Counselors are Going Online
There is a multitude of websites devoted to mental health. Some of
these sites offer information or assistance in finding a therapist. But something
new has entered the world of Internet psychology. This new phenomenon is online
counseling.
Why have therapists begun offering their services through the Internet?
"I think people have seen there is a niche in the marketplace," explains Dr.
Shirley Vandersteen. Vandersteen has noted the popularity of chat rooms where
people commonly discuss problems in love and life.
Dr. Sandra Levy Ceren has definitely recognized an increase in the number
of sites offering information in psychological matters. But she doesn't feel
that counseling plays that big a part. "There is more access to finding a
therapist online, but not necessarily doing therapy online," says Ceren.
But there are enough people who seek therapy from their home computer that
there are plenty of sites that do offer online counseling. Now patients and
doctors can have a therapy session via e-mail or a chat room. In fact, patients
may even take part in group therapy.
But like many new ideas, online therapy has met with its share of accolades
and criticism.
Benefits
As for the patients, the prospect of visiting a doctor's office and speaking
face-to-face is difficult. "People who are concerned that seeking counseling
seems like an admission of frailty may find it easier to find help on the
Net than in person due to the sense of anonymity afforded them." That's according
to Therapy Online, an Internet site offering online counseling.
Dr. Todd Kettner agrees that a computer therapy session enables those who
are homebound to receive the attention of a doctor.
The thought of going to an office is hard for some. But it is absolutely
impossible for those who seek treatment but live too far away from medical
help. "It is especially difficult to get psychological help in rural areas,"
explains Kettner.
Through his schooling in the U.S. and his current practice in Canada, Kettner
views this lack of access as a common problem. "Tele-sessions, or phone sessions,
and online sessions would eliminate the difficulties."
Affordability is another big issue for many when contemplating whether
to see a mental health professional. For those who can't pay the hourly rate
to go to the doctor's office, online counseling is an alternative. Many Internet
sessions cost about $30, whereas a visit to an office can cost upwards of
$100. That's according to an article by Steve Tanner called Virtual Shrinks:
eTherapy Gains Momentum.
For the therapist, online counseling offers the opportunity to earn some
extra money from home without taking up so much office time. The number of
mental health practitioners going online is growing, says Larry Freeman. He
is the ethics and professional standards director of the American Counseling
Association.
Yet few therapists rely only on online counseling to earn a living. Instead,
online counseling is often used in combination with the traditional therapy
session, says Vandersteen.
Setbacks
"There are a lot of hazards to online therapy because there has been so
little research," says Vandersteen. "We don't know if the services provided
are effective."
Vandersteen is very concerned when it comes down to location. For example,
an online therapist may be working from New York and the patient with whom
they are communicating may live in Toronto. This difference in locale can
cause a lack of information, such as names of family or physical access to
the patient themselves, that may result in inadequate care.
"If a person is at risk, there is a legislative requirement to intervene,"
explains Vandersteen. "If I'm talking to someone in a small town in Sweden,
I have no way of helping them."
This lack of person-to-person contact is a major concern for many psychologists.
"Certainly with text-based chat formats, you lose information through the
processing," says Kettner. "The doctor can't pick up on emotions such as tone
of voice and facial expression. You lose some of that."
Ceren also regards this as a problem and hopes that it can be remedied.
"Video therapy with audio might be better, so we can see the facial expressions
and body movements."
Another issue doctors face is in taking the word of their patients. "People
use code names for anonymity," says Vandersteen. "There is opportunity for
distortion. Having an Internet therapeutic relationship is very limited."
Ethical and Security Issues
Could a third party break the patient-doctor bond of secrecy? Psychologists
in general are very wary of the confidentiality of the Internet. This factor
keeps many psychologists from pursuing online counseling. "This is a primary
concern," says Kettner. He recommends that patients do not include confidential
material when they e-mail him.
"There are no boundaries," says Vandersteen. "You are leaving a communication
record on the computer. Anyone in your household can look at it."
Vandersteen says that distance between patient and doctor is also a problem
where ethical matters are concerned. "You may be violating ethical standards
where that person is residing."
Other standards that are at risk, according to Vandersteen, are standards
of practice and the fact that there is no screening. "Anyone can call themselves
a therapist and go online," Vandersteen says.
"There is difficulty in verifying the licenser of the mental health provider,"
says Freeman. "We, at the American Counseling Association, have separate ethics
pertaining to online counseling and we hope that each member will adhere to
those ethics."
Online Therapy and the Mental Health Practitioner
Currently, most doctors and counselors who practice online also maintain
a separate office outside of the computer. According to Psychology Information
Online, a therapist can expect to pay about $200 to get a basic website up
and running. This is a cost many are willing to pay in order to get their
name out there and enable them to reach more clients.
Also, online therapy is so new and there are enough office therapists going
online that it has not yet caused an increase in the demand for those in psychological
professions. However, Freeman feels that the popularity for online therapy
will continue to grow, particularly when certain criteria are met.
"Once it's been clearly defined, and stipulations such as special training
are required. It's a new frontier," says Freeman. "It still has its quirks,
but through time, those quirks will be worked out."
Links
Psychology Information Online
Offers counseling services and other information concerning psychology
Therapy Online
Explore a detailed outline of the benefits of online counseling
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