Dami Charf speaks calmly and gesticulates with his hands. "Anyone who has had traumatic experiences in childhood can tell from their reactions in adulthood," she says in one of her YouTube videos. "For example through fear of loss or the feeling of constantly having to do something to be loved."
Charf, 55, curly gray hair, talks about behavior patterns. She is a naturopath for psychotherapy and specializes in trauma healing. In her online self-help course, she explains that the first three years of life determine how we react to events and people.
Charf is one of numerous providers of online therapies. If you search for the offers on Google, it quickly becomes confusing: Selfapy, Minddoc or Mentavio are the names of the websites that promise help in psychological emergencies.
"It is often difficult for those seeking help to assess the quality of such offers," says the website of the association "Pro Psychotherapie". It is particularly important to pay attention to the qualification of the provider: whether the Internet program is used or accompanied by a psychotherapist or a specialist in the field of psychotherapy.
- Here you will find a checklist from the Federal Chamber of Psychotherapists and experts from the German Society for Psychiatry and Psychotherapy).
Shaking hands is not possible online
Applying the checklist to Dami Charf's offer does not fulfill all of the points. Although she gives detailed information about her training and further education, makes her course content transparent, and user satisfaction can also be seen in the comments on her page. However, your program does not offer an opportunity to individually check whether the treatment is successful: there is no feedback for the user, he has to judge for himself whether the program is of any use to him.
"In the course of the course you will notice that you see things differently, perceive them differently and at some point start to behave differently", promises Charf and smiles encouragingly at the camera. "At that moment, your environment will also behave differently." With her good-natured manner, she gives her viewer the feeling that she has a compassionate person in front of her, who knows what she is talking about - if you can judge that if you only see a person on the screen.
But can you really work on deep-seated experiences with an online course - or do you need a sensitive discussion partner who is physically present on such a sensitive topic? Doesn't there have to be an interaction between patient and therapist, doesn't it need concrete answers to individual questions?
"Online offers are an effective alternative access to therapeutic measures," says Heinz Thiery, Managing Director of the German-speaking Society for Online Consulting (DGOB). "Above all, people are reached who cannot be reached through face-to-face offers." For example, employees who find it difficult to find a free therapy place due to their working hours. Young people who don't feel taken seriously by adults. Deaf people or people who live in rural areas and have no local therapist. But also people who are ashamed of their experiences and do not necessarily want to talk about them at first - for example, victims of sexual abuse. The offers can also serve as bridging the waiting time until the therapy place
- Read a guest post here about how the health system stands in the way of treating mentally ill people: How a lobby association harms mentally ill people
An online consultation offers an alternative setting: "For many it makes a difference whether they can sit relaxed in front of the computer at home or in an unfamiliar environment should open up to an initially unfamiliar person," says Thiery. Especially in behavioral therapy, which is also used for trauma, one can observe great success through competent online offers: "Patients are offered a suitable learning program with which they can then practice in everyday life," says Thiery. This can also be conveyed well via video tutorial.
Charf has also uploaded some of her explanatory videos to YouTube, around 15,000 people have subscribed to their channel. The complete self-help courses can be bought on their website. The tutorials cost between 57 and 270 euros. Online therapies are not yet standard services in Germany, but some health insurance companies are already covering the costs.
Charf also sees the limits of her online courses: she can explain how the psyche works, how certain conditioning processes work and where they come from. "However, when I sit in a room with a person, I can include physical reactions." It triggers a certain feeling in every person to sit opposite someone else or to shake hands.
Better online than no advice at all?
Personal contact - at least in the diagnostics and patient education - is essential, according to a statement by the Federal Chamber of Psychotherapists (BPTK) on digitization in psychotherapy. "During treatment, therapy monitoring by psychotherapists or doctors must be ensured." Proof of effectiveness is also important. After all, therapeutic exercises that do not work at all, or that work too little, could increase the patient's impression that they cannot cope with their depressive mood. "He continues to experience his illness helpless," says the statement.
"We advocate the integration of digital programs in psychotherapy," said a spokesman for the BPTK. Digital offerings could complement psychotherapy, but not replace it. "We also demand that digital treatment programs must prove their effectiveness before they can be used."
Thiery from the DGOB also sees dubious therapy offers as dangerous. "An inexpert offer can actually make the disease worse," he says. It is important that the therapists behind the online courses are accessible to the patient, for example via chat or email.
In general, online advice is better than no advice at all. The trade association therefore wanted to compile a register with certified offers. The professional association of German psychologists already has such an overview.
