Despite the potential for self-destructive behavior, many people turn to the Internet for support and guidance in coping with life’s problems. The American Psychological Association (2000) claims that some 60 million people look to the 15,000 available sites to find health-related information on the Internet. Among these sources are sites such as HelpHorizons.com, which allows visitors to chat with a licensed professional or search for a counselor who seems to match their particular interest. Others function as clearing houses for therapists, such as the site for the International Society for Mental Health Online (ismho.org) and Metanoia.org. These sites, and many other reputable ones, offer a mental health alternative to those who might not otherwise seek or have access to such services.
Research has shown that people actively seek out online interaction to improve their psychological well-being. In this section, we review some of that research, tracing the emergence of online therapy, its methods of support, and its potential shortfalls.
Coming to Online Therapy
Many people who go online in search of help are searching for some kind of therapy. To mental health professionals, therapy is “a series of contacts between a professionally trained person and someone seeking help for problems that interfere with his or her emotional well-being”. Thus, traditional therapy consists of a meeting between a trained therapist and a client or group of clients. In recent years, a precedent for more distant contact has been established by so-called “self-help” books and cassette tapes that purport to provide the same content that a therapy session would. Such products clearly lack the vital relationship between therapist and client that many mental health professionals would insist is crucial to the process. This connection is perceived as fundamental to the success of any treatment program, a common concern is expressed among scholars considering the implications of online therapy. Even those who celebrate the potential benefits of online therapy note that it should function as a complement to, rather than a replacement for, personal interaction with a trained therapist.
Another move away from traditional therapy has emerged in the form of social support groups, also called “self-help groups,” such as Alcoholics Anonymous. The key feature of these therapy programs is that people suffering from the same concern provide guidance and support to one another. In this way, they help not only themselves, but one another at the same time. The popularity of this type of therapeutic interaction has gained considerable momentum, and there are now programs to help people coping with other addictions, including gambling and sex, among many others. Estimates place between 8 and 10 million Americans in some sort of face-to-face social support group.
Both forms of non-traditional therapy can be found online. On one hand, a number of psychotherapists offer their services through mediated channels by providing their clients with e-mail, chat, or telephone consultations. On the other hand, virtual support groups have been founded on topics ranging from anorexia to cancer to help people who have these conditions communicate with one another.
Several factors contribute to the attraction of seeking therapy online.
The first of these factors is anonymity. There is, unfortunately, a good deal of social stigma still attached to seeking professional help when it comes to mental health. E-mailing a concern to an online psychologist or visiting an electronic bulletin board discussing a particular concern allows people to seek out the help they may need without exposing themselves to the potential embarrassment that comes with visiting a mental health facility or attending a social support group meeting. Coincidentally, participants in online exchanges have been found to disclose more about their conditions, probably because they do not sense being as readily judged by the recipients of their messages, given the lack of nonverbal cues to indicate disapproval or disappointment.
The presence of fewer status cues (such as dress and jewellery) also seems to level the playing field for participants who may be from different socioeconomic groups. For these reasons, online therapy might be especially helpful in treating people who experience apprehension in social settings.
The second attractive quality of online therapy has to do with its ability to transcend distance. People who live in rural areas, the physically disabled, and those with no transportation have difficulty getting access to mental health care through traditional means. Thus, forms of online therapy have the potential to reach people who otherwise might not be able to get access to this kind of help. Additionally, the comfort of being able to experience therapy in the security of one’s own home was highly rated by participants in one survey.