What You Need to Know About Online Therapy

Patient Expert

The Wall St. Journal reported this week that Instant Messaging is becoming popular with therapists who are conducting therapy online. Given the popularity of patient-to-patient support chat rooms on the Internet, it's not surprising that professionals are utilizing this tool.

Therapy can be an extremely important part of depression treatment, if not the only form of treatment someone participates in. However, it is in some ways an extremely complex process. Therapists rely on visual and aural cues they receive from the patient to diagnose and treat almost as much as they rely on the patient's words. For instance, when the therapy is approaching a painful subject, the patient's responses may be completely normal, but they may be displaying signs of avoidance or anxiety by averting their gaze, biting their lip or twisting a ring on their hand. All very subtle signs, but also very telling when seen by a trained professional during therapy. When a therapist treats someone online they are handicapped by having only text and emoticons, which are poor substitutes for the real thing, to guide them.

However, there are some real benefits to online counseling.

  • Sometimes it is the only way for people who live in rural areas or are housebound to receive counseling. Other people are in situations that don't allow them much freedom to get out and see a therapist - they're the caregiver for someone who's ill or simply are a working parent with very little free time.
  • Online therapy is a good way for people who are new to therapy and too embarrassed or intimidated to participate in face-to-face therapy to see what it's about. Once they are comfortable with the therapeutic process, they might be able to move to face-to-face therapy.
  • For a variety of reasons, some people need the complete anonymity of the Internet in order to receive counseling - they may live in a small town, or have a job that would be affected if anyone knew they were in therapy.

At this point, online counseling is not regulated. It is as important to check the credentials of an online therapist as one you would see in person, if not more so. The therapist should be licensed to practice in his or her own state. While a license doesn't guarantee competence, it does mean that the therapist has been educated and trained. You can check Credentials and Licensure here .

Read Melissa's Therapy FAQ and the American Psychological Association's "How to Find Help Through Psychotherapy" to get an idea of what should happen in therapy and what makes it successful.