Counseling done over the Internet can be convenient and affordable. But there are things you should know before you try it.
Kelly’s got the blues again. When she got home from work, she found a mean voice message from her ex-husband. Her depression has been improving with help from her therapist, but her ex’s words really hurt. Instead of having to wait for an appointment, she logged on to her therapist’s Web site and wrote a long e-mail.
In the U.S., about one in four adults has a diagnosable mental illness each year, but only a fraction of them get the help they need. Online therapy may offer hope for those who have missed out on therapy’s benefits because of cost, lack of access or fear of stigma.
Online therapy is also called cybercounseling or telepsychology. It can bring mental health support to people at their convenience in the privacy of their own homes. And it is breaking down barriers that have kept many people from seeking mental health treatment.
What is online therapy?
Online therapy is much like psychotherapy done in an office in terms of methods and results. But it is done remotely using technology instead of face-to-face.
Online therapy may be conducted using a variety of technologies, such as:
- Internet telephone
- Online chat or instant messaging
- Video conferencing
In most cases, you type out your issues or concerns and send them to the therapist. The therapist reads and responds to your message for a fee. Here are two typical scenarios:
- You make an appointment online and then interact with the therapist in real time using chat or messaging.
- You write an e-mail to the therapist at your convenience. The therapist responds to your message within a set period of time.
Some therapists combine online therapy with face-to-face sessions or phone calls.
What are the pros and cons of online therapy?
- May make it easier to discuss private issues
- Makes therapy available even if you live in a remote area or are in a relationship that makes it difficult to be away from home
- Can be accessed at times that fit with your schedule
- Private – no one else will know that you are seeking therapy
- Gives you a record of the therapist’s responses that you can review whenever you want
- May be difficult if you don’t type well or have trouble expressing yourself well in writing
- May be hard to develop a relationship with the therapist
- Risk of misunderstandings due to lack of physical cues
- May not be appropriate for certain types of mental health issues, such as schizophrenia
- Possible privacy and security issues, which is the case with anything that is done online
Making a decision about online therapy
Deciding to seek online therapy can be a positive step toward better mental health. But be wary when choosing a therapist. Anyone can put up a Web site and claim to offer therapy. Do your homework before you get started.
When considering a therapist, find out:
- The therapist’s name. Nicknames or aliases are common on the Internet. You should know the real name of your therapist.
- Qualifications. The therapist should supply you with information about his or her training as a therapist. These may include degrees, licenses or certifications. The therapist should provide phone numbers or Web addresses where you can confirm these qualifications.
- Memberships. Ask if the therapist belongs to any professional groups, such as the American Psychological Association and the National Association of Social Workers. At present, there is no group that approves or monitors online mental health providers.But, organizations such as the International Society for Mental Health Online (ISMHO) and the National Board for Certified Counselors issue guidelines for online therapy that promote ethical standards.
- Fee for services. Some therapists charge by the word or by the e-mail. For real-time therapy, such as chat or instant messaging, you might be charged by the minute.
- Privacy policies. Find out how your information and messages will be protected. This may be ensured by accessing a secure Web site and using passwords. Be aware, though, that even with established privacy measures, your information may not be entirely secure.
- Procedures. For example, the therapist should specify whether sessions will be conducted in real time, with immediate responses, or you will wait for responses. If you will wait, find out how quickly you can expect to receive replies.
- Emergency contacts. Find out what to do if technology fails (for example, your Internet connection goes down). You should have a backup way to contact the therapist. Likewise, the therapist may want to have an alternate way to contact you. He or she may also want the name of your family doctor in case of an emergency.
You should also consider whether online therapy suits your needs. Some research has shown that it can be helpful for depression. But it may not be a good choice if you have a severe mental illness. You may need to be under the care of a psychiatrist.
If you have thoughts of death or harming yourself or someone else, call 9-1-1 or seek emergency help right away.