Sunday, December 30, 2007
The Reason People Are Afraid of Obtaining Help and Therapy and how EmergencyTherapy.com Might Help
This article is to address why so many people have mental health problems and do not do anything about it. How many people do you know who smoke, drink, eat too much or too little, have anger problems, depression, bipolar disorder, anxiety, drug addiction or other issues that hurt their lives? If I answer, their are numerous people I meet that fit this description. I feel so many people do not reach out for help because they are worried about facing themselves. Often underneath the negative behaviors are an inner pain or a struggle that has been going on for many years. It might be a parent that didn't treat us right, or abuse we suffered from people (possibly physically or mentally). Whatever the reason, dealing with our past is scary and shows that we are vulnerable. The problem is that if we don't confront the issue it can only get worse. Any of the above mentioned problems can lead to serious issues whether it be health problems, loss of friends, jobs, or even our freedom. I too faced many horrible experiences and it is only when I went to therapy and explored who I really was that I began to find my path. I've found happiness, am married, help others as a psychotherapist and started a company that gives therapy online called EmergencyTherapy.com. EmergencyTherapy.com provides online counseling with licensed professionals and I originally came up with the concept many years ago. It is my belief that by having easy access, 24 hours a day that many people will begin to find help for their problems. Each licensed social worker and psychologist that is hired for emergencytherapy.com is personally picked for their genuine care and interest in helping people. I hope as we head into 2008 that you consider taking the chance to improve your life by obtaining therapy. If you know someone that could use it, it would be an honor if you recommended EmergencyTherapy.com. Happy New Year and may this year be filled with more joy and inner peace.
EmergencyTherapy.com for Therapy And How 9/11 Created A Hero
Therapy from EmergencyTherapy.com may be your first step in changing your life. This is a story from our sister blog AmericanHelpers.blogspot.com. It shows the courage and story of a remarkable man. We wanted to share this story with you to show you how someone used a terrible experience and turned it into something that has helped thousands of kids.
Blake Rockwell was in New York and had been working in banking and investment management when 9/11/2001 killed thousands of people on Wall Street. Even though his office was located in Midtown Manhattan, he had two coworkers who died - one who was his acting boss for a short time while his permanent boss was on medical leave. A couple weeks after 9/11, a good friend died from lung cancer (a nonsmoker) at the age of 32.
After these experiences, Rockwell says “I began to examine my life and what I was doing with it. I questioned what I was truly passionate about. As a result, I created Special Spectators, a Chicago-based 501(c)(3)nonprofit organization, that creates magical days for seriously ill children and their families at college football games across the United States.”
This organization has been helping thousands of children with their work. Since 2002, Special Spectators has created the quintessential Saturday experience complete with tailgate parties, mascots, cheerleaders and marching bands for approximately 3,800 children and parents. Rockwell says “Over the last five years, we've hosted about 110 game day events that provide these kids with special access to people and areas of the stadium that are not accessible to most fans. Our youngsters tour locker rooms, meet coaches and walk on the field during a time out. The field visit is one of my favorite moments. While the kids are standing on the 50 yard line, a stadium announcement tells the fans why these kids are attending the game, explains Special Spectators and asks the crowd to give the children a warm welcome to the stadium. Typically this results in a standing ovation.”
Special Spectators has grown tremendously since their first season
in 2002 when only two schools participated. They now have nearly 40 including Rutgers, Georgia, Oklahoma, Colorado,
Auburn, Miami, Tennessee, and UCLA.
Blake Rockwell deserves a huge thank you and truly is an American Helper. It is people like him who deserve to be applauded. He took his experience and loss on 9/11 and turned it into creating an organization that touches the lives of thousands of sick children. He might not always hear how much he is appreciated but today we are honoring him and inducting him into our American Helpers Hall Of Fame. Rockwell says “The amazing growth and accomplishments we've made in just 5 years-110 game day events enjoyed by 3,800 seriously ill children and parents-has all been done with only volunteers and a total out of pocket cost of only $40,000! That's a little over $10 per person.”
If you would like to see Special Spectators in action, you can view one of their clips on YouTube at
http://www.youtube.com/results?search_query=%22Special+Spectators%22&search=
For more information about helping this organization please go to
www.SpecialSpectators.org
If you feel you need to make a career change, have a problem you want to overcome, or could use counseling or therapy look at www.emergencytherapy.com to speak with therapists licensed as social workers or psychologists. You might be able to overcome your adversities and create a better life.
EmergencyTherapy.com on Therapy for New Years Resolutions
Therapy from EmergencyTherapy.com is a great idea for those looking to make positive changes for the New Year. It seems around the beginning of each year many of us look back and see what we can improve upon. Examples include quitting smoking, dealing with an anger problem, losing weight, pursuing a new career, finding a healthy relationship or being a better husband, wife, parent, or child. These are all extremely important topics that can greatly improve your life. www.EmergencyTherapy.com is a site created to provide online counseling and therapy. Each therapist is either a licensed social worker or psychologist. The importance of that fact is that each has not only graduated college but either obtained a masters degree or a doctorate. In addition, they have spent enough time studying and working with people that they are capable of providing the help you need. What is the best gift to give yourself for the New Year? My suggestion is to identify difficulties in your life and what the problem is telling you. For example if you feel tired, out of shape, or have trouble breathing your body is saying it wants to be healthier. If you smoke, drink, are overweight than any of these issues might be worthwhile to work on with the therapists at EmergencyTherapy.com. I wish you a wonderful New Year and hope 2008 is filled with happiness, prosperity, and better health for your family and you.
Wednesday, December 26, 2007
Therapists and Therapy at www.EmergencyTherapy.com, Online Therapy Article
Would Freud have imagined that one day people would be sitting on a computer from the comfort of their home interacting with psychologists and social workers? I am pretty confident he didn't foresee the changes that have begun to take place. This article will explore why the internet is helping therapy evolve into the modern computer age. Let's look at the typical therapy practice. A therapist rents an office or works for an agency. They wait for clients. The clients must travel from wherever they are and attempt to be on time to meet for the counseling sessions. I as a psychotherapist have seen that many people forget the date and time of their sessions, have something important come up, and they possibly are resistant to obtaining counseling. Often when someone first reaches out for help they are ready and willing to talk about it instantly. A typical in person session might not be available for one or two weeks. By the time that date approaches the person might not be willing to share the reason they wanted help. This is common with people who have addictions, fetishes, been abused or are depressed. It takes so much courage to open up and discuss the concern. Many are not ready to sit and talk to someone face to face. In addition, the generations that grew up with the internet are spending so much time doing things online that they want help right away. Online therapy provides privacy, instant help, and helps people not yet ready to go to a therapists office in person. Critics make valid arguments about the challenges faced but the use of online therapy is helping many people. www.EmergencyTherapy.com was founded as a site to offer affordable online therapy with licensed social workers and psychologists. The goal is to help as many people as possible. In addition, research has proven that millions of people have mental health problems but are not getting treatment for it. For those people, online therapy is a great place to begin to explore obtaining help for these problems. If you have something to work on or have a friend in need of help online therapy might be a great place to start. www.EmergencyTherapy.com offers therapy online at a price anyone can afford.
Online Counseling Studies from www.EmergencyTherapy.com
Studies are beginning to discuss the use of online therapy as a medium to help assist people with mental health issues. This is extremely important as the use of internet therapy increases. www.EmergencyTherapy.com was established to assist people to obtain what has been referred to as e-therapy. EmergencyTherapy.com uses only licensed professionals to work with clients. It is their stringent policy of only having licensed social workers and psychologists perform the function of providing help online. The reason for this includes that in order to properly help someone a large amount of study and training is needed. For example, each licensed therapist from www.EmergencyTherapy.com has attended and completed college, graduate school and is licensed in their home state. In addition, they have worked in a variety of settings including hospitals, clinics, mental health organizations and government agencies. It is this fact that allows these therapists to be prepared to handle the tough questions that can often be posed during counseling on the internet. It is often suggested if someone is in a life threatening situation such as being suicidal, they need to go to their local emergency room. The reason for this is they need to have face to face care. For many other issues online therapy can be effective, inexpensive and a relief to people. The reason for this is that many people with mental health problems do not reach out for help for the fear of being embarrassed or looked at as strange. An example of this is a recent person who contacted me about a bizarre obsession they had. If we had met face to face, they might have felt that I would judge them. In fact, this person told me that opening up online was the first step in them managing and getting treatment for this problem. The client reports the obsession became a large part of their life and hurt many of their friendships and interactions. They feared losing their job and family. With proper help using online therapy this individual began to face this problem and learned techniques to help overcome it. This is a classic example of how the internet can be the gateway to obtain online therapy to assist with issues that make people's lives difficult. www.EmergencyTherapy.com is a great way to begin online therapy as an affordable and easy way to obtain assistance.
Therapy at www.EmergencyTherapy.com and National Institute of Mental Health Study on Internet Based PTSD Therapy
This is a fantastic article about the use of internet therapy in a pilot program completed by the National Institute of Mental Health. www.EmergencyTherapy.com provides therapy on the internet with licensed social workers and psychologists. Each therapist has been trained to handle various mental health issues. It is great that a discussion of the efficacy of online help is being opened.
National Institute of Mental Health - Science Update
2007-11-29
Internet-based PTSD Therapy May Help Overcome Barriers to Care
"NIMH-funded researchers recently completed a pilot study showing that an Internet-based, self-managed cognitive behavioral therapy (CBT) can help reduce symptoms of post-traumatic stress disorder (PTSD) and depression, with effects that last after treatment has ended. This study supports further development of PTSD therapies that focus on self-management and innovative methods of providing care to large numbers of people who do not have access to mental health care or who may be reluctant to seek care due to stigma. The researchers published their study in the November 2007 issue of the American Journal of Psychiatry.
Brett Litz, Ph.D., of the National Center for PTSD at the VA Boston Healthcare System and Boston University, and colleagues recruited service members from the Department of Defense who had developed PTSD following the September 11, 2001, attack on the Pentagon or from recent combat exposure. Forty-five participants first met with a therapist to determine their baseline PTSD and depression symptoms, and then were randomly assigned to one of two 8-week long, therapist-assisted, Internet-based treatments.
One treatment used strategies from CBT, which previous research has shown to be effective in relieving symptoms of PTSD. This CBT-based therapy aimed to first help participants identify situations that triggered their PTSD symptoms by working with a therapist and then improve their ability to manage those symptoms through on-line homework assignments. The other therapy, called supportive counseling, asked participants to monitor their own current, non-trauma-related problems, and then write about those experiences online. These participants also received periodic phone calls or emails from their therapist, who provided supportive but non-directed counseling. Participants in both groups were asked to log on daily to a Web site specific to their assigned treatment. After rating their PTSD and depression symptoms using a checklist, participants were allowed access to the Web site where they could find information about PTSD, stress, trauma, and other related health topics; communicate with their therapist; or complete treatment-specific activities.
After eight weeks of treatment, participants in both groups had fewer or less severe PTSD and depression symptoms, but those in CBT-based therapy showed greater improvements than those in supportive counseling therapy. Six months after their first meeting with a study therapist, participants who received CBT-based therapy showed continued improvements, while those in the supportive therapy group experienced an increase in PTSD and depression symptoms.
These findings suggest the CBT-based online therapy may be an efficient, effective, and low-cost method of providing PTSD treatment following a traumatic event to a large number of people. The researchers noted that fewer people completed the CBT-based therapy than the supportive counseling therapy. However, regardless of therapy group, the discontinuation rate among study participants was similar to the 30 percent discontinuation rate reported in studies of face-to-face treatment. Further study is needed to improve treatment use and completion and to test Internet-based PTSD therapies in a larger study population.
Reference
Litz BT, Engel CC, Bryant R, Papa A. A Randomized Controlled Proof-of-Concept Trial of an Internet-Based, Therapist-Assisted Self-Management Treatment for Posttraumatic Stress Disorder. Am J Psychiatry. 2007 Nov;164(11):1676-84."
We hope that further studies are completed to help educate the public about the use of online counseling or e-therapy. www.EmergencyTherapy.com provides therapy on the internet to help people facing mental health issues. www.EmergencyTherapy.com can be used to help different types of problems as evidenced by the study described above. It is our opinion that as time goes on, online therapy will become more popular and have the ability to be the starting point for many people facing problems. There are too many of us that have issues that effect our lives but that do not obtain treatment. Hopefully, the privacy of the internet will allow many to feel comfortable to make the initial contact. www.EmergencyTherapy.com offers therapy at an affordable price as to allow anyone to obtain online mental health services.
National Institute of Mental Health - Science Update
2007-11-29
Internet-based PTSD Therapy May Help Overcome Barriers to Care
"NIMH-funded researchers recently completed a pilot study showing that an Internet-based, self-managed cognitive behavioral therapy (CBT) can help reduce symptoms of post-traumatic stress disorder (PTSD) and depression, with effects that last after treatment has ended. This study supports further development of PTSD therapies that focus on self-management and innovative methods of providing care to large numbers of people who do not have access to mental health care or who may be reluctant to seek care due to stigma. The researchers published their study in the November 2007 issue of the American Journal of Psychiatry.
Brett Litz, Ph.D., of the National Center for PTSD at the VA Boston Healthcare System and Boston University, and colleagues recruited service members from the Department of Defense who had developed PTSD following the September 11, 2001, attack on the Pentagon or from recent combat exposure. Forty-five participants first met with a therapist to determine their baseline PTSD and depression symptoms, and then were randomly assigned to one of two 8-week long, therapist-assisted, Internet-based treatments.
One treatment used strategies from CBT, which previous research has shown to be effective in relieving symptoms of PTSD. This CBT-based therapy aimed to first help participants identify situations that triggered their PTSD symptoms by working with a therapist and then improve their ability to manage those symptoms through on-line homework assignments. The other therapy, called supportive counseling, asked participants to monitor their own current, non-trauma-related problems, and then write about those experiences online. These participants also received periodic phone calls or emails from their therapist, who provided supportive but non-directed counseling. Participants in both groups were asked to log on daily to a Web site specific to their assigned treatment. After rating their PTSD and depression symptoms using a checklist, participants were allowed access to the Web site where they could find information about PTSD, stress, trauma, and other related health topics; communicate with their therapist; or complete treatment-specific activities.
After eight weeks of treatment, participants in both groups had fewer or less severe PTSD and depression symptoms, but those in CBT-based therapy showed greater improvements than those in supportive counseling therapy. Six months after their first meeting with a study therapist, participants who received CBT-based therapy showed continued improvements, while those in the supportive therapy group experienced an increase in PTSD and depression symptoms.
These findings suggest the CBT-based online therapy may be an efficient, effective, and low-cost method of providing PTSD treatment following a traumatic event to a large number of people. The researchers noted that fewer people completed the CBT-based therapy than the supportive counseling therapy. However, regardless of therapy group, the discontinuation rate among study participants was similar to the 30 percent discontinuation rate reported in studies of face-to-face treatment. Further study is needed to improve treatment use and completion and to test Internet-based PTSD therapies in a larger study population.
Reference
Litz BT, Engel CC, Bryant R, Papa A. A Randomized Controlled Proof-of-Concept Trial of an Internet-Based, Therapist-Assisted Self-Management Treatment for Posttraumatic Stress Disorder. Am J Psychiatry. 2007 Nov;164(11):1676-84."
We hope that further studies are completed to help educate the public about the use of online counseling or e-therapy. www.EmergencyTherapy.com provides therapy on the internet to help people facing mental health issues. www.EmergencyTherapy.com can be used to help different types of problems as evidenced by the study described above. It is our opinion that as time goes on, online therapy will become more popular and have the ability to be the starting point for many people facing problems. There are too many of us that have issues that effect our lives but that do not obtain treatment. Hopefully, the privacy of the internet will allow many to feel comfortable to make the initial contact. www.EmergencyTherapy.com offers therapy at an affordable price as to allow anyone to obtain online mental health services.
Internet Therapy Article, Online Therapy, EmergencyTherapy.com
The concept of internet therapy and online therapy such as the help offered on the site www.EmergencyTherapy.com has helped numerous people. Here is fantastic article about therapy on the internet.
From USA Today:
"Internet therapy clicks for patients
By Marilyn Elias
Pat Underwood was reeling from a hard slap of midlife emotional pain when she began therapy three months ago. She was grieving over her father's recent death. Old sibling conflicts had resurfaced. After remarrying, she had left good friends behind in Tennessee and moved with her new husband to Madison, Ga., where she had no job or friends. The therapy, she says, "has been a great help. I've been able to work through a lot of problems." She has never met her counselor, though, because he lives 2,100 miles away. He's Peter Chechele (Check-a-lee), a San Francisco marriage and family therapist who treats many clients at his "office" in cyberspace.
Online counseling is the hottest and certainly the most controversial new trend in therapy, many experts say.
Five years ago, six therapists practiced online. Now there are more than 500, says consumer advocate Martha Ainsworth, whose Web site, www.metanoia .org, provides information and independent credentials checks of therapists doing e-therapy. "The field has just exploded," she says.
Therapists practicing on the Net are primarily psychologists, licensed clinical social workers, marriage and family counselors and other licensed professional counselors; very few are psychiatrists.
About 90% of the counseling is done by e-mail, she says. Clients send therapists e-mails any time of the day or night. Counselors typically respond within a day or two, sometimes within hours. Most charge by the e-mail response, but some allow unlimited e-mails over a specific time for a single fee.
Chechele, for example, offers varied plans, including unlimited e-mails over 30 days for $200.
Occasionally, Net counseling is done in "chats" that permit clients and therapists to message back and forth for the usual "50-minute hour" of therapy. There's a small, leading edge of work with Web cameras and audio that allows therapists and patients to visit virtually through their computers.
E-therapy is not suited for people with severe mental disorders, such as schizophrenia or bipolar disorder (manic-depression). Medication is not generally prescribed by therapists on the Net because anyone with a problem serious enough to need drugs also needs a face-to-face counselor. But for many others, boosters say, the advantages of Net therapy abound:
* It's tailor-made for business travelers and employed parents who find it hard to carve out daytime hours or keep weekly appointments in one city.
* It costs less. E-mails average $25 to $50 each, Ainsworth says. Even rates of $90 an hour fall below typical therapy charges of $125 to $165.
* It can work faster. There is evidence that people self-disclose more quickly using a computer than they do face-to-face, says Johns Hopkins University psychologist Patricia Wallace, author of The Psychology of the Internet.
* It may attract those too embarrassed to face a therapist: childhood sexual-abuse victims, the obese, those with physical deformities or painful secrets.
Jessica Bride, 26, marketing and communications director for a restaurant chain, had been seeing therapist Mark Sichel in his New York office last year when her work started to require a lot of travel.
As the youngest director her firm ever had, and a woman to boot, "I found I had a lot of challenges on the job," Bride says. A painful romantic breakup added to the stress.
When she's on the road or even at work in New York, e-mail exchanges with Sichel "offer great immediacy. As a problem comes up, you can deal with it right away. I like the rapid response. It heads off trouble when you're right at the edge of blowing," says Bride, who fields about 50 phone calls a day.
The Net's downside
But is such online support truly psychotherapy? No way, critics argue. And can it hurt rather than help? Absolutely, says the chorus of opponents.
The downside of all that lack of inhibition online is greater potential for deception, Wallace says. Either the patient or the therapist may not be who he says he is.
Deception by patients may not even be deliberate.
"Often, a patient will not think they're suicidal or that their problems are serious, and they turn out to be. The Net is packed with depressed people," says San Diego psychologist Marlene Maheu, who runs Netpsych, the largest Internet professional discussion list for U.S. therapists.
She points to therapists' moral responsibility to report impending suicides to emergency agencies and their legal duty to report child abuse or other violence. "Some of these online therapists don't even have the client's address, or the address may not be real. So how can you prevent tragedy?"
So far, no "tragedies" or lawsuits have surfaced, says Russ Newman, executive director for professional practice at the American Psychological Association. But it's debatable whether Net therapy is even legal, he adds. Therapists are licensed to practice in a specific state, so is it all right to treat clients living in another state through the medium of cyberspace?
"We just don't know. This is frontier territory," says Newman, an attorney and psychologist.
There's no research to support the effectiveness of online counseling, and that troubles Maheu. "We're ethically mandated to use treatments based on research. This is like a physician using shark bone on ill patients."
The e-therapist's loss of visual cues can hamper perception. And the lack of cues isn't just dangerous, it can be fatal.
Take a woman with an eating disorder. She claims to be 5-foot-8 and weigh 140 pounds. "You can't trust the veracity here — there can be terrible distortions," says Sichel, the New York therapist. "You can come up with a behavioral plan for a person to lose weight, and this behavioral plan will kill them. ... I'm also afraid of children posing as adults." That's why Sichel uses e-therapy only with those clients he has already seen in his practice.
Trust can be a key issue for help-seekers, too. Plenty of Americans would hesitate to let their traumas all hang out at some place they can't even visualize. In a December 2000 poll by online analysts Jupiter Media Metrix, 42% of 3,500 adult Net users said they'd be so concerned about privacy that they wouldn't consult a therapist online.
A trusting relationship is at the heart of first-rate therapy, and you can't get it staring at a computer, says MIT psychologist Sherry Turkle, author of Life on the Screen: Identity in the Age of the Internet. "You can spill your guts, but spilling your guts is not the same as good therapy," she says.
People err, though, in judging Net therapy against a yardstick of the "real" thing, says Calverton, Md., psychologist Richard Sansbury, who does both kinds. Face-to-face work can get quite complicated. Online works best for clients with a focused, specific problem and a clear goal, for those who are ready to see how they contribute to their problem and to use guided behavioral techniques to solve it.
In online therapy, "I'm not doing a lot that an understanding grandmother wouldn't do, but not everybody has an understanding grandmother," Sansbury says.
Seeing value in e-therapy
Still, some therapy clients feel the Net has unique, powerful value. Troy Hill, a 30-year-old New York actor, has been struggling with his parents' rejection. "I'm gay, and that's just not OK," he says. "I can't change them. And I can't change the fact they want to change me."
Hill forwards some of his father's "attacking" e-mails, along with proposed replies, to Sichel, his therapist. The counselor can see directly what's said by Dad, and also how the words are perceived by Hill.
"It's helped me so much to see if I'm overreacting, whether I'm heightening the conflict by what I write back or helping to resolve it," he says. The work online "has really helped me to set boundaries, to see the good in my relationship with my parents and be realistic in how much I can expect them to understand and accept me."
Even the most ardent critics of e-therapy think it's bound to grow rapidly as audio and video technology advance in the next few years
In the short term, land mines might explode first.
"No doubt, there will be errors, breaches of trust, and tragedy as e-therapy develops," writes Longwood, Fla., therapist Michael Freeny in the March/April 2001 Psychotherapy Networker, a professional journal. "But I think the risks are worth taking if we can provide online care to millions of people who would otherwise not have benefited from mental health services."
Ainsworth concludes: "E-therapy doesn't work for everyone. But for those for whom it does work, it works in a very profound way. This truth should not be minimized, nor should any of the concerns.
"That is the nature of exploring a new frontier."
The above was a great article and shows the discussion about online therapy.
This is certainly an exciting time for therapy and online therapy. www.EmergencyTherapy.com offers therapy and online therapy designed to help you. The therapy provided by www.EmergencyTherapy.com comes from licensed social workers and psychologists. The goal is to provide affordable and easy access to online therapy and e-therapy in order to help overcome various challenges.
From USA Today:
"Internet therapy clicks for patients
By Marilyn Elias
Pat Underwood was reeling from a hard slap of midlife emotional pain when she began therapy three months ago. She was grieving over her father's recent death. Old sibling conflicts had resurfaced. After remarrying, she had left good friends behind in Tennessee and moved with her new husband to Madison, Ga., where she had no job or friends. The therapy, she says, "has been a great help. I've been able to work through a lot of problems." She has never met her counselor, though, because he lives 2,100 miles away. He's Peter Chechele (Check-a-lee), a San Francisco marriage and family therapist who treats many clients at his "office" in cyberspace.
Online counseling is the hottest and certainly the most controversial new trend in therapy, many experts say.
Five years ago, six therapists practiced online. Now there are more than 500, says consumer advocate Martha Ainsworth, whose Web site, www.metanoia .org, provides information and independent credentials checks of therapists doing e-therapy. "The field has just exploded," she says.
Therapists practicing on the Net are primarily psychologists, licensed clinical social workers, marriage and family counselors and other licensed professional counselors; very few are psychiatrists.
About 90% of the counseling is done by e-mail, she says. Clients send therapists e-mails any time of the day or night. Counselors typically respond within a day or two, sometimes within hours. Most charge by the e-mail response, but some allow unlimited e-mails over a specific time for a single fee.
Chechele, for example, offers varied plans, including unlimited e-mails over 30 days for $200.
Occasionally, Net counseling is done in "chats" that permit clients and therapists to message back and forth for the usual "50-minute hour" of therapy. There's a small, leading edge of work with Web cameras and audio that allows therapists and patients to visit virtually through their computers.
E-therapy is not suited for people with severe mental disorders, such as schizophrenia or bipolar disorder (manic-depression). Medication is not generally prescribed by therapists on the Net because anyone with a problem serious enough to need drugs also needs a face-to-face counselor. But for many others, boosters say, the advantages of Net therapy abound:
* It's tailor-made for business travelers and employed parents who find it hard to carve out daytime hours or keep weekly appointments in one city.
* It costs less. E-mails average $25 to $50 each, Ainsworth says. Even rates of $90 an hour fall below typical therapy charges of $125 to $165.
* It can work faster. There is evidence that people self-disclose more quickly using a computer than they do face-to-face, says Johns Hopkins University psychologist Patricia Wallace, author of The Psychology of the Internet.
* It may attract those too embarrassed to face a therapist: childhood sexual-abuse victims, the obese, those with physical deformities or painful secrets.
Jessica Bride, 26, marketing and communications director for a restaurant chain, had been seeing therapist Mark Sichel in his New York office last year when her work started to require a lot of travel.
As the youngest director her firm ever had, and a woman to boot, "I found I had a lot of challenges on the job," Bride says. A painful romantic breakup added to the stress.
When she's on the road or even at work in New York, e-mail exchanges with Sichel "offer great immediacy. As a problem comes up, you can deal with it right away. I like the rapid response. It heads off trouble when you're right at the edge of blowing," says Bride, who fields about 50 phone calls a day.
The Net's downside
But is such online support truly psychotherapy? No way, critics argue. And can it hurt rather than help? Absolutely, says the chorus of opponents.
The downside of all that lack of inhibition online is greater potential for deception, Wallace says. Either the patient or the therapist may not be who he says he is.
Deception by patients may not even be deliberate.
"Often, a patient will not think they're suicidal or that their problems are serious, and they turn out to be. The Net is packed with depressed people," says San Diego psychologist Marlene Maheu, who runs Netpsych, the largest Internet professional discussion list for U.S. therapists.
She points to therapists' moral responsibility to report impending suicides to emergency agencies and their legal duty to report child abuse or other violence. "Some of these online therapists don't even have the client's address, or the address may not be real. So how can you prevent tragedy?"
So far, no "tragedies" or lawsuits have surfaced, says Russ Newman, executive director for professional practice at the American Psychological Association. But it's debatable whether Net therapy is even legal, he adds. Therapists are licensed to practice in a specific state, so is it all right to treat clients living in another state through the medium of cyberspace?
"We just don't know. This is frontier territory," says Newman, an attorney and psychologist.
There's no research to support the effectiveness of online counseling, and that troubles Maheu. "We're ethically mandated to use treatments based on research. This is like a physician using shark bone on ill patients."
The e-therapist's loss of visual cues can hamper perception. And the lack of cues isn't just dangerous, it can be fatal.
Take a woman with an eating disorder. She claims to be 5-foot-8 and weigh 140 pounds. "You can't trust the veracity here — there can be terrible distortions," says Sichel, the New York therapist. "You can come up with a behavioral plan for a person to lose weight, and this behavioral plan will kill them. ... I'm also afraid of children posing as adults." That's why Sichel uses e-therapy only with those clients he has already seen in his practice.
Trust can be a key issue for help-seekers, too. Plenty of Americans would hesitate to let their traumas all hang out at some place they can't even visualize. In a December 2000 poll by online analysts Jupiter Media Metrix, 42% of 3,500 adult Net users said they'd be so concerned about privacy that they wouldn't consult a therapist online.
A trusting relationship is at the heart of first-rate therapy, and you can't get it staring at a computer, says MIT psychologist Sherry Turkle, author of Life on the Screen: Identity in the Age of the Internet. "You can spill your guts, but spilling your guts is not the same as good therapy," she says.
People err, though, in judging Net therapy against a yardstick of the "real" thing, says Calverton, Md., psychologist Richard Sansbury, who does both kinds. Face-to-face work can get quite complicated. Online works best for clients with a focused, specific problem and a clear goal, for those who are ready to see how they contribute to their problem and to use guided behavioral techniques to solve it.
In online therapy, "I'm not doing a lot that an understanding grandmother wouldn't do, but not everybody has an understanding grandmother," Sansbury says.
Seeing value in e-therapy
Still, some therapy clients feel the Net has unique, powerful value. Troy Hill, a 30-year-old New York actor, has been struggling with his parents' rejection. "I'm gay, and that's just not OK," he says. "I can't change them. And I can't change the fact they want to change me."
Hill forwards some of his father's "attacking" e-mails, along with proposed replies, to Sichel, his therapist. The counselor can see directly what's said by Dad, and also how the words are perceived by Hill.
"It's helped me so much to see if I'm overreacting, whether I'm heightening the conflict by what I write back or helping to resolve it," he says. The work online "has really helped me to set boundaries, to see the good in my relationship with my parents and be realistic in how much I can expect them to understand and accept me."
Even the most ardent critics of e-therapy think it's bound to grow rapidly as audio and video technology advance in the next few years
In the short term, land mines might explode first.
"No doubt, there will be errors, breaches of trust, and tragedy as e-therapy develops," writes Longwood, Fla., therapist Michael Freeny in the March/April 2001 Psychotherapy Networker, a professional journal. "But I think the risks are worth taking if we can provide online care to millions of people who would otherwise not have benefited from mental health services."
Ainsworth concludes: "E-therapy doesn't work for everyone. But for those for whom it does work, it works in a very profound way. This truth should not be minimized, nor should any of the concerns.
"That is the nature of exploring a new frontier."
The above was a great article and shows the discussion about online therapy.
This is certainly an exciting time for therapy and online therapy. www.EmergencyTherapy.com offers therapy and online therapy designed to help you. The therapy provided by www.EmergencyTherapy.com comes from licensed social workers and psychologists. The goal is to provide affordable and easy access to online therapy and e-therapy in order to help overcome various challenges.
International Society of Mental Health Online Suitability
This is a suitability guideline created by the International Society for Mental Health Online. It is organizations like this that have helped create guidelines and suggest proper treatment. Proper treatment guidelines are helping companies like www.EmergencyTherapy.com to properly use criteria when determining if someone is able to be helped with online therapy or e-therapy. This is a great article to help you think about online therapy and the suitability of using it.
From The International Society For Mental Health Online:
"Assessing a Person's Suitability for Online Therapy
These guidelines were developed by the Clinical Case Study Group of the International Society for Mental Health Online. They outline some basic issues in determining a client's suitability for online psychotherapy. Although they are designed mostly with text-based therapy in mind (e-mail, chat), many of these guidelines apply also to other online methods of communication (e.g., internet telephoning, video conferencing). "Suitability" refers to a variety of factors, including the person's preferences regarding online therapy, how suggestible the person is within a particular communication modality, his or her skills in communicating within that modality, and the potentially therapeutic aspects of that modality for the person. Because there are many possible formats for online clinical work, as well as many different theories of psychotherapy, these guidelines are not intended to be exhaustive or definitive. Hopefully, clinicians will adapt these ideas to the unique aspects of each of their online psychotherapy cases.
While conducting the assessment, the clinician needs to keep in mind the ethical issues regarding online therapy, such as those described in the suggested principles of the International Society for Mental Health Online. As these suggested priniciples indicate, it's important to inform clients about issues regarding privacy, the potential benefits and risks of online therapy, and possible safeguards. The client's ability to understand this information and his/her attitudes regarding these issues could be important determinants of the client's ability to benefit from online therapy.
1. What communication methods are adequate or preferable for assessing the client?
The clinician has a variety of communication methods for conducting the initial assessment of the client: in-person, video-conferencing, phone, email, and instant messaging or chat. Clients may have a preference for this initial contact, which may in itself be of diagnostic significance. Clients interested in online therapy may prefer a text-only setting for this first contact. They may feel more comfortable in that setting, be more able to express themselves, or wish to maintain some anonymity. Clients' preferences need to be considered along with the potential advantages of conducting the assessment using different communication methods. Combining different methods during the assessment process will yield more comprehensive and qualitatively different information about the client's personality and behaviors. Face-to-face and/or phone interviews should be encouraged during the assessment phase, although these methods may not be absolutely necessary in every case. Assessment within the preferred medium may be sufficient if communication within that medium is accurate and efficient.
Assessing the client with the communication method that will be the medium for therapy is important. However, the clinician should consider the possibility that the client may benefit from therapeutic work in communication environments that are NOT his or her stated preference. It also is possible that the person may benefit from therapy that includes more than one environment (face-to-face, phone, email, chat, etc) - which means that the treatment will involve more complex variables regarding contact time and format than traditional in-person therapy. The client's preferences, skills, and attitudes regarding work within multiple environments will be important factors to consider.
2. How might the person's computer skills, knowledge, platform, and internet access affect the therapy?
The ability to benefit from online therapy will be partly determined by the client's computer skills and knowledge, especially if the communication setting involves installing and learning new software and/or hardware. If the person seems to communicating efficiently and accurately within the setting of choice, no further assessment of the person's skills may be necessary. If therapy will move to another setting, it is important to assess the extent to which an online client is able to effectively use the computer hardware and software at his/her disposal to communicate in a manner which feels natural and allows for nuance in describing and expressing oneself. Part of the assessment process might involve a trial stage in which the therapist and client test out the communication pathway between them, without yet having established a commitment to the therapy. Some questions to consider include the following:
-- Does the person demonstrate adequate knowledge of his/her computer system and internet technology?
-- Is the person motivated and capable to experiment with new communication environments and techniques?
-- Is the person's computer system compatible with that of the clinician?
-- What kind of internet access does the person have?
-- Where is the client accessing the internet (home, work) and does this present any problems regarding privacy or any technological difficulties (e.g., firewalls that limit internet activities)
-- If the client's internet access is problematic, are there viable alternatives (e.g., a web-based e-mail account)
3. How knowledgeable is the person about online communication and relationships?
The ability to benefit from online therapy will be partly determined by the person's familiarity with the technique and psychological aspects of online communication. First-hand participation is valuable, as well as the person having read about the internet and talked to others about it.
-- What is the person's lifestyle in cyberspace?
-- What experience does the person have with communicating online?
-- If the person has online relationships or belongs to online groups, what have these social activities been like?
-- In what settings did these relationships develop and for how long?
-- What other activities does the person pursue online, and what is his/her attitude about life in cyberspace?
4. How well is the person suited for the reading and writing involved in text communication (email, chat)?
If the therapist will be working with the client via typed text, assessing the clients experience with reading and writing is important. A person's reading and writing skills may not be equivalent, but both are necessary for text-based therapy. Some people may prefer reading over writing, or vice versa, which could have a significant impact on text-based communication. Assess the person's motor and cognitive skills for reading and writing, as well as the person's psychological experience of these activities. What does reading and writing mean to the person? What needs do these activities fulfill? It may be helpful to discuss how the person's attitudes and skills regarding in-person communication compare to those regarding text communication. When assessing the person's suitability for text communication, it's important to remember that developing and enhancing the person's reading and writing skills may be intrinsic to the therapeutic process.
Because chat/IM is a different experience than e-mail, it's important to determine the client's skills and preferences regarding these synchronous versus asynchronous methods of communication, as well the person's potential to benefit from these different methods. It may be informative to ask the client to complete a writing exercise that is relevant to the type of online therapy being offered (e.g., a summary of the history of one's life, a description of a scene related to the presenting complaint, an essay about one's personality or family members, an objective description of a specific problematic behavior).
Some questions to consider during the assessment stage include the following:
-- Does the person like reading and writing?
-- What kinds of experiences has the person had with reading and writing?
-- What do reading and writing mean to the person?
-- Are there any known physical or cognitive problems that will limit the ability to read and write?
-- How well can the person type?
-- Does the person enjoy in-person and phone conversations. Why?
-- How does the person feel about the spontaneous, in-the-moment communication of chat/IM as opposed to the opportunity to compose, edit, and reflect, as in e-mail?
-- Might there be therapeutic benefits of using chat, e-mail, or some other method of text communication even though the person may not prefer that particular method?
5. How might previous and concurrent mental health treatment affect online therapy?
If the person has been in therapy before, this will have created some impressions and expectations of what therapy is like. It is important to assess how these impressions and expectations are influencing the person's attitudes about online therapy, especially if the communication method will be different than that used in the previous therapy. Inquire about what type of therapy it was, the therapist's style of intervention, the duration of the therapy, the goals and outcome. Compare these factors to what will be offered in the online therapy. If the person currently is involved in other online or in-person mental health treatments, how will this influence the therapy?
6. How might personality type, presenting complaint, and diagnosis influence the person's suitability for online therapy?
This is a complex topic that deserves more clinical research. A separate set of guidelines could be devoted to it. One basic issue is the level of care a person may require (see Stofle's description). People who need full or partial hospitalization with close observation and supervision may not be appropriate for online therapy. The level of care a person requires also may change over time, thereby requiring that the clinician assess the person's history of level of functioning, and then periodically reassess the client during the therapy. As a rule of thumb, severe pathology and risky behaviors - such as lethally suicidal conditions - may not be appropriate for online work. Tendencies towards poor reality testing and strong transference reactions may become exacerbated in text communication, thereby making them difficult to manage and potentially destructive to the treatment. People with borderline personality disorders often challenge the boundaries of therapy, which can be especially problematic in e-mail communication and when combining different methods of communication. The clinician may need to set very clear rules about when, where, and how therapy takes place. The structure offered by online therapy may attract people who experience problems with impulsivity, internal emptiness, splitting, and aggression which otherwise get acted out in the comparatively unstructured social world of cyberspace. More clinical research is needed to determine what types of significant pathologies might be treated online, and how.
Assessing personality disorders and types (antisocial, narcissistic, schizoid, avoidant, paranoid, depressive, manic, masochistic, obsessive-compulsive, histrionic, dissociative) may lead to valuable information about how these people react to various forms of online therapy. Will avoidant and schizoid people fare well in the potentially anonymous environment of text conversation? Will the projective mechanisms of paranoid people be overly exaggerated in text communication? Can people with dissociative tendencies benefit from work across communication settings - or by participating in online groups - or will such work amplify those tendencies by encouraging fragmentation into different online persona? More clinical research is needed to answer these questions and refine the assessment process.
Diagnostic testing can be valuable in assessing the psychopathological factors that might influence the efficacy of online treatment. If it's not possible to arrange in-person testing, online tests could be an easy-to-access supplement to the assessment interview. Hopefully, in the near future, professionally managed web sites will become available that offer diagnostic tests as an aid for online therapists. When using online tests, consider such factors as accessibility, affordability, user-friendliness, security of test results, compliance with ethical principles, reliability, and validity.
Of course, many assessment principles that apply to therapy in-person also apply to online therapy, but will not be reiterated here. In addition, the type of online therapy being offered (psychodynamic, cognitive, behavioral, humanistic, etc.) will determine the types of questions raised during the assessment stage. Whether a person might benefit from a particular style of therapy will be partly determined by how that style of therapy operates in an online environment.
7. How might physical and medical factors affect online therapy?
Does the person have any visual, auditory, speech, or motor disabilities, or any chronic medical condition? Is the person on medications? If so, how might these disabilities and medications affect the person's motivation for and ability to utilize online therapy? Some people are drawn to text communication, where there is no face-to-face contact, because they prefer to hide their physical appearance. Does the person present any signs that possibly indicate a medical condition that needs to be assessed in-person by a physician? Although text communication can be effective in assessing some psychiatric symptoms, other symptoms rely heavily on face-to-face cues (e.g. flat affect, motor retardation, degenerated physical appearance, slurred speech, tremors, etc.). If any auditory and visual cues are essential in assessing the person's condition, the clinician will need to contact the person by phone or face-to-face, or refer the person to another professional to complete the assessment.
8. How might cross-cultural issues affect the therapy?
It is very likely that the online clinician will receive requests for therapy by people from other countries and cultures. In these cases clinicians must determine whether communication will be significantly hindered by differences in language, and whether they are familiar enough with the person's culture in order to effectively conduct psychotherapy. Although cross-cultural issues are also important in in-person therapy, such issues may be unique and magnified in an online therapy when the client is living in a country that is geographically distant from the therapist.
9. What other online resources might be appropriate to incorporate into a treatment package?
A wide variety of potentially therapeutic resources are available online, including informational web sites, support groups, mental health message boards, self-help instruction, and experiential software. The assessment process might include an explanation of these resources to the client, and then a determination of whether the client is interested in or could benefit from them. The goal is to determine whether a multi-modal treatment plan might be therapeutic, and if so, what might those modalities be.
Online therapy will not be appropriate for all people seeking help. In these cases, the online practitioner should have the skills and resources to make appropriate referrals. When the practitioner determines that high risk or other factors indicate that a person is best served by seeking immediate treatment within his or her locality (e.g., for suicide prevention, medication assessment, etc.), such a referral or assistance in finding an appropriate referral should be provided."
From The International Society For Mental Health Online:
"Assessing a Person's Suitability for Online Therapy
These guidelines were developed by the Clinical Case Study Group of the International Society for Mental Health Online. They outline some basic issues in determining a client's suitability for online psychotherapy. Although they are designed mostly with text-based therapy in mind (e-mail, chat), many of these guidelines apply also to other online methods of communication (e.g., internet telephoning, video conferencing). "Suitability" refers to a variety of factors, including the person's preferences regarding online therapy, how suggestible the person is within a particular communication modality, his or her skills in communicating within that modality, and the potentially therapeutic aspects of that modality for the person. Because there are many possible formats for online clinical work, as well as many different theories of psychotherapy, these guidelines are not intended to be exhaustive or definitive. Hopefully, clinicians will adapt these ideas to the unique aspects of each of their online psychotherapy cases.
While conducting the assessment, the clinician needs to keep in mind the ethical issues regarding online therapy, such as those described in the suggested principles of the International Society for Mental Health Online. As these suggested priniciples indicate, it's important to inform clients about issues regarding privacy, the potential benefits and risks of online therapy, and possible safeguards. The client's ability to understand this information and his/her attitudes regarding these issues could be important determinants of the client's ability to benefit from online therapy.
1. What communication methods are adequate or preferable for assessing the client?
The clinician has a variety of communication methods for conducting the initial assessment of the client: in-person, video-conferencing, phone, email, and instant messaging or chat. Clients may have a preference for this initial contact, which may in itself be of diagnostic significance. Clients interested in online therapy may prefer a text-only setting for this first contact. They may feel more comfortable in that setting, be more able to express themselves, or wish to maintain some anonymity. Clients' preferences need to be considered along with the potential advantages of conducting the assessment using different communication methods. Combining different methods during the assessment process will yield more comprehensive and qualitatively different information about the client's personality and behaviors. Face-to-face and/or phone interviews should be encouraged during the assessment phase, although these methods may not be absolutely necessary in every case. Assessment within the preferred medium may be sufficient if communication within that medium is accurate and efficient.
Assessing the client with the communication method that will be the medium for therapy is important. However, the clinician should consider the possibility that the client may benefit from therapeutic work in communication environments that are NOT his or her stated preference. It also is possible that the person may benefit from therapy that includes more than one environment (face-to-face, phone, email, chat, etc) - which means that the treatment will involve more complex variables regarding contact time and format than traditional in-person therapy. The client's preferences, skills, and attitudes regarding work within multiple environments will be important factors to consider.
2. How might the person's computer skills, knowledge, platform, and internet access affect the therapy?
The ability to benefit from online therapy will be partly determined by the client's computer skills and knowledge, especially if the communication setting involves installing and learning new software and/or hardware. If the person seems to communicating efficiently and accurately within the setting of choice, no further assessment of the person's skills may be necessary. If therapy will move to another setting, it is important to assess the extent to which an online client is able to effectively use the computer hardware and software at his/her disposal to communicate in a manner which feels natural and allows for nuance in describing and expressing oneself. Part of the assessment process might involve a trial stage in which the therapist and client test out the communication pathway between them, without yet having established a commitment to the therapy. Some questions to consider include the following:
-- Does the person demonstrate adequate knowledge of his/her computer system and internet technology?
-- Is the person motivated and capable to experiment with new communication environments and techniques?
-- Is the person's computer system compatible with that of the clinician?
-- What kind of internet access does the person have?
-- Where is the client accessing the internet (home, work) and does this present any problems regarding privacy or any technological difficulties (e.g., firewalls that limit internet activities)
-- If the client's internet access is problematic, are there viable alternatives (e.g., a web-based e-mail account)
3. How knowledgeable is the person about online communication and relationships?
The ability to benefit from online therapy will be partly determined by the person's familiarity with the technique and psychological aspects of online communication. First-hand participation is valuable, as well as the person having read about the internet and talked to others about it.
-- What is the person's lifestyle in cyberspace?
-- What experience does the person have with communicating online?
-- If the person has online relationships or belongs to online groups, what have these social activities been like?
-- In what settings did these relationships develop and for how long?
-- What other activities does the person pursue online, and what is his/her attitude about life in cyberspace?
4. How well is the person suited for the reading and writing involved in text communication (email, chat)?
If the therapist will be working with the client via typed text, assessing the clients experience with reading and writing is important. A person's reading and writing skills may not be equivalent, but both are necessary for text-based therapy. Some people may prefer reading over writing, or vice versa, which could have a significant impact on text-based communication. Assess the person's motor and cognitive skills for reading and writing, as well as the person's psychological experience of these activities. What does reading and writing mean to the person? What needs do these activities fulfill? It may be helpful to discuss how the person's attitudes and skills regarding in-person communication compare to those regarding text communication. When assessing the person's suitability for text communication, it's important to remember that developing and enhancing the person's reading and writing skills may be intrinsic to the therapeutic process.
Because chat/IM is a different experience than e-mail, it's important to determine the client's skills and preferences regarding these synchronous versus asynchronous methods of communication, as well the person's potential to benefit from these different methods. It may be informative to ask the client to complete a writing exercise that is relevant to the type of online therapy being offered (e.g., a summary of the history of one's life, a description of a scene related to the presenting complaint, an essay about one's personality or family members, an objective description of a specific problematic behavior).
Some questions to consider during the assessment stage include the following:
-- Does the person like reading and writing?
-- What kinds of experiences has the person had with reading and writing?
-- What do reading and writing mean to the person?
-- Are there any known physical or cognitive problems that will limit the ability to read and write?
-- How well can the person type?
-- Does the person enjoy in-person and phone conversations. Why?
-- How does the person feel about the spontaneous, in-the-moment communication of chat/IM as opposed to the opportunity to compose, edit, and reflect, as in e-mail?
-- Might there be therapeutic benefits of using chat, e-mail, or some other method of text communication even though the person may not prefer that particular method?
5. How might previous and concurrent mental health treatment affect online therapy?
If the person has been in therapy before, this will have created some impressions and expectations of what therapy is like. It is important to assess how these impressions and expectations are influencing the person's attitudes about online therapy, especially if the communication method will be different than that used in the previous therapy. Inquire about what type of therapy it was, the therapist's style of intervention, the duration of the therapy, the goals and outcome. Compare these factors to what will be offered in the online therapy. If the person currently is involved in other online or in-person mental health treatments, how will this influence the therapy?
6. How might personality type, presenting complaint, and diagnosis influence the person's suitability for online therapy?
This is a complex topic that deserves more clinical research. A separate set of guidelines could be devoted to it. One basic issue is the level of care a person may require (see Stofle's description). People who need full or partial hospitalization with close observation and supervision may not be appropriate for online therapy. The level of care a person requires also may change over time, thereby requiring that the clinician assess the person's history of level of functioning, and then periodically reassess the client during the therapy. As a rule of thumb, severe pathology and risky behaviors - such as lethally suicidal conditions - may not be appropriate for online work. Tendencies towards poor reality testing and strong transference reactions may become exacerbated in text communication, thereby making them difficult to manage and potentially destructive to the treatment. People with borderline personality disorders often challenge the boundaries of therapy, which can be especially problematic in e-mail communication and when combining different methods of communication. The clinician may need to set very clear rules about when, where, and how therapy takes place. The structure offered by online therapy may attract people who experience problems with impulsivity, internal emptiness, splitting, and aggression which otherwise get acted out in the comparatively unstructured social world of cyberspace. More clinical research is needed to determine what types of significant pathologies might be treated online, and how.
Assessing personality disorders and types (antisocial, narcissistic, schizoid, avoidant, paranoid, depressive, manic, masochistic, obsessive-compulsive, histrionic, dissociative) may lead to valuable information about how these people react to various forms of online therapy. Will avoidant and schizoid people fare well in the potentially anonymous environment of text conversation? Will the projective mechanisms of paranoid people be overly exaggerated in text communication? Can people with dissociative tendencies benefit from work across communication settings - or by participating in online groups - or will such work amplify those tendencies by encouraging fragmentation into different online persona? More clinical research is needed to answer these questions and refine the assessment process.
Diagnostic testing can be valuable in assessing the psychopathological factors that might influence the efficacy of online treatment. If it's not possible to arrange in-person testing, online tests could be an easy-to-access supplement to the assessment interview. Hopefully, in the near future, professionally managed web sites will become available that offer diagnostic tests as an aid for online therapists. When using online tests, consider such factors as accessibility, affordability, user-friendliness, security of test results, compliance with ethical principles, reliability, and validity.
Of course, many assessment principles that apply to therapy in-person also apply to online therapy, but will not be reiterated here. In addition, the type of online therapy being offered (psychodynamic, cognitive, behavioral, humanistic, etc.) will determine the types of questions raised during the assessment stage. Whether a person might benefit from a particular style of therapy will be partly determined by how that style of therapy operates in an online environment.
7. How might physical and medical factors affect online therapy?
Does the person have any visual, auditory, speech, or motor disabilities, or any chronic medical condition? Is the person on medications? If so, how might these disabilities and medications affect the person's motivation for and ability to utilize online therapy? Some people are drawn to text communication, where there is no face-to-face contact, because they prefer to hide their physical appearance. Does the person present any signs that possibly indicate a medical condition that needs to be assessed in-person by a physician? Although text communication can be effective in assessing some psychiatric symptoms, other symptoms rely heavily on face-to-face cues (e.g. flat affect, motor retardation, degenerated physical appearance, slurred speech, tremors, etc.). If any auditory and visual cues are essential in assessing the person's condition, the clinician will need to contact the person by phone or face-to-face, or refer the person to another professional to complete the assessment.
8. How might cross-cultural issues affect the therapy?
It is very likely that the online clinician will receive requests for therapy by people from other countries and cultures. In these cases clinicians must determine whether communication will be significantly hindered by differences in language, and whether they are familiar enough with the person's culture in order to effectively conduct psychotherapy. Although cross-cultural issues are also important in in-person therapy, such issues may be unique and magnified in an online therapy when the client is living in a country that is geographically distant from the therapist.
9. What other online resources might be appropriate to incorporate into a treatment package?
A wide variety of potentially therapeutic resources are available online, including informational web sites, support groups, mental health message boards, self-help instruction, and experiential software. The assessment process might include an explanation of these resources to the client, and then a determination of whether the client is interested in or could benefit from them. The goal is to determine whether a multi-modal treatment plan might be therapeutic, and if so, what might those modalities be.
Online therapy will not be appropriate for all people seeking help. In these cases, the online practitioner should have the skills and resources to make appropriate referrals. When the practitioner determines that high risk or other factors indicate that a person is best served by seeking immediate treatment within his or her locality (e.g., for suicide prevention, medication assessment, etc.), such a referral or assistance in finding an appropriate referral should be provided."
Therapy and Online Therapy Story, www.EmergencyTherapy.com
The media is discussing the new technique of therapy on the internet also known as e-therapy or online therapy. www.EmergencyTherapy.com is a provider of internet therapy and offers counseling with licensed social workers and psychologists. Here is an interesting article about therapy on the internet like the therapy offered at www.EmergencyTherapy.com.
From WebMD:
From Couch to Keyboard: Cyber Therapy Booms
It's a far cry from Freudian psychoanalysis on a couch, but, nonetheless, more and more Americans are using the Internet to access mental health counseling.
Web sites for emotional problems abound with trendy sounding name like "Headworks," "Conscious Choices," or "The Problem Solvers@TherapyAve.com". Another e-counseling venue, "Marriage Matters," features a cyber shopping mall and a pressroom.
It's estimated they get millions of hits -- many from the estimated one in five of us suffering from mental illness, and all at the price of $30-80 per hour session, which can be much less than traditional psychotherapy. But when all the emailing and chatting has been said and done, has anything been accomplished? Or have users actually been harmed by the process?
"The benefits are that millions of people are getting good information that they very likely would not access if it wasn't for the Internet. ... [The] bad news is that there is information out there on the [Internet] that does not promote good health," Michael Faenza, MSSW, president and CEO of the National Mental Health Association, tells WebMD.
Last week, the NMHA sponsored a 1-day meeting here, which included key mental health organizations and Internet specialists, to address some of the problems that online counseling has spawned. The major issues include varying quality of information on the sites as well as their objectivity (i.e., whether the offerings are unbiased research or simply disguised commercial material).
Confidentiality of e-discussions between therapists and patients also must be addressed, so people will feel free to reveal their innermost thoughts online, according to mental health professionals attending the event. Perhaps the key dilemma is how to protect these particularly vulnerable people from being exploited by fraudulent operators.
At the end of the day, the group agreed that in addition to all of these proposed reforms, there needs to be something like a "Good Housekeeping" seal of approval, so patients know what they're getting. Several online codes of ethics already exist, although it's not clear how many sites are adhering to these quality standards.
"Like with everything else in the world, there are charlatans out there, ... [but] the seller of a product or information wants to be perceived as credible," Mark Helmke, senior director of public affairs for NMHA, tells WebMD.
Although the Food and Drug Administration has made an effort to crack down on illegitimate online pharmacies that prescribe drugs without proper medical supervision, apparently no federal regulation specifically targets these mental health web sites.
And bad advice may come at a high price.
"Down the road there are all sorts of possibilities, and I'm pretty excited about some of them, but it's pretty much buyer beware at this point," says Ronnie Stangler, MD, chairwoman of the information technology committee of the American Psychiatric Association and a psychiatry professor at the University of Washington in Seattle.
Stangler tells WebMD of one horror story about a woman being treatment for depression. When the patient later turned to a credible-sounding web site for advice, an online psychiatrist told her that her doctor's diagnosis was wrong. It turned out the web site was sponsored by a drug company with its own agenda.
"Obviously, this [online] physician knew very little about the patient, ... so it's potentially very disruptive," Stangler tells WebMD.
Other mental health specialists are also dubious of meaningful therapy without direct contact.
"There's no accountability, no responsibility. ... It's very easy for a private practitioner [on the Internet] to hang out a shingle," Jerilyn Ross, MA, LICSW, tells WebMD. A participant in the meeting, Ross says that when she treats a patient for an anxiety disorder, she's liable. "But on the [Internet], I can open a site and say to people with phobias, 'Go jump off the balcony.' I can say anything," says Ross.
Still, online counselors like Judith Schwambach, PhD, of Evansville, Ind., feel they offer services of special value. "[We offer] the convenience of doing so, the anonymity, especially if these people suffer from phobias ... so they can just sit at their desk ... or wherever they have a computer and have the privilege of contacting a doctor," Schwambach tells WebMD. Computers also can help overcome the stigma of being treated, she says.
Schwambach offers both online and office counseling at $90 per hour for either service. "I welcome my people to check me out -- that I really am who I say I am," she says. However, Schwambach acknowledges that Indiana has no formal certification process -- only a PhD is required to do counseling. If there were a rigorous accreditation process for online counseling, Schwambach says she isn't sure she'd continue her 8-year practice.
Online counseling tends to focus on problems like depression, marital or sexual issues, and anxiety. Because of the distance between the patient and practitioner, it may be more difficult to handle emotional crises such as suicidal or violent tendencies.
Psychologist Richard Sansbury, PhD, of Calverton, Md., admits online treatment doesn't work well for those who are "paranoid" about private discussions over the computer. "They can't deal with the uncertainty that email exchange involves," Sansbury tells WebMD. That type of patient, he says, can obsess over what kind of person the therapist is, or whether the individual has a valid license.
"We are pioneers," says Sansbury. "There is much more not known than what is known. That's right on my web site: Before you contact me, understand this is an experiment."
www.EmergencyTherapy.com wants to provide you with information about online therapy so when you are ready you may decide if this is a viable option for you. EmergencyTherapy.com was founded in order to help people overcome various problems. Therapy at www.EmergencyTherapy.com is only provided by licensed social workers and psychologists. They feel it is important to provide help that protects your confidential information and also understands the difference between traditional in person therapy and online therapy provided at www.EmergencyTherapy.com.
From WebMD:
From Couch to Keyboard: Cyber Therapy Booms
It's a far cry from Freudian psychoanalysis on a couch, but, nonetheless, more and more Americans are using the Internet to access mental health counseling.
Web sites for emotional problems abound with trendy sounding name like "Headworks," "Conscious Choices," or "The Problem Solvers@TherapyAve.com". Another e-counseling venue, "Marriage Matters," features a cyber shopping mall and a pressroom.
It's estimated they get millions of hits -- many from the estimated one in five of us suffering from mental illness, and all at the price of $30-80 per hour session, which can be much less than traditional psychotherapy. But when all the emailing and chatting has been said and done, has anything been accomplished? Or have users actually been harmed by the process?
"The benefits are that millions of people are getting good information that they very likely would not access if it wasn't for the Internet. ... [The] bad news is that there is information out there on the [Internet] that does not promote good health," Michael Faenza, MSSW, president and CEO of the National Mental Health Association, tells WebMD.
Last week, the NMHA sponsored a 1-day meeting here, which included key mental health organizations and Internet specialists, to address some of the problems that online counseling has spawned. The major issues include varying quality of information on the sites as well as their objectivity (i.e., whether the offerings are unbiased research or simply disguised commercial material).
Confidentiality of e-discussions between therapists and patients also must be addressed, so people will feel free to reveal their innermost thoughts online, according to mental health professionals attending the event. Perhaps the key dilemma is how to protect these particularly vulnerable people from being exploited by fraudulent operators.
At the end of the day, the group agreed that in addition to all of these proposed reforms, there needs to be something like a "Good Housekeeping" seal of approval, so patients know what they're getting. Several online codes of ethics already exist, although it's not clear how many sites are adhering to these quality standards.
"Like with everything else in the world, there are charlatans out there, ... [but] the seller of a product or information wants to be perceived as credible," Mark Helmke, senior director of public affairs for NMHA, tells WebMD.
Although the Food and Drug Administration has made an effort to crack down on illegitimate online pharmacies that prescribe drugs without proper medical supervision, apparently no federal regulation specifically targets these mental health web sites.
And bad advice may come at a high price.
"Down the road there are all sorts of possibilities, and I'm pretty excited about some of them, but it's pretty much buyer beware at this point," says Ronnie Stangler, MD, chairwoman of the information technology committee of the American Psychiatric Association and a psychiatry professor at the University of Washington in Seattle.
Stangler tells WebMD of one horror story about a woman being treatment for depression. When the patient later turned to a credible-sounding web site for advice, an online psychiatrist told her that her doctor's diagnosis was wrong. It turned out the web site was sponsored by a drug company with its own agenda.
"Obviously, this [online] physician knew very little about the patient, ... so it's potentially very disruptive," Stangler tells WebMD.
Other mental health specialists are also dubious of meaningful therapy without direct contact.
"There's no accountability, no responsibility. ... It's very easy for a private practitioner [on the Internet] to hang out a shingle," Jerilyn Ross, MA, LICSW, tells WebMD. A participant in the meeting, Ross says that when she treats a patient for an anxiety disorder, she's liable. "But on the [Internet], I can open a site and say to people with phobias, 'Go jump off the balcony.' I can say anything," says Ross.
Still, online counselors like Judith Schwambach, PhD, of Evansville, Ind., feel they offer services of special value. "[We offer] the convenience of doing so, the anonymity, especially if these people suffer from phobias ... so they can just sit at their desk ... or wherever they have a computer and have the privilege of contacting a doctor," Schwambach tells WebMD. Computers also can help overcome the stigma of being treated, she says.
Schwambach offers both online and office counseling at $90 per hour for either service. "I welcome my people to check me out -- that I really am who I say I am," she says. However, Schwambach acknowledges that Indiana has no formal certification process -- only a PhD is required to do counseling. If there were a rigorous accreditation process for online counseling, Schwambach says she isn't sure she'd continue her 8-year practice.
Online counseling tends to focus on problems like depression, marital or sexual issues, and anxiety. Because of the distance between the patient and practitioner, it may be more difficult to handle emotional crises such as suicidal or violent tendencies.
Psychologist Richard Sansbury, PhD, of Calverton, Md., admits online treatment doesn't work well for those who are "paranoid" about private discussions over the computer. "They can't deal with the uncertainty that email exchange involves," Sansbury tells WebMD. That type of patient, he says, can obsess over what kind of person the therapist is, or whether the individual has a valid license.
"We are pioneers," says Sansbury. "There is much more not known than what is known. That's right on my web site: Before you contact me, understand this is an experiment."
www.EmergencyTherapy.com wants to provide you with information about online therapy so when you are ready you may decide if this is a viable option for you. EmergencyTherapy.com was founded in order to help people overcome various problems. Therapy at www.EmergencyTherapy.com is only provided by licensed social workers and psychologists. They feel it is important to provide help that protects your confidential information and also understands the difference between traditional in person therapy and online therapy provided at www.EmergencyTherapy.com.
Online Therapy Article,Therapy at www.EmergencyTherapy.com
Here is an article about therapy on the internet. This online therapy is like what www.emergencytherapy.com provides on their website.
From The Toronto Star:
"Late at night when his children were asleep, the 45-year-old software developer would brew a pot of Earl Grey tea and head to the computer in his rural Prairie home. He'd pour out his troubles in an email – to his psychotherapist in Toronto.
She'd respond within 48 hours, he'd write back, and so went his therapy over the course of a year.
"I wasn't constrained by an appointment time," says the software developer, who asked not to be named. "I also find it easier to be more open in an email. My inhibitions and insecurities tend to be stronger in person."
More counsellors – and employee assistance programs – are offering the online alternative, mainly through email but also via instant messaging on secured websites.
E-therapy practitioners point to the convenience with sessions anytime, anywhere, and the privacy. They say clients tend to organize their thoughts better when writing, get to the heart of the matter quicker, and have the therapist's responses to reread. It costs about the same than in-person sessions.
"Online counselling isn't just a second cousin, something you do because you can't get an appointment," says Cedric Speyer, clinical supervisor of e-counselling at Shepell FGI. "In many ways it's better."
Not so fast, say others.
Ian Nicholson, chair of professional affairs for the Canadian Psychological Association, worries about licensing issues, lack of computer privacy, and missed nuances without in-person contact.
"The mainstream view is cautious," says Nicholson. "We don't really have a lot of evidence about its effectiveness."
A 2004 review in the Journal of Clinical Psychology found few differences in the outcomes of online or in-person therapies.
Gerry Smith, a vice-president at the employee assistance program Shepell FGI, says his firm's client satisfaction rate for online therapy is the same as in-person therapy, about 95 per cent.
"Clients experience the same level of resolution of their problems," says Lawrence Murphy, an online counsellor since 1995, "and they tend to complete their therapy in fewer sessions."
While in-person counselling attracts four women for every man, says Murphy, the ratio is closer to two to one for online work. "Men may feel more in control of the information, more comfortable in their own place," says Murphy, co-founder of therapyonline.ca. The Prairie software developer, who wanted counselling for relationship issues, chose the online route mainly to save time.
"With face-to-face therapy you might think, `I wish I'd asked ...' right after you walk out," he says. "With email, you can make sure you said what you needed to say."
The big bonus was having the responses to reread. "Life isn't a straight line," he says. "You go up and down. Sometimes I'd find myself needing reassurance about something. It's handy to go back to the emails."
To flush out feelings in cyberspace – forget the smiley and sad emoticons – a counsellor needs training.
"I was skeptical before I did it," says Toronto psychotherapist Kali Munro. "But you pick up a lot by how something's written. I was astounded at how much perceptiveness can come through a computer."
Murphy, who teaches an online training program in collaboration with the University of Toronto School of Social Work, has developed techniques, such as describing emotions inside a pair of brackets – ("feeling concerned").
"Online therapy is an oxymoron as far as I'm concerned," says Brampton psychotherapist Richard Isaacs. "You need the direct relationship with the therapist."
He makes the distinction between psychotherapy, delving into personality issues and making life changes, and counselling, dealing with day-to-day problems. Some counselling could be done online, he says.
Shepell FGI's Speyer argues that the online dialogue can go very deep, overcoming what he calls the "static of personality," the mannerisms, gender, accent, things that might hinder a relationship. Writing, he points out, is a window into a person's thought processes.
"I can hear my therapist's voice in my head although we've never spoken," says a 49-year-old woman who receives counselling through instant message sessions. She and the therapist schedule times to chat on a secure Internet site.
"If I boo-hoo in a session I'm not embarrassed. I would be, face-to-face."
There are caveats, of course. Cyber-therapy isn't for those suffering from severe mental health problems, those who feel suicidal or who need a lot of support with a challenging situation. "Face-to-face is more anchoring," says psychotherapist Munro, who does both. And clients need to be comfortable expressing themselves in writing. It's hard to picture tough guy-in-therapy Tony Soprano pouring out his feelings in an email.
But, Murphy points out, e-therapy is merely a new approach to an old tradition: "Freud wrote letters as part of his counselling practice."
If you want to learn more about online therapy or therapy on the internet go to www.emergenctherapy.com. EmergencyTherapy.com offers therapy online and via the telephone in order to help people facing various health challenges. As can see from the article, therapy on the internet is becoming a more popular way of obtaining help from the privacy of your own home. Therapy at www.EmergencyTherapy.com can be a good option for those looking to get help for various issues. Each therapist on www.EmergencyTherapy.com is a licensed social worker or psychologist. They have been hand picked for their training, experience, and abilities to handle mental health problems. The www.EmergencyTherapy.com therapists each have graduate degrees in their fields, are licensed to practice in their state, and have helped numerous people to overcome challenges.
From The Toronto Star:
"Late at night when his children were asleep, the 45-year-old software developer would brew a pot of Earl Grey tea and head to the computer in his rural Prairie home. He'd pour out his troubles in an email – to his psychotherapist in Toronto.
She'd respond within 48 hours, he'd write back, and so went his therapy over the course of a year.
"I wasn't constrained by an appointment time," says the software developer, who asked not to be named. "I also find it easier to be more open in an email. My inhibitions and insecurities tend to be stronger in person."
More counsellors – and employee assistance programs – are offering the online alternative, mainly through email but also via instant messaging on secured websites.
E-therapy practitioners point to the convenience with sessions anytime, anywhere, and the privacy. They say clients tend to organize their thoughts better when writing, get to the heart of the matter quicker, and have the therapist's responses to reread. It costs about the same than in-person sessions.
"Online counselling isn't just a second cousin, something you do because you can't get an appointment," says Cedric Speyer, clinical supervisor of e-counselling at Shepell FGI. "In many ways it's better."
Not so fast, say others.
Ian Nicholson, chair of professional affairs for the Canadian Psychological Association, worries about licensing issues, lack of computer privacy, and missed nuances without in-person contact.
"The mainstream view is cautious," says Nicholson. "We don't really have a lot of evidence about its effectiveness."
A 2004 review in the Journal of Clinical Psychology found few differences in the outcomes of online or in-person therapies.
Gerry Smith, a vice-president at the employee assistance program Shepell FGI, says his firm's client satisfaction rate for online therapy is the same as in-person therapy, about 95 per cent.
"Clients experience the same level of resolution of their problems," says Lawrence Murphy, an online counsellor since 1995, "and they tend to complete their therapy in fewer sessions."
While in-person counselling attracts four women for every man, says Murphy, the ratio is closer to two to one for online work. "Men may feel more in control of the information, more comfortable in their own place," says Murphy, co-founder of therapyonline.ca. The Prairie software developer, who wanted counselling for relationship issues, chose the online route mainly to save time.
"With face-to-face therapy you might think, `I wish I'd asked ...' right after you walk out," he says. "With email, you can make sure you said what you needed to say."
The big bonus was having the responses to reread. "Life isn't a straight line," he says. "You go up and down. Sometimes I'd find myself needing reassurance about something. It's handy to go back to the emails."
To flush out feelings in cyberspace – forget the smiley and sad emoticons – a counsellor needs training.
"I was skeptical before I did it," says Toronto psychotherapist Kali Munro. "But you pick up a lot by how something's written. I was astounded at how much perceptiveness can come through a computer."
Murphy, who teaches an online training program in collaboration with the University of Toronto School of Social Work, has developed techniques, such as describing emotions inside a pair of brackets – ("feeling concerned").
"Online therapy is an oxymoron as far as I'm concerned," says Brampton psychotherapist Richard Isaacs. "You need the direct relationship with the therapist."
He makes the distinction between psychotherapy, delving into personality issues and making life changes, and counselling, dealing with day-to-day problems. Some counselling could be done online, he says.
Shepell FGI's Speyer argues that the online dialogue can go very deep, overcoming what he calls the "static of personality," the mannerisms, gender, accent, things that might hinder a relationship. Writing, he points out, is a window into a person's thought processes.
"I can hear my therapist's voice in my head although we've never spoken," says a 49-year-old woman who receives counselling through instant message sessions. She and the therapist schedule times to chat on a secure Internet site.
"If I boo-hoo in a session I'm not embarrassed. I would be, face-to-face."
There are caveats, of course. Cyber-therapy isn't for those suffering from severe mental health problems, those who feel suicidal or who need a lot of support with a challenging situation. "Face-to-face is more anchoring," says psychotherapist Munro, who does both. And clients need to be comfortable expressing themselves in writing. It's hard to picture tough guy-in-therapy Tony Soprano pouring out his feelings in an email.
But, Murphy points out, e-therapy is merely a new approach to an old tradition: "Freud wrote letters as part of his counselling practice."
If you want to learn more about online therapy or therapy on the internet go to www.emergenctherapy.com. EmergencyTherapy.com offers therapy online and via the telephone in order to help people facing various health challenges. As can see from the article, therapy on the internet is becoming a more popular way of obtaining help from the privacy of your own home. Therapy at www.EmergencyTherapy.com can be a good option for those looking to get help for various issues. Each therapist on www.EmergencyTherapy.com is a licensed social worker or psychologist. They have been hand picked for their training, experience, and abilities to handle mental health problems. The www.EmergencyTherapy.com therapists each have graduate degrees in their fields, are licensed to practice in their state, and have helped numerous people to overcome challenges.
Monday, August 27, 2007
Therapy, Emergency Therapy and Online Therapy
Therapy is one of the most important ways to overcome problems. In the past, people got therapy through a therapy office or a hospital. There is now a big movement of therapy over the internet. Online therapy might help you to overcome many isssues you are facing. It is easy, convenient and inexpensive. www.EmergencyTherapy.com provides therapy online for people around the world. The therapy provided is given only by licensed social workers or psychologists. Studies are beginning to show the efficacy of therapy online. Therapy from www.EmergencyTherapy.com offers a low cost way to obtain help.
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