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Can a PC really be the key to fixing reality?
Cybertherapy, is it a sustainable and effective long-term alternative to face-to-face therapy?
The meaning of therapy and the many types of therapy available, have changed dramatically from when therapy was first documented in classic Greece in the form of ‘milieu therapy’. This consisted of sufferers being taken out of their everyday environments and being placed in a simpler, more restful environment until they recovered. Indeed the types of therapy available to address specific issues, strengthen awareness and lead to a clients own solutions have broadened. In a society where the types of therapists available are infinite, it is indeed a complex process just identifying the specific therapy required. Essentially all forms of therapy traditionally require the client and counselor to be in the same vicinity, having face-to-face contact. In the contemporary world, the very dynamics of ‘face-to-face’ therapy are now being challenged due to the rapid development of technology. The ubiquitous use of the internet, has led people to become more actively involved in things like virtual communities and chat rooms, therefore it is hardly surprising that online or ‘cyber’ therapy, is becoming available.
The National Board for Certified Counselors defines the services offered by online therapists as the practice of professional counseling and information delivery that occurs when client(s) and counselor are in separate or remote locations and utilize electronic means to communicate over the Internet.
Certainly, this method makes therapy more widely available and indeed has many advantages, however, it is important to observe and question, just how much society is relying on the Internet, its incorporated ‘virtual worlds’ and for the purpose of this essay, these online services like Cybertherapy, for answers and resolutions to ones problems in reality? Is Cybertherapy really a sustainable and effective long-term alternative as apposed to face-to-face therapy?
In order to accurately address this question, it is important to look at the traditional forms of therapy and consequently some advantages and disadvantages associated with them.
Therapy can be described at a remedial treatment of a mental or bodily disorder or alternatively an agency designed or serving to bring about rehabilitation or social adjustment. Indeed the specific types of therapies are endless and may include areas like Psychotherapy, Art Therapy, Behavioral Therapy, Cognitive Therapy, EMDR Therapy, Family and Marital Therapy, Gestalt Therapy, Humanistic Therapy, Play Therapy, Speech Therapy and Electroshock therapy. They all traditionally require face-to-face therapy. In other words, where there is a physical presence and communication between Client and Therapist. The success of these sessions often revolves around this physical presence and communication, as therapists are able to gain a vital insight into the patient through not just their spoken words, but also body language and expressions. However, as this physical presence is required, it often causes basic organizational problems in scheduling suitable meeting times for both Client and Therapist. Indeed this may be an important and crucial factor where Cybertherapy proves advantageous.
As mentioned above, Cybertherapy is on-line therapy practiced with a qualified, licensed professional with a client, screen to screen, on the Internet. It was developed from the mid 1980’s as psychologists and other therapists transpired to communicating with clients through email in the organization of such things as meeting times. At the same time, the use of interactive bulletin boards and discussion rooms was becoming prevalent and therefore the idea of ‘Online’, or ‘Cyber’ Therapy was formed.
Therapy generally involves supportive techniques that help lead a client to strengthened awareness and to their own solutions; however it is questionable, when exercised over the internet, how Cybertherapy can properly fulfill this criteria?
Indeed one of the most obvious advantages of Cybertherapy is the unconditional, flexibility and service delivery for both professional and client. Furthermore, the use of therapy through the internet enables individuals and/or communities, who are otherwise too remote for regular contact, to gain regular access to professional help. This may also prove advantageous to physically disable patients who find it difficult to reach a professionals office or work environment. In the event of either party moving around or traveling, Cybertherapy allows scheduled sessions to continue despite the changing environments.
Another factor, which may encourage people to undertake Cybertherapy as apposed to face-to-face therapy is the ability to remain anonymous. Specific issues, (perhaps rape cases) may indeed be easier resolved if dealt with by anonymous parties.
On the other hand, issues which people may believe are too trivial to enlist the help of a professional may also be dealt with in a relaxed, non-committing atmosphere.
Most mental-health professionals agree that online therapy sites are not providing psychotherapy or psychological counseling on the traditional sense and may use such terms as “consultation”, “individualized information”, “behavioral telehealth”, or simply “advice” to describe their services. (4therapy Network)
Regardless of what terms – whether it be ‘consultation’, ‘individualized information’ or ‘advice – are used for online therapy, these services are obviously based around the same core values. Overall, the use of online therapy simply adjusts the dynamics of the ways in which communication between professional and patient transpires.
Being online, means there is no physical presence and communication between patient and therapist, consequently resulting in a loss of metacommunication (A loss of visual and auditory cues that are essential to accurate diagnosis and ongoing assessment of the therapeutic progress). Perhaps this may have a drastic influence on the overall effectiveness of consultations?
In addition to this, the partial anonymity involved may result in the client and/or therapist finding it easier to hide behind ‘electronic defenses’, thereby making it more difficult to have a truly intimate relationship and instead, result a somewhat, compromised relationship.
Consider the following quote from Donna Gibbs and Kerri-Lee Krause in their book, Cyberlines:
Have we transcended the body through cyberspace or have we merely transcended the ‘difficult’ marginalized identities, making it easier for people to ‘pass’ as the more dominant ‘acceptable’ identities? Perhaps the internet both foregrounds identity and makes it easier to ignore.
This also raises questions about the lack of control on the situation, in knowing who is really at either end of the communication - posing an ongoing threat to client-therapist confidentiality.
There exists a crucial operative gap between authentication and identification. (Gibbs & Krause 2000:187)
Initially, how can a patient be certain about a therapist’s competence in one of possibly hundreds, of therapists available online?
Once a therapist has been chosen, there are many legal, jurisdictional and ethical issues involved regarding issues like the type of license held (if one is held at all?) and whether the specific license is applicable and certified in the many regions a therapist may be required to operate in, over the internet.
A therapist has a responsibility for the welfare of the client, however the anonymity of online therapy, may not properly provide the Therapist with enough information to carry our appropriate crisis management when needed.
Ultimately there will always be complications regarding the actual technology itself.
“In the new world of information technology, traditional forms of written and spoken communication are combining with images, pictures, linguistic shortenings of all kinds, repackaging of bits and pieces of related words, typographical signs and other inventive usages to form a new language and new literacy’s.” (Jordan 1999: 56)
Could this lead to misinterpretations between client and patient? There is also the ongoing possibility of technology failure which could, amongst other problems, result in lost or grossly delayed messages. This also introduces the risk of the therapist’s clinical records, of a case vanishing.
Can one really tell if Cybertherapy will be sustainable and effective in the long-term?
It can be concluded that whilst Cybertherapy has the advantages of making therapy more widely available and extremely flexible, it also carries constraints regarding patient confidentiality, a loss of vital metacommunication, ongoing risks of technology failure, legal, jurisdictional and ethical issues, as well as general misinterpretations in communication. A recent survey on the 4therapy website states,
“Recent studies indicate that people aren’t really looking for full-fledged therapy on the Internet, rather, they’re looking for fast answers to questions or quick, general solutions to their problems.”
With this is mind, Cybertherapy may indeed be an essential tool, to discuss general queries on line and subsequently be a starting block for directing people onto specialized therapy when appropriate. Cybertherapy may also be useful in one-off situations when it is impossible for physical meetings and thus an online therapy session can occur.
With the constant development and utilization of the internet and other technologies it would be ignorant to assume that Cybertherapy is just a passing trend and that this means of consultation will not be fully employed in the future. Perhaps when considering such treatment in the future one may consider the following: Indeed through the internet, therapy can reach places it has never before, but just how much does this compromise the quality of therapy given?
BIBLIOGRAPHY
HREF1: & nbsp; &n bsp; “4therapy Network – Types of Therapy” www.4therapy.com/consumer/about_therap y/item.php?uniqueid=4924@categor yid=27
HREF2: & nbsp; &n bsp; Holmes, Leonard (1997): “You Can’t do Psychotherapy on the Net (yet)” www.mentalhealth.about.com/library/weekly/aa0104 99.htm
HREF 3: & nbsp; &n bsp; Ingram, John: “Cybertherapy: Pariah with Promise?” www.selfhelpmagazine.com/ppc/viewpoint/cybparp r.html
HREF4: & nbsp; &n bsp; Johnson, Cathy (2004): “Cybertherapy” www.abc.net.au/health/features/cyber/
HREF 5: & nbsp; &n bsp; Suler, John (1999): “Psychotherapy in Cyberspace” http://www.rider.edu/" title="http://www.rider.edu/" target="_blank"http://www.rider.edu/~suler/psycyber/therapy.html
Gibbs, Donna & Krause, Kerri-Lee (2000): Cyberlines – Languages and Cultures of the Internet. Albert Park: James Nicholas Publishers Pty Ltd
Harper, Charlotte (1999): Weird Wild Web. Victoria: Penguin
Jordan, Tim (1999): Cyberpower – The Culture and Politics of Cyberspace and the Internet. London: Routledge
Court, John (2004). Up Close and Personal: Counselling on the Net. Internet, Media and Mental Health Conference. Brisbane. April 21-24
Delaware, Alex (2004): Therapy. Random House Publishing Group
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