Monday, December 28, 2015

Integration of Technology into Therapy

As technology advances, the counseling field continues to adapt while maintaining ethical and professional standards.  Concierge Counseling offers e-therapy to established clients as a concierge service.  E-therapy comes in a variety of shapes, sizes, and names, from cyber counseling, to online counseling, tele-health and tele-psychiatry. It is differentiated from traditional face-to-face counseling (FTF) by offering counseling through email, chat rooms, text messaging, video-conferencing, voice-over-the- internet phones (VOIP), interactive websites, and a myriad of resource delivery systems.

The strengths of e-therapy include the following:

§  E-therapy offers the clinician a rich tool in leveraging the impact of counseling services. Typically, the weakest link in most treatment systems is aftercare.

§  E-therapy provides a means of accessing clients who might otherwise not get help, such as those with special needs, the handicapped, deaf, non-ambulatory, agoraphobics, ambivalent or pre-contemplative clients, low income patients without means of transportation, clients with hectic lives, those who need daily follow-on contact, or those in rural areas where distance prohibits regular clinical contact. E-therapy offers help to those needing an instant response when no resources would otherwise be available to them.

§  E-therapy can be cost-effective, accessible, affordable, and, for many of our clients, it offers a much-desired anonymity. For clients who are uncomfortable with face-to-face therapy, it offers unique privacy and confidentiality.

§  E-therapy provides the client and the clinician a permanent record of the sessions, progress notes, self-paced activities, and a personal home page for all clients, etc.  Some platforms also provide safety features that allow permanent deletion of messages by the client which may prove helpful in domestic violence situations.

§  Over time, costs for online services will continue to decrease, and through high-speed broadband connections, the speed of communication will dramatically increase. Advanced encryption will further ensure security of information. And the Internet and computer systems will be readily available to most U.S. citizens.

§  The tools now available to counselors through the internet is almost limitless, from multi- media presentations, video vignettes, flash and static slides, interactive slides, group and private messaging, client homepages to assess issues such as self-esteem, anxiety, and sobriety progress. Personal journaling is not enhanced, as are homework assignments, and synchronistic and a synchronistic communication (Gross, 2002).

Issues Counselor Face
Mental health professionals will need to acquire not only a new vocabulary but also core skills, such as:
§  How to establish rapport with clients over the Internet. This is not a new skill as a hotline and Employee Assistance Program counselors have been able to do so, often in high-risk situations.

§  How to maintain a professional “tone” when there might be no verbal communication; again, this is not a new issue as hearing impaired and blind counselors have been able to “see and hear” clients in different and unique ways.

§  When the counselor is visible onscreen, issues such as the counselor’s make-up, nuances of facial expressions, body language, voice inflection, etc. Although obviously in face-to-face communication these issues are relevant as well, the internet and monitor make these issues more obvious, visible, and important to the client/counselor communication.

§  Online group etiquette needs to be taught to counselors and clients (Kraus, et al, 2004).

Preliminary results of internet counseling appears to point to higher percentages of people completing the treatment program, higher abstinence rates for alcohol and drug abusers, the vast majority of cyber clients state that it was beneficial. A new term has been coined: virtual intimacy. It seems, from early research, that people are more comfortable talking online than Face-to-face. There is something reassuring and safe about the technological shield under which we can communicate online.
There seems to be more uniform treatment results, more personal attention given to clients through the use of personal homepages, and other tools. There is greater client involvement and interaction in online treatment than in traditional face-to-face counseling.
So where do you go if you are interested in e-therapy? First, contact the reputable firms who have pioneered the use of the Internet in counseling, such as,, and others. Second, contact your trade association (ACA, NAADAC, APA, NASW, NBCC) concerning training programs available and the ethical standards that apply.

Change is constant and certain.  As counselors we know that we can evolve with the rest of the world or watch the world evolve around us.  As the approved clinical tool box grows so can the opportunity to be assist someone on their journey. 

K. Derrig-Palumbo, Online Therapy, New York: W.W. Norton, 2005
Freeman, John, The Tyranny of Email. New York: Scriber, 2009.
B. Gross, Online Therapy: Annals of the American Psychotherapy Association, Washington, DC: 2002 Hubble, Duncan, Miller, The Heart and Soul of Change, (2nd edition) Washington, DC: American Psychological Association, 2010.
R.C. Hsiung, E-Therapy Case Studies, New York: W.W. Norton, 2002.
R. Kraus, J. Zack, and G. Strickman, Online Counseling, London: Elsevier Academic Press, 2004.
Morosov, E. The Net Delusion: The Dark Side of Internet Freedom. New York: Perseus, 2011.

We at Concierge Counseling appreciate your visiting our blog.  Do you have any thoughts about e-therapy?  Share them with us, and visit us at our website  

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