Telehealth & E-Therapy

Clinical Update
By Zur Institute

For a complete list of all Clinical Updates, click here.

In today's fast-paced world, many view psychotherapy as a place to slow down and take a break from the rest of our lives. But what if psychotherapy were an extension of our 21st century lives? Many therapists are exploring just that in the growing field of telehealth, also called e-therapy, e-counseling, or tele-mental health. Some simply supplement their in-person practices with email or text conversations; others conduct therapy as . . . avatars.

There is much to learn about our clients and ourselves from how we communicate online. From email signatures (or lack thereof) to behavior in an online group, clients reveal parts of themselves online that may not surface face-to-face (at least, not in the same way).

Telehealth expert Dr. John Suler addresses these issues and many more in his new 2-unit course: Telehealth and Psychology of the Web: Conducting Therapy in Cyberspace

Dr. Suler has been researching therapy online for many years and offers a fresh, humorous, insightful and useful perspective on what we have to learn about our clients online, as well as how to be effective in text and other online communication. This course also provides extensive online telehealth resources.

Here is a sampling of tips:

Online psychotherapy can be ethical and effective.

Therapy via online mediums is not appropriate for everyone

Suitability of a client for online therapy depends on personality, comfort with technology, presenting issues and preferences.

It is in the best interest of all therapists to be comfortable doing at least minimal therapeutic interaction online. As with commerce and education, it is the way of the future.

Different aspects of people's personalities will come out online, such as areas they want to explore or personal details they aren't comfortable revealing face-to-face.

The disinhibition effect of non face-to-face communication enables many people to share more, be more personal and open, and to have a greater potential to benefit from psychotherapy.

Suler has pioneered this research area and raised our understanding of the Internet as psychological space with unique features, such as the disinhibition effect, anonymity, invisibility, dissociative imagination, etc.

Text communication puts people at a more equal status: this includes the CEO, the therapist, construction workers and clients.

Boundaries are important online, just as they are offline. Therapists must learn to navigate these boundaries.

Confidentiality regarding safe record-keeping is as important electronically as in hard copy.

A skillful group facilitator knows when to step in, how to handle member transgressions and manage the size of the group.