"Therapy Online: Good as face to face?"

[Trinka Polite]

Here's an article I found today on CNN:

"Today, with the Internet, people can use the instant message format to communicate with real therapists. A new study in The Lancet suggests that real-time chat therapy with a psychotherapist is successful in helping people with depression."

Full article on this link:
http://www.cnn.com/2009/HEALTH/08/31/online.internet.therapy.cbt/in...

[Trinka Polite]

You may want to check out the "Sound Off" section below the article to see readers' comments.

[Deborah J. Boyd]

One thing I have noticed is that there are many pretenders online. They do not post pictures but if you accept that and move on they will gradually say enough so you can get a good idea of who they are, or in some cases should be. If you think about it, the Internet allows people to be accepted that might not be ordinarily. I am not a trained therapist but in order to establish Peace on Earth I need to be able to listen to many points of view without being too judgmental. I get annoyed with Eastern religions and the confusion between personal Peace and World Peace. War will never create Peace. War can only lead to destruction. This does not mean we should not have police action.

[Relationship Café]

As a therapist, I have expressed to my face to face clients (and plan to share with my online clients when I get some) that I work with what they give me. If they choose to give me lies, then I am working with their lies. An example: A couple come in stating that they want to work on their marriage. I later find out that they aren't really married but living together and the woman wants to get married and the man does not. I was working on their marriage focusing on commitment and the 'vow they made'. There were no vows. How would I know? Online or Face to Face, I work with the information I am given. I am not a private investigator to go out and see if they are lying to me or not. So, I caution them to tell me what they want me to work with. However, I am discerning and I do pay attention to what I am told, seeking for the truth in it all.

[Alisa E. Clark]

I'd like to see how it compares to CBT face to face. Hopefully that study will be forthcoming? I like having someone across from me, especially for long term care. I want to see a real person who's invested in me. Although, some may prefer the annonymity? Everyone is different. Chat therapy will likely be preferred by some. Thanks for the article. Very interesting.

[Art Matthews, MA LPC DCC]

I think it's interesting that we consider the use of the internet as creating a "new" approach to therapy. Distance therapy has been around since there were phones and psychotherapists. Who knows, some forward thinker may have even used the USPS to send and receive communication before that.

What is therapy? Can you pinpoint an action, a statement, a technique and say that this is a therapeutic intervention? To me, it's the relationship. Relationships are created F2F and at a distance. Some folks are well suited to certain methods of communication and not well to others.

Matching therapist to client and delivery model to the therapeutic relationship is what is necessary.

[Tifany Riddans]

The LANCET article cited does not support the consluon the CNN author draws.

That CNN person draws an erroneous conclusion - if she had bothered to read the article oif she had taken any research classes she'd know not to make such a huge mistake.

The LANCET population studied was not an open internet population, but rather a very well selected group pre-screened non-suicidal and non-severely depressed people by primary care docs. They also had tremdnous backup care in the form of all those primary care docs who referrred them.

That LANCET group is VERY different from a group of people contacting us through the internet without any screening or backup at all.

This kind of thing can get us into trouble if people read it and think it's safe to just hang a shingle out there and work with anyone online and completely without backup.