Dispelling 4 “Dangers” of Online Therapy – Part 1
By Joan Swart, Psy.D.
Despite the exponential growth of the access and speed of online communication channels, many traditionalists remain convinced that online therapy, also called e-therapy, is fraught with life-threatening dangers and risks. Are they correct? To me, the answer is a resounding NO. However, some of their concerns are justified, but all are manageable by simple measures. Before looking at the many benefits of e-therapy in a second installment (read Part 2) let’s get some of these concerns out of the way first.
The therapist-client relationship is not as strong as in person-to-person therapy.
The correlation between the therapeutic alliance and delivery mode of psychological treatment appears to be weak. Multiple large research studies, including a recent analysis that combines the results of 840 individual reviews, by Madalina Sucala from the Mount Sinai Medical School in New York and her colleagues, titled “The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review,” found no difference. They indicated that e-therapy seems to be at least equivalent to face-to-face therapy regarding therapeutic alliance. It is a widely accepted fact that the strength of the therapist-client relationship is directly related to the success of the treatment.
Visual and verbal clues are not as obvious, and misunderstanding is likely.
In my article “Conceptualizing Mode Deactivation Therapy as a Moodle-Based Online Program for Adolescents and Adults to Relieve Belief-Oriented Distress” I raise the fact that verbal and nonverbal signs may be lacking in e-therapy. In text-based therapy such as email and Internet courses, there is a delay between the question and response. The client can take as much time to think before answering as they prefer. Therefore, a more thoughtful and guarded response is expected rather than an instinctive reaction.
But is this necessarily a bad thing? No, it can be even more enlightening for the client as it allows him or her time to contemplate all aspects of the question. In a sense, it is more empowering as the client decides when they are ready to respond. Nonverbal cues such as facial expressions and body language, which are usually very useful in person-to-person interactions lack or are completely unavailable in online therapy depending on the mode, such as video, email, or an online course. But, think about it, does this not also remove some pressure and anxiety from the client? And, it certainly reduces the possibility of misinterpretation by the therapist and client. After all, body language is not very precise and open to guesswork and wrong assumptions.
Will my information be private and secure?
The issue of online privacy and security is often raised as a concern. However, as with traditional person-to-person therapy, the therapist has precisely the same duty and responsibility to ensure that client information is kept safely away from prying eyes and misuse. Nowadays, as data is stored electronically in any case and the safeguards put in place whatever the mode of therapy have to be efficient and secure, as does the ethical considerations of the use and distribution of client information.
How do I know I am getting a competent and ethical online service?
This is another frequently raised concern and, frankly, a valid one. However, the same uncertainty applies to traditional therapy services. It is still dependent on the expertise and credibility of the therapist and his or her practice. Any good online practice has their credentials prominently displayed on their website, which may include accreditations, endorsements, affiliations, qualifications, and physical contact details. If you are considering online treatment, make sure to check those and communicate with the company personally if still unsure. Similarly, such a service should have their terms and conditions, and limitations of service, expectations, and professional relationship clearly explained. There should also be contact references to emergency and other services, should it be required. If a provider meets all these requirements, the chances are that they provide an ethical and professional service!
These are four of the most mentioned concerns about online therapy. I trust that these discussions have satisfied doubts about the safety and risks of online therapy. Next time, I will focus on the many benefits that e-therapy offer (read Part 2).