Long before the advent of electronics, Freud analyzed by correspondence some patients. As early as 1985, Cornell University set up a specialized e-mail response service that was immediately successful and continued until 2012.
On the web, psychology and psychotherapy were first an object of exchange before becoming a practice. People with psychological difficulties (or their relatives) started by using the network as a means of communication, information and help, and structured themselves into communities. The first mental health professionals invested the Internet in 1995. In the 2000s, we witnessed in the Anglo-Saxon world the opening of real cyber-clinics that can bring together dozens of psychotherapists.
As early as 1999, the International Society for Mental Health Online (ISMHO) set up a group of experts to study the clinical cases treated by online terapi.
In here, the National Union of Psychologists as the French Federation of Psychologists and Psychology are not resistant to the principle of online therapies, as long as a strict framework is respected.
The different types of online therapy
Psychological counseling by individual response by email or on a forum
Long-term psychotherapy by email
Real time psychotherapy by instant messaging
Videoconferencing psychotherapy, which allows a real interview by interposed screen
Online support groups that can be professionally trained
The internet can also be used in addition to psychotherapy, which extends the therapeutic follow-up time and increases the amount of material accumulated by the therapist.
We can also mention experiments such as the therapy of “attentional disengagement” developed by A.Heerenn, a researcher at UCL, to treat emotional disorders via a computer program. This type of therapy can be done online.
Why consult online?
The first obvious interest of an online therapy is accessibility. Internet facilitates access to the therapist, that the patient is not able to move (handicap, geographical distance), or that it is slowed by the idea of a real meeting (if it suffers from phobia, anxiety and / or shyness).
- It allows to remain anonymous.
- Online therapy can also be of economic interest, with lower fees.
- It is more flexible in terms of time (e-mail exchanges, flexible appointments).
- The virtual exchanges allow the undecided to get a better idea of the possible work with a psychotherapist.
In addition, the Internet has specific advantages from the point of view of therapy:
- Some people are more expressive in writing than in a face-to-face meeting. For example, trauma survivors may prefer the silence and non-tactile quality of textual communication.
- The preservation of exchanges allows the therapist and the patient to return to old exchanges.
- Asynchronous conversation helps to clarify thoughts and questions.
- An online therapy cannot take into account the large amount of information communicated non-verbally during a “physical” exchange, hence potential misunderstandings.
- Risk situations (suicidal risk, for example) are more difficult to assess. More generally, the loss of visual and auditory cues reduces the ability to make a diagnosis.
- It is more difficult for the therapist to respond to the reporting requirement for abuse or violence.
Online therapies are not indicated for psychotic or medication-dependent patients (Stofle, 1997), but how do you make the necessary assessments online?To date, there is no appropriate training for online practice.