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By Caroline Fleck

About this blog: I am a clinical psychologist, mother, and wife committed to using my life to help the lives of those around me. In addition to seeing clients in my private practice, I contribute to various training and research initiatives in cli...  (More)

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Is Web Therapy a Good Idea?

Uploaded: Apr 17, 2015
Few topics are as popular or controversial in psychology today as web therapy (often called teletherapy). This intersection of technology, science, and therapy seems to have captivated consumers and providers alike (Showtime went so far as to base an entire TV show around this topic). Part of what makes web therapy so interesting, is that it raises a range of unique ethical and legal issues.

Now, full disclosure, I provide web therapy to a select number of my clients. Despite this fact I, like many therapists, remain conflicted about how popular web therapy has become and some of the ways in which it is being used. Having spent countless hours discussing, researching, and using this new form of therapy, I thought I'd share some of what I've encountered.

On the plus side, web therapy has some undeniable strengths and overcomes some of therapy's greatest limitations. For starters, it enables people to connect with a therapist even if they are homebound, in rural communities, or require a unique type of therapy that is not readily available.

When I was closing my practice in Seattle to come to California, I hated the idea of abandoning my clients. Many of them had spent months in therapy working to develop a strong therapeutic alliance that enabled us to tackle serious problems. Some of them expressed concern that their progress might be stymied by having to transition to a new therapist and "start over." I shared their concerns.

Because I was licensed in both Washington and California, I was legally able to provide web therapy to some of my clients. Conducting session online enabled me to keep working with my Washington clients without missing a beat. I continue to work with several of these clients and firmly believe that their treatment benefited from the continuity of care.

Web therapy also has the obvious advantage of being super convenient. You can avoid traffic to and from the doctor's office, talk within the comfort of your own home, and save on commuting and childcare expenses. These benefits may seem insignificant, but considering that many folks seeking therapy struggle with issues related to anxiety, depression, and stress management, these small comforts can go a long way to increasing the probability that someone will seek treatment and/or stick with it.

All of that sounds great, but as I stated, these benefits are not without their drawbacks. Some of the biggest issues surrounding web therapy are confidentiality (it is inarguably much more difficult to ensure the confidentiality of sessions conducted online rather than in a soundproof office), licensure (most states require that the provider be licensed in the state that the client resides), and reimbursement (many insurance companies will not pay for services provided online).

There are other clinical considerations to keep in mind as well. For instance, issues that require ongoing crisis management like suicidality and self-harm can be difficult to manage remotely. It can also be more challenging for clinicians to diagnose certain disorders based on online interactions alone where factors like eye contact, behavioral idiosyncrasies, and distractibility are harder to assess. Finally, although technology has come a long way, it still has a long way to go. I have had web sessions fail due to bad connections, interruptions in internet service, and malfunctions in software. If there is no alternative means of connecting, clients could go days or weeks without sessions while waiting for technological issues to resolve.

When it's all said and done, I think web therapy is a promising new direction for psychotherapy. If, however, your problems are severe, or you require a thorough diagnostic assessment, I might consider meeting with a clinician in person, at least initially to determine a diagnosis and treatment plan. Anyone pursuing teletherapy in California should confirm that their online therapist has a current and valid California state license and closely review the limits to confidentiality outlined by their web therapist.
What is it worth to you?


 +   8 people like this
Posted by Question, a resident of Old Mountain View,
on Apr 20, 2015 at 2:39 pm

Love your blog! Have a question. Are there any therapy web sites you recommend or would stay away from?

 +   3 people like this
Posted by Caroline Fleck, a Mountain View Online blogger,
on Apr 20, 2015 at 5:10 pm

Caroline Fleck is a registered user.

Thanks!I don't know if there are any sites that I would recommend or advise against. So much of the experience is determined by the specific therapist. The colleagues I have who do web therapy do it as an extension of their practice (they have an office and offer web therapy to the clients they serve or to clients that have moved). Interestingly, the state of California has been pretty supportive of web therapy and has been really proactive in outlining recommendations and laws around its use. I would I highly recommend that you review the credentials of anyone on the sites you are considering. Also, be sure to note their title. A life coach is very different from a psychologist, which is very different from a psychiatrist. You want to be sure that you are connecting with someone who is qualified and licensed to provide the type of help you are seeking.

 +   1 person likes this
Posted by David Silva, a resident of Sylvan Park,
on Jul 13, 2015 at 7:08 am

After your article i started gooling about web therapy and what i found - there is a tv serial name "Web Therapy" =)

Anyway thanks for an article, it led me to think about new theme for an essay.
Best regards,
Web Link

 +  Like this comment
Posted by chairsns, a resident of Blossom Valley,
on Oct 10, 2015 at 9:58 am

Ha Ha Ha What is web therapy do you know?Actually first time heard about this web therapy.Just looking for best answer_____

 +  Like this comment
Posted by kanika singh , a resident of Jackson Park,
on Jun 6, 2016 at 10:31 pm

great article i like it thanks for sharing it.

 +   1 person likes this
Posted by Falafel5, a resident of Blossom Valley,
on Jun 13, 2016 at 10:42 pm

Falafel5 is a registered user.
Excellent post share and blog, thanks for information.

 +   1 person likes this
Posted by Abhimanyu, a resident of Blossom Valley,
on Jun 30, 2016 at 4:18 am

Nice sharing. Visit this link to hack whatsapp online: Web Link

 +   2 people like this
Posted by Shilpa Malhotra, a resident of Gemello,
on Sep 8, 2016 at 9:41 pm

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