V

Contraindications


If you are in an abusive relationship, it can be extremely risky engaging in online therapy due to the potential risk of the abuser finding the therapist’s details/messages/emails in the client’s device or overhearing a conversation with the therapist.

The following information has been extracted from the UK government website.

Anyone can be a victim of domestic abuse, regardless of gender, age, ethnicity, socio-economic status, sexuality or background.

If you answer yes to any of the following questions, you might be in an abusive relationship.

a silhouette of a hand reaching for a doorknob signifying domestic abuse


a man crying in the shower suffering from emotional abuse

Emotional abuse
Does your partner, or former partner, ever:


  • belittle you, or put you down?
  • blame you for the abuse or arguments?
  • deny that abuse is happening, or play it down?
  • isolate you from your family and friends?
  • stop you going to college or work?
  • make unreasonable demands for your attention?
  • accuse you of flirting or having affairs?
  • tell you what to wear, who to see,
    where to go, and what to think?
  • control your money?
a wooden mallet held over an egg to resemble threatening behaviour

Threats and intimidation
Does your partner, or former partner, ever:


  • threaten to hurt or kill you?
  • destroy things that belong to you?
  • stand over you, invade your personal space?
  • threaten to kill themselves or the children?
  • read your emails, texts or letters?
  • harass or follow you?
  • Have you ever felt afraid of your partner or former partner?
  • Have you ever changed your behaviour because you’re afraid of what your partner, or former partner, might do?
a hand with bruised knuckes

Physical abuse
The person abusing you may hurt you in a number of ways.
Does your partner, or former partner, ever:


  • slap, hit or punch you?
  • push or shove you?
  • bite or kick you?
  • burn you?
  • choke you or hold you down?
  • throw things?
a woman from a previously abusive relationship holding one hand up defensively

Sexual abuse
Sexual abuse can happen to anyone, whether they’re male or female.
Does your partner, or former partner, ever:


  • touch you in a way you don’t want to be touched?
  • make unwanted sexual demands?
  • hurt you during sex?
  • pressure you to have unsafe sex – for example, not using a condom?
  • pressure you to have sex?
  • If your partner, or former partner, has sex with you when you don’t want to, this is rape.

Other contraindications to counselling may include, but is not limited to:

  • Self-Harm, Suicidal Thinking and Risky Behaviours
  • Eating Disorders
  • Borderline Personality Disorder
  • Severe Mental Health Conditions such as:

    • Bipolar Disorder
    • Schizophrenia
    • Pyromania
    • Intermittent Explosive Disorder
    • Brief Psychotic Disorder
    • Addiction and Substance Abuse Disorders (including Alcohol, Illegal or Prescription Drugs)
  • Serious medical conditions
someone suffering from a severe mental health disorder


An woman showing body language

Because the therapist may not be able to accurately assess how the client is doing physically (for example, seeing cuts on the client’s arms, or the progression of medical conditions which could cause a sudden episode of severe illness such as diabetes or epilepsy), the therapist needs to rely on self-reporting by the client and this could potentially lead to missed signs of risk to the client, which would be extremely hard to manage working remotely online. Especially if the presentation of severe mental health conditions manifest in missing sessions, being late and/or not responding to messages. Although, during sessions this can also be missed, due to a lot of body language cues not being seen by the therapist (in live chat or email therapy there would be no body language cues whatsoever).

In the case of substance abuse the therapist wouldn’t be able to smell alcohol or look closely at the client’s pupils to tell if the client is under the influence, and that can determine whether a person maintains full psychological contact, because when dealing with addiction and most of these disorders mentioned above, the client can break away from reality throughout the session (not being able to tell what is real and what is not) creating potential risks to the clients themselves or others around them, which becomes extremely hard for the therapist to manage remotely whilst working online.

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