What is most perhaps most inauspicious is the dearth of cybertherapy research to help assuage the pratfalls and answer the questions clinicians, governing boards protecting the rights of mental health consumers, and clients have. As it is apparent more and more individuals are seeking this modality to supplement or replace the need for face-to-face counseling, a valid question is what is etherapy and what does it entail? To examine each facet of cyberpsychology is to understand that online counseling involves reading and writing with narrative therapy, the approach developed by Michael White and David Epston holds that the knowledge and stories (narratives) emanating from their culture, families and experiences shape persons, and bibliotherapy. B ibliotherapy is a family of technique for structuring interaction between a facilitator and a participant based on mutual sharing of literature. These are the utilized techniques. “Online services are typically delivered in the form of email communications, discussion lists, live chat rooms, or live audio or audiovisual conferencing” (eTherapy, 2003).
“Telemedicine may involve electronic mail counseling which involves the exchange of brief narratives, chat room correspondence, online support groups, or in a group format, computation involving a series of email exchanges among members with the counselor as the coordinator” (Mallen, Day & Green, 2003). As in face-to-face groups, the cybertherapy's group leader, too, must function to build the foundations of a successful group. Gladding (1994) relates group leaders must be cognizant of the group's power and potency. Planning ahead and being sensitive to the stage of development of the group are imperative. The first step in the process is pre-group planning, establishing objectives, and group membership screening as seen with traditional face-to-face groups.
“Screening allows leaders to select members and members to select leaders and groups. The ideal group size of eight to 12 allows members an opportunity to express themselves without forming into subgroups” (Gladding., 1994). Few and clear should be the group social criterion for rules. Most groups meet for one and one half to two hours each week for 12 to 16 sessions. A sense of equality is suggested and can be established via minor environmental manipulations such as the chairs set up in a circle to encourage forum discussion, but this dynamic may be less ubiquitous in the online context. Social transactions become more complex as keeping track of communication patterns may be more cumbersome.
Face-to-face communication messages are sent and most importantly interpreted verbally and through paraverbal behavior. This is omitted within the boundaries of Telemedicine and introduces supplementary concerns that have little substantive research- Internet etiquette, coined netiquette (Starr, n.d.) within itself warrants research as inferences are often made and can lead to miscommunication. Skeptics have always wondered whether cohesive groups could really emerge at all in a computer-mediated environment. Some believed that the lack of the usual social cues and the transitory nature of so many online interactions would make it unlikely that genuine and satisfying groups could develop (Wallace, 1999).
With respect to the fee schedule, it is unknown at the time of this paper's development if managed care providers compensate their consumers for employing telemedicine. Assuming not, prospective clients and clinicians pondering entry into cyberpsychology should be abreast of the financial aspect. Clinical social worker Grimble (2003) posts an email session begins with the consumer:
Selecting the package you desire and paying the appropriate amount to PayPal. Then, you send me an email through the encrypted service provided on this site. Write a brief summary of your concern(s) and/or question(s). I read your email and send you my response within 48 hours after payment is received. You do not need an appointment to send email. One email costs $25.00, $70.00 will purchase three emails, and five emails costs $150.00 ( Grimble, S.S ., 2003).
Chat sessions occur through the secured private chat room available for eTherapy Online clients. You select the package you desire and send payment to PayPal. Next, fill out the Client History form, Then, you schedule a time that is convenient—please list several choices. Remember to schedule using my Time Zone (Eastern Standard Time for entire year) ( Grimble,S.S ., 2003).
Grimble's rates are $35.00 for one half-hour chat session, $100.00 for three half hour chat sessions, $65.00 for one 1-hour chat session, and $180.00 for three 1-hour chat sessions. It is postulated that comparatively, d istance counseling will result in substantial cost savings, consumer satisfaction and increased accessibility (Snow, 2001). Clients whose insurance precludes reimbursement for services would be willing and able to pay a much more modest fee to reach out from the comforts of their own desks. Office visits with mental health professionals can cost as much as $140 while fees for Internet providers average $20 per inquiry (Powell, 1998).
