Online therapy comes with problems, majority of them concerning anonymity where the counselor does not know the client or much about him. This raises issues of duty to contact third parties in case there is need to do so. Moreover, not everybody qualifies for online therapy since some cases will still need face-to-face therapy to diagnose the condition (Cook & Doyle, 2002). Therefore, it is necessary to have a resolution to such problems so that online therapy can be a viable option. The main solution meant to some of these problems is drawing up of a formal agreement with the clients requiring them to give full contact information and real identity as well as a family member’s contact (Robinson, 2009). This will be of help in cases of crisis as the counselor can be in a position to attend to the client or recommend him or her to a crisis therapist when necessary. The goal of this solution is to eliminate anonymity that creates too much disinhibition between the counselor and the client as well as that of ensuring therapist accountability to the client.
This solution of creating a formal agreement between the client and the counselor involves giving of full contacts that will enable the counselor to communicate with the client when the methods used are not enough to give comprehensive answers or to provide support. Sometimes the counselor might require more detailed responses and observations in order to evaluate the client’s progress, which might not be possible within online therapy. More still, emails and texts may not offer enough response to the clients and at times, there could be delays that could hinder complete response (Robinson, 2009). In the agreement, clients will be required to give contacts of their families so that when there is need for crisis intervention, the counselor can be informed to take the right measures. Additionally, clients would have to agree to being referred to crisis management therapists near them to ensure enough care for the client. With such an agreement, there will be no hindrance caused by anonymity where the counselor is not aware of the client’s geographical area, which also influences the practice of therapy as it differs within different locations.
Using this solution has its advantages to both clients and counselors since unbeneficial anonymity is eliminated and counselors are in a position to take full responsibility of their services to the clients. For instance, a counselor will be held responsible in case a client is undergoing a crisis and the counselor fails to take the right action. With such an agreement moreover, the family will inform the counselor of the crisis, and action taken to prevent harm. This is unlike when there lacks an agreement, with the counselor never being fully up-to-date with the client’s condition. In addition, knowing the location of the client will help the counselor in delivering therapy in accordance with the laws and regulations of the area. In addition, the counselor will know the nearest therapist to refer the client to in case of a crisis. Finally, the counselor can be in a position to call the client on the phone when there is no response to emails and texts that have been sent for some time, which could be an indication that something may be wrong.
On the other hand, this solution has its disadvantages with the main one being that eliminating anonymity may make the clients feel vulnerable to victimization. This is because anonymity allows clients to express their feelings without fear of victimization from people around them (Suler, 2004). When the client has to allow the counselor to have contact with his family, some may be discouraged as they would want to keep their issue from their families and might fail to seek treatment at all. In addition, when clients have to agree to being referred to other counselors for crisis management, some will feel that there is no confidentiality with the whole process and might refute to this resulting in refraining from treatment.
While the resolution will solve some of the problems faced in online therapy, there may be challenges and barriers in its implementation. One of these is a negative attitude to change where clients will feel victimized by having to disclose their real identity to not only counselors but also families, which they may not want to do. Most of the people seeking online therapy are encouraged by the anonymity of the internet, and revealing their identity may sound like a threat to their problem. Li censure is another one of the barriers where counselors might be forced to seek license to operate in areas they are not yet licensed to operate in considering that practices are different within different area codes (Rochlen, Zack, & Speyer, 2004).
The other challenge is presented in the computer skills required to keep records of who one’s clients are. More so, counselors might be required to ask their clients to apply for insurance covers of online therapy that might prove difficult to obtain. Conclusively, seeking an agreement is going to enable counselors deliver and track the progress of their clients, thereby placing them in a position that requires them to take full responsibility of their services to the clients. On the other hand, this solution might discourage some people who may not want to give up their anonymity to counselors since it may mean exposing their mental issues to friends and family.
Cook, J., & Doyle, C. (2002). Working Alliance in Online Therapy as Compared to Face-to-Face Therapy: Preliminary Results. Cyberpsychology & Behavior, 5 (2): 95-105.
Robinson, E. (2009). Online counseling, therapy and dispute resolution: A review of research and its application to family relationship services. Australia: AFRC Briefing15.
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): 269-83.
Suler, J. (2004). The Online Disinhibition Effect. Cyberpsychology & Behavior, 7 (3): 321-326.