MENTAL HEALTH: Online Counseling Increases in Popularity
An increasing number of patients and therapists have started using the Internet as an alternative to traditional counseling, taking comfort in the anonymity that online counseling offers, the Los Angeles Times reports. Online therapy generally consists of an exchange of e-mails over the course of a few hours or days. Julie Keck, a Newport Beach psychologist who does 40% of her counseling at CouselingCafe.com while keeping a traditional office practice, said, "I call it 'email counseling.' This isn't therapy. Therapy is a lot more leading the patient to their own solutions ... learning who they really are. Email counseling is more like direct advice. Anyone who says it's more than that is fooling themselves." The Internet provides solace for Americans who are reluctant to seek counseling and then stick with it after an initial visit. Rick Harrison, a Newport Beach family and marriage therapist who runs PsyNet.com, said, "People aren't looking for therapy on the Internet. They are looking for fast answers to questions under the cloak of anonymity. They ask questions they wouldn't ask face to face." Vicky Laszlo, a Marlboro, N.J.-based counselor, said that most online therapists are marriage-and-family therapists and psychologists, with nearly half having a Ph.D. Therapists charge on average $18 an e-mail, according to Laszlo.
Is It Safe?
Despite the lure of anonymity, online counseling has its detractors. Los Angeles psychiatrist Dr. Walter Jacobson said that online counseling "lacks a crucial element in the relationship between patient and therapist." He added, "A bond has to form -- being able to make eye contact, how comfortable they are. You are not going to get that in email. I think sometimes the treatment may be suboptimal." June Caldwell, a Redondo Beach marriage-and-family therapist who also started a counseling Web site, said that she "remains uneasy with the many unresolved aspects of etherapy, such as how to handle clients who suffer a crisis, how to ensure privacy and confidentiality and how to abide by state laws governing mental health practices." Jacobson added, "When you're online, you can't see someone getting tense, getting upset, getting guarded. In a room, you can de-escalate. You can say, 'Let's back away,' calm them down and get to a safe place. While online, you may not know that they're freaking out. They may even be on the verge of suicide, and you can't do a thing" (Roan, 3/7). John Grohol, an Austin, Texas-based psychologist, explained some therapists' reservations: "A lot of concern remains about doing online therapy because we don't have the research yet to show it's safe and effective." But that's not to say that online counseling will soon be over. In the last few years, the number of mental health providers online has increased from a "handful" to 300, Grohol said (Elias, USA Today, 3/7). He added, "Most people recognize this is one of those snowballs that you can't stop from rolling down the hill. It's a question of how can you do it the most ethical and effective way possible" (Los Angeles Times, 3/7).