therapy (also referred to as Internet therapy, distance therapy, cyber
therapy or e-therapy) is used to describe the variety of ways a
professional counselor or psychotherapist can communicate with you over
the Internet or telephone. It may consist of emotional support, mental
health advice or the same professional services clients receive in
face-to-face therapy. It could be as brief as one question, or an
ongoing conversation. It may take the form of e-mail, chat, video or
even Internet phone (voice-over-IP).
Online therapy is not the same as traditional face-to-face psychotherapy.However, for
many the stigma associated with seeking mental health treatment still
gets in the way, or trust issues make it difficult to sit with someone
in person while revealing sensitive information. Online
therapy can also feel safer or like a good first step for those who
feel overwhelmed at the prospect of seeking help and the trust risks
involved. For example, many
sexual abuse survivors report that they feel too frightened to see a
therapist in person, at least in the initial stages of their healing.
It may be much less frightening for them to receive therapy online from
the safety and familiarity of their own home.
In considering the possibility of Online Therapy it is important to
consider the potential benefits and areas of concern. The following
lists are not all inclusive but hopefully give you a starting point.
When might Online Therapy be a good choice for you?
You are struggling with an anxiety disorder, agoraphobia or other issues that make it difficult to attend traditional therapy
You live in a rural area
hard to find therapists with the expertise you seek in your area (LGBT
affirming therapists or those with expertise in complex trauma might be
are busy, travel out of town for work, have a schedule that conflicts
with typical office hours available: email therapy would let you
compose your message at your own pace and send it at any time.
You feel concerned about issues of trust, privacy, disclosure, being seen
You a physical disability or mobility issues which makes getting to traditional therapy too difficult
You have an easier time writing rather than speaking certain issues. This is often the case for trauma survivors
You have never tried therapy and feel this would be an easier way to start
like a written record (with email or chat forms of therapy) to review
as needed. This can be especially useful if memory issues are present,
for example with dissociative amnesia.
What should you consider before starting Online Therapy?
Therapy is not the best resource for people in immediate crisis. Crisis
lines, a local walk-in clinic or emergency room may be better options.
If you or someone else is actively suicidal, you can call 1-800-SUICIDE.
Therapy is still a relatively new field. Make sure you seek out a
practitioner who is experienced in general and aware of the specific
risks as well as the advantages.
the form of Online Therapy to your strengths: If youíre going to work
with a therapist by e-mail or chat, you must be comfortable writing
expressively, informally, and in some detail. If you donít like to
write, or if you tend to misinterpret written communication,
videoconferencing or Internet phone would be better options.
any form of therapy, you must be willing to share your thoughts,
feelings and self for therapy to really work. This may be even more the
case when your therapist does not have nonverbal information to draw
How comfortable/familiar are you with technology? Those new to email, chat or video conferencing may have a harder adjustment.
should have a way to contact the therapist in case technology fails.
For example, if your computer crashes in the middle of a session, do
you have the therapist's phone number?
about additional privacy/confidentiality issues specific to these
formats: others' having access to your computer or email accounts
(using a work computer is never a good idea), accidentally sending
email to the wrong address, encryption and storage issues.
sure that the online therapist clearly identifies their credentials,
areas of expertise. Ideally, you should be able to verify these , for
example through a licensing board.
Potential miscommunications given different communication methods. It can
be hard to read tone in email or chat! Can you be prepared to elaborate
or ask for clarification rather than assuming the worst?