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From Couch to Keyboard: Cyber Therapy Booms
Feb. 22, 2001 (Washington) -- It's a far cry from Freudian psychoanalysis on a couch, but, nonetheless, more and more Americans are using the Internet to access mental health counseling.
Web sites for emotional problems abound with trendy sounding name like "Headworks," "Conscious Choices," or "The Problem Solvers@TherapyAve.com". Another e-counseling venue, "Marriage Matters," features a cyber shopping mall and a pressroom.
It's estimated they get millions of hits -- many from the estimated one in five of us suffering from mental illness, and all at the price of $30-80 per hour session, which can be much less than traditional psychotherapy. But when all the emailing and chatting has been said and done, has anything been accomplished? Or have users actually been harmed by the process?
"The benefits are that millions of people are getting good information that they very likely would not access if it wasn't for the Internet. ... [The] bad news is that there is information out there on the [Internet] that does not promote good health," Michael Faenza, MSSW, president and CEO of the National Mental Health Association, tells WebMD.
Last week, the NMHA sponsored a 1-day meeting here, which included key mental health organizations and Internet specialists, to address some of the problems that online counseling has spawned. The major issues include varying quality of information on the sites as well as their objectivity (i.e., whether the offerings are unbiased research or simply disguised commercial material).
Confidentiality of e-discussions between therapists and patients also must be addressed, so people will feel free to reveal their innermost thoughts online, according to mental health professionals attending the event. Perhaps the key dilemma is how to protect these particularly vulnerable people from being exploited by fraudulent operators.
At the end of the day, the group agreed that in addition to all of these proposed reforms, there needs to be something like a "Good Housekeeping" seal of approval, so patients know what they're getting. Several online codes of ethics already exist, although it's not clear how many sites are adhering to these quality standards.
"Like with everything else in the world, there are charlatans out there, ... [but] the seller of a product or information wants to be perceived as credible," Mark Helmke, senior director of public affairs for NMHA, tells WebMD.
Although the Food and Drug Administration has made an effort to crack down on illegitimate online pharmacies that prescribe drugs without proper medical supervision, apparently no federal regulation specifically targets these mental health web sites.
And bad advice may come at a high price.
"Down the road there are all sorts of possibilities, and I'm pretty excited about some of them, but it's pretty much buyer beware at this point," says Ronnie Stangler, MD, chairwoman of the information technology committee of the American Psychiatric Association and a psychiatry professor at the University of Washington in Seattle.
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