What You Need to Know About Online Therapy

A Look at the Ins and Outs of Online Psychotherapy

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Online therapy, also known as e-therapy, e-counseling, teletherapy or cyber-counseling, is a relatively new development in mental health in which a therapist or counselor provides psychological advice and support over the internet. This can occur through email, video conferencing, online chat, messaging, or internet phone. Online therapy can occur in real-time, such as in phone conversations and online chat rooms, or in a time-delayed format, such as through email messages.

It is important to note that online therapy cannot be considered psychotherapy and will never replace traditional therapy. In many ways, e-therapy shares some similarities with life-coaching. While online therapists cannot diagnose or treat mental illness online, they can offer guidance and advice to people experiencing problems in relationships, work, or life.

E-therapy has limitations, but it is quickly becoming an important resource for a growing number of consumers. Despite a lack of research on the effectiveness of online treatment, e-therapy offers mental health professionals another way of providing services to clients.

How Does Online Therapy Work?

Primary tools for communicating in online therapy include:

  1. Email
  2. Instant Messaging (IM)
  3. Real-Time Chat
  4. Internet Phone
  5. Videoconferencing

The History of Online Therapy

Distance communication between a therapist and client is not a new concept. Sigmund Freud utilized letters extensively to communicate with his clients.

Self-help groups began emerging on the internet as early as 1982. Today, there are numerous sites offering mental health information as well as private e-therapy clinics such as Find-a-Therapist.com.

The growth in online counseling and mental health services has led to the foundation of the International Society for Mental Health Online.

This dramatic rise in the availability of online health care has led to a need for information and guidelines for customers interested in receiving mental health services via the internet.

Online Therapy Today

While online therapy is viewed with skepticism by a large number of mental health professionals, it has received support from many patients who have utilized online mental health treatments. In a review of studies published in the journal World Journal of Psychiatry, patients receiving mental health treatment through video conferencing reported "high levels of satisfaction."

Online therapy is not appropriate for everyone, but it has shown effectiveness in some situations. For example, recovering addicts might benefit from online therapy, especially for those who feel uncomfortable attending traditional face-to-face support groups.

Dr. John M. Grohol of PsychCentral notes that while many psychologists are willing to try e-therapy, there is a notable lack of consumer demand. "People are so used to getting services for free online, the idea of having to pay for professional therapy online is still not something most are willing to do," he explains. "If it's going to cost pretty much the same as it would for face-to-face services, many are going to opt for the face-to-face services."

Online psychotherapy services have some advantages and disadvantages that should be carefully considered. Convenience is often cited as one of the greatest benefits while unreliable technology and lack of insurance coverage are potential downsides.

Before you consider online therapy, you should think about issues such as confidentiality, ethical and legal issues as well as the qualifications of online therapists.

Training and Qualifications for Online Therapists

Just as therapists and counselors in "real-world" settings can have a range of qualifications and licenses, online therapists can also differ considerably in their training and credentials.

While some sites may promise a quick and easy path to becoming an online therapist, the fact is that the educational and training requirements to become an online therapist are exactly the same as they are for a therapist or counselor practicing in a traditional face-to-face setting.

However, the actual practice of online therapy is very difficult to regulate since therapists can operate from anywhere in the world making it tough to enforce state laws regulating education, training, and scope of practice.

Online therapy is appealing to mental health consumers, who often view it as a convenient, economical and accessible alternative to traditional face-to-face therapy. However, it also poses a number of unique concerns including questions about the confidentiality of client information the appropriateness of using online therapy as a treatment method for various psychological disorders.

If you are interested in becoming an online therapist, then you should check the laws in your state determine the requirements for becoming a licensed therapist or counselor.

The Online Therapy Institute also offers a good ethical framework for the use of technology in mental health. These guidelines suggest the minimum practices and standards required for ethical online therapy:

  • Therapists should only work within the scope of their practice. In other words, an online therapist should only offer services that he or she is trained to provide.
  • Online therapists should adhere to the laws and guidelines specified by their geographic location. For example, in the U.S., only individuals who have received specific training and have passed the required licensing process are legally allowed to call themselves Psychologists.
  • Therapists should obtain knowledge, training, and supervision in online therapy practices and techniques. This includes formal training (college or university courses), informal training (workshops and conferences), and clinical supervision (either face-to-face or online).
  • Online therapists should have a solid understanding of technology. This include both how to use the tools required to deliver psychotherapy online, but also how to ensure that client information remains private and secure.

Sources:

Chakrabarti S. Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World J Psychiatry. 2015 Sep 22;5(3):286-304. doi: 10.5498/wjp.v5.i3.286.

DeAngelis T. Practicing Distance Therapy, Legally and Ethically. Monitor on Psychology, March 2012. 43(3), 52. http://www.apa.org/monitor/2012/03/virtual.aspx.

Ethical Framework for the Use of Technology in Mental Health. Online Training Institute. http://onlinetherapyinstitute.com/ethical-training/.

Grohol, JN. Wait, There's Online Therapy? PsychCentral. http://psychcentral.com/blog/archives/2011/07/14/telehealth-wait-theres-online-therapy/.

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