Online therapy (sometimes called “e-therapy”) is not as strange as it may seem at first. It’s simply using the internet to conduct private counseling sessions. It’s the fastest growing method of psychotherapy today, and is recognized by the American Psychological Association, the American Psychiatric Association, and the American Counseling Association.
Most people are concerned, logically enough, that the richness of personal counseling cannot occur when the therapist and client are connected only electronically. I won’t argue that point. When face-to-face (F2F) therapy is possible, it is preferred. But I’ve found a number of situations where online therapy works very well, and can actually work better than traditional methods:
- A client leaves the area, but wants to continue counseling with the therapist s/he has learned to trust rather than “starting again” with a new therapist;
- The patient is not comfortable with traditional, face-to-face counseling (e.g., too shy or embarrassed, agoraphobic), and would otherwise not access psychotherapeutic help;
- There are barriers to an office visit, such as a physical handicap, illness, a business trip, time problems (cannot come in during office hours), hospital confinement, etc.;
- The person simply prefers the convenience of “anytime, anywhere” contact with a therapist who is known and trusted, or would rather sit in an easy chair at home than come into a professional office.
Online therapy can be text-based (i.e., exchanging secure, private e-mails), which has the advantage of not being time-bound. That it, is is a process of responding to one another in “installments” much like e-mail or texting, so you can respond at your convenience. More common today however, is a session scheduled for a specific hour, where both therapist and client sit at their computer or other device at the same time and enjoy both visual and auditory contact thanks to apps like Skype, Apple’s FaceTime, and ooVoo, among others. This comes close to a “real” psychotherapy session, but with the potential advantages mentioned above.
My own stipulations about online counseling are stated below. Some of them may contradict one or two of the statements already made supporting e-therapy, but that is simply because of my own preferences, opinions, and comfort with this process.
- I will not engage in online therapy with someone I cannot meet at least once in my office. This is not just to attach a face to a name, but also to assess the appropriateness of online counseling to the individual and the problems we are to address. Online therapy is not Dr. Laura (god forbid) or a quick advice approach -- although there are ample such sites on the Internet today.
- In that vein, I will not do online counseling with anyone who may be (or may become) suicidal or otherwise unpredictable in behavior (e.g., aggressive, impulsive). This does not mean e-mail contact is inappropriate for such clients, but rather that e-therapy cannot be the primary form of counseling for those with such risks.
- I must have my “Online Counseling Agreement” form understood and signed by the client before conducting e-therapy. You can inspect this form online.
If these caveats seem reasonable to you, and online counseling is appealing, contact me so we can discuss it further. I’ve also put together a checklist of things to consider, and encourage you to read it. If you want to learn more about online therapy as an alternative counseling method, check out a couple of articles I found very helpful: Intimacy in Psychotherapy Online, by Walter Logeman and a more extensive Myths and Realities of Online Clinical Work by the ISMHO’s Clinical Case Study Group.