Therapy in L.A.


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September 2000
By Joyce Parker, Ph.D.

Recently there has been an explosion of on-line counseling services. I have received numerous requests to join lists of professionals who will be receiving referrals to do counseling on the web. Primarily commercial forces are driving these new telehealth companies. Instead of responding to an assessed need of potential clients they are being driven by the technology itself and the easy access to a worldwide clientele. This leaves the potential clients vulnerable to extremely costly and elaborate systems that may not deliver better or even effective mental health care. Is e-mail psychotherapy an effective form of helping people with their problems? Can counselors who have been trained in face to face practice transfer those skills to answering e-mails on the internet or participating in video conferencing with clients who live hundreds or thousands of miles away? If clinicians are often challenged by a diagnostic issue with in-person clients imagine the difficulty that may be encountered when diagnostic cues are more severely limited. Clinicians need to be held to the same standard of care whether they are providing services on-line or in-person. Can we ensure client confidentiality on the web? We have all heard the stories about hackers that have penetrated some of the most secure computer systems. How can we ensure confidentiality to clients from our personal computers? Lastly, counselors are at a disadvantage when the clinicianıs primary information as the identity of a client comes from words on a computer screen. There is very little way of knowing how disturbed an individual is. Counselors pick up all kinds of cues about the severity of an individualıs problems from seeing and hearing, from the sense of the person in the room. Without those important pieces of information it may be difficult if not impossible to gauge the level of distress that a client may be experiencing and how dangerous the client may be to himself or others. These are some of the issues that need to be considered carefully before jumping into this new frontier.

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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