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].

How I became an online therapist

Elizabeth Longshaw

I began working online in March 2020, because of the COVID-19 pandemic. The enforced lockdown gave me an opportunity to reappraise the way I work and enabled me to learn a new skill. Counsellors are expected to regularly undertake training, assess abilities, and develop new ways of working but I see this as integral to my practice. Therefore, lockdown gave me the opportunity to re-evaluate the way I work. Consequently, I am now qualified to work online in addition to working face-to-face and am looking to offer a blended approach, where I incorporate both ways of working. This serves as a means where I can reach out to a greater number of people in need which, in turn, is even more enriching for me.

Email Elizabeth Longshaw

How I became an online therapist

Eleanor Carn

“I became an online therapist in 2015 after realising that many people who could benefit from regular therapy might be unable to make appointments that they had to also factor in costs to travel to and from sessions, or were put off by the idea of being in a waiting room, or were unable to carve out the time to go out for therapy due to work or childcare, or other factors. My traditional therapy training was quite anti the idea of online therapy, seeing it as less than the “real thing” of face to face, I always felt this was wrong, and that not changing with the times would one unhelpful for clients and therapists alike. We use the internet for everything else, why should therapy be different? I believe in meeting clients where they are, and that the right match between a client and a therapist shouldn’t just be dictated by geographical proximity. Being able to meet clients online has also allowed for flexibility when clients have needed to relocate, changed work, or had major life changes like having children. 

Since training in online therapy, as well as the UK, I have worked with clients in Malaysia, India, France, Slovenia, and Hong Kong. For many English Speaking expats, the ability to have therapy in their first language is invaluable. 

I currently still live in the UK, although my dream is to move to a slightly warmer climate! Working online makes this a possibility too.” 


ACTO’s first online conference

2020 and 2021 have been years like no other. For online therapy this has seen enormous growth for our online profession. And so much to learn, so much to excite us.

Our Conference will be an exciting thought-provoking day with:

  • leading expert speakers, providing a series of presentations of key topics in the field,
  • interactive workshops and
  • time to network and relax together in the online therapeutic professional community.

This is a conference for all mental health practitioners working online, including therapists, psychologists, psychiatrists, social workers and other health care professionals.


Topics include:

  • Joining the Dots between the Past and the Present
  • Why do we do what we do do?” What does the research tell us?
  • “If a thing is worth doing, it’s worth doing well.” ACTO: driving up standards in online therapy
  • Super Vision: the oversight keeping us on the straight and narrow in the digital space
  • The Voice within the Written Word. Text Based Therapy with CYP
  • Lessons from Covid, the way forward
  • Online supervision


There will be an exciting selection of workshops to choose from during the afternoon. You will be able to select two workshops from a large selection.  Workshops will include Working internationallyWorking with Children and Adolescents, Inclusivity, Diversity and Social Justice, but there will also be many more to choose from.

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