Therapy in L.A.


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January 2001
By Joyce Parker, Ph.D.

For-profit companies are in the process of signing up thousands of therapists to provide on-line therapy services to web users. Therapists will be able to create their own web pages and will be given a virtual office. The company will bill for the service usually through the use of credit cards and send therapists their fee. They will either take a service charge out of each session fee or bill therapists directly per month for providing the website and virtual office. For now, many insurance companies cover on-line therapy. But if the practice becomes widespread, insurance companies may choose to exclude it.

Because visual and voice clues are missing from e-mail and chat room counseling, therapists will need to acquire additional training to be able to overcome the challenges inherent in providing this kind of service. A new written therapeutic language may need to be developed that can express feelings and describe emotional reactions within online interactions. Even with additional training and continuing education there is risk that seriously disturbed patients will not be identified and interventions to help them will not be adequate.

On-line counseling can be useful to the homebound and those in rural areas who have limited access to qualified mental health professionals. The anonymity of the Internet may make it easier for individuals whose problems involve a stigma to come forward and seek help. It may also be a plus for people who are home with small children.

There is a lack of empirical evidence that Internet counseling is effective. Yet this type of counseling seems to be rapidly developing a presence. An Internet search showed at least 300 to 400 mental health professionals who are already offering on-line services. Confidentiality is another important issue. According the Goutham Menon in the NASW News, January 2001,computers can leave a text residue that can be read by others. Software have been developed that can read the contents of computers without the knowledge of the owners. Clients need to be warned of the hazards. There are software programs that can be loaded as an antidote to this problem. Legal issues involve such things as which area would have jurisdiction in liability cases, where the therapist works or where the client resides. States now administer licensing laws and most licenses to practice psychotherapy are restricted to a single State. So at present there is a question of whether it would be legal for a therapist from one State to practice on a client from a State in which he or she is not licensed.

Companies are beginning to investigate the idea of contracting with employee assistance programs and other organizations to provide online therapy to members and employees. So it appears that online counseling is the wave of the future whether we are ready for it or not.

The author of this article, and founder of the website, Joyce Parker, passed away in 2011. To honor her we are keeping her articles posted at this website.

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