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What is
online counsellING?
Online Counselling refers to the delivery of any mental and behavioural health service in an indirect setting through
communication technologies such as the telephone, e-mail, synchronous chat, and video-conferencing 
(Mallen & Vogel, 2005)

Why Online Counselling?

Convenience: Focused Attention on Increased awareness of self
Clients do not need to client: & others
travel to agency Less distractions Practitioner & client can
Increase motivation of can make it easier self-monitor how they are
clients to be involved for practitioners to expressing themselves
focus on session

Comfort of familiar settings: Increased privacy: Creativity:

Less threatening Only practitioner and Use and explore new
Clients feel more relaxed client know that they technology and
and willing to self- are attending the opportunities in
disclose session unfamiliar circumstances

A G E N C Y- R E L AT E D C O N S I D E R AT I O N S

1 3
Management of risks & safety Assessment of client suitability
issues
Have a robust SOP within the organisation Ensure that client is not at imminent risk (e.g.
to bridge communication in the event of suicidality, abuse, etc.)
an emergency/crisis No mental health issues that might render online
Emergency contact number should be counselling unsafe for the client
obtained during intake before session Client's access to safe and private physical space
to attend the counselling session

2 4
Provision of clinical supervision A g e n c y a n d /o r f u n d e r s ' r e q u i r e m e n t s
Prepare staff before they start Clear direction between agency and
providing online counselling regardless of practitioner on purpose and requirements of
staff's level of experience online counselling
Review email/text exchanges between Understanding of intentions behind these
staff & client during supervision requirements help guide practice
C L I E N T- R E L AT E D C O N S I D E R AT I O N S

Implementation of a Adapt assessment & thought Informed consent as

clear session structure process to suit online format good governance

Explaining the session In lieu of body language, Ensure compliance with

structure to the client can practitioners should openly share PDPA at all times, and seek
alleviate concerns & anxiety, their thought processes with the consent when using online
and clarify expectations client to conceptualise issues & recordings for supervision
about online counselling needs clearly online purposes

references Mallen, M., & Vogel, D. (2005). Introduction to the

Major Contribution. The Counseling Psychologist,
33(6), 761-775. doi: 10.1177/0011000005278623
SPECIAL Ms Sylvia Tjahjadi, Senior Counsellor, Samaritans of Singapore (SOS)
Mr Shawn Lai, Counsellor, Samaritans of Singapore (SOS)
Mr Aston Tan, Counselling Psychologist, Community Psychology Hub
THANKS TO: (CPH)
Mr Tony Ong, Manager (Counselling Services), Counselling and Care
Centre (CCC)

Produced by MSF Office of the Director-General of Social Welfare | Sep 2020

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Methods of
online counsellING

Video-Conferencing Phone Counselling Email/Text Messaging

Provides visual feedback Greater sense of control Client can reread emails
CHARACTERISTICS OF

for practitioner & client to for client (can terminate again - impact of caring
self-monitor and regulate call when necessary) letters (Luxton et al.,
expressions Greater anonymity for 2014)
P L AT F O R M

Convenience of access
clients increases Nuances in language
can reduce
their willingness to self- without non-verbal cues
withdrawal/no-show
disclose can lead to
from services
Requires client to have a Requires practitioner to misinterpretation or loss
private location for video be more directive in of meaning
conferences exploring options

Clarify expectations and Acknowledge emotions Use short, simple

limits of online Ask tentative but direct sentences
counselling questions (e.g. "I'm Use tentative words
SPECIFIC TIPS

Set house rules about use wondering if you have such as "seems" "feels
P L AT F O R M

of platform (e.g. no ever thought of harming like" "might"

photo/video yourself?") Reflect client's
recording without Manage silence carefully perception as
consent) perception, not fact (e.g.
Give empathic
Discuss rules around "It seems like you feel
responses and assurance
the use of other devices abandoned v.s. You are
that you are present in
during sessions abandoned")
moments of silence
Be explicit in verbalising
thoughts in lieu of visible
body language
GENERAL

Be verbally active to demonstrate that you are present

Be attentive to both emotional and practical concerns
TIPS

Be directive in your questioning and guidance

Close-ended questioning or establishing code words/phrases to indicate lack
of safety can be helpful if client is near perpetrator

references Bobevski, I., Holgate, A., & Mclennan, J. (1997). Characteristics of effective telephone
counselling skills. British Journal Of Guidance & Counselling, 25(2), 239-249. doi:
10.1080/03069889708253805 SPECIAL Ms Sylvia Tjahjadi, Senior Counsellor, Samaritans of Singapore (SOS)
Mr Shawn Lai, Counsellor, Samaritans of Singapore (SOS)
Mr Aston Tan, Counselling Psychologist, Community Psychology Hub
Feiyue Family Service Centre (2020).  Engaging Clients During COVID-19. 

Luxton, D., Thomas, E., Chipps, J., Relova, R., Brown, D., & McLay, R. et al. (2014).
THANKS TO: (CPH)
Mr Tony Ong, Manager (Counselling Services), Counselling and Care
Caring letters for suicide prevention: Implementation of a multi-site randomized
Centre (CCC)
clinical trial in the U.S. military and veteran affairs healthcare systems.
Contemporary Clinical Trials, 37(2), 252-260. doi: 10.1016/j.cct.2014.01.007

Produced by MSF Office of the Director-General of Social Welfare | Sep 2020

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Online Counselling:
working with children

Considerations when working with children

Informed Whether the parent Making referrals Initial engagement

consent from should be present to other services can be scary for
parent during sessions child
Check if parents are
The presence of the Be ready to Use engagement
comfortable with
parent/s can be helpful refer the child to techniques to
child being seen by the
in facilitating the more start conversation/
practitioner. Online session, but can also appropriate build emotional
counselling is feasible for hinder sessions if clear services where safety (e.g. ask them
children who are able to expectations are not set necessary. about their favourite
adequately focus during and agreed upon. toy).
sessions

tips for working with children

Use age appropriate language do not talk down to them

Use language that is easily Treat your child clients the same way
understood by the child. that you would your adult clients.

reflect the client's perspective do not take sides

Parents may read their child's emails or ask Do not be too quick to criticise or
them about their sessions, hence it is dismiss potential resources (e.g.
important to state clearly when something is teachers, parents or peers).
your client's opinion

references Kit, P., Teo, C., Tan, M., & Park, Y. (2017). Singaporean Counsellors’
Online Counselling Experiences with Children: An Exploratory
Qualitative Study. Journal Of Asia Pacific Counseling, 7(2), 141-168.
SPECIAL
doi: 10.18401/2017.7.2.3 THANKS TO:
Sori, C., & Hecker, L. (2020). Ethical and Legal Considerations When
Counselling Children and Families. Australian & New Zealand Journal
Of Family Therapy, 36(4), 450-464.
Produced by MSF Office of the Director-General of Social Welfare | Oct 2020
Ms Sylvia Tjahjadi, Senior Counsellor, Samaritans of Singapore
(SOS)
Mr Shawn Lai, Counsellor, Samaritans of Singapore (SOS)
Mr Aston Tan, Counselling Psychologist, Community Psychology
Hub (CPH)
Mr Tony Ong, Manager (Counselling Services), Counselling and
Care Centre (CCC)
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Online Counselling:
ethical considerations
Ensure Inclusivity seek Clarity in Agency SOP
Ensure that vulnerable groups are not Provide boundaries for practice
excluded due to lack of access and between the personal and
professional self
Assist the elderly who may not be familiar
with using technology Designate a specific area at home for
work
Be aware that some clients may be slower Use organisation Zoom accounts &
at typing/reading from a screen. Do adjust office phone numbers
sessions accordingly Agencies should set boundaries
between workers and clients such as
Explore alternatives such as phone or text for replying text messages only during
clients with unstable internet connection office hours, except for critical cases
Provide training to staff to ensure
Provide alternatives and adapt services competency
for Persons with Disabilities  Refer to Infographic #6
(e.g. Visual or hearing impairment)
Provide clarity on escalation procedures for
Address considerations related to working emergency/crisis cases (e.g. informing
with children (Refer to Infographic #3) supervisor, involvement of police)

Ensure Privacy Uphold Safe Practice

Privacy for the practitioner Dress appropriately in sessions with
Use virtual backgrounds to protect clients
practitioner's private space
Write simply and clearly
Privacy for the client  Use appropriate language
Avoid acronyms and jargon
As clients may not have private space,
allow them to turn off their videos if Be mindful of tone used
needed Written communication does not
Seek consent when recording session convey tonal variations as clearly as
for supervision verbal communication

Ensure Safe Practice

Maintain contact regularly through Maintain connection with client's
various modes  support network  for crisis support
Remote means to support face-to- (e.g. neighbours, family nearby)
face (e.g. zoom)

Ensure client confidentiality Ask to sight vulnerable members of the

Use passwords to encrypt family during sessions and be alert of
documents with client data signs of breach of safety plans (e.g.
bruises on child)
Seek regular supervision to explore
unfamiliar experiences of working
online

references Gamble, N., Boyle, C., & Morris, Z. A. (2015). Ethical practice in
telepsychology. Australian Psychologist, 50, 292-298. SPECIAL Ms Sylvia Tjahjadi, Senior Counsellor, Samaritans of
Singapore (SOS)
Mr Shawn Lai, Counsellor, Samaritans of Singapore (SOS)
Barnett, J. E., & Kolmes, K. (2016). The practice of tele-mental health:
Ethical, legal, and clinical issues for practitioners. Practice Innovations, 1,
53-66.
THANKS TO: Mr Aston Tan, Counselling Psychologist, Community
Psychology Hub (CPH)
Mr Tony Ong, Manager (Counselling Services), Counselling
Harris, B., & Birnbaum, R. (2014). Ethical and legal implications on the use
of technology in counselling. Clinical Social Work Journal, 43, 133-141. and Care Centre (CCC)

Produced by MSF Office of the Director-General of Social Welfare | Oct 2020

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Online Counselling:
challenges & resources
Challenges of Online Counselling

Technological Accessibility increases Suicidal or family

difficulties client multi-tasking violence risk
Poor WiFi connection Clients might be easily Dealing with client
Clients might struggle distracted by work, disclosure when there
with technology and chores or even social is a lack of access to
compatibility issues media the client physically

More fluid Privacy

boundaries concerns
Less control over client's Difficulty in finding a private space to
movements and environment attend counselling sessions
Client & practitioner's physical Potential for clients to take
locations might be exposed
photos/videos of the session without
practitioner's knowledge

Managing Challenges and Limitations Technical Resources

Be the one to raise privacy & safety Common platforms for online counselling:
issues Doxy.me
Zendesk
Prepare ahead of sessions with safety Zoom
plans and coping skills Skype
Cisco Webex
Be flexible & willing to make Tips for using Zoom:
exceptions Hiding self-view (for self-conscious clients)
https://support.zoom.us/hc/en-
Be creative in finding solutions us/articles/115001077226-Hiding-or-
showing-my-video-on-my-display
Acknowledge limitations and manage Virtual Backgrounds:
expectations https://support.zoom.us/hc/en-
us/articles/210707503-Virtual-Background

references Barnett, J., & Kolmes, K. (2016). The practice of tele-mental

health: Ethical, legal, and clinical issues for practitioners.
Practice Innovations, 1(1), 53-66. doi: 10.1037/pri0000014
SPECIAL
Ms Sylvia Tjahjadi, Senior Counsellor, Samaritans of
Singapore (SOS)
Mr Shawn Lai, Counsellor, Samaritans of Singapore (SOS)

Gamble, N., Boyle, C., & Morris, Z. (2015). Ethical Practice in

THANKS TO: Mr Aston Tan, Counselling Psychologist, Community
Psychology Hub (CPH)
Telepsychology. Australian Psychologist, 50(4), 292-298. doi: Mr Tony Ong, Manager (Counselling Services), Counselling
10.1111/ap.12133 and Care Centre (CCC)

Produced by MSF Office of the Director-General of Social Welfare | Nov 2020

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Online Counselling:
Importance of self-care
Physical

Spiritual Moral (Ethics)

Biopsychosocial
Approach
to Self-care

Cognitive Psychological

Emotional Culture
Diagram Credit:
Social Mr Tony Ong, Counselling
and Care Centre (CCC)

Setting Boundaries & Considerations for Supervision

Practising Self-Care
For Practitioners
Speak to your supervisor if you
need additional emotional support
or training on using unfamiliar
Take breaks and
engage in hobbies techniques

Switch off devices Seek consultation with supervisor

after office hours either during or immediately after
emergencies/crises

Designate specific For Supervisors

places at home for
working Check in on your supervisees
regularly to find out how they are
Understand your coping
limitations
Listen to what's happening to your
Practice mindfulness
in between sessions supervisees instead of merely

to reorientate yourself hearing them

Barnett, J., & Kolmes, K. (2016). The practice of tele-mental

references health: Ethical, legal, and clinical issues for practitioners.
Practice Innovations, 1(1), 53-66. doi: 10.1037/pri0000014
SPECIAL Ms Sylvia Tjahjadi, Senior Counsellor, Samaritans of
Singapore (SOS)

Christopher, J., & Maris, J. (2010). Integrating mindfulness as

THANKS TO: Mr Shawn Lai, Counsellor, Samaritans of Singapore (SOS)
Mr Aston Tan, Counselling Psychologist, Community
self-care into counselling and psychotherapy training. Psychology Hub (CPH)
Counselling And Psychotherapy Research, 10(2), 114-125. doi: Mr Tony Ong, Manager (Counselling Services), Counselling
10.1080/14733141003750285 and Care Centre (CCC)
Produced by MSF Office of the Director-General of Social Welfare | Nov 2020