ONLINE THERAPY
(below is an excerpt from the book "Choosing an Online Therapist: A Step by Step Guide to Finding Professional Help on the Web*")
What is online therapy? Online therapy is the provision of counseling or therapeutic services over the Internet (via e-mail, chat, audio, and video) by a licensed or credentialed therapist. This book focuses on e-mail and chat therapy, which are the main modalities online therapists are using as of this writing. Video interaction between therapist and client generally requires expensive equipment and a great amount of Internet bandwidth, so it has yet to become a major focus for private therapists and small companies. Even with technological advances and reduction in prices for video equipment, there will still be a number of people who will prefer text-based therapy over video. With e-mail and chat, all a therapist and a consumer need before they can work together online is a computer, a connection to the Internet, an Internet Service Provider (ISP) and the software which the ISP provides.
Before we ask the question "Why online therapy?" it is important to ask "Why therapy?" After this question is answered satisfactorily, we can start to explore the issues and questions related to online therapy, such as: Can online therapy work? Can online therapy work with the issues I am facing? What are the issues I need to be aware of in online therapy? How do I find a competent online therapist?
So, why therapy? The answer is simple—people go to therapy because it works. Multiple studies show that psychotherapy is effective in helping people. The American Psychological Association has published an article online entitled “The Efficacy of Psychotherapy” (http://www.apa.org/practice/peff.html), which lists and discusses multiple studies. These studies clearly show that therapy is effective. Consumer Reports published a study on the effectiveness of psychotherapy in November 1995. Dr. Martin Seligman reviewed this study (http://mentalhelp.net/articles/seligm.htm) and described it as “the most extensive study of psychotherapy effectiveness on record.” He discussed a number of “clear-cut results” of the study, the first one being: “Treatment by a mental health professional usually worked. Most respondents got a lot better.”
Therapy helps us change our lives. It teaches us skills and helps us see ourselves in a more realistic light. Therapy helps us get rid of misconceptions about ourselves and the world and also helps us function better both in the world and more specifically in relationships. Therapy can help fill that gaping hole inside that some of us feel. It can teach us how to live effectively with illness, whether that illness is mental or physical. Therapy can help us find relief from emotional pain. Therapy can help us deal with the stress of living in a very chaotic and complicated world. In general, therapy can help us be better partners, parents, lovers, and people. It can help us find the peace and happiness we deserve.
Therapy comes in many forms today: Cognitive Behavioral Therapy, Rational Emotive Behavioral Therapy, Narrative Therapy, Transactional Analysis, Person Centered Therapy, and Humanistic Therapy, just to name a few. These different types will be briefly discussed in Appendix C for the interested reader.
If face-to-face (F2F) therapy works well, why consider online therapy? Well, the truth is, many people would rather participate in therapy face to face as opposed to online. I’ve had e-mail exchanges with people who needed information concerning what to do about a problem and when I suggest they seek therapy, they often say, “Can you refer me to a therapist in my area?” When I tell them about the possibility of online therapy, they don't want to hear about it. “What? I need to see the therapist I’m talking to.” Even though many people (and therapists) prefer face-to-face therapy, there are more and more people and therapists who are interested in online therapy. Here are some reasons why:
1. Geography. Some people are isolated geographically and it can be quite a problem because of physical distance to get to a clinic or a private therapist’s office. Even if access to a good therapist locally is not a problem for you, you are not bound by the limits of geography when you are online. You can access a therapist in another state or on another continent! You can find a treatment expert who specializes in the issues you face and access that person wherever he or she may be. It’s wild to think you can live in Des Moines and can be in treatment with a therapist in Hong Kong!
2. Disability. Certain disabilities limit a person’s ability to travel even short distances. This is a non-issue in online therapy, because you don’t have to leave your home. Equipment can be purchased that enables people with a wide variety of disabilities to effectively use the computer and be able to benefit from online therapy.
3. Shame/guilt. Some people don’t seek therapy because they feel ashamed or guilty. Many have been raised to believe people are “crazy” if they need to see a counselor. Fortunately, this stigma is being reduced in recent years, in part, perhaps, as a result of education that is available on the Internet. Recent articles tell us that it is easier to "open up" online than it is in face-to-face therapy. People who have accessed online therapy tend to be more open more quickly, thus moving the therapeutic process along.
4. Community status. Some seek online therapy because their status in the community could be affected by their seeking any type of counseling. Although all ethical therapists and agencies abide by the laws of confidentiality, there is nothing that prevents a neighbor from seeing my car in the Mental Health Center parking lot every Tuesday night at 7 p.m. People in sensitive positions (mayor, police chief, city councilperson, and the like) deserve the right to access therapy as well as the rest of us. This issue applies in any instance in which the public’s perception of a person has a large effect (as in the perception of a corporation’s CEO and the effect that has on the corporation’s stocks, for example).
5. Social phobia/panic attacks. People who suffer from agoraphobia or panic attacks often have great difficulty leaving their homes. Online therapy is the logical choice for these folks. I’ve talked to colleagues who report success in helping people online with these issues.
Does online therapy work? Clearly, not enough studies have been done to say scientifically that online therapy works. Many authors discuss anecdotal evidence of how well online therapy works. Also, there are a number of research projects going on to examine this issue. The International Society of Mental Health Online (www.ismho.org/) created a Clinical Case Study Group to discuss “psychotherapy cases and professional clinical encounters that involve the Internet” in the fall of 1999. Organized and facilitated by John Suler and Michael Fenichel, this group is one of the first to conduct a systematic investigation of online therapy. More information about this group can be found at www.rider.edu/users/suler/psycyber/casegrp.html. Sixteen therapists discussed psychotherapeutic interventions that they conducted either totally or partially online. The cases presented consistently demonstrated the fact that therapeutic interventions conducted by ethical therapists can be provided online and the clients respond in a positive manner.
To make arrangements to attend a chat therapy session, please click on the Arrangments button.
*To learn more about the book, or to order, please email the publisher, Linda Grobman at linda.grobman@paonline.com or go to www.socialworker.com/onlinetherapist.htm .