The potential to communicate on-line opens up whole new possibilities for emotional healing. While some decry the use of technology as an intermediary and claim that the artificial, dehumanizing medium is the "message," there is no doubt that the internet will take on a greater and greater role in the therapy/counseling universe. Why is this? For two reasons. First, in people's busy lives, productivity and efficiency are at a premium. Simply stated, it takes too much time to drive (or worse, take public transportation) to the therapist's office. It will not not be long before people say "Do you remember when we spent an hour in the therapy office and an hour in the car?" Second, the internet gives clients extraordinary choice. Rather than being restricted to their own community, clients can pick therapists from anywhere in the world--language replaces locale as the only barrier.
The availability of internet therapies in different modalities, however, is no guarantee of their effectiveness. Do internet therapies (e-mail, icq/chat, and video) work? How do they compare to traditional face-to-face therapy? Because the use of the internet for this purpose is so new, there is little empirical research on this matter, but we can make an educated guess based upon our understanding of the therapy process.
In Psychotherapy: The Restoration of Voice I identified three parts of the therapy process: discovery, broadening and deepening understanding, and developing a strong therapeutic relationship.
If we use these three processes, discovery, broadening and deepening understanding, and developing a strong therapeutic relationship, as criteria, how do internet therapies stack up against traditional face-to-face therapy.
| Face-to- Face | ICQ/Chat | Internet Video | ||
| Discovery | Yes | Yes | Yes | Yes |
| Broadening and Deepening Understanding | Yes | Yes, but difficult and very inefficient | Yes, but inefficient | Yes |
| Developing a Strong Therapeutic Relationship | Ideal | Difficult and very inefficient | Difficult and very inefficient | Probably yes |
From this table, you can see that both e-mail and ICQ/Chat are adequate for the discovery part of therapy, but they they are less than ideal beyond this function. E-mail suffers because the therapist is unable to interrupt and ask a question in order to better understand what the client is thinking/feeling at the moment. The therapist can send an e-mail, but he or she has to wait for a reply--a thirty second clarification turns into a day's wait. ICQ/Chat solves the immediacy problem, but the mechanics of typing slows the therapy process to a standstill, and keeps the therapist from attending fully to the client. Internet video shows promise. One question remains to be answered: Will the video technology somehow interfere with the human relationship building process? My guess is that it won't. If it did, people would not laugh and cry at movies; rather they would stare, like my dog Watson, blankly at the screen.
Face-to-face therapy remains the ideal mode of treatment, because it offers the fewest obstacles to a genuine therapeutic relationship. But internet video, with its advantages of time efficiency, and almost unlimited choice of therapists will likely grow in popularity as broadband and fast computers become widely available. It remains to be seen whether this technology will somehow dehumanize the therapy process.