Bad day at the office? Spouse acting unresponsive? Generally
Help is just an e-mail away.
As the Internet becomes an increasingly popular venue for advice-
wielding therapists, Web counseling has emerged as one of the
debates in psychotherapy.
The dozens of individuals plying their trade on-line say e-mail
counseling is not only convenient and affordable but, for some
people, also more conducive to free expression. Skeptics, and there
are many, call it an oxymoron.
"You can tell a lot of stuff from someone's voice," notes Dr.
Douglas Weiss, owner of the Fort Worth Heart to Heart clinic for
sexual addiction. "Whereas if you just wrote me an e-mail, I
wouldn't know if you were 50 or 21. It robs you of a large part of
that intuitive, interactive part."
On-line counselors offer a virtual ear to individuals suffering
everything from low self-esteem and sexual addictions to eating
disorders and anxiety. They claim professional, confidential and
comparatively low-cost treatment, as close as the nearest computer
Think "modem-as-sofa" and get comfortable.
"Nobody's grandmother will be surprised by the fact that you can
create a lot of intimacy through writing letters," says Lawrence
Murphy, co-founder of Therapy Online, based in Canada. "All of the
clients have been impressed with the connections they've been able
make" with their Web counselor, he adds.
Murphy and partner Dan Mitchell opened their on-line office two
years ago, marrying interests in computers and counseling. They also
saw a need not being met.
"There are a lot of people who find it difficult to come into an
office and sit in front of another person and disclose their
problems," Murphy explains. People in small towns might not have
easy access to a therapist. Worse still, the local psychologist
might be a relative. And clients who move around a lot don't want to
tell their stories to five different psychologists.
With on-line counseling, "you never miss an appointment," Murphy
says, "you don't have to get a baby sitter, you don't have to take
hour off work, you don't have to wait until the appointment to talk
about what happened."
The Internet supports about 50 on-line advice givers, according to
Dr. John Grohol, director of Mental Health Net. Most of them
appropriately refer to themselves as counselors, he says, not
"Counseling is looked at more as helping the person to determine
what the best course of action might be and it deals generally with
much simpler problems," Grohol says. "To actually say that you're
doing psychotherapy on-line is taking a big leap in terms of what
been traditionally known as psychotherapy."
The ethics code of the American Psychological Association states
that productive therapy requires a "professional relationship"
between psychologist and client. That, says Dr. Stuart Tentoni,
would be extremely difficult to develop without face-to-face
"Psychotherapy is based upon both verbal and nonverbal
communication," says Tentoni, coordinator for the Norris Health
Center at the University of Wisconsin at Madison. "Since one cannot
see the person on the other end of the keyboard, it is impossible to
get a full sense of that person's situation to adequately render
opinions or advice to them."
But even Grohol, who studies on-line behavior and leads mental-
health chats on the Internet three times a week, acknowledges the
appeal of Web counseling.
"(On-line) relationships are very real and they're just as intense
and just as important as they are in the real world," he says. "So
it's no surprise to me that people are trying to establish
therapeutic-type relationships (over the Internet). Whether it's
therapy or not, I don't know."
One of the biggest concerns surrounding on-line therapy is fraud. …