The Internet has revealed itself as a mediator between therapists and clients as online counseling websites surface all over the web. Online counseling, sometimes called E-therapy or cyber-counseling, is when a professional offers emotional support and advice over the Internet. Possible mediums of communication include e-mail, instant messenger, or Internet phone.
Prior to the popularization of the Internet and the World Wide Web, on-line self-help groups existed in the 1980’s in the form of computer bulletin boards systems (BBS). The success of the aforementioned are thought to be the precursors to modern online counseling. The earliest known organized service to provide mental health advice online was "Ask Uncle Ezra," a free service (to this day) offered to students of Cornell University in Ithaca, NY.
Advocates of contemporary online counseling claim it is effective when traditional means of counseling are unavailable, i.e. one lives in a remote location or has financial restraints and issues. For some people, the anonymous and private reality of online counseling is very appealing. A benefit of online counseling for the counselor includes no office space to rent and email relations that allow a convenient response time. Online counselors agree E-therapy is not for people who exist in a state of crisis and further, one must be comfortable writing and expressing their emotions with the written word. Some people who have tried e-therapy say it’s a little like keeping a journal. You can write at length, and explore your thoughts and feelings. Online counseling costs, on average, about $40 per session.
Critics of online counseling argue that it will never replace traditional, face-to-face relationships. These critics state that online counseling does not afford a therapist the ability to interpret their clients’ body language, facial cues, and tone of voice–since all of these aspects are absent in an online counseling session. Online counseling, some protest, lacks the integrity of the relationship formed between a client and therapist. Additionally, psychotherapy across state lines becomes a grey area in regards to state licensure. In Minnesota, for example, the license restricts therapists to business conducted only in Minnesota. The majority of liability insurance companies will cover online work as long as it is conducted within the bounds of the psychologist's license. Thus far, there have been no legal challenges.
Because online counseling is a relatively new form of therapy, regulations have yet to be established. The International Society for Mental Health Online (http://www.ismho.org/) has published ethical guidelines to assist professionals in the development of ethical e-counseling practices.
The official stance by the psychotherapy community is still in question in regards to the efficacy or non-efficacy of online counseling.
“Studies investigating the long-term effectiveness of e-therapy for the treatment of specific disorders or conditions are currently lacking. As a relatively new treatment modality, e-therapy has not yet progressed to the status of an empirically validated therapeutic medium. There is a need for additional research into the risks and benefits associated with e-therapy in the treatment of various conditions.”
Excerpted from The American Psychiatric Association (http://www.psych.org)
The most popular reason for online counseling is, for the therapist and the client, the convenience. According to the Surgeon General’s report on Mental Health (1999), one in five Americans has a diagnosable psychological problem while nearly two-thirds of them never seek treatment. For those people that are too busy, or who may feel embarrassed or uncomfortable seeing a therapist, online counseling offers a variation on the traditional scope of counseling.