Best Practices in eTherapy
Definition & Scope of e-therapyJohn M. Grohol, Psy.D.
May 14, 1999 rev.1
What is e-therapy?E-therapy is a new modality of helping people resolve life and relationship issues. It utilizes the power and convenience of the Internet to allow simultaneous (synchronous) and time-delayed (asynchronous) communication between an individual and a professional. The focus of e-therapy varies from client to client. Some clients will want to discuss interpersonal relationships, or learn new ways of dealing with stress. Other clients may use e-therapy as an adjunct to other types of real-world services, or to help clarify issues they are currently working on. Still others will use e-therapy to "check-in" from time to time with an objective third-party professional to take stock in their life and work on more philosophical life issues.
What is e-therapy not?E-therapy is not psychotherapy, nor is it psychological counseling. Since it does not presume to diagnose or treat mental or medical disorders, and because it does not limit who may be appropriate to provide e-therapy services, it would be inappropriate to compare it to traditional face-to-face psychotherapy, assessment, or counseling services. Like other types of therapy (occupational therapy, bibliotherapy, physical therapy), e-therapy helps a person address issues of concern to them in their lives under the guidance of a professional. E-therapy does not diagnose disorders, nor does it treat diagnosed mental or medical disorders. E-therapy is similar to the idea of "coaching," helping a person address specific concerns with specific skills. But e-therapy is flexible enough to also address more philosophical issues as well, if an individual so desires.
What makes e-therapy better than other modalities of help available?When e-therapy is conducted via its preferred modality (e-mail, an asynchronous communication), it allows both the client and the professional to fully reflect on issues discussed in a previous correspondence. Unlike other helping methods, such as traditional psychotherapy, e-therapy's strength is in the ability to explore and flesh-out a person's concerns without awkwardness or the need to "think on one's feet."
In fact, because there are no social and nonverbal cues in e-therapy, the participants can get to the point of issues quickly and easily. Embarrassment and other impediments (e.g., confidentiality fears) don't have to be issues in e-therapy. E-therapy's ability to provide a forum for tapping into the wealth of educational material online is unparalleled in the real-world. And because e-therapy is text-based, it is more likely to access the skills most associated with reading and comprehension. This means the cloud of emotion can be, perhaps, more readily lifted via e-therapy's methods.
What makes e-therapy worse than other modalities of help available?E-therapy's strength is also its weakness -- without nonverbal cues, communications between the participants have a greater potential for being misunderstood. It also requires that a person be adept and relatively comfortable with reading and writing, and that the participants be able to communicate at similar levels of comprehension.
What is the future of e-therapy?E-therapy is a term I coined to address all current online modalities of helping people with general life and relationship issues, via a text-based interface. Other modalities of treatment utilizing technology may or may not fall within the e-therapy purview, depending upon their intent and scope of help. For the foreseeable future, e-therapy's strength lies in its use of text- based communication, preferably via e-mail, but may also include chat.
What about e-therapy's naysayers?Since the beginning of time, from Aristotle to Freud, pundits who believe they have some unique, specialized knowledge have criticized those who seek to break conservative, traditional modes of treatment. Many such professionals are protectionists, seeking to ensure that specific professions continue to hold their unique position in the world of mental health care. Suggesting that there may be new modalities for helping people deal with their problems upsets this delicate balance between the professions, since such a modality may very well transcend each individual mental health profession.
Some objections are legitimate, but statements such as "you can't help people with these types of problems online" are absurd, ignoring current knowledge and research. It also ignores the hundreds of people who have already sought out and received this kind of help online.
For more information about e-therapy, I suggest reading the other essays in the Best Practices in e-Therapy series.