July 21, 2011
Online therapy also known as online counseling or e-therapy involves the provision of professional counseling services to clients through the internet. Online therapy uses e-mail, instant chatting, and video conferencing as well as internet phone to connect the client to the professional (Cook and Doyle, 2002). It is a means of replacing the traditional psychology where the clients visit the counselors at their office for a face-to-face treatment with online psychology. The increasing use of the internet everyday has caused the increase of online therapy where clients find it easier to hold their sessions with the professional counselors without having to visit their offices (Alleman, 2002). Several studies have proved it as effective just as the traditional method though many still refute its ability to replace the face-to-face therapy. One main effect of online therapy is the Online Disinhibition Effect (Anthony, 2009).
Disinhibition is the culture found in the internet where people due to anonymity of identity find it easy to say or write anything, which has helped many people express themselves without fear of victimization. Disinhibition can be analyzed into several components that give therapy clients the courage to express their inner or true self. The first component is the ability of the client to remain anonymous to the psychologist where the clients can use different names if they wish not to disclose their identity. The psychologist will only know what you want to tell them and this makes the clients feel less vulnerable when they open up their problems. More still, when not identified they feel that they are not responsible on what they decide to tell about themselves and could give a sense that they are describing another person that is not them. According to Anthony (2009), this is referred to as “dissociation”.
Another component of the disinhibition is invisibility where the client is not physically seen by the therapist, and this gives them courage to do or say what they cannot say face-to-face with another person. Their identity may be known through e-mail and instant messaging but lack of physical appearance gives more courage to the clients to express what they want, further magnifying the disinhibition effect. Most people have computers at home and probably no one will be there to see what one is writing and this adds courage to the clients especially the shy people.
The third component of disinhibition is the asynchronicity effect where the client feels that he or she can choose to see the therapist later since online interaction is not immediate such as emails where they take some time before responding with some taking more time even days before a response. With little time or some delay time before a response, clients are able to think and reflect on what they write, creating an ability to express themselves, which they might not do with a face-to-face conversation (Rochlen, Zack & Speyer, 2004). Many psychologists say that clients feel safer sending information and leaving it there other than a direct conversation where online therapy gives the ability for people to express what they keep to themselves or the imagination that they could not say in real since writing about you is like having a conversation within oneself.
The fourth disinhibition component is equalizing all people irrespective of what one is or where they come from. This has been enhanced by the lack of the internet in recognizing status of a person or authority. With anonymity, one can talk to anybody irrespective of class, race, gender or status since the internet does not recognize such boundaries. This makes the clients feel equal to the other person they do not know. In most cases when in front of an authoritative figure, people are not in a position to express themselves well since they would not like disapproval. Online communication provides a leveled ground for all people to express themselves (Suler, 2004).
What has happened with online therapy is that is has provided services for all people who can use the internet. For instance, referring to a previous case where a client sought services from an online therapist from a different state where the two states have different rules when it comes to therapy. It happened that the client suffered from serious mental illness and the therapist did not know since he could not examine the client on a one-on-one therapy and continued to provide online therapy through e-mails and instant chatting. The client reached a destructive point and acted violently by assaulting several people when he got worse. It was found that he was receiving online treatment and the therapist was summoned and blamed for his behavior, where it was said he was supposed to find out how serious the case was, considering he had gone beyond his state.
This affected the reputation of the therapist who had to take the blame for what happened to the client and the assaulted persons who had to seek minor treatment from injuries. From the therapist’s point of view, due to disinhibition effect, he was not able to verify the truth of the information delivered to him hence did not make a good judgment about his condition. The assaulted people were affected too, since they had to seek medical attention. For the client, he had to be confined in a mental institution until he would be proved okay to leave. However, despite going to a mental institution, he was not held responsible for his actions, which was an advantage for him.
Alleman, J. R. (2002). Online Counseling: The Internet and Mental Health Treatment. Psychotherapy River Edge-, 39, 199-215.
Anthony, K. (2009). John Suler’s Disinhibition Effect as summarized by Kate Anthony. Retrieved from http://www.onlinetherapyinstituteblog.com/?p=298
Cook, J.E., and Doyle, C. (2002). Working Alliance in Online Therapy as Compared to Face-to-Face Therapy: Preliminary Results. CyberPsychology & Behavior, 5 (2): 95-105.
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.
Suler, J. (2004). The Online Disinhibition Effect. Cyberpsychology & Behavior, 7 (3): 321-326.