online-sales.jpg On-line therapy is one of the newest trends in mental healthcare. Although many clients still choose the face-to-face approach, on-line counseling has become an important option for some clients in certain situations. It is not intended for serious mental health issues or illnesses requiring medication, but it can be successful in helping people through difficult life issues like divorce or interpersonal conflict.

A Mental Health Minute by Cristina Frick

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Electronic therapy is often conducted through e-mail. Clients ask therapists questions about a situation or express their thoughts and feelings, and the therapist will respond. Internet chats are sometimes used as well, allowing clients to have a “real-time” fifty-minute session on-line. Therapy using web cameras is currently being developed as well.

This method of counseling is surprisingly effective when used in addition to other treatment. One study found that clients who received on-line therapy as a follow-up to inpatient treatment fared better than those who did not receive it. The study made no comparison of on-line follow-up with face-to-face follow-up to see which would be more effective, or which would lead to greater participation by patients.

Another study concluded that on-line therapy is an important source of support for those struggling with addiction.

There are good reasons why someone might seek on-line therapy, like being homebound or wanting anonymity. Other reasons on-line therapy is succeeding include the following:

  1. People living in rural areas who do not have easy access to a psychologist can receive therapy.
  2. People who could not normally afford therapy can get e-Therapy, via e-mail for as little as $25, or for a flat rate, which is usually cheaper than traditional therapy.
  3. People who would not normally seek traditional therapy because of stigma might choose the on-line option.
  4. It is convenient for those with difficult schedules.
  5. It allows people who are disabled or cannot leave the house to receive treatment.

Although it shows promise in many situations, if you suspect you may have a serious mental illness, such as major depression, schizophrenia, or bipolar disorder — and certainly if you are feeling suicidal, you should seek a therapist’s help in person rather than using the online approach. Here are some other cautions about this treatment type:

  • The therapist may not even have the client’s real address or contact information should an emergency arise.
  • The Internet poses confidentiality issues.
  • Many insurance policies do not cover it.
  • If web cameras or Skype/voice systems are not used, it may be impossible for therapists to read a client’s vocal tone or body language in order to decipher whether the client is telling the truth.
  • It is much harder to build a trusting relationship, which is one of the hallmarks of effective treatment. It may also be harder to build positive regard and empathy for the client. Less attention may be given to the online client.
  • Therapist credentials need to be checked carefully.

While it shows promise for clients who might not otherwise receive therapy, it is important that it be conducted ethically and that clients educate themselves about its appropriate use. Learn more about online therapy from USA Today.


IMPORTANT NOTE: If you are feeling depressed or think you might be suffering from a mental illness, find a therapist in your state . If you are feeling suicidal, or if you know someone who is, (warning signs include marked changes in sleeping or eating, profound sadness or hopelessness, giving away belongings/saying goodbye to others, or a sudden lifting of depression because the person may mistakenly feel they have “found a way out”), please get help. Call the Suicide Hotline at 1-800-SUICIDE (784-2433) or 1-800-273-TALK (8255). Suicide is not the answer for your pain, and there is help and hope available. Please call now.  

pink-rose.jpgCristina Frick is a contributing writer and volunteer editor at the Good News Network since 2006. She is currently completing her Master’s degree in Clinical and Community Psychology at the University of North Carolina at Charlotte and plans to gradute in December. View a list of all of Cristina’s articles here — including previous columns in her Mental Health Minute series.


  1. This is an excellent article, and makes sure to re-direct potentially suicidal persons to seek help – now. It also points out potential problems with online help in the mental health field. In my positive change consulting work, I frequently have persons seeking me out confidentially after a workshop, and sometimes on line. It is always important to make sure the person seeks help as soon as possible from a licensed professional in their area. In the long run, we know that the internet will become a more reliable source of help for people with health issues of all types. This help can prove to be a powerful and far-reaching ally in the mental health field.

  2. Hi Visionarease,

    Thank you so much for your thoughtful comment. I agree that on-line therapy can be an important resource when used in the right circumstances, and it is important to be aware of both the risks and the benefits. I also agree that this method of therapy may become more reliable as time goes on. I would love to know more about your consulting work. Glad you are enjoying the column- have a great week!:-)


  3. Howdy! This blog post couldn’t be written any better! Looking through this article reminds me of my previous roommate! He continually kept preaching about this. I’ll send this post to him. Pretty sure he’s going to have a good read. Thank you for sharing!
    Joseph –

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