You might be asking yourself "what is email therapy?" and "how does it work?". This blog post will go through all of this from start to finish - this is how I have set up my own practice, other people may have a different way of working so it is always good to check this out.
What is email therapy?
Email therapy is a form of written text based therapy. It is asynchronous in its delivery which means that there is a time delay in sending your email with what you're looking to explore and then receiving your therapists response.
Email therapy has many pros and cons, similar to other types of therapy:
Pros | Cons |
|---|---|
Flexibility - allowing for time to write the email before the "deadline" so can fit around changeable commitments rather than leading to cancelations or needing to postpone. This is particularly useful for those with shift work or those of use with disabilities or chronic illnesses that may be unpredictable in how they impact us on a day to day basis. | No immediate response - if you're in a moment of distress with a situation you won't be in your therapists presence to guide you through that in the moment, but instead will have to wait. |
Time to reflect and form a response- you will get your therapists email and have time to reflect on the words before writing your next sessions content. This can be useful for neurodivergent or anxious individuals who might want to take time over their choice of words. This can be a negative for some people. | May not feel comfortable or safe - As above, you may be left with some difficult feelings to navigate with only written text rather than the physical or vocal presence of someone which can feel unsafe or uncomfortable for some people. |
Doesn't rely on physical appearance or vocal cues - there is an element of anonymity with email therapy where you do not need to rely or be perceived by your physical and vocal facets, e.g. for trans individuals with dysphoria this can be liberating to not have to present in any type of way but instead just focus on the words they want to express themselves. | Word limit might feel constrictive - most therapists will have a word limit on emails to allow for enough time to process and reflect. We will still allocate our time to these sessions akin to video, phone, or face-to-face. And so the word limit allows for a therapist and client to keep some time boundary on the sessions. |
Chance for equal exchanges - Due to the exchange being email where client will send and therapist will respond, there is a much more equal chance of response, whereas with video, phone, or face-to-face therapy there can be a risk of the client or therapist taking up majority of the space to talk. | Can be miscommunications in reference to tone and meaning - as with any text based communication, tone and meaning tends to be inferred and this can lead to misunderstanding and miscommunication. This absolutely can be worked through in sessions, but it needs both therapist and client to be able to keep this awareness when reading, reflecting, and replying. |
How does it work practically?
Your therapist will have their own way of working and will hopefully outline this in a contract or with some form of guidance. But the basics are:
You will set up a secure email address to use for your therapy exchanges - your therapist will also have theirs set up.
You will then have a day & time for each week to send your email by.
You can write the email at any time in the space between your day/time and your therapists last response, but you send your email by the agreed day/time.
If you don't manage to send your email in time, this would be a missed session, and your therapist may not reply to you due to having time allocated for other clients and downtime. My process is to manage this on a case by case basis.
If you go over your word limit, your therapist may only respond to what they are able to in their allocated time. My word limit for emails is 750 words as on average, with reflection, this will fill a 50 min time slot similar to my other video and phone clients.
Your therapist will then outline when they will send their reply - my framework is within 48 working hours of your set day & time.
If you're unable to take time for a session in a week then you should still email your therapist to let them know you won't "make" the session that week.
I still have expectations outlined around being in a quiet and confidential space for when you are reading and replying to emails, confidentiality still being respected, what happens in terms of late/missed sessions, when payments are to be made by etc. and so I still require potential clients to have a consultation with myself to go through the contract, what they're looking for from therapy, and if they have any questions. I do offer these through a one-off video/phone consultation or it can be done via the chat function in the Google Meet session so that we are talking in immediate responses.
How does it end?
I ask for 2 weeks notice for sessions to end regardless of the medium we are meeting in. I do this as it gives us a chance to round off the work we have been doing and allow a chance for a positive ending experience (hopefully!).
Summary
Email therapy hasn't had a massive amount of research done into it yet as with other modes of e-therapy, they are in their infancy. However, the research that has taken place has found that email therapy can be just as effective in creating a therapeutic relationship and having positive outcomes in therapy as face-to-face therapy.
It can allow a safe space for clients to write out their emotions, feelings, experiences, and situations they have gone through and are going through, it allows clients to feel heard and build a therapeutic relationship with the therapist too.
My Experience:
I have worked with many organisations in text-based support. A lot of the time this has been live text based support where there is chance for immediate responses. I joined the Samaritan's as a Listening Volunteer back in my first year of University which gave me intense training and experience in phone call support but also email support, which was asynchronous support.
I later had the honour of working with The Mix, in their Counselling Team where I offered therapy via phone call and live text based support, where I was able to build therapeutic relationships with individuals offering a fairly solution focused approach within 4-8 sessions.
I also worked with GriefChat and BIMM offering live text based support on a one-off basis, dealing with immediate distress and situations.
So how can I help?
All of this work has given me experience in building therapeutic relationships with individuals via written text, to hold a safe space for you as the client to share, explore, process, and reflect on what's going on for you. It can be amazing at how quickly text based support feels safe and gives the ability to put into words something you don't feel able to say out loud. You are able to take your time in typing out what is going on for you, in a process of bringing the internal, from your head, through your body to the external, in typing the words out and sending them off.
As mentioned above in the post this can be especially helpful for individuals struggling to present a certain way, and so it can take the pressure off your physical expression and allow focus to the situation and feelings. I work with identity mostly - this means I am GSRD (Gender, Sexuality, and Relationship Diversity) affirming, fat-affirming, Neurodivergence affirming, and disability & chronic illness affirming too. I want to work with YOU, you as a whole on who you are in this world, the relationship to your self, and then how this influences your experience in this life. You can find out more about me and how I work via the highlighted links.
Thinking of trying it? See if I have availability here:
You can also check out my FAQ's and If you're still left with questions get in touch with me via info@emilyduffytherapy.co.uk