Online counseling or online therapy is a form of professional
mental health
Mental health is often mistakenly equated with the absence of mental illness. However, mental health refers to a person's overall emotional, psychological, and social well-being. It influences how individuals think, feel, and behave, and how t ...
counseling that is generally performed through the internet. Computer aided technologies are used by the trained professional counselors and individuals seeking counseling services to communicate rather than conventional face-to-face interactions. Online counseling is also referred to as teletherapy, e-therapy, cyber therapy, or web counseling. Services are typically offered via
email
Electronic mail (usually shortened to email; alternatively hyphenated e-mail) is a method of transmitting and receiving Digital media, digital messages using electronics, electronic devices over a computer network. It was conceived in the ...
,
real-time chat, and
video conferencing
Videotelephony (also known as videoconferencing or video calling) is the use of audio signal, audio and video for simultaneous two-way communication. Today, videotelephony is widespread. There are many terms to refer to videotelephony. ''Vide ...
.
Some clients use online counseling in conjunction with traditional
psychotherapy
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...
, or nutritional counseling. An increasing number of clients are using online counseling as a replacement for office visits.
While some forms of
telepsychology
Telepsychology is the use of telemedicine within the practice of psychotherapy, wherein a medical professional uses online tools to assist patients. Some tools may include, but are not limited to: Zoom (software), Skype, email, online chatting, ...
and
telepsychiatry
Telepsychiatry or telemental health refers to the use of telecommunications technology (mostly videoconferencing and phone calls) to deliver psychiatric care remotely for people with mental health conditions. It is a branch of telemedicine.
Tele ...
have been available for over 35 years,
the development of internet video chat systems and the continued increase of the market penetration for the
broadband
In telecommunications, broadband or high speed is the wide-bandwidth (signal processing), bandwidth data transmission that exploits signals at a wide spread of frequencies or several different simultaneous frequencies, and is used in fast Inter ...
has resulted in the continuing growth of online therapy. Some clients are using videoconferencing, live chat and email services with a
mental health professional
A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a ...
in place of or in addition to face-to-face meetings.
History
One of the first demonstrations of the Internet was a simulated psychotherapy session between computers at Stanford and UCLA during the International Conference on Computer Communication in October 1972. Although this was a simulation and not actual counseling, the demonstration created an interest in the potential of online communication for counseling. As access to the internet, bulletin boards, and online services became more available in the 1980s, and online communication became more common, virtual
self-help groups {{short description, None
This is a list of self-help organizations.
Twelve-step programs
Recovery programs using Alcoholics Anonymous' twelve steps and twelve traditions either in their original form or by changing only the alcohol-specific ref ...
naturally developed. These self-help groups may be considered a precursor to online counseling. When the
World Wide Web
The World Wide Web (WWW or simply the Web) is an information system that enables Content (media), content sharing over the Internet through user-friendly ways meant to appeal to users beyond Information technology, IT specialists and hobbyis ...
became public in the early 1990s and mental health professionals began to create websites offering mental health information, some began to receive requests for personal help and started to respond to these requests, leading to the advent of online counseling.
Information on sources related to online counseling was first created by Martha Ainsworth. In 1995, Martha Ainsworth began searching for a competent therapist because she had some psychological complaints. Her travel requirements made it difficult for her to consult a face-to-face therapist, and therefore, she needed an effective alternative online therapist. She only found a dozen web pages that offered online treatment for psychological complaints. Afterward, Martha Ainsworth wanted to reach the general public with her experiences and founded a clearinghouse for mental health websites, named Metanoia. By the year 2000, this clearinghouse contained over 250 websites of private practices and more than 700 online clinics where a therapist could be contacted.
According to metanoia.org, the first service to offer online mental healthcare was "Ask Uncle Ezra", created by staff of Cornell University in 1986 for students. By mid-1995 several fee-based online services offering mental health advice had appeared.
Between 1994 and 2002, a group of trained volunteer crisis counselors called "
Samaritans
Samaritans (; ; ; ), are an ethnoreligious group originating from the Hebrews and Israelites of the ancient Near East. They are indigenous to Samaria, a historical region of History of ancient Israel and Judah, ancient Israel and Judah that ...
", began providing suicide prevention services via email. There has been continuous increase in number of online counselling therapists and groups due to increase in web-based services and anonymity associated with virtual sessions.
Advantages and disadvantages of online counseling
Advantages
Online counseling offers several advantages. These include:
* ''Increased accessibility'': Online counseling fills an unmet need for clients located in areas traditionally under-served by traditional counselors. Rural residents, people with disabilities and
expatriates
An expatriate (often shortened to expat) is a person who resides outside their native country.
The term often refers to a professional, skilled worker, or student from an affluent country. However, it may also refer to retirees, artists and ...
, along with under-served
minorities
The term "minority group" has different meanings, depending on the context. According to common usage, it can be defined simply as a group in society with the least number of individuals, or less than half of a population. Usually a minority g ...
, often have an easier time finding a suitable therapist online than in their local communities.
It also makes counseling accessible to clients who face difficulties in keeping appointments during normal business hours,
while decreasing the number of missed appointments for in-person therapy.
Along with accessibility of therapists, online counseling also enables accessibility of information to the clients. In face-to-face counseling, information is stored only with the therapists. In online counseling, the transcripts of communications between the therapist and clients may be available to therapists as well as clients. This allows people seeking therapy to monitor changes in their own conditions.
* ''Increased comfort and convenience'': Online counseling can offer higher comfort and convenience for clients and therapists alike. Therapists or clients may not need to travel for their sessions, which may be less expensive and more comfortable for all involved. In addition to the convenience, many people also enjoy the perceived confidentiality that comes with online counseling. They tend to feel more comfortable sharing information with their mental health professional and may feel less ashamed and powerless due to the removed environment.
* ''Less expensive'': Although most therapists charge the same fees for teleconsultations as they would for direct counseling, teletherapy can be relatively less expensive as it does not involve travel costs if both parties have internet access from where there are.
* ''Approachable treatments'': Online access to therapy may help remove the stigma around mental health and can help individuals feel more comfortable with discussing mental health issues.
Disadvantages
Some of the disadvantages of online counseling include:
* ''Anonymity and privacy'': Online counseling uses technology-aided devices and internet as the main medium for communication between the therapist and the client. All the personal and sensitive information of patients is stored on internet sites or devices. This increases the risk of data theft.
While online counseling can feel more private than face-to-face interactions, there is potential for breaches of privacy in online counseling.
For example, non-encrypted electronic Internet communications might be intercepted, and records could be accessed by family members or hackers.
In online counseling, there may be a lower risk of discrimination based on race, ethnicity, age or gender, because these factors can be more difficult for the therapist to perceive in an online context.
It is important to establish the safety of the site and verification of therapist or client before beginning an online counseling session.
* ''Finding the right match for therapeutic needs of clients'': Online counseling does not guarantee the right match for the therapeutic needs of the clients. Emotional and visual contact can be absent during online counseling sessions. This absence may prevent therapists from sensing negative feelings like anger, terseness, or irritation in clients. It can also cause the sessions to be more straight to the point and less emotionally gradual, which can be beneficial or not depending on the client's need.
* ''Establishing authenticity of therapists or counselors'': Counselors and therapists are professional health care providers and hence require licenses to undertake clients for counseling as a part of their mandatory professional requirements. Psychologists and professional health care providers also require licensing in the state or other governmental subdivision where they practice in order to take clients. As the internet allows clients to choose therapists all across the world, establishing legitimacy and authenticity of the therapists or counselors may be difficult.
* ''Unreliable technology'': Slow internet, power outages are some of the challenges that can arise from using technology for counseling.
* ''Requirement for digital literacy:'' The digital literacy of elderly adults is increasing substantially as six in ten seniors use the internet and 77% own a cell phone. However, the elderly population continues to lag in their own adaptation to newer technological developments. International studies from 2009 to 2020 have come to show that older adults have lower measures of online communication and collaboration, digital safety, and positive attitudes on technology usage.
Medical uses and effectiveness
Although there is some preliminary support for the possibility that online counseling may help populations that otherwise underutilize traditional in-office counseling, the question of the effectiveness and appropriateness of online counseling has not been resolved.
Mental health
Research from G.S. Stofle suggests that online counseling would benefit people functioning at a moderately high level.
J. Suler suggests that people functioning at a particularly high level, and who are well-educated and are artistically inclined, may benefit the most from using text-based online counseling to as a complement to ongoing psychotherapy.
Severe situations, such as
suicidal ideation
Suicidal ideation, or suicidal thoughts, is the thought process of having ideas or ruminations about the possibility of dying by suicide.World Health Organization, ''ICD-11 for Mortality and Morbidity Statistics'', ver. 09/2020MB26.A Suicidal i ...
or a
psychotic episode
In psychopathology, psychosis is a condition in which a person is unable to distinguish, in their experience of life, between what is and is not real. Examples of psychotic symptoms are delusions, hallucinations, and disorganized or incohere ...
, might be better served by traditional face-to-face methods,
although further research may prove otherwise.
Cohen and Kerr conducted a study on the effectiveness of online therapy for treatment of
anxiety disorders
Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause phys ...
in students and found that there was no difference in the level of change for the two modes as measured by the State-Trait Anxiety Inventory.
As the main goal of counseling is to alleviate the distress, anxiety or concerns experienced by a client when he or she enters therapy, online counseling has strong efficacy under that definition.
Research has come to show that the effects and benefits online counseling has to offer is equivalent or comparable to in-person counseling. This suggests that therapeutic effects can be available to patients without having to go into the office, wait in a waiting room, or even leave the home. Client satisfaction surveys have demonstrated a high level of client satisfaction with online counseling, while the providers sometimes demonstrate lower satisfaction with distance methods.
Nutrition counseling
Nutrition counseling specific to conditions is available by many consultants online using Skype or another face-to-face program. This is especially effective for people with a busy work schedule, and others who cannot make it to an office regularly. Online consulting for imbalances in
blood lipid
Blood lipids (or blood fats) are lipids in the blood, either free or bound to other molecules. They are mostly transported in a phospholipid capsule, and the type of protein embedded in this outer shell determines the fate of the particle and its ...
levels,
blood sugar regulation
Blood sugar regulation is the process by which the levels of blood sugar, the common name for glucose aqueous solution, dissolved in blood plasma, are maintained by the body within a narrow range. This tight regulation is referred to as glucose h ...
, and other health conditions make it easier to manage when using nutritional approaches.
Smoking cessation
The effectiveness of real-time video counseling for helping people to stop smoking is unclear.
Few studies compare the effects of video and telephone counseling on smoking cessation.
There is current research that suggests web-based interventions incorporating components of clinically valid therapies, such as cognitive behavioral therapy, motivational interviewing, and acceptance and commitment therapy, can significantly reduce smoking rates for some cancer survivors, particularly those with a higher nicotine dependency. However, further research is needed to identify more predictors and moderators of engagement in these interventions.
New technological applications in online counseling
Online counseling has evolved with the newer developments of technology and therapeutic programs. There are now apps and programs being developed to make the complex processes of therapy and planning manageable for the patient through their smartphone. This makes certain resources more readily available to the patient in the form of self-monitoring, self-improvement courses, treatment and care management, and data collection of personal trends and symptoms.
"MyCompass" is a specific self-help program that many online counselors use for their patients. This tool helps track factors associated with treatment plans including, mood, personal log data, and diary entries. These collections allow the program to examine therapeutic factors and present the individual and their practitioner with how these different factors influence and impact one another.
Online counseling and COVID-19
Online counseling increased dramatically in 2020 during the
COVID-19 pandemic
The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began with an disease outbreak, outbreak of COVID-19 in Wuhan, China, in December ...
as many countries issued lockdowns to control the spread of the virus. Consequently, mental health professionals were unable to meet with their clients in person, so continued treatment online.
In addition to this transition, the pandemic and associated quarantine caused many people to become anxious and depressed, which resulted in an increased demand for mental health services. Because online counseling became so prominent during this time, the overall use of online counseling increased even as social distancing eased.
[Melanie Riedel: ''Von der Präsenzsitzung zur Online-Therapie – wie sich die psychologische Behandlung verändert''. Online-Therapie-Vergleich.de, 2025]
online-therapie-vergleich.de
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See also
* Cyberpsychology
Cyberpsychology (also known as Internet psychology, web psychology, or digital psychology) is a scientific Interdisciplinarity, inter-disciplinary domain that focuses on the Psychology, psychological phenomena which emerge as a result of the Inte ...
* Social media therapy
Social media therapy is a form of expressive therapy. It uses the act of creating and sharing user-generated content as a way of connecting with and understanding people. Social media therapy combines different expressive therapy aspects of talk th ...
* Telephone counseling
Telephone counseling (also known as telephone therapy, telephone-based or telephone-delivered psychological treatment) refers to the use of the telephone to deliver any type of psychological treatment or therapy (such as cognitive behavioral thera ...
References
{{DEFAULTSORT:Online Counseling
Counseling
Internet culture
Treatment of mental disorders
Telemedicine