Benefits of Cybertherapy
Some researchers posit online therapy offers many advantages over face-to-face therapy. Interapy includes psychoeducation, screening, effect measures, and a protocol-driven treatment via the Internet. Proponents of telemedicine present it as an alternative to face-to-face counseling sessions and it can proffer services to those physically able to meet with a mental health professional or can serve in the capacity as supplemental support outside those sessions (Oravec, 2000). “The popularity of the Internet and related computer networks will increase the popularity of telemedicine as a cost-effective and efficient method of dispersing medical expertise to remote sites” (Lloyd, 1996). As previously stated, e therapy can serve as a viable alternative when access to professional help when it is not available locally; “removal of barriers due to time, distance, scheduling, care-giving responsibilities, and difficulties related to verbal communication; ability of both therapists and clients to think- through and formulate responses; and cost-savings” (Finn and Banach, 2000).
A great hope for the Internet has always been that the virtual world would at least put a dent in discrimination and prejudice. Without cues to detect race, gender, or age we would not be able to indulge in racism, sexism, or ageism (Wallace, 1999). It is understandable that for divergent reasons the prospect of interacting with complete anonymity with others may help client fully embrace unabashed self-disclosure. The constraints posed by discrimination or prejudice on the basis of race, creed, sexual orientation, aesthetics, gender, age…the categories are too voluminous for the scope of this paper- should in theory be eradicated if not assuaged with cyberpsychology.
Constraints of Cybertherapy
“There is some evidence, (about the effectiveness of Telemedicine) both in the research and anecdotal reports, that using the Internet can have negative consequences” (Finn and Banach, 2000). The use of psychotechnologies to deliver care online “has specific, though evolving, indications, contraindications, and risks” (Maheu, 2003). As the prevalence of online counseling rises, however, there is a lack of substantive empirical (Snow, 2001) research or evidence about the effectiveness of online therapeutic services, and little has been written about the risks involved in using online counseling or human service related resources. “Online counseling and other modes of online mental health care are also associated with a number of problems that mental health care educators and supervisors are helping to mitigate” (Oravec, 2000).
From a technological standpoint problems can vary from Internet Service providers (ISPs) being down, thus desisting online communication until the server is back up for either the client or therapist, potentially fostering feelings of abandonment (Snow, 2001), to therapists not assuming responsibility for the clients welfare and causing irrevocable harm. The latter will be more discussed in-depth in the section to follow. Nuisances can also disrupt the cathartic nature of groups as, “Unfortunately, in online support groups, junk email is common (known as ‘spam'), as are hostile comments by participants (or ‘flames') as well as intentional efforts at deception” (Oravec, 2000). Infiltrators and harassers intentionally disrupt proceedings. Counselor vigilance is required.
Another problem with many e-mail groups is their amorphous membership and process. Often the implicit norm is that users can subscribe and unsubscribe whenever desired, participate or lurk as desired, respond to others, ignore them or digress. This lack of structure sometimes leads to a group that is fragmented, disorganized, and lacking in group spirit and identity according to the International Society for Mental Health Online (ISMHO) (Suler and Feniche, 2000). Snow (2001) also posed an evocative point stating minorities are twice as likely not to have Internet access as others. As etherapy was intended to embrace all, does it unwittingly exclude others? Socioeconomics also plays a dynamic, as it will impact an individual's ability to access a secured computer.
Resources and Technological Advancements within Cybertherapy
A computer- controlled telecommunications system, Telephone-Linked Care, is designed as a behavioral intervention for smokers who are trying to quit. It has an expert system that controls the logic of a series of interactive telephone conversations. Programs were infrequently used in clinical practice but raised important questions about the nature of human interaction in counseling settings (Oravec, 2000).
To some it seems somewhat apocalyptic to think of computers intervening when humans malfunction socially, emotionally, and behaviorally, but this example of technological advancements within the sects of behavioral medicine is not isolated. Perhaps less invasive and formidable, virtual reality (VR) may also play a strong role in the near future, providing ways in group counseling efforts for individuals to interact with each other in a constructed environment (Oravec, 2000). Operating somewhat like a triage with levels of technological intrusiveness ascending, the tertiary stage of technological advancements to facilitate telemedicine may be listservs. To access group psychotherapy individuals should type the commands listserv@lists.apa.org. Haim Weinberg owns the list. “This listserv is for any clinician who works with a group psychotherapeutic modality and for the discussion of group work and group psychotherapy” (Grohol, 2000, p. 121).
