The impact of the internet on our social and business lives meant that the use of typed text surged before much sense could be made of how or when it was appropriate. The need to meet face-to-face or make a telephone call was replaced with the speed and ease of sending an email. In addition, the use of mobile phone short message services ('texting') has also meant that the spoken word has found a back seat in our interaction with one another. The implications for the future of communication within society in the light of these technological developments is not the remit of this chapter, but it is worth noting how this has demanded a rush in development of electronic mental health provision and therapy in particular. The essential point is that the widespread use of text communication in internet therapy provision has happened despite concern with and lack of evidence about its appropriateness or efficacy.
As early as 1966, Joseph Weizenbaum developed a programme called ELIZA 1 to emulate a Rogerian therapist, using a basic natural language engine that recognised keywords and could reply in hard-coded stored sentences. This was done to show how a computer could convincingly be considered to be an actual person, in this case a therapist. ELIZA's communication was very basic, and yet an interesting result emerged as its users developed meaningful relationships with the program, sharing sensitive information and considering the exchange to be therapeutic, even after becoming aware that they were interacting with a piece of software (O'Dell and Dickson 1984). The first attempt to use internet communication to deliver therapy dates back to 1972, between computers at Stanford and UCLA. Fee-based 'mental health advice', usually one-off question and answer sessions, started to appear in the early 1990s. By 1995, ongoing helping therapeutic relationships were being used through what is now considered therapy via email and internet relay chat.
In early 1999, I started researching internet therapy in response to my own use of email and chat rooms as a therapeutic tool. Already familiar with the social use
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