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Mental Health

What’s the Deal with Online Therapy?

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Marlene M. Maheu, a therapist, uses video conferencing to communicate remotely with patients. She has served on task forces to address issues of online therapy. Credit Sandy Huffaker for The New York Times

Online counseling or “web therapy” is an emerging practice in the world of social services.  Although online counseling is not a substitute for traditional psychotherapy, it has many benefits, including flexibility, anonymity, comfort, and convenience.  Perhaps you are nervous about going to therapy—with online counseling you can test it out for as little or as long as you’d like in many different modalities.

Many services are offering “Skype” or video counseling using secure software, or voice phone calls directly with a therapist, or even text message/email therapy that is not offered in “real time”—giving you and the therapist both a chance to respond when most convenient for you.  Whichever modality you choose, the world of online counseling can introduce you to therapy in a non-invasive, comfortable manner at your own pace.

However, online counseling is not appropriate for everyone.  Online counseling likely does not include prescribing medications, which can be essential to the recovery of severe mental illnesses.  It is also not appropriate for anyone who is currently suicidal or homicidal, or anyone who is currently experiencing psychotic symptoms. If this is the case, you should immediately call 911 or your local emergency authority.

Another draw and danger of online therapy: anonymity. Many people avoid treatment for reasons of shame or privacy. Some online therapists do not require patients to fully identify themselves. What if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient? Read More

Most importantly, anyone who needs intensive support or hospitalization is not a good fit for online counseling. Online counseling should be used as additional support and not a replacement for those needing intensive treatment.  Another limitation of online counseling is the difficulty in interpreting voice tone, body language, and other forms of non-verbal communication in traditional therapy methods.

Although online counseling is not appropriate for everyone and some professionals are still skeptical about it, there are studies showing online counseling can be just as effective as face-to-face in person therapy with a better attendance rate.

The Journal of Affective Disorders reported a University of Zurich study divided a group of 62 patients in half and found that depression was eased in 53 percent of those given online therapy, compared to 50 percent who had in-person counseling. Three months after completing the study, 57 percent of online patients showed no signs of depression compared to 42 percent with conventional therapy.

In an April 2012 edition of Psychiatric Services, it was reported that in a four-year Johns Hopkins study that included close to 100,000 veterans, the number of days that patients were hospitalized dropped by 25 percent if they chose online counseling. This is slightly higher than the number of hospital visits experienced by patients who used face-to-face counseling.

Lastly, according to the American Psychiatric Association in 2007, patients in Ontario, Canada were assigned to face-to-face or live video counseling and experienced statistically the same clinical outcome and level of patient satisfaction. The only difference was that the cost of providing the online service was 10% less per patient.

Overall, online counseling permits the client to access therapy when it’s convenient for them and without having to leave the comfort of their home.  It could be a type of counseling that can reach more people in need which is necessary and important.  What do you think?

Brittany Freese is an established mental health professional and graduate of New York University’s Silver School of Social Work. She is an LGBTQ affirmative therapist whom seeks to identify the strengths in her clients and allow them to recognize and utilize those strengths. Brittany has counseled clients in both rural and urban settings, and embraces diversity in a non-judgmental, strength-based, empathetic manner. Visit Brittany at http://www.bfreesecc.org/ or read her blog.

          
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