Three years ago, I typed 'online therapy' into a search engine and got zero hits. Recently, I did the same and got 11.5 million. In a speed warp of another kind, psychology's lumbering professional organisations and regulatory bodies are scrambling to take a position on this new way to deliver mental wellness. What is the view of professionals on how well it works? Who are the therapists? What kind of experience can a client expect? How much does it cost? The professional pack is split. But leaders generally approve conditionally, especially for clients with specific problems, rather than general psychological malaise. I think it also lends itself to culturally stigmatised problems - the sort of taboo subjects that fall between the cracks of extended family support systems, upon which collectivist societies like Hong Kong traditionally rely. Deeper, archaeological forms of therapy that delve into a person's developmental past may be less suitable. They tend to place more importance on non-verbal signs, like tone of voice and body movements, to detect hidden meaning. Emails certainly have their own unconscious register, of course, and the literary-minded people to whom therapies like psychoanalysis appeal may be more attuned to the written word. But some therapists - and I would guess particularly this breed - may be more resistant to technological mediation than their potential clients, suggests a recent article in Professional Psychology: Research and Practice. For people simply looking for an accepting and unshockable sage to help them through a specific problem or a rough patch, there is plenty of choice. A client is still better off deciding on the sort of therapy that most suits them beforehand. But that is always the case. The internet, incidentally, is as good a way as any to find out about the various approaches on offer before selecting a practitioner. Prices should be in the same ball park as face-to-face therapy. This can be for a pre-arranged instant-message session lasting, say, an hour, or a series of email exchanges over days or weeks, or a mix of emails and telephone calls, for instance. The nature of the exchanges will depend on the practitioner's approach, the problem and the dynamic the two people create between them. In many recent forms of short-term counselling, a client should expect to feel accepted yet challenged; honest reflection should be met with encouragement and empty ruminations should be discouraged. It should be remembered that a good therapist does not allow a client to become trapped in a comfortably dependent relationship. One of an ethical professional's principal goals should be to make themselves redundant. Some therapists initially see an e-practice as a way to cut overheads and make more money. But online work can be lonely and disorientating, compared with tightly scheduled office appointments that involve plenty of direct human contact. Naive or disorganised practitioners can easily end up being swamped by a poorly channelled stream of competing and escalatingly urgent messages. To do the job professionally takes as much, if not more, time and effort than regular practice, even after taking into account the extra effort required to hone a whole new range of skills. Wading through what is on offer is no easy task for clients. Charlatanism is rife. If any accreditation is claimed, it should be checked with the awarding body. But accreditation schemes are patchy in some countries, such as Britain. Another way to check the therapist's reputation is to run a search using information from their CV. E-practices and companies offer another tier of client protection. Assurance of confidentiality, such as by encryption, is worth paying attention to, as are secure payment arrangements and specifics about how many and how long emails can be, and the turnaround time a client can expect for responses. A reputable site ought to make it easy for clients to get answers. More generally, Metanoia is a good online consumer guide on the subject. 'Behavioural telehealth', as some fence-sitters call it, is at an ungainly stage of development. Traditionalists scoff. But leaders in the field agree that it is not a question of whether it is a good idea or not. It is here, so for practitioners it is more a matter of whether they want to add this particular format to their range of skills, or even specialise in it. For clients, it is good to know that among the frauds and quacks are an increasing number of very capable professionals. After all, if you can get divorced by phone text-message, why not get counselling by email? Jean Nicol is a Hong Kong-based psychologist and writer everydaypsychologist@yahoo.com