Masking takes a heavy toll, both mentally and physically, on the individual.

The task of trying to access medical support, GP appointments and specialist care, can become an overwhelming pressure for parents and carers. Without financial, emotional and practical support, families are often left struggling, which can exacerbate vulnerabilities, and perpetuates a lack of independence for the young autistic person. Unsurprisingly, with public services so strained, autistic young people are overlooked as waiting lists for assessment grow, and many wait years to receive a diagnosis. The sheer number of obstacles to accessing support can further the autistic person’s sense of isolation, which can in turn impact the individual’s engagement at school, in their community and wider society.

Leaving education in a heightened state of overwhelm is hardly conducive to starting out in the world of employment. Too many young people with autism can find that their late teens up until their early 30s are often spent in recovery from trauma and burnout. I’ve known young autistic people barely able to function, too exhausted to care for themselves or to even leave their home. It can last for months and even years, leaving a legacy of feeling broken and overwhelmed, which continues well into adulthood if left unhealed.

Given the current state of our public services, there are no quick answers, but if we wish to redress this imbalance in rates of employment for autistic people, we will need to look at how our mainstream education system treats young autistic pupils, and it’s long overdue that we find better ways of supporting them.

Applying for jobs
When entering the world of work, young autistic people find that they meet familiar challenges from their days in education. Firstly, there are application forms to navigate and filling out forms can be really confusing for those of us who are autistic and neurodiverse. If you also struggle with dyslexia or ADHD, as many autistic people do, the seemingly simple task of form filling, can feel like being asked to tie your shoelaces using only your teeth; unless you’re a serious contortionist, it’s simply impossible.

The information the employer requires may not be clear to those who are neurodiverse, leaving questions such as: ‘What might I include in a personal statement?’, ‘How do I write about my strengths’ and, ‘What I might bring to a particular job when I don’t like talking about myself?’ For the autistic person, these application processes can be so confusing and overwhelming that they can feel that they have failed at the very first hurdle, without the form even being completed or sent.

Next, there is the interview process. At this point, any autistic person may omit a loud groan. If you have ever been prepped for an interview, the usual tips for good interview etiquette are to keep good eye contact with the interviewer, speak confidently about yourself, convey ease and knowledge of the job, shake the person’s hand. Every single one of these tips can be hellish for many autists to attempt.

I once went for a job interview in which I managed to keep masking my high levels of anxiety for the first part of the interview. However, by the time I had to face the interview panel, I had such a strong migraine that I was effectively blinded. I just pretended I was OK and simply turned my head
to the sound of someone’s voice – I was very good at masking in those pre-diagnosis days. I could conceal the blindness I was experiencing from the migraine, which was triggered by intense
anxiety, and it never occurred to me to say, ‘I have a migraine’.

‘I’m new here’
It’s usual that a new job is rather daunting but for the autistic person, there is so much more to be negotiated. Typically, problems will occur for the new autistic employee if they are unclear about what is being communicated and asked of them; if the work environment is noisy or bright because sensory overload can become intolerable; or if the autistic person begins to feel overwhelmed, isolation and meltdowns can occur which can trigger any trauma and shame from childhood experiences.

What can employers do?
While it may appear that the picture is a bleak one for the small numbers of autistic people who do enter the workforce, I am optimistic that there is plenty that can be done to improve the situation. This begins with employers, and a good example of best practice can be found at Career Accelerator, a leading UK education business that is focusing on improving the lives of neurodiverse people, and aiming to connect neurodiverse students with prospective employers.

The employer, Pearson, recently took part in a programme to match employees who had lived experience of neurodiversity to mentor students into the workforce. Kevin Lyons, a Senior HR Manager at Pearson explains: ‘We participated in the Career Accelerator programme with our employees as mentors to expand their knowledge and understanding of neurodiversity, while also benefitting from mentoring young neurodivergent people. By embracing neurodiversity, we aim to attract and retain a diverse neuro-inclusive workforce and foster a culture where everyone can thrive. Since the programme, we have changed our recruitment processes to ensure we can attract more people who are neurodiverse.’ 9

It is a promising start that is to be welcomed, bridging the gap between school and entry into employment in a way that highlights both inclusivity and understanding. Elsewhere, the
National Autistic Society, in association with the Bloomfield Trust, is providing a programme aiming to address the imbalance in the rates of autistic people in employment by providing candidates for employment with pre-employment training and workplace support, while also giving employers
support, resources and training in neurodiversity.10

The Anna Freud Centre, reported that between 11 to 15% of all patients at risk of attempting suicide are autistic and that 41.4% of people who died by suicide may be autistic7
Researchers at University College London published a study of 500 autistic students, and found that a staggering 43% of these students were persistently absent from school 8
The same study also found that the chances of missing school were almost 100% when the students attended a mainstream school rather than a specialist school.

There was further positive news in April this year, when the UK Government announced it would be undertaking an autism employment review and that it is working closely with the charity, Autistica ( It will begin by asking employers, employer groups, groups working with autistic people and autistic people themselves to identify the barriers to job searches and career progression, before moving on to develop solutions that work both for autistic people and for employers and public services.

Writing in The Guardian, the Minister for Disabled People, Health and Work, Tom Pursglove, and the Conservative MP, Robert Buckland, outlined their intentions: ‘We want more autistic people to reach their full potential and live the rewarding and fulfilling lives they deserve. In particular, employers need to stop seeing autism as a drawback and recognise it as an asset.’11

These initiatives are steps in the right direction, but much more needs to be done, and the finances and resources need to be available to match any promises made. So often, professions that are attractive to those with autism include archaeology, engineering and computer programming, but it’s important not to fall into the trap of making assumptions about the kind of work that autistic people can do, for we can work in many different settings, including as therapists.

Coming out at work
The writer, Susan Dunne explains how when she was diagnosed with autism later in life and told her peers at work, they responded with, ‘We always thought you were a bit weird.’12 Those of us with autism will be very familiar with the ‘weird’ label, and the feelings of isolation and shame it can engender. She also recalled those who thought her autism diagnosis meant that she was now incapable of continuing with the job that she had been doing for years.12 Line managers need training and support in how to manage a neurodiverse workforce, and know when and where to signpost autistic staff for help.

The therapy profession
Therapy can offer a space in which the autistic person’s strengths and abilities can be explored and their vulnerabilities held, but therapists supporting young autistic people into work
or higher education have a pivotal role to play. However, I believe that specialist training is required for therapists to be able to understand how best to work with their autistic clients. It’s worth acknowledging that our profession still sees autism as a ‘disorder’, a ‘deficit’ and ‘impairment’. The Anna Freud Centre has recently launched an autism training programme in collaboration with AT-Autism for NHS England.14 The training programme has been co-designed, produced and co-delivered with autistic people to promote an ‘experience-sensitive, trauma-informed’ approach. It is such a positive step forward in challenging the myths around autism by including autistic people in devising the training programmes. We are also seeing growing directories of autistic therapists – these can
offer neurodiverse clients a connection to a specialist who is likely to have a lived experience of working through many of the issues connected with autism with which they are struggling.

Closing thoughts
I’d like to caution readers that despite the stereotypes that exist in popular culture, not all autists possess extraordinary talents or abilities like the character played by Dustin Hoffman
in Rain Man. Indeed, this view of autists can become a stereotype that hampers both access to support and also early diagnosis – but with the right conditions in the workplace, we can all bring our unique perspectives and gifts, if we are given the chance.

Our strengths can enrich the working environment, for example, when we bring our rigorous approach and attention to detail to tasks, or when we notice ambiguity in the channels of
communications and ensure that it becomes clearer for everyone in the workplace. As society gets better at understanding the needs of the neurodiverse community, I’m hopeful that the therapy profession will also become more embracing of the fact that there are autistic therapists (I am one), psychologists and carers, and we can all be empathic too. I hope this article contributes to the growing conversation about
autism, work and the therapy profession; and in the process, gives a voice to some fellow and future autists whose experiences of the workforce have been missing for far too long.

Rachael Klug

Rachael Klug BSc, MSc, PhD, BACP Accred is an autistic therapist and supervisor who works in a private, online setting. She is a Director of the Association for Counselling and Therapy Online
(ACTO) and specialises in working with neurodiversity and trauma. Rachael’s special interests are walking her dog, meditation, birdwatching, and sometimes Arsenal – if they are doing well!

This article first appeared in the October 2023 issue of BACP Workplace, published by the British Association for Counselling and Psychotherapy. ©BACP 2024

1 National Autistic Society. The Autism Employment Gap. [Online.]
employment-gap (accessed 26 July 2023).
2 Office for National Statistics. Outcomes for disabled people in the
UK: 2021. [Online.]
bledpeopleintheuk/2021 (accessed 26 July 2023).
3 I Am Autism. Autism: Support at work. [Online.] www.i-am-autism. (accessed 3 September 2023).
4 Office for National Statistics. Changing trends and recent
shortages in the labour market: 2016 to 2021. [Online.]
ntshortagesinthelabourmarketuk/2016to2021 (accessed 3
September 2023).
5 National Autistic Society. The causes of autism. [Online.]
the-causes-of-autism (accessed 24 August 2023).
6 Autistica. Supporting autistic children and young people
through crisis. [Online.]
Crisis-resource-2020.pdf (accessed 26 July 2023).
7 Cassidy S. Suicidality and self-harm in autistic people.
A presentation at the Anna Freud and AT-Autism Community
of Practice Event; 23 May 2023.
8 University College London, Brain Sciences. School absence and
refusal high among students with autism. [Online.]
high-among-students-autism (accessed 25 August 2023).
9 Career Accelerator. Why hiring neurodiverse staff is good for
business. [Online.]
verse-staff-is-good-for-business (accessed 26 July 2023).
10 National Autistic Society. Autism at work programme. [Online.]
programme (accessed 3 September 2023).
11 Purglove T, Buckland R. Autistic people often out of the
workplace. That should end. The Guardian 2023; 2 April.
(accessed 26 July 2023).
12 Dunne S. Autism in the workplace: Always thought you were a
bit weird. The Guardian 2015; 25 June.
workplace-always-thought-you-were-a-bit-weird (accessed 26
July 2023).
13 Milton DEM. A mismatch of salience: explorations of the nature of
autism from therapy to practice. Brighton: Pavilion Publishing and
Media Ltd; 2017.
14 Anna Freud Charity. National Autism Trainer Programme. [Online.]
(accessed 26 July 2023).

Blog Events

How to risk assess effectively working online

“Safeguarding needs to run through us like letters on a stick of rock; it is the bedrock of what we do,” Pippa Copleston

Free Workshop: Wednesday 10 April 2024 – 1.30 pm (1 hour)

Pippa Copleston is a practising counsellor with 25 years’ experience. Based in East Sussex, Pippa provides Online, In person and Blended Counselling, Psychotherapy and Clinical Supervision.

This April and October, Pippa is running two workshops specifically for ACTO members, to give practitioners valuable insight into risk and safeguarding issues whilst working online.

Below, Pippa explains why she passionately believes that safeguarding is so important, and provides detailed information about the free workshops.

Why are you passionate about the importance of safeguarding?

Since working online since 2016 it has become clear to me that there is little information or training available specific to therapists wishing to work online – apart from dedicated online courses. I have been fortunate enough to work as both a therapist and then as a Clinical Lead with safeguarding responsibility in an employed capacity for online providers. In these settings, I have worked using variety of delivery methods, including anonymous text based therapy, telephone counselling and other settings where safeguarding is a little trickier than for in-person therapists. During the pandemic, I used this experience to ensure that I was working as safely as I could remotely. During lockdown,  I was concerned by some attitudes and assumptions that I came across; that working online was no different to working in person, and so chose to take a General Certificate to increase my skillset and formalise the experience I had. I followed this by completing a Diploma in Online and Blended Supervision, and through doing this, recognised the need for Supervisors also to have good knowledge of safeguarding and risk when supervising online therapists. Safeguarding is relevant to all age groups, and therefore, all clients.

What is the objective of the workshop/webinar?

The aims is to share some ideas about good practice, stimulate thinking and reassure therapists that although this is a tricky area it’s still possible! I believe that we all continually learn from each other, and so I welcome additional ideas and knowledge from participants.

What are the intended outcomes of the session (what will participants learn/benefit from)?

The first session will look at:

  • How and why we risk assess
  • The “pros and cons” of using formal established assessment tools
  • How we risk assess effectively in our particular work setting, and to share useful resources.

There are “points to consider” throughout the presentation, just as a reminder to update and assess how we keep our clients and ourselves safe, particularly if working with clients not based in our country. The session’s aim is to encourage participants to further develop the processes we currently use and create up to date resources for clients and ourselves after the session with peers or in supervision.

What will be included in the following sessions?

The next session in October 2024 will be about effective safeguarding – i.e. what to do after risk has been identified, depending on our geographic location and that of the client, their age group using the resources that we have adopted. There are two sessions as one hour is not enough to cover both topics sufficiently.

I intend to run much more in depth training expanding on the topics covered in the two workshops, and am hopeful that this will be CPD of around 30 to 40 hours, presented live and using interactive activities. I hope that this may lead to peer groups being formed after the training is completed. I also intend to produce modular, recorded versions of training.

What are the main risks around not following safeguarding guidelines?

So many! Very briefly, obviously, client safety and /or that of others, including suicide or physical harm. There is also risk to us in terms of professional reputation and risking have a complaint raised or legal proceedings. More widely, we owe it to the profession to be robust and clear in how and why we keep our clients safe so that therapy, particularly remote provision, is recognised as safe and contained.

Are there any emerging new risks around safeguarding – and how do we approach these to reduce risk?

There are always emerging new risks, particularly as we are all using the internet. The increase of risk for harm and exploitation is especially evident the more that the disinhibition effect influences what people say and what people hear or trust. There is more risk of exploitation, and greater access to online therapy means that as therapists, we have exposure to far more clients and risk is not always obvious. Statistically, therefore, we are in a position where we may be exposed to potentially more risky presentations and disclosures from clients. This is where safeguarding training and updating this training, keeping abreast of new developments and being risk aware is, as it always has been, important.

In your view, what constitutes safeguarding?

Briefly, safeguarding needs to run through us like letters on a stick of rock; it is the bedrock of what we do. Good safeguarding is about being clear about our rationale for what we do, without be hyper vigilant. Safeguarding is not always clear cut, risk can be nuanced and often involves being brave and making a well-founded decision in the moment. Therefore, the guidelines we follow and the supervision that we have needs to reflect this to show that decisions and actions we take are well founded, not dismissive, negligent, hasty, or damaging to the client.

Blog CYP

“I really enjoy working with children and young people…they take positive risks”

New ACTO Chair and accredited integrative CYP therapist Basi Amodu shares the motivations behind her career choices and priorities for the organisation

Basi Amodu did not initially set out to be a therapist.

During the early stages of her career, Basi had a number of differing jobs before becoming a mother, ranging from location and reportage work in Cuba and South Africa to working in the property management industry. Then when she became a mother and decided to work within her local community in a local library, she successfully applied for a role at a school as a Home School Coordinator – a bridge between, home, school and Children’s Services. This proved to be a seminal moment. Assigned to working with families impacted by alcohol, substance misuse, mental health and domestic abuse, Basi could see how positive changes in the family environment were less significant for the smallest children in those families. Basi’s sole mission became how to make systemic changes using the statutory bodies that would benefit the children, young people, and their families to help them have the best possible start in life. In conjunction with this, Basi also became the Project Coordinator for the Young Carer’s Service in area of West London. This fostered Basi’ ambition to work garner more support from the statutory bodies that had the resources to effect real change in the lives of young people and their families.

Building the foundations for a career in counselling and therapy

Much of Basi’s work involved working with families impacted by mental health, substance/alcohol, and domestic abuse – often referred to as the ‘toxic trio.’ Although Basi enjoyed the work, she realised that to help get the families more financial and practical support, she needed a new form of language and additional skills to advocate on behalf of her clients.

A chance conversation with a colleague pointed Basi in the direction of a new foundation course in counselling children which encouraged her to apply. In due course, Basi not only completed the foundation course but went on to study for a postgraduate diploma in counselling and immediately after the master’s degree in counselling at the University of East London.

Basi explained:

“Domestic violence funding was being stopped and I realised that I wanted to focus more on children and young people. By developing my therapy work, therapeutic skills and drawing on my experience and background, I could assist more disenfranchised children and families, ensuring that they received the crucial early intervention they required.”

“Children are not as afraid of change as adults are.”

Developing strategies for coping with change in our lives can be a challenge for all age groups. One of the reasons why Basi finds it rewarding to work with younger age groups is her belief that children and young people are more willing to take positive risks – and are arguably not as afraid of change as adults are.

Basi said:

“Children and young people know that when we meet for a therapeutic counselling session, they are coming into a space to talk about difficult things. I use my creative and listening skills, to provide a safe space that allows young people to challenge their lived experiences, offers them the opportunity to explore and express themselves without judging them. These methods help children to find the answers to the questions they are struggling with themselves.

“I find it incredibly rewarding to accompany young people on their journey – even if I may not see the eventual positive changes in their lives in the future.”

It is not only working with children and young people that Basi finds fulfilling professionally. Helping parents to deal with challenges in their lives is equally satisfying, for example working with parents to understand their parental struggles often stem from a space of fear (not wanting to repeat mistakes) and love for their child. Supporting parents to explore their role not just as parents but also as people in their own right. One way of doing this is to offer space for parents to understand their own school and childhood experiences. For Basi, it is important that this process is a collaborative one without personal judgement.

The transition to working online.

The advent of the COVID-19 pandemic resulted in therapists and counsellors moving their practices online as lockdown restrictions were enforced during 2020/1. For some therapists this represented a major challenge, getting to grips with technology and seeking to offer clients a comparable experience to that of a face-to-face session. Yet not for Basi.

Basi had already gained online experience using Skype to work with younger clients who had were now at university and wished to continue their sessions virtually without having to find another therapist.

This experience encouraged Basi to further research the benefits of working online, for example in countries like South Africa, Ethiopia and Canada had been using ‘Telehealth’ before the pandemic as a lifeline for many in remote communities. Many of Basi’s clients viewed online working as a backup; not perfect or a long-term solution, but one which could work for some of her clients.

In March 2020 the pandemic hit whilst Basi was working privately and within a digital school. Due to having family in Europe Basi was able to prepare her private clients for the transition to online working, sharing creative resources, coaching families with using Zoom and other platforms, and re contracting the work. The clients were practising using the video and live chat platforms in the months leading up to the first UK restrictions. The transition to working online was rapid but Basi was prepared as were her clients. Once the UK government shut the country down the new service launched within 24 hours.

Basi said:

“This period was incredibly intense. I was working with a full cohort of students, and we knew that restrictions to face-to-face contacts were imminent.

“We were thoroughly prepared though, providing briefings for parents, and explaining how it would work. The result was that it was a seamless experience for our young clients. That’s not to say that it did not have its own challenges; and like many thousands of therapists and counsellors, we were training as we were delivering!”

Working online has therefore been an extremely positive experience for Basi, so much so that although she continues to work in person in school, her private practice and clinical supervision work is online only.

Addressing the concerns of practitioners on working online

Basi understands the unease that some practitioners feel about working online. She explained:

“I appreciate that some therapists and counsellors are uncomfortable about working online. They have concerns about their abilities to pick up non-verbal clues from their clients, they feel that it is difficult to maintain the same connections – and perhaps believe that online is not appropriate for dealing with specific issues. I am aware too that some professional bodies have a view that it is not possible to work with certain cohorts, for example clients under 11 years of age. Furthermore, some individuals are not confident about working with the technology and feel limited by it.

“These are all legitimate concerns – which as an organisation supporting online practitioners we need to be fully understanding of. Nonetheless, there are many reasons to be excited about the benefits of working online.”

In Basi’s opinion demonstrating how practitioners can work with different traumas and issues is key to convincing those who are either sceptical or have yet to try working online:

“Working online is not an emergency system; it is another way of working which can offer many different ways, and tools, for you to work with clients.

“There are several therapists who are using technology in innovative and exciting ways to work with children and young people, such as Lesley Simpson-Gray,  Jessica Stone and Ellie Finch.

“By working online, we do not only expand our reach, but we also expand our skills and our competencies – ultimately offering more choice to our clients.”

These experiences convince Basi that online working has increased her creativity, boosted her confidence, expanded her contacts – and helped her to work with clients who find the in-person sessions daunting due to concerns about body image or for reasons of disability or accessibility. Where appropriate, Basi can work without a camera and use Live Chat to communicate.

Working online internationally does though have other important considerations.

Basi is an Associate Member of the Barbados Society of Psychology and understands how legal systems can differ in countries across the world. This makes it crucial to be mindful of client safety, as the laws and regulations governing a territory could be very different to the UK. In addition, it is essential to undertake the necessary training and groundwork to ensure that as a therapist or counsellor, we have the appropriate set of competencies to help a client overseas.

The future of ACTO

This year saw Basi elected as the new Chair of ACTO in succession to Adrian Rhodes.

Basi explained that it although she did not put herself forward to do it, it is a role that she is now relishing – and is keen to make sure that ACTO focuses on delivering more benefits to its members. She explained:

“When I agreed to be Chair, I was clear that I was not just a director but a member, too. This means that it is important that we increase the services and benefits we provide to our members, whether they are students, professionally qualified or in supervisory roles.

“That is why I have a number of priorities for the coming year and beyond.

“Firstly, we need to incorporate our training providers more closely within ACTO, helping members and potential members to access the professional training they need.

 “Secondly, we want to grow our membership – and this requires us to be seen as the leading body in the UK for online digital working; driving up standards and showcasing innovation which benefits our clients. This also necessitates that we understand that as newer members qualify, they may have different needs from those who have worked online for many years. We must change and adapt.

“And finally, we must be ambitious. I feel that one of ACTO’s long-term aims should be to be regulated by the Professional Standards Authority. This would give both members and clients greater protection and more confidence about our status. It is likely to involve significant work – but for me, it represents a real opportunity to grow and professionalise the organisation.”

Basi Amodu was talking to Simon Frost


About Basi Amodu

Basi is a MBACP (Accred) of the BACP and an Associate Member of the BSP (Barbados Society of Psychology) and Chair of ACTO. She is an integrative creative therapist in schools and private practice working with children, young people (CYP) and adults. Basi also works as a clinical supervisor working with therapists and other experts in the helping professions. For further information about Basi please click here.

ACTO conference 2023

ACTO is hosting its next annual conference on 4 November 2023. More information will be available on the news and events pages soon.

Blog Diversity

Two Voices: National Refugee Week

ACTO directors Olivia Djouadi and Adrian Rhodes reflect on their different experiences

National Refugee Week takes place the 19 – 25 June, in recognition of World Refugee Day on 20 June. The week-long events are a festival celebrating the contributions, creativity and resilience of refugees and people seeking sanctuary.

In celebration of this event, ACTO invited two directors of the Board to write about their personal experiences. Here are their respective stories.

Olivia Djouadi

Olivia Djouadi is a qualified psychotherapist and a decade ago married a refugee from North Africa. She shares her experience of being married to a refugee including the political issues they faced around people’s attitudes towards immigrants and immigration.

Olivia: I met my partner and we fell in love straight away – indeed, four months later we were married.

Being now married to a refugee, I was a bit taken aback by the views expressed by many people about immigrants. At the time, I was a student doing an MA in British politics and I was hoping to work in Parliament. I was stunned that so many negative views existed still to this day, particularly given our experiences from history.

It was a very difficult time for me. I was studying for my master’s and during that time they sent my husband back to a war zone which Britain deemed safe. My tutors gave advice but I was also told by others why we were not accepted – I was female, I had a chronic illness, my surname was my married name, and I didn’t have full time work as a student.

We were given a meeting in Tunis as my partner’s country was in a war zone; so we both flew there. Each of us had separate and very intrusive interviews that were shocking. This upset us both and we began to realise our marriage may be over. My American friends who were married to British people in the UK never seem to have this treatment. Fortunately, the interview went in our favour and after 6 months my husband was able to return to the UK to live with me.

A change of direction – working at a refugee centre

I decided to give up  my politics degree and I went in a different direction working in refugee centres in the UK in SE London.

I also recall one particular incident. At the refugee centre where I worked the then home secretary came for a visit. I was very pregnant at that time. I saw red and went rushing over as I wanted to ask if he was going to send my babies father back to a war zone. Thankfully a colleague stopped me and led me away.

My partner found work and met all the requirements asked of him.  Many however didn’t from those I supported at the refugee centres. I enjoyed my work though; I found that I had an aptitude for helping people who had  been living in war zones who had what looked like Complex PTSD. Looking back now with my experience and training as a psychotherapist, I know now this is what they had.

Another concern at the time was after 9/11 in America anyone who looked Muslim received unwarranted comments; this continued to when our kids went to secondary school. The events of 7/7 in London was another challenging period – but pointing towards 3.7 million Muslims in the UK is not fair and is discrimination.

 Adrian Rhodes

Adrian Rhodes is the past chair of ACTO, a qualified psychotherapist since the 1980s as well as a Clergyman in the Church of England. In 2022 following the invasion of the Ukraine, his family invited a Ukrainian refugee family to stay at their home in Manchester.  


When the war broke out in February last year, a psychotherapist colleague in the Ukraine sent out an appeal asking for someone to host his family whilst he stayed behind. My wife and I had the space to share in our home – and it seemed to us to be a very small thing to do – helping other people in such a tragic situation.

Arrival: first experiences of life in the UK

Six weeks later the mother and her two children – a son who is 11 years and a daughter aged 9 arrived to stay with us in Manchester. They have now been with us for a year. Whilst their paperwork to enter the UK was being reviewed, they stayed with another psychotherapist colleague in the Netherlands. On reflection, I think that this ten week delay in arriving here helped them a bit to get over the initial shock of having to leave their husband and Dad at the Polish border – on the day of his birthday.

The UK represented a place of safety, nevertheless not surprisingly this whole experience has been a challenge for all the family. The children struggled at first, especially the son, and still talk of their experiences of the war. However they can still see their dad on a daily basis online – whilst not the same, it does keep them in contact.

Fortunately we got  the two children into school very quickly and they are now flourishing.

Language has been a problem for the mum and the son. But the daughter’s English (she could speak a little of the language when she arrived) has been very good from the start; indeed, she is now fluent.

Understanding and dealing with cultural differences

One of the other challenges for them has been to get used to the different pattern of life here in the UK, and the fact that they are missing Ukrainian customs.

Holding onto their culture and identity is clearly important to the family and they have made a number of contacts with the Ukrainian community in Manchester, which is historically strong.

For us, my wife and myself, it’s been a delight having them.

What of the future?

The future obviously remains troubling and very uncertain. I feel that their main challenge – and that of many Ukrainians living here perhaps – is how to move on. It’s not easy living in someone’s home. Culturally the UK and the Ukraine are very different in many ways; and views differ, for example, on the appropriate roles and tasks for men and women. I think it was quite surprising for the mother to see me washing up as a man!

They are enjoying their life with us, and we really enjoy spending time with them. However at some point they will face the issue that refugees all face to enable to stay in the long-term, for example getting a job, building up money to pay a deposit for renting a properly by themselves.

The schools the children currently attend are good. How do they move on though? This may mean need to move schools, further disruption to their education.

Finishing on a positive note, the response from the local community has been incredible. On Christmas Day we had the doorbell ringing several times and presents were left from people we did not even know. Also, local people are inviting them to birthday parties and the family have received donations of an iPad and the like. It has been wonderful.


Trauma Special Interest Group

ACTO is setting up a Special Interest Group for practitioners specialising in trauma related issues. Find out more about the group below.

Who is the group for?

This group will be for individuals who want to explore and share their understanding of working with clients online who present with a history of past or recent trauma(s).  As we begin to consider the topic some initial questions came to mind.

What is trauma? 

It comes in many shapes and sizes and often comes in disguise. Put simply, it is often defined as an experience, or traumatic event, that we find deeply distressing that can cause us to think, feel and behave differently either in the short-term or throughout our lives. However, whilst each of us may have a different perception of trauma and how we uniquely respond to it, there are also many common elements in how our minds and bodies respond. 

The role of the Trauma SIG

In this group we can look at ‘what is trauma?’:

  • What difference does working with trauma ‘online’ make?
  • How confident do we feel?
  • What special considerations might there be?
  • How can we support our clients to navigate these difficult experiences to start their journey of healing? 
  • What helps?
  • What do different clients need?
  • How can online talking therapies and creativity play their part?
  • What does the literature have to say and what specific guidance is there?
  • What experience have you had and have there been any particular learning curves you have experienced?

We might also be interested to think about ourselves as therapists and vicarious trauma. When we are working ‘remotely’ online how do we ensure we are not working in isolation and suffering as a result.

These are some of the questions that we have come up with, but you may have questions of your own to bring for discussion. This group to be led by members active participation.


Next meeting will be held via Zoom on Saturday 27th January 2024. Contact us via email below for access details.

Contact Us

If you are interested in building a community of practice working online with trauma, then please email:

Liz Harrison


Deep Diving in the Unconscious: accessing hidden parts through the aesthetic and emotional nature of Music

Join Helen Mason for our latest free webinar and discover the benefits of this exciting form of creative therapy 

Friday 2 June 2023 

11.00 – 12.00 midday 

Music has long been a passion for Helen Mason. When she was in her 20s living in Oxford, Helen worked as a musician playing flute in a band, touring and performing in both the UK and abroad. Nowadays Helen continues to enjoy a wide range of different types of music including electronic composition and playing the classical piano – combined with her role as a qualified music therapist. In this article, we explore why Helen decided to change career to help clients, using the power of music.  

Inspiration and discovery into the world of music therapy  

Helen’s journey into music therapy came following an opportunity to work in a local hospital with patients experiencing various mental health conditions. It was a profoundly moving experience; and showed how music could make people more relaxed, connect people socially and reduce isolation.  

  A change of career beckoned; and Helen moved to Bristol where she commenced her Postgraduate diploma in Music Therapy training under the guidance of Professor Leslie Bunt, a very respected music therapy practitioner and trainer.   

  Helen is a qualified music therapist registered with the Health and Care Professions Council (HCPC). She has had over 30 years’ experience working as a music therapist with a diverse range of client groups, mostly adults, in a variety of settings including the NHS. Having done a further in-depth training in Music and Imagery she is also a Fellow of the Association of Music and Imagery (FAMI). Some of her clients work in the creative industries, such as writer’s and film makers. Helen also enjoys her work with arts therapists and counsellors in training, offering supervision for Guided Imagery and Music practitioners and students.   

Music and imagery therapy – providing a sensory and immersive experience  

Therapeutic practitioners are skilled and eloquent in using words to help our clients; talking and listening are of course fundamental to therapeutic work. Nonetheless, therapy using music and imagery offers something different and complementary to written and spoken language – as sometimes words are not enough.  

Helen uses pre-recorded music for her sessions; mostly classical music from western composers. However, she does include music from other composers from different cultures and musical genres too including more contemporary creators.  


Join us on 2 June for our free webinar with Helen Mason  

During the webinar, Helen will provide examples of how the harmonies, melodies and timbre of the sound can offer an immersive experience to the client, helping with healing and growth. Helen will play some musical excerpts as well as sharing images, and give examples of the techniques she uses during a client session.   

The free webinar is on Friday 2 June between 11.00 am – 12 midday:  

More information about Helen Mason  


LinkedIn profile  

Blog Neurodiversity

The Neuro-Affirming Therapist

Blog post for ACTO during neurodiversity week -13th to 19th of March 2023 

The Neuro-Affirming Therapist

What is neurodiversity?

Neurodiversity is a natural and valuable form of human diversity (Walker, 2021). The neurodiversity paradigm is a way of thinking that asserts that among human beings there is a natural variation of minds, and it states that there is a type of mind that is typical, the dominant neurotype, along with populations of neurominorities. This mindset shift offers a framework for understanding and accepting difference, with a special emphasis on comprehending ability and disability differently from the traditional view of those concepts. All variations of cognitive style are valued equally, and strengths and benefits are accounted for, while simultaneously holding in mind the (sometimes, or often, disabling) impact on those people, of a society set up for the dominant neurotype.

For individuals aligned with the neurodversity movement, neurodivergence is core to a persons identity as a human being. Neurodivergent people have found each other in places on the internet, such social media groups and forums. There are benefits of being part of a wider collective, such as meeting other people like you, to hear stories similar to your own, and to share ways to feel encouraged about what life has to offer as a neurodivergent person. Bonding, discussing, or even just reading such things is validating and can alleviate a sense of isolation and hopelessness. 

Who is neurodivergent?

Under the umbrella of the term ‘neurodiversity’ are people that identify with one or more of many conditions: Autism, ADHD, BPD, epilepsy, bipolar, OCD, C-PTSD, Dyslexia, DID, Tourettes, Schizophrenia, NPD, other developmental conditions, and acquired neurodiversity such as dementia and Parkinsons. 

As psychotherapists and counsellors we can work therapeutically with clients in these populations by moving away from thinking in terms of ‘disorder’, ‘disease’, and ‘dysfunction’ being problematic and needing remediation or facilitating into ‘normal functioning’. And instead, move toward an attitude of embracing cognitive diversity as normal and opening up to thriving and wellbing being defined by the neurodivergent client. 

In our therapy rooms, neurodovergent people are deserving of respect and accommodation. They do want to be understood for who and what they are, rather than being defined by what they have had a lifetime of being told they are not. Understanding the neurodivergent clients concept of a fulfilling life may lead to defining the outcomes of therapy, rather than what the therapist may think that the client should achieve. Damien Milton and Lyte Moon wrote a paper entitled ‘The Normalisation Agenda’ which explain that ‘normal’ had become equated with ‘healthy’  and that there was an unconscious professional bias toward seeking to normalise any atypical people for the good of society and for the good oth themselves (Milton, Moon, 2012). Chapman and Bovell (2022) assert that ethical interventions focus on the neurodivergent person flourishing, rather than on normalisation.

Neurodivergent-Affirming therapy

Along with resisting normalising clients (seeking to  hide or ‘fix’ a perceived deficit), psychotherapists and counsellors can bear in mind the following three principles when working with neurodivergent clients. 

  1. Recognise and value alternative forms of functioning and cultivate neurodivergent affirmation in therapeutic practice.
    • This enables neurodivergent thriving and can counter neurotype dysphoria (Chapman, R. 2020)
  2. Facilitate a positive neurodivergent identity with clients
    • Cooper et al stated that ihaing a positive autistic identity protects against mental health problems and encouraged therapists to help facilitate this with clients (Cooper, Smith and Russell, 2017)
  3. Consider confronting clients internalised stigma, when appropriate
    • Bortha and frost have written about internalised stigma being a predictor of higher psychological distress and poor mental health (Bortha and Frost, 2020).

Using the neurodiversity framewrok for understanding and accepting human minds that diverge from the norm, and unguardedly listening to neurodivergent clients conceptualisations and interpretations of social life and relationships, positions psychotherapists and counsellors to understand the issues presented by neurodivergent clients. Gaining perspective on why the neurodivergent client believes that they are in therapy and what they want out of having therapy is, in itself, a huge step toward being a neuroaffirming therapist. As is pursuing the possibly atypical conceptualisation of a fulfilling life. 


  1. Bortha M, Frost DM. Extending the Minority Stress Model to Understand Mental Health Problems Experienced by the Autistic Population> Society and Mental Health. 2020 10(1) 20-34.
  2. Chapman R, Bovell V. Neurodiversity, Advocacy, Anti-Therapy. In Matson JL, Sturmey P, editors. Handbook of Autism and Pervasive Developmental Disorder. Autism and Child Psychopathology Series. Cham: Springer; 2022.
  3. Chapman, R. Neurotype Dysphoria. [Internet] Psychology Today. 2020. Accessed 10.03.2023.
  4. Cooper K, Smith LGE, Russell A. Social Identity, self esteem, and mental health in autism. Eur J Soc . Psychol. 2017 47(7) 844-54.
  5. Milton, Damian, Moon, Lyte (2012) The normalisation agenda and the psycho-emotional disablement of autistic people. Autonomy, the Critical Journal of Interdisciplinary Autism Studies, 1 (1). ISSN 2051-5189. (KAR id:62638)
  6. Walker, N. Neurodiversity: Some basic terms and definitions [internet] accessed 2023.
  7. Walker, N.(2021) Neuroqueer Heresies.  Autonomous Press 


Vauna Beauvais. 

MSc Psychotherapy, Certified Transactional Analyst, Certified Cybertherapist, PGCDip Counselling. UKCP registered Psychotherapist.

Vauna is a UKCP registered Psychotherapist specialising in working with neurodivergent adults.  She has been seeing clients for over 20 years in private practice. She is also a clinical supervisor for counsellors and psychotherapists who are seeing neurodivergent clients and for therapists who are autistic themselves.Discovering at over 40 years old, that she is Autistic with ADHD herself, she turned her interest toward understanding the autistic experience and what that means for therapists, trainers, clinical supervisors, and for autistic clients.Areas of interest over the years have included performance and executive functioning and she has developed a neuroaffirming approach to coaching for people with ADHD or ADD.She is a qualified Coach and Trainer, a Certified Transactional Analyst, and a Certified Cybertherapist, and is currently serving on the board of directors for The Association for Counselling and Psychotherapy Online (ACTO)


Celebrating International Women’s Day

ACTO Directors nominate women who have inspired them in their lives

Today 8 March is International Women’s Day and is a global day celebrating the social, economic, cultural and political achievements of women.

This year the United Nations is marking the day with a theme titled DigitALL: Innovation and technology for gender equality. The objective is to highlight how technology is crucial to advancing rights and the impacts of a growing digital gender gap.

We asked two ACTO directors to tell us about some of the women who have inspired them in their lives.

Mieke Haveman, ACTO’s webmaster:

“There are several women who have inspired me throughout my life. The first is my grandmother, and the second is Aletta Jacobs. Aletta was a Dutch doctor who fought for the right for women to vote in the Netherlands over a century ago.

“Another inspirational woman is Maya Angelou.

“After secondary school I went to Teacher Trainer’s college. We had some American teachers there and I will never forget the first trimester were we were introduced to US literature. A particular favourite was I Know Why the Caged Bird Sings by Maya Angelou. I was blown away by the courage and the willpower of Maya. From very poor beginnings she worked herself up to be the woman who read the poem at President Clinton’s inauguration. I remember watching that with awe as well. She has always stood up for not only black women, but as I saw it for women in general. She used compassion and the power of words to make a difference in the world.”

Kiren Sweetman, ACTO director:

“My niece is an amazing woman who has a passion for wildlife and the planet.  She is amazing really – she needs very little and expects even less.  She thinks about the impact the decisions she makes might have on the world and is an example to me of how to live a life that is gentle and sustainable.

“I find it difficult to choose between two of my favourite actresses, both named Hepburn.  Katherine for her strength and independence, and Audrey for her grace and kindness – all qualities that I find inspiring in women.

“My friend had a stroke in her 20’s, leaving her left side weak.  She walks with callipers, and does not have the use of her left hand.  She sometimes gets muddled and has frequent headaches.  She has survived breast cancer twice.  Yet she will drop everything to help me if ever I am in need.  This, to me, is true female friendship – no judgment, just support and love as we help one another through life’s peaks and troughs, and share the joy and the in-between ‘nothing’ moments with one another.”

For more information about International Women’s Day go to

Blog Diversity Virtual Reality

My journey from Marketing to Psychotherapy

How Lesley Simpson-Gray overcame her challenges, specialising to work with multiple-heritages and neurodiverse clients using virtual reality

Lesley Simpson-Gray’s career began working in the field of product communications, undertaking research into people’s buying behaviour. However, starting a family was the catalyst for personal change as Lesley realised she wanted to change pace as well as reduce the time she spent working with office technology.

Curiosity and interest in how and why people do things is important to Lesley. The adoption of their daughter by Lesley and her husband Rickey – a vicar in the Church of England – provided a further turning point. As a family, they would need considerable support to cope with her emotional development. This experience was the spark to encourage Lesley to pursue a complete career change by training as a psychotherapist and helping others with their emotional needs; particularly as her own family has a history of mental health problems.

The road to qualifying: realisations and overcoming challenges

Training proved to be an experience which was challenging and at times extremely tough – but also self-discovery following a diagnosis of dyslexia and ASD. Lesley is a first generation child of immigrants to the UK, with a mixture of Nigerian, British & Irish, Ghanian and Jamaican ancestry.

Lesley said:

“A lot of that is unseen because I identify as a Black woman. Because I recognise that it is hidden to others, I’m curious about how children identify themselves with diverse cultures held within their parentage and wider families.

“As a neurodiverse trainee therapist I had an awful time – dyslexia was acceptable, but ASD stirred up a sense of taboo, a lack of safety and some shocking biases held by therapists. All of the things that we try not to show with our clients. Peers and course directors were terrified by the incorrect belief that I and all people with ASD had no theory of mind, no empathy, connection or communication skills. They wondered how I had slipped through the net and got onto the training, and it certainly wasn’t safe to allow me to qualify! 

“So consequently I stayed fairly quiet, only hinting that I had ASD and that my traits were not all down to developmental trauma.  Now, several years later, I feel it’s safe to identify as a psychotherapist who is also autistic.”

“It wasn’t safe to be different”

Several years after qualifying, Lesley is happy to speak about these experiences, her fear of not being white and neurotypical and a feeling that it wasn’t safe to be different. She felt that training organisations often did not take responsibility for the impact on their trainees at a very vulnerable time; resulting in Lesley and other students distressed and crying during many training days. Furthermore, she believes that people do not take responsibility for how they see you as a person or how they behave or speak.

Lesley continued,

“ I was seen and told at various times that I was ‘angry’ and ‘aggressive’ – the stereotypical Black woman. I was described as being ‘bitter,’ ‘hostile’ and ‘ungrateful;’ even dangerous, disturbing and unsafe. Training organisations don’t always see that their practices and micro-aggressions lead to trauma in the here and now. It’s too easy to define this as developmental trauma from the past that you need to go away and fix in order to be a safe therapist.”   

Qualifying similarly proved to be a bitter-sweet moment.

On opening the email which told Lesley that she had qualified as a psychotherapist, her feeling was one of total disillusionment rather than elation. Maybe she thought, I don’t wish to be a psychotherapist at all? The training had sought to help them as professionals to create a ‘safe’ emotional space for clients. Yet, they had been repeatedly immersed in a world that was emotionally terrifying.

Diversity and psychotherapy

According to research, people of colour have a higher risk of developing a mental health problem in adulthood; but they’re less likely to receive support for their mental health[1]. One of the difficulties faced by Black people and those from other communities is finding culturally appropriate therapy.

Lesley’s personal experience is a case in point:

“I remember how unsafe it felt to say to my first therapist that I had issues to do with ethnicity that she didn’t understand. I printed out an article and asked her to read it. She skimmed it quickly and quietly passed it back to me.”

At the time, Lesley felt that even to be able to say “I would like a Black therapist” was quite challenging; indeed, to ask a therapist what training have you done to understand my needs as a Black person?

A Black Perspective: Accessible & Inclusive Online Therapeutic Spaces

Starting her own private practice in 2017 Lesley is now an experienced Child and Adolescent Psychotherapist and certified Cyber-Therapist. Her lived experience as a Black, British professional has led to her special interest in raising the profile of neurodiversity, especially amongst care-experienced children and young people with a cultural connection to the African diaspora.

Later this month, Lesley will present a webinar organised jointly by Onlinevents and ACTO, encouraging other therapists and counsellors to join her on an innovative journey using virtual therapy space. The session will invite people to think about their own journey, as Lesley shares her own experiences and how it has shaped her use of technology.

“Given my background, I am aware of what this brings to my ethnicity. It is not always easy to define, so we need to ask how do children identify themselves, how can they identify? It does not always come down to being black or white.

“Children often have many different ethnicities within their family or origin and different cultures. How do they make sense of their own identity? For example, I have a lot of Jamaican culture but I was born and raised in the UK.

“In the webinar, I hope that others will be inspired by how technology and virtual reality can help us as professionals to work with clients – of all ages – to explore and create their own environments and avatars. We’ll use a 3D model which will enable us to define, for example, our skin, the dimensions, our hair colour. These are amazing tools where  we have a blank canvas and they stimulate our imagination. Critically, these modelling techniques allow you to be curious about how you define yourself; and importantly, not to be defined by others.”

Lesley Simpson-Gray was interviewed by Simon Frost.

Webinar details

Saturday 25 March 10am – 12 midday GMT

Cost: Participants can pay a self-select fee. The guide price is £20.

For further information, please click here.



Loss and Survival: a lesson in why training is crucial

Research report into the experiences of psychoanalytic psychotherapists working online highlights the importance of training for all therapists working online

Understanding the impacts of the period of lockdown during the COVID-19 pandemic is of undoubted importance, providing crucial insights into how future health emergencies can be managed.

It is therefore welcome to see research published on the subject, including this project that explored the experiences of psychoanalytic psychotherapists based in the UK during the first period of lockdown.

The research findings

The findings of the research study concluded that the psychotherapists primary concerns focused on loss and survival, with sub-themes relating to holding the frame, worries over a loss of security and safety, challenged analytic technique and altered relationship dynamics.

However, what is disappointing about the research article is that it barely mentions the importance or relevance of training.

Why is training for working online critically important?

Training and CPD provide each of us with the knowledge, the skills and expertise which ensures that our clients receive the best possible care – and also offers safeguards to ourselves as working practitioners. Working online is no different.

Those who have pioneered the work of online therapy have much to give to all those who are considering working online, whether on a long-term basis or in situations where it is necessary, such as during the recent pandemic.

Innovators in the development of online therapy have really given thought to the processes, frame, disinhibition effect, transference/counter-transference issues etc that can occur or change once therapy transfers online.

Furthermore, there is a real risk if you do not undertake any training, as you are likely to be working outside your set of competencies.

BACP guidance

It is consequently surprising that the thought of actually training to work online did not arise during the project, as each of the issues raised in the study are covered in training courses which would have been available to all at the start of the pandemic.

Indeed, the BACP has produced excellent guidance which strongly recommends training for working online.  It highlights the challenges of changing the method or medium of communication within the therapeutic relationship, for both practitioners and their clients. For example, it cites the fact that online relationships of all kinds are qualitatively different from those held in a physical space. The document recommends that practitioners think carefully about what is needed to ensure that they become competent in this new way of working. Training and preparation are vital ingredients to achieving this successful evolution into a new way of working.

The benefits of a supervisor

As a practising online counsellor, I have seen at first hand the benefits of training and the important role of a supervisor. Supervisory support furthermore reduces the risk of isolation and can guide those working online to access the tools and information, increase their skills and improve the effectiveness of the techniques applied. In addition, supervision must be online e-supervision, by an experienced practitioner who understands the differences to face-to-face work.

Training and research are key

At ACTO, we passionately believe in the importance of high levels of training across all the modalities, and to transform our individual modalities.

Training builds knowledge, skills and understanding. This process also encourages us to use research data to assess efficacy and the appropriateness of different approaches.

Let us hope that in the coming years, all those working within the mental health professions can benefit from good quality training; reducing the feelings of loss and survival and enabling them to thrive.

About the Author 

Kiren Sweetman is a person-centred counsellor and registered member of the British Association for Counselling and Psychotherapy (BACP). Kiren is also a director of ACTO.

Research study article

Taylor, L. Kegerreis, Rohleder, P. (2022). Loss and Survival: Experiences of Psychoanalytic Psychotherapists Working Remotely During the COVID-19 Pandemic. British Journal of Psychotherapy. 27 November 2022. [Last accessed 06.12.2022].

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