Examination of the existing body of research as well as the veritable strengths and limitations of online counseling will contribute to the contentious dialogue about the subspecialty of cyberpsychology.
The advent of eTherapy has grown to confounding predominance as clients are increasingly seeking this medium to eradicate psychological malfunction. T he mental health profession is unprepared for the growth and related implications of mental health therapy delivered over the Internet. Although there is valid reason to embrace the intrinsic worth of cyberpsychology, there are also multitudes of reasons to conclude more research is needed. There is a dearth of empirical evidence substantiating the merits or the pratfalls of etherapy. Examination of the existing body of research as well as the veritable strengths and limitations of online counseling will contribute to the contentious dialogue about the subspecialty of cyberpsychology.
Online counseling: Integrating Group Dynamics and Technology
Cybertherapy, cyberpsychology, telemedicine, etherapy, and interapy are analogous terms used interchangeably to describe online counseling, which is gaining increasing prominence as a viable medium for the delivery of mental health services. Interapy circumvents inconvenience, social stigma, and mobility concerns for individuals that may be non-ambulatory, hence impeded to travel to a mental health care professional's office. Powell (1998) relates one promising aspect of cybertherapy is “increased access to services for rural or remote populations, physically handicapped or late stage terminally ill patients” (Powell, 1998). It is further theorized “online counseling is providing an important option for individuals who cannot physically meet with mental health professionals or who need supplemental support outside of those sessions” (Oravec, 2000). The affects of etherapy are far reaching across milieus and subjects by virtue of the advances of the Internet and are of special value to individuals with computing proficiency.
Corroborating the generalizability and timeliness of an online medium such as cybertherapy, according to Finn and Banach (2000), a 1997 survey reported approximately 47,000,000 adults use a computer and approximately one fourth of these use the Internet. Snow (2001), conversely, estimates Internet usage to be significantly higher in 2001 with 429,000,000 adults using a computer, assumedly worldwide, with 41% emanating from North America . To reflect the emergence of cyberpsychology as a technological paradigm, Maheu (2003) reports computer-mediated communication in the delivery of mental health services is acquiring the status of a psychotherapeutic subspecialty. Etherapy can be facilitated synchronous or asynchronous with o nline self-help groups, as well. Zastrow (2001) approximates over a thousand self-help groups now connect people with one another through email, chat rooms, and web sites on the Internet.
Online self- help groups promoting autonomous functioning can serve the needs of a frequently forgotten population as individuals such as homebound caregivers can use a computer to find specific information and prompt support (Zastrow, 2001).
As interapy's prevalence seems steadfast, what is dually imperative is that both the prospective client and the online clinician increase their cognizance of the benefits as well as the potential pratfalls to online counseling. Online health care broadly encompasses concepts ranging from Internet Usenet discussion groups on health care topics, to email consultation between clinicians, to real-time interpretation of digital diagnostic imaging taken thousands of miles away, to experimental remotely controlled robotic surgical instruments (Lloyd, 1996).
Online Group Processes
When examining an already contentious subject of etherapy for the individual it is understandable group counseling adds additional layers of complexity. Telemedicine is an emerging taxonomy in the mental health field. Furthermore, online support groups are emerging as they proffer access to direct, open, supportive conversation. For example, America Online has a lupus support group that meets via a live chat room in which participants can exchange messages in real time every Wednesday night (Oravec, 2000). As more people are utilizing the resources of etherapy and online support groups, an issue of additional concern is if a science based theoretical model is being applied in these settings. Are all models of group dynamics or a therapist's construct appropriate and practical in the online venue?
As traditional face-to-face groups include pre-established regiments and follow a semblance of Tuckman's model of forming, storming, norming, performing, and adjourning. In the performing stage, the interdependence develops which occupies approximately 50% of a typical group's time. The final stage, adjourning deals with termination (Gladding, 1994; Zastrow, 2001). “Issues of separating from the group are raised. Celebrating the accomplishment of goals is also a primary focus within this stage” (Gladding, 1995) in which group members foster cohesion becoming closer psychologically.
It s uncertain how online groups can follow these empirically based models as online group counseling can involve series of email exchanges among members with the counselor as a coordinator. Paraverbal communication that has been deemed as paramount to the group process does not pose as a factor in the confines of cybertherapy.
(Cyberpsychology) can also incorporate group video conferencing sessions or chat room exchanges where interaction among participants is more direct and immediate. Group therapy can be powerful, and groups can hurt as well as help individuals in the counseling context. Groups have impressive capabilities to heal and to wound. Experienced mental health professionals should be involved in on-line group counseling so some of theses dangers are reduced and all participants have the opportunity to benefit from the proceedings (Oravec, J.A., 2000).
