Online Therapy

Online Therapy







Online Therapy

            Online therapy is associated with various problems, which include inability to intervene in case of an emergency, legal implication, and a restriction on the nature of cases that can be handled through online therapy. However, perhaps the main problem that online therapy poses has to do with lack of a visual element where the therapist and the client are not able to interact visually as most online sessions are handled through electronic mail or online discussion forums. This results in instances where the counselor does not have the ability to observe key behavioral cues exhibited by the client, which may offer additional insight into the nature of the client’s problem. Indeed, most critics of online therapy cite this as the main reason why online therapy should be discouraged. However, the practice seems to be gaining ground, given the fact that more than 65 percent of psychologists have reported using the telephone to conduct psychotherapy (Griffiths, 2001). For that reason, it is important that the main problem associated with online therapy, that of lack of a visual element, be addressed.

One way to address this problem is through use of video during calls. Video conferencing, as the practice is referred to, is indeed becoming more common in the field involving online therapy (Manhal-Baugus, 2011). Using video conferencing, the therapist and the client are able to communicate visually, and the counselor has the ability to make note of visual cues given by the client. This is the main advantage presented by video conferencing during an online therapy session. The intimacy between the counselor and client is enhanced and the therapeutic connection, based partly on non-verbal cues, is obtained and maintained.

Another advantage of this solution is that, unlike traditional face-to-face therapy, online video conferencing is not intimidating to the client. In fact, the client feels comfortable and relaxed because he or she is in a familiar environment. By carrying out a video conference therapy session in the client’s comfort zone, the counselor has the ability to get more information about the client than he would have via email or telephone-conducted therapy (Allerman, 2002). A disadvantage of this solution is that much as the counselor has the ability to read non-verbal cues given by the client, there are expenses incurred by both the counselor and the individual seeking the therapy. To begin with, therapists are required to undergo extra instruction in order to learn the basics of conducting online therapy sessions. This instruction covers online security risk, patient confidentiality, and video skills, incurring additional instructional costs on the therapist. Secondly, direct costs are incurred by both the counselor and the individual seeking the therapy using video calls, as the most reliable service providers are quite expensive.

A second possible solution to the problem is that of having an actual face-to-face session with the client on a regular basis. This involves the patient going to the therapist’s office where his or her problems are discussed. However, this would be done only occasionally, as the main mode of counseling remains online. This solution is advantageous because it enables the therapist to observe the patient closely during the face-to-face sessions, as well as monitor his progress when sessions are held (Rochlen, Zack, & Speyer, 2004). The solution is also advantageous because the therapy costs are much less than those sessions involving physical interaction and those done using video conferencing. Moreover, there is a reduction of security risks associated with video conferencing using this method.

However, this solution has its disadvantages. To begin with, online therapy sometimes comes as a solution to the problems posed by face-to-face therapy sessions. Bringing the face-to-face element back into therapy sessions may not be well received by some patients, who may have opted for online sessions for their convenience. Additionally, this solution is problematic because the therapist is still not able to read non-verbal cues on a regular basis. This causes a breakdown of communication in certain instances, some of which may be crucial. It is important that both the therapist and patient determine what solution would work best for them, only after weighing the merits and demerits of both possible solutions.


Alleman, J. R. (2002). Online Counseling: The Internet and Mental Health Treatment. Psychotherapy River Edge-, 39, 199-215.

Griffiths, M. D. (2001). Online therapy: A cause for concern? The Psychologist, 14, 244-248.

Manhal-Baugus, M. (2001). E-Therapy: Practical, Ethical, and Legal Issues. CyberPsychology & Behavior, 4(5), 551-563.

Rochlen, A. B., Zack, J. S., & Speyer, C. (2004). Online therapy: review of relevant definitions, debates, and current empirical support. Journal of Clinical Psychology, 60 (3): 269-283.

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