The Internet and World Wide Web have revolutionized commerce and communication and have provided anyone with a computer and a modem with easy access to a vast assortment of products and services. The quality of these products and services varies widely, and the axiom of "buyer beware" clearly applies to the Web. It is not surprising that some counseling professionals have begun to use the Web to offer professional services to clients. Although accurate estimates of the number of WebCounseling sites or their rate of growth are difficult to obtain, current evidence suggests that there are several thousand mental health professionals with some Web-based dimension to their practice (Bloom & Walz, 2000; Grohol, 1998). Most seem to use the Web to advertise their office practices or to communicate with current clients or colleagues. However, the number of those who offer WebCounseling as an exclusive treatment intervention for clients seems to be relatively small and may number no more than several hundred.
Currently, WebCounseling primarily consists of e-mail exchanges (both synchronous and asynchronous) and communication through synchronous chat rooms. Videoconferencing is a rarely used option (Day & Schneider, 2000; Magaletta, Fagan, & Ax, 1998; Rabasca, 2000) but may become more viable when technical problems are resolved (Sussman, 1998). As with any new phenomenon, terminology is in flux and a number of different names are in use to refer to Web-based services--WebCounseling, computer-mediated counseling, cybercounseling, E-counseling, e-mail counseling, Internet counseling, online counseling, and telehealth services. For the purposes of this article, we use WebCounseling, the term adopted by the National Board for Certified Counselors (NBCC).
Because scholars predict its continued growth and because WebCounseling has the potential to benefit or to harm consumers (Bloom & Walz, 2000; Duncan & Watts, 1999; Griffiths, 2001; Gutterman & Kirk, 1999; Jerome et al., 2000; Lee, 1998; Sampson, Kolodinsky, & Greeno, 1997), this form of service has attracted the attention of professional associations in counseling and mental health. Both NBCC (1997) and the American Counseling Association (ACA, 1999) have published WebCounseling guidelines for counselors. In contrast to the official professional codes of ethics, however, compliance with these standards is voluntary, and their major role is to inform and encourage competent and responsible service. The American Psychological Association (APA) is in the process of developing revised guidelines (Jerome et al., 2000) and has already published a set of principles for practicing in telehealth settings (APA, 1996; Reed, McLaughlin, & Milholland, 2000). The International Society for Mental Health Online (ISMHO), a group established by professionals providing online services, has also developed standards for practice and has actively fostered research initiatives for WebCounseling. In fact, ISMHO (2000) has produced the most extensive set of guidelines for practice published thus far and has been conducting case study research through a closed listserv of practitioners (available at http://www.ismho.org). One independent Web-based guide for consumers has emerged under the leadership of Martha Ainsworth, who is also active in ISMHO. This service, called "Metanoia" (Ainsworth, 1999), provides potential consumers with recommendations for choosing a WebCounselor, a directory of Web providers, and a service to check the credentials of those providers.
Two potential benefits of this medium are regularly cited in the literature. The first is its potential to act as a gateway to help people, who might not otherwise seek counseling, to gain confidence in the ability of counseling to assist them with their problems (Griffiths, 2001; Lee, 1998). The second is its potential to provide access to professional service for people in remote areas and people whose medical or physical conditions make face-to-face contact with a professional difficult (Childress, 1998; Holmes, 1999; Sleek, 1995). …