Academic journal article Journal of Mental Health Counseling

E-Mail Communication: Issues for Mental Health Counselors

Academic journal article Journal of Mental Health Counseling

E-Mail Communication: Issues for Mental Health Counselors

Article excerpt

In an era where fast, efficient communication is needed, e-mail has emerged. From its beginning in 1971, professionals have used e-mail to communicate--lawyers, counselors, psychologists, and social workers with clients; nurses and physicians with patients. But despite its advantages, e-mail can cause problems. This article discusses both the positive use of electronic communication and the need to address fundamental counseling issues that arise in using it. The article reflects the AMHCA and ACA ethical codes for the use of technology in the counseling relationship. It also looks at e-mail communication between counselor and client with special attention to challenges of which counselors should be aware.


In an era of increasing need for communication, c-mail has emerged as an inexpensive means of communication. From its beginning in 1971 it was described as a fast, efficient, and economical means of communication, especially for the business world. Although initially designed as a brief, simple means of communication, 38 years later it has evolved into a complex, extensive means of communicating within the global community. Furthermore, because e-mail has expanded rapidly, it has become a common means of communication. The Radicati Group (2009) estimates that 210 billion e-mails are sent each day.

Although initially e-mail mainly served the business community (Fisher, 2008; Hoffman, Hartman, & Rowe, 2003; Peek, Peek, Roxas, Robichaud, & Blanco, 2007), it has expanded into numerous other arenas, including physician/patient (Brooks & Menachemi, 2006; Caffery & Smith, 2006; Constantino, Crane, Noll, Doswell, & Braxter, 2007; Nijland, Van Gemert-Pijen, Boer, Steehouder, & Seydel, 2008); attorney/client (Hricik & Scott, 2007; Walther, 2007); nurse/patient (Constantino et al.; Caffery, Stewart & Smith, 2007; Cleary, 2005; Dean, 2008; DeSantis & Keller, 2007; Edwards, 2008); counselor/client (Abroms, Gill, Windsor, & Simons-Morton, 2009; Alemi, Haack, Nemes, Aughburns, Sinkule, & Neuhauser, 2007; Bradley & Hendricks, 2009; Caffery & Smith; Chester & Glass, 2006; Haberstroh, Duffey, Evans, Gee, & Trepal, 2007; McAdams & Wyatt, 2010; Watson, Jones, & Burns, 2007; Welfel, 2009); psychologist/client (Carlbring, Furmark, & Steczko, 2006; Fisher & Fried, 2008); and social worker/client (Finn, 2006; Parker, 2008); and its use continues to expand (DeSantis & Keller, 2007). Madden and Jones (2008) conducted a survey of the use of e-mail and reported that 81% of the participants said that they use it in their homes and businesses.

Studies related to e-mail issues faced in the physician/patient arena have produced a variety of findings. Gaster et al. (2003) studied e-mail use in a large academic medical center and reported that about 72% of physicians used it to communicate with patients. Houston, Sands, Nash, and Ford (2003) explained that electronic communication through e-mail or other web-based technologies may improve the physician-patient relationship by providing rapid, asynchronous interactions for responding to patient questions. Eysenbach (2000) found that physicians received unsolicited e-mails and other electronic communications from patients and others requesting specific advice about diagnosis, prognosis, referrals, and second opinions as well as general medical advice.

In a discussion of the conflicts that may arise between attorneys and clients using e-mail, Hricik and Scott (2007) described how the nature of electronic communication may exacerbate persona and lead to imputed disqualification of both the attorney and the law firm because someone not yet a client can send unsolicited confidential information to a lawyer. Doing so creates an implied attorney/client relationship when none actually exists. In fact, "opinions so far conclude that, by maintaining a website [that contains an e-mail contact address], a lawyer has manifested an intent to offer to form attorney-client relationships and to keep submitted information confidential" (p. …

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