Is the Future of Counseling and Therapy Online?

| Staff Writers

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Is the Future of Counseling and Therapy Online?

26.2 percent of U.S. population (59 million people) suffers from a diagnosable mental health or addiction disorder. But less than 1/3 of those get professional help.

52: percentage of adult Americans who believe mental health therapy is difficult to get.
1 in 10 Americans are stressed, could benefit from therapy, but don’t get it.
Among those who have needed treatment, but not gotten it, people are most likely to cite the following reasons why:

  • cost (39 %)
  • the belief that their problems aren’t serious enough (35 %)
  • skepticism as to whether it would work (32 %)

Men more likely than women to say they don’t trust therapists (22 % vs 11 %) and that they don’t want to be associated with the types of people who need therapy (21 % vs 9 %).

Online therapy may help some who cannot or will not go in person.

Online therapy began 42 years ago:
1972: A first. Simulated psychotherapy session between computers at Stanford and UCLA.

1986 -2012: Ask Uncle Ezra, the earliest known organized service to provide mental health advice.

  • Now on “sabbatical.”
  • Advice for Cornell U. students

1993: A site called Depression Central: online depression support group.

1994: The Samaritans

  • Volunteer crisis counselors from 1994 to present
  • In 2001, responded to 64,000 queries
  • Now have 68 branches, including Australia and Hong Kong

1995: Shareware psychological consultation available through:

  • Help Net
  • Shrink Link

1995: the first e-therapists did person to person work:

  • Cyberpsych chat service
  • The Pink Practice in London

E-therapy today:

4 types. Two types entirely via the Internet. Others combine Internet communication with in-person treatment.

  • E-therapy – psychotherapists form ongoing helping relationships that take place on the Internet.
  • Mental health advice – psychotherapists respond to one question in depth, again solely via Internet.
  • Adjunct services – psychotherapists use Internet communication to supplement traditional, in-person treatment.
  • Behavioral telehealth and telepsychiatry – mental health professionals (typically psychiatrists) use videoconferencing systems to work with patients in remote locations.
    20: percentage of counselors and psychotherapists offering online, email or telephone counseling services.
    Study: 42 % with online therapy recovered from depression versus 26 % with usual care.

Pros and Cons of online therapy:

  • Accessibility
  • Convenience
  • Affordability
  • Near elimination of Social Stigma
  • Anonymity
  • Communication via email, chat rooms, video-conferencing, Skype


  • No face to face: possible absence of verbal and nonverbal cues
  • Confidentiality could be breached (hacked)
  • Effectiveness: greater risk of misdiagnosis
  • Therapist credibility (due diligence needed)
  • Ethical issues
  • If no one knows who is treating whom, how is quality service ensured?
  • If a practitioner does not know where a client is, how can they call for help, such as suicidal threats?
  • Insurance companies rarely cover the costs of online counseling.
  • Medication cannot be prescribed after an online counseling session.

The Good News Is:

80: percentage of Internet users, or about 93 million Americans, have searched for a health-related topic online.
That’s up from 62 percent of Internet users who said they went online to research health topics in 2001.
Online therapy using SKYPE is increasingly popular.

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Self-Help: There’s an App For That…

iOS/Apple Apps
T2 Mood Tracker – a mobile application that allows users to self-monitor, track and reference their emotional experiences. [Also for Android]
PTSD Coach – Provides opportunities to find support, and tools that can help users manage the stresses of daily life with PTSD. [Also for Android]
LearnPanicCBT – Self-treatment for panic disorder that is based on Cognitive Behavior Therapy principles
Stress Check – This research-based assessment tool provides users with an overall stress score that illuminates their current level of stress

Android Apps
Stop Panic and Anxiety Attacks – Use when you experience a panic attack and to help you learn to tolerate and control the anxiety symptoms..
Worry Box – Self-help for worry and anxiety.
Cognitive Diary CBT Self-Help –How to recognize thinking that interferes with achieving your goals in life and how to change that thinking
DBT Self-Help – Helps you manage overwhelming emotions.

Are artificial intelligence and robots the future of mental health?
Maybe THAT future is NOW:

Paro: a therapeutic robot in the form of a baby harp seal used to reduce stress. Paro has the ability to learn its name and change its behavior.
Keepon is mainly used with autistic children.
Popchilla can be used through an iPad application.
Phobot helps children who suffer from extreme anxiety and phobias.
Nao assists in autism therapy and caregiver assistance therapies. It can act like a personal assistant because it has human-like interaction based on voice and gesture.
ELIZA is a computer program that acts as a psychotherapist. ELIZA uses string substitution and responds based on keywords. Some people believed that ELIZA was an actual human being.


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