DISCLAIMERS

In order for you to appropriately utilize therapy conducted online, you need to be aware of the following:

1. Online therapy is still considered to be in the experimental stage.  Little research has been done to measure its effectiveness.  By contrast, face to face therapy has been studied extensively and most of these studies do demonstrate that utilizing therapy is effective in helping you change.
2. Psychotherapy, by definition, relies upon the use of "non-verbals" to help the therapist do the work.  Non-verbals include posture, tone of voice, movements and everything else beyond the words.  Non-verbals are not available in online therapy and this makes the interpretation of your communication much more difficult.  Communication online can also be prone to misinterpretation.  It is very important that both you and your therapist work hard at communicating effectively with one another.
3. Therapists have not been taught in schools regarding how to work with clients online.  There are peer supervision groups (see www.ismho.org) that provide an opportunity for therapists to discuss cases in a confidential manner and learn from one another.  It appears at this time that therapists have been able to translate the skills they have used in face to face to online work.  
4. It is possible to intercept email sent between a client and a therapist.  However, it has been said that there is no greater likelihood of someone intercepting an email between client and counselor as there is someone eavesdropping on a face to face session.  It is quite possible to misdirect email simply by not paying close attention to whom you are replying.  It is always suggested that you 1) never send/receive personal email from a work computer and 2) that you always double check the To: address box prior to clicking the send button.  You are also welcome to check out the encryption programs available at little or no charge.  If you are interested in using encryption email with me in our work, just let me know and we will explore several options.  I will make every effort to insure that your confidentiality is maintained throughout our work together.
5. You are not in the physical presence of therapist, which can be cause for concern.  The therapist is better able to intervene with you if you both are in the same room. Concerns have also been expressed regarding if your therapist is in another state or country.  If you do have a problem with your therapist, what recourse do you have?  The recommendation usually is to work with a therapist who is licensed in the state in which you live.
6. There are certain issues which are clearly inappropriate for online work at this time:  Suicidality; Thought Disorders and psychological issues with a physical component to name a few.  IF YOU ARE SUICIDAL, YOU MUST SEEK HELP IMMEDIATELY!  You should call 911 or get yourself to an Emergency Room for an evaluation.  You can also call 1 800-SUICIDE, (National Hopeline), a number that will link you to a suicide hotline.  
7. You will need to talk specifically about the issues you want to address online as a part of an assessment process.  
8. Outcomes:  One of three things will happen because of your participation in online therapy:  you will get better, you will stay the same or you will get worse. 
9. You are free to stop therapy at any time.  You are free to seek a referral to another therapist if you are unsatisfied with your treatment.  You are free to seek face to face therapy at any time.
10. You must be at least 18 years of age to access therapy online.