Online counselling or psychology, could be supplementary to face-to-face.  But I wouldnt think it effective as the only interaction.  This is because non verbal communication is an important part of understanding someone. And understanding is a critical part of counselling.  If a client had a face-to-face session, it could be appropriate to use online for some follow up conversations, in between face-to-face sessions.

I would definitely consider seeing an online psychologist. I travel lots and have a busy work schedule so online would be really convenient. The only reason that i would prefer face to face over online is that i would develop a relationship with the psychologist and feel more comfortable with them rather than chatting to a stranger online.

Well, my first thought about online psychology would be that it'd just about require webcams from both parties (making it semi-face-to-face).

However, I seriously doubt it'd work for me (with or without webcams). Considering that the reason why I'd ever be seeing a psychologist is something that gives me issues with attention and/or distractability ... it'd just be the wrong environment for me. I find the good thing about going to the psychologist is the actual going there, and that it makes me be there and pay attention. Sitting me down in front of a computer with all the possibilities that offers, and the number of things that may pop up on the screen, just wouldn't work.

OK, I'll be a bit more open than I would normally be on the web here. I've seen many psychologists, psychotherapists, and psychiatrists in my life. I have researched psychological theories and practices for years, though I am not a qualified psychologist. I know many personally though.

I get the impression you are asking, as you have an idea for a site. If so, I'd think twice. While many people may love to have a psychologist that they do not see face to face, where the social pressure would be less, I do not believe a psychotherapy session over webcam would be beneficial in the long run.

1. Body language is skewed. You cannot read someone's body language, consciously or unconsciously, as good via webcam as you can in person. Add in technological factors such as video lag, distortion, etc. and this becomes even less beneficial.
2. Many people's issues contain some sort of escape behaviour, often detrimental to one's condition. Physically going to see a psychologist helps prove to the person that their fears may not be well-founded. Giving the option to close off a window on a screen and suddenly they don't have to deal with it, will keep the cycle going for these people.
3. The psychologist will not have any certainty that the person can pick up on all visual aids. For instance take someone with a fear of pens - if a psychologist decides to start playing with a pen without pointing it out, to later say "you didn't realise but i was playing with a pen for the last 10 minutes, and you were safe" and disprove the fear, she/he couldn't comfortably do this with any reasonable ease over a webcam.

I don't want to sound like an authority in psychology, but as I have been around the topic a hell of a lot, I felt my help may be useful to some degree I hope this helps.

Matt

LOL. No.

Matt, your points are really insightful. I agree with your points but I reckon that people are getting better at communicating emotion online.
It's becoming a normal part of social interaction. Research that i have read suggests that even chat can be sufficient to get the point across. Many psychologists use Skype thesedays, with considerable success. Even with Chat only! No video.

I have no idea about dealing with escape though? That's an interesting challenge, maybe it wouldn't work for some conditions.

And finally, perhaps we can use online visual aids like video or images? They'd have to be pre-prepared and tested for effectiveness though.

Reading the discussion, I get the distinct impression that we need to define (?) the type of help that can be provided online, and the kinds of conditions it might help.

It sounds like MattUK's points are referring to more serious problems, and Breezy is addressing the 'lighter' issues (if I can call it that).

So what I mean is, online therapy might not help with severe depression, but might be great with conditional depression.

Personally, the big barrier to me using an online session would be privacy and trust. This is not to say that  those issues don't apply to face-to-face situations, but somehow, those feel like bigger issues online.

I don't know how I could trust a therapist without establishing a rapport, and imo, non-verbal communication is a big part of that.

I've met a lot of people in real life after first meeting them online, and the two personae are often pretty different. (My explanation is that we tend to 'read' online written communication in our own voices) Video communication doesn't quite cut it either. All you see is the person's 2D face, and it's just not enough.

Just from personal experience, I'm thinking that it'd be really really hard for me to communicate with an online therapist vs an offline one

If I need a Physcologist I will first be suffering with something and my General Practitioner will refer me to one.  I don't go along with the "having a shrink" kind of lifestyle because if coping with day-to-day problems requires regular professional opinion/advice/counselling (or whatever) on a regular basis then it's time to change your lifestyle...

Thanks dekrazee1 you are totally right regards the more serious problems, these require long-term, often weekly, consultation with a psychologist.

University research so far has shown that cognitive behaviour therapy (CBT) is most effective online. This is generally used for less debilitating conditions. The therapy tool that we are creating will focus on CBT type therapies.

I think that trust can be gained in this context, just like more people now have more trust using their Credit Cards online, they never used to! Of course it may take some time to generate and perhaps referrals from Doctors or other psychologists will help in the interim? Plus perhaps government support (or even Medicare)

I know you have a lot of experience with online comms, much more than me! I must say I am always amazed when I meet people from Twitter in real person! Can be quite surprising! But does the way you 'listen' to a 'text-based' voice really matter? What if you were deaf? Of course with text-based comms you miss the tone of voice, type of voice and facial expressions. However, surely we can communicate these things with CAPS, S p a C e S, , Punct-u-ation!, formatting and other things *sneaky smile*

Humans will make the most of the medium and tools we are given. What we need to do now is work out what is the right 'set' of tools to offer in our pilot of this new project so that we can match the face-to-face experience as best as possible.

What things would you add to chat, so that people can communicate emotion etc adequately?

In Tangler you have Font, Emoticons, movies, formatting, all sorts! How do they work? Do people use any of them? How much do people use them? Why did you choose the set you have?

What does everyone else think too?

However, surely we can communicate these things with CAPS, S p a C e S, , Punct-u-ation!, formatting and other things *sneaky smile*

Sorry, but text based communication is never enough for me. I find it very very limiting.
It works fine for social situations such as this, but as soon as the communication gets 'heavy' it's impossible to use.

For example, what I've written above ^^, by reading that, you have no idea what kind of mood I'm in, which 'voice' I'm using.

If I'm having a discussion with a far-away friend, and things get serious, they wanna talk abt a problem, a situation etc, I'll always shut off IM and call em instead. I can't gauge how exactly they feel abt the situation unless I hear their voices. Of course, nothing beats face-to-face, but as you say, we make the most of what we have.

So, coming back to your question - in addition to (IM) chat, you'll need voice and video chats.

I'm not a big fan of voice chats either, but, as in all social situations, once you've learnt the other person's communication method, and the two people have established their own communication environment, it gets easier.

I'm thinking that people in remote areas may not have the band width to support voice or video chat. Do you have any ideas about other creative ways that people could express emotion online?

One idea that I had was a sliding emotion scale, colours, or other visual tools to help people express their emotion. What do you think?

That might work, sure.

My first reaction to that was that if I'm looking for help, I don't necessarily want to fiddle with scales to tell someone how I'm feeling.

However, if it is the only form of help I can get, then I'll have to make do, won't I?

One idea that I had was a sliding emotion scale, colours, or other visual tools to help people express their emotion. What do you think?

  Sooooo, if someone typed a message that looked something like this then you would know they were feeling more than a little bit blue???

I have a concern... A therapist and a client/patient usually establish a good relationship over time...  I've noticed in a related subject that someone, although not always the same person, would be available to assist a person seeking online assistance.  Isn't that questionable customer service?

Here's an analogy: I work at a call center.  It's my duty to call back a person when I'm working on their issue and it's resolved or needs more work, etc.  That way the customer doesn't have to call back in to someone different and explain the whole issue all over again.

Another problem is that if it's an ongoing issue, and it's explained again by the customer, some details may be remembered differently or explained differently when calling in for the 2nd, 3rd time, etc.

On top of that, depending on who the last customer care rep was talking with the customer, that care rep may have interpreted the information the customer gave him/her one way (and not necessarily in a way that might help the customer), and then noted his/her own interpretation of the issue.  Do the online therapists keep track of the clients' information?  Is this information secure?  If this information is shared between online therapists, I am sure each online therapist brings his/her own experience and ideas as to how to treat the issue...

Then, in the call center scenario, when I or another rep gets the call, and reads the notes regarding the customer's last call, what was noted is sometimes a total mismatch, once more thorough troubleshooting/questioning/investigating is done.

So how can this forum offer consistency?

Sorry to be such a devil's advocate, but therapists tend to want to put their clients'/patients' wellbeing first and foremost, so I am not sure this could be provided in this type of forum.

I continue to like the premise...  My thinking is that this could be used for minor issues, but if a person needs more, would your services recommend that the customer seek counseling?

There are 'free' or 'discounted' options out there in most communities.  Universities, church groups, advocates, social services, societies...  But if the person who needs the help isn't aware of those, they perhaps should be pointed in the right direction.  Are you willing to be the launching point in some cases and not try to take on people's problems who clearly need to actually 'see' someone in person?

And if you are willing to point the client in the right direction, that's good, but how will you be able to tell for sure?  What if you, no fault to yourself, were not informed enough by the typing (ie: the client/customer didn't indicate, couldn't relay enough emotion, etc) that someone was in serious trouble?  What would be the consequences and could you live with them?  How will you know if they client ever did seek the help they needed or were too afraid to do so? Would you even find out what happened to them?  If someone logged in once and then you never heard from them ever again, how would that sit with you?

Would people then be required to register with their phone & cell number, address information, etc so that in the case of an emergency an online therapist would hopefully know when to call that person's local health authorities/next of kin to alert them that the client may or may not be in trouble??  What would a client's reaction be if nothing at all was wrong and all of sudden an ambulance and their parents were franticly banging on the door at 2am?

Wow, these ideas are just starting to pour out of me. So much to figure out for an online forum!  lol

h