Caution the keyword on the virtual couch

Online psychological services - "psybertherapy" - may have people looking for shrinks in all the wrong places. Ask the right questions before baring your psyche online

By: Lanny Boutin

  Thinking of going online to find a psychotherapist? You might first want to consider some words of caution from Dr. James Ogloff, a professor of psychology and law at Simon Fraser University.
  "It's a buyer beware world on the Internet. And it's maybe even more important when you're dealing with people's personal problems." notes Dr. Ogloff, who is also president-elect of the Canadian Psychological Association and chair of its ethics committee. "Our committee's worked on psybertherapy guidelines for two years, but with the speed it's changing, it is hard to even know what we're dealing with."
 

"Anyone can set up a psybertherapy site - even Dr. Laura. She's not a psychologist so no one can regulate her behaviour," says the chair of the Canadian Psychological Association's ethics committee

  Many clients may not know what they are dealing with either. Though most people might assume the dispensers of online therapy are professionals, in reality most psybertherapy sites are run by laypersons whose conduct is not monitored or regulated. "Anyone can set up a site", says Dr. Ogloff, "even Dr. Laura. She is not a psychologist, so no one can regulate her behaviour."
  Some web-based psybertherapists offer audio-video conferencing, but most provide contact by e-mail only. Dr. Ogloff's personal opinion is that "e-mail is an inappropriate way to do therapy. It can provide information, or answer direct questions. But it's unsuitable for complex questions, especially when the therapist has not even met the patient."
  The use of e-mail for therapy also raises security questions. Most guidelines recommend encryption technology be used for all correspondence, but as Dr. John Grohol, a clinical psychologist, author and member-at-large of the International Society for Mental Health Online's executive committee, notes, "encryption's difficult to install and register, and for a person who's emotionally distressed, it can be too much hassle."
 

  E-mail can also be misdirected and without a password system can be read or answered by anyone.
  None of this is to say that there isn't a place for online therapy. When conducted by regulated professionals, psybertherapy can be used effectively to supplement face-to-face contact, particularly in situations where distance is a problem.
  "I've been involved in a project to bring psychiatric services to the Prince George, B.C. jail," says Dr. Ogloff. "We have someone make a physical visit, and then once a week talk with inmates through audio-video conferencing. With live voice and video, it's almost like being in the same room."
  "Another example of where this type of therapy fills a need is the north," he adds. "The Yukon has one psychiatrist and, I think, four psychologists, so it's very common for psychologists in Whitehorse to travel by car, once every few weeks to remote communities and the rest of the time talk with patients on the telephone."
  Martha Ainsworth, author of Metanoia.org, a consumer review site for Internet therapy, agrees that "online therapy is not a substitute for tried and true face to face psychotherapy," but an adjunct in cases where its difficult to make the trip to a therapist's office.
  She also list situations where psybertherapy should not be used:

• If you have tough or complex problems to work through.
• When you have a serious crisis, or are feeling suicidal.
• If you're uncomfortable expressing yourself in writing.

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