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.
