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Should You Get Help from Online Mental Health Services?

Updated on May 6, 2013

by Kathy Batesel

When you have nowhere to turn, online mental health professionals offer a possible alternative to traditional therapy.
When you have nowhere to turn, online mental health professionals offer a possible alternative to traditional therapy. | Source

Is Online Therapy Beneficial?

Even though seeking help for problems doesn't carry the stigma it once did, many people still feel uncomfortable at the idea of making an appointment to see a local mental health professional for their problems.

Their fear is understandable. Even though they know therapists are sworn to maintain confidentiality, they could have trouble explaining their weekly absences to family members or friends without lying, and the truth - that they need help coping with their problems - can make them feel worse.

Estimates claim that about 20% of all people have a mental health issue at some point in their lives, and that three-fourths of them will never seek help. Online therapy may provide them with a forum that offers more anonymity and a greater chance to be honest with someone they'll never meet in person. It can let them get therapy when time or family constraints would normally prevent them with getting help.

However, before selecting an online therapist, there are certain things that should be considered.

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Does Online Therapy Work?

Studies have shown conflicting information about the benefits of online therapy, but because online counseling isn't as established as face-to-face psychotherapy, critics have feared that it would be less effective. Some studies support their concerns, while others show it to be at least as effective as traditional counseling, if not more so.

Online therapists may work with patients through e-mail, chat, or webcam sessions. Traditional therapists meet with their patients individually or in group sessions.

Critics of online therapy say important elements of communication may be lost. E-mail and chat therapy removes most non-verbal cues. Traditional therapists may observe small muscle movements, tone of voice, or other body language cues like scratching one's nose or ear. These can signal that the patient is uncomfortable, is saying something that contradicts their own inner thoughts, or that they feel a certain way. Webcam therapy returns these signals to the therapeutic process to some degree, even though the patient's full body, including their hands, may be difficult to observe during video conferencing.

Another potential disadvantage is that group therapy provides invaluable feedback and support for certain types of problems, such as alcoholism or grief recovery. In group sessions, patients often begin to learn that it's ok to feel vulnerable at times, and that they'll not only survive their vulnerable moments, they'll find friendships because of their courage in facing those painful issues. The online therapeutic community cannot provide the power of touch and inherently builds in protection that hinders a patient's ability to discover and celebrate their ability to be vulnerable - one of the major building blocks needed for learning to trust other people.

On the other hand, patients often report feeling at least as satisfied with online mental health counseling as the people who select in-person therapy. To date, surveys have examined people who sought online treatment for depression and anxiety problems.

Drawbacks to Online Care

Mental health professionals have a duty to be aware of both what a patient reports to them and what they can observe directly while working toward specific treatment goals. Their records normally keep track of four important aspects of therapy:

  • Subjective information - What their patient reports.
  • Objective information - Information that doesn't come from the patient, but can be observed or is reported by other people.
  • Assessment - What the therapist believes is going on after considering the subjective and objective information discovered during the session.
  • Planning - Upcoming steps to reach the treatment goals.

E-mail and chat based counseling removes much or all of the objective information a counselor can use to help their client make sense of their lives. This can prolong the therapy process and even distract the patient and therapist from identifying some important treatment goals.

Another consideration is that sometimes what the patient sees as a problem is a symptom of a more complex issue. For instance, people with bipolar disorder may only see a therapist when they are feeling depressed, and hide the super-energized manic stages. This can hinder them from receiving an accurate diagnosis and appropriate medication to control their condition. The end result is that they can become entangled in numerous treatments for depression that fail to give the patient permanent ways to manage their lives.

For disorders like addictions or anger management, patients may find it easier to fool their therapist into believing progress is made when they're really spinning their wheels. They can find the "right" answers to give and put on a good show so that they can convince their wives, husbands, friends, or others that they're in counseling and doing what their counselor suggests, while continuing to behave in ways that hurt others.

Finally, before beginning online therapy, people should confirm their therapist's qualifications, areas of expertise, and ensure their therapy sessions will remain confidential. (This includes encrypting data to prevent it from being intercepted.)

The Big Picture About Online Therapy

Online mental health treatment may be an excellent choice for people with anxiety or depressive disorders. People who are sincerely motivated to change their lives for the better can benefit from it without the discomfort or time constraints involved in seeing a local professional.

However, people who are interested in couples therapy, family therapy, or who have complex issues or organic disorders like shizophrenia, bipolar disorder, or personality disorders are less likely to see a benefit from online counseling.


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  • jellygator profile image

    jellygator 5 years ago from USA

    It will be interesting to see how outcome studies reflect this difference as online therapy becomes more entrenched, won't it? Thanks for reading and commenting, Gsidley!

  • gsidley profile image

    Dr. Gary L. Sidley 5 years ago from Lancashire, England

    An interesting topic, Jellygate. Voted up.

    In the UK, financial pressures facing our National Health Service are leading the providers of mental health services to look for cheaper options, and online provision and computerised therapies are increasingly being considered.

    Although I suspect there is an important role for such provision for some people with mild to moderate mental health problems, one of the main disadvantages is that there is limited opportunity to develop a therapeutic relationship with the psychologist or counselor. Evidence from outcome studies consistently shows that the quality of the relationship with the therapist is the most potent predictor of a good outcome.