Since 2006, online therapy was conducting successfully. Online therapy is to provide mental health to peoples on internet. They also known as e-therapy, web therapy or distance therapy. People can benefit from it with video conferencing, e-mailing, texting, audio messaging etc. (Klein & Proudfoot, 2009). The aim of the current study is to create awareness for online therapy. It is hypothesized that helping people to understand advantages and disadvantages of online therapy. In todays, we should quick solutions to our important psychological and physical problems. Also, we are so busy and we have different responsibilities and actions so generally, we cannot find enough time to go any psychologists or therapists (Klein & Proudfoot, 2009).
Following the section we asked question ‘’ who can become an online therapists?’’ Some people said maybe clinical psychologist or who have degree of psychology can become online therapist. Also, other person said clinical psychologist who are qualified some degree about online therapy can be online psychologist. Then we gave answer that is online therapist is psychologists, psychiatrists or psychological Counselor. For become online therapist; first you should complete undergraduate psychology or psychiatric education. Moreover, online therapist should be qualified about internet use and communication programs via internet for example WhatsApp, skype or facetime etc. (Abbott et al., 2008).
Online therapy can be performed by different therapy methods included different techniques. For instances; psychodynamic approach, humanistic approach, cognitive behavioural therapy (Anthony & Nagel, 2010). In psychodynamic approach we can use transfer, feedback, misspellings and projection. Online psychologists should consider to giving feedback and should analyse with clients about progress. Misspellings can give cues to psychologist about client’s unconsciousness circumstance. Online therapy can negative effects on clients so online therapist should consider projection because in online therapy; client can access to therapist anytime this can create negative emotions to psychotherapist then he/she can project these emotions onto clients. When client and therapist cannot see each other closely, different impersonation in their dreams. For this reason, psychologists should consider transfer. In humanistic approach; online therapist can use unconditional acceptance, the therapist is consistent, empathy. When they are together, client express their history with body language, jest or mimics for example they can smile but in online therapy, most of the time verbal expressions occur. On the other hand, in cognitive behavioural therapy is most appropriate approach for online therapy compared to others. Therapist can give homework via internet also if they combine homework with bibliotherapy, psychoeducation and solution-focused therapy (Anthony & Nagel, 2010).
Some situations online therapy is more effective. For instance, you have relationship problems and you feel stress more also you do not know what to do and you do not know what are you experiencing but you want to solve this problem and want to give best decision so you need expert’s opinion. When this situations appear, online therapy can be best solution. We showed video for effectiveness of therapy. QRL: https://www.youtube.com/ .Summary of the Anna’s case is Anna has anxiety and depression problems related with her boyfriend. Therefore; she loss job and she breaks up boyfriend also she does not know how she overcome these problems. Finally, she decides to getting help form online therapy and end of the therapy, she said that I feel better, I can cope with my problems and I learn to manage my problems. Furthermore, we asked question to class ‘’ what do you think about advantages and disadvantages of online therapy’’. After this question; one person said that it can be advantage for people who have mobility limitations. Also, another person add this can be effective for a short-term but when we look longer period especially some situations like get over anxiety or depression we need real treatment.
Then, we agree with them and explain more. When we attend to advantages of online therapy, we see people who have an intense life and need urgent meetings. In addition to that some people away from face to face therapy because of feel shy. In addition to that, they can want anonymity and online therapy provide this opportunity. They or some people cannot find qualified therapist which they live, they should benefit from online therapy more (Barnett & Scheetz, 2003). Generally; people with depression, anxiety, and social phobia and self-esteem problems are considered to consult online therapists. Because they can feel uncomfortable during normal therapy conditions so these people think that we solve our problems more easily via online therapy.
On the one hand, online therapy has some disadvantages. In online therapy, it is difficult to create trust relationship between clients and therapist. Also; face to face relationship, body language or tone of voice cannot understand adequately for both of them. Some client has not enough technological information for access to online therapy or internet. Moreover, online therapy mostly available in our world but there are not sufficient investigations about it. Therapist do not apply online therapy people who have psychiatric disorders, schizophrenia, major depression and anorexia etc. because they are incapable for solving crisis situations (Botella et al., 2009). After we explain advantages and disadvantages, we asked ‘’ what do you think about online therapy, is it effective or ineffective ’’.
Furthermore, online therapy is more beneficial for some people those have physical disability or want to stay anonymous. Besides, when individual moves from their country to other country, they can face difficulty to find therapist at this issue online therapy helps. In contrast; if client’s age is under 18 and client has severe mental disorder or psychiatric problems, online therapy cannot be apply. Also, if case conveys high suicidal risk online therapy cannot be conduct. Moreover, there are a lot of sites or companies of online therapy. First of all, 7 cups of tea offers safe
and confidential online space. QRL: https://www.7cups.com/ .Client can contact listeners in 7 cups of tea with any reasons. These listeners do not judge client just they understand and help. They complete Active Listening training program so they are licensed professionals like Eleonora Capuozzo (Member of the National Council of Psychotherapists), Samantha Endicott (Licensed Professional Counselor), Johanna Liasides (Psychologist). Secondly, P-therapy helps different people with different problems for finding best professionals. QRL: http://p-therapy.com/. Client can contact via phone, instant messaging or video conferencing. They consider relationship between client and therapist also they work together on their goals. Many professional work there for example Brian Mahan (Somatic Experiencing Practitioner), Rachel Cooke (Counselling & Psychotherapy) etc. Last one is Talk space. It is an online and mobile therapy. QRL: https://www.talkspace.com/ .It was found New York in 2012. Users of talk space can contact with listeners via smartphone like Ions and Android, tablet or desktop without travelling anywhere. There are over 1000 qualified therapist. For instances; Melissa Moreno (Licensed Clinical Social Worker Psychotherapy), Matt Lawson (Licensed Professional Counselor in Illinois) etc.
At the beginning, we asked ‘’would you like to get help from the psychologists in these companies and are they enough to solve your problems? What do you think? ‘’ One student said that these companies use advertisement to get people and people pay money then starts to therapy but I think it is not enough for solving problem because we cannot see any jests or mimics, body languages also hard to trust them. Another students mentioned that I heard 7 cups of tea claims we do not judge just listen. I think this is not helpful.
We started ethical dilemmas with questions that is ‘’what other ethical dilemmas could be in online therapy? ‘’ and more discussion issues occur. Firstly, we discussed competence and students said this can create crisis because we do not sure licence of therapists
(American Psychological Association, 2010). Also, we talked about payment issues like how you pay end of the all session or end of the every session. Then, teacher gave additional comment that is maybe ıf you do not pay you can logout or maybe beginning of the therapy they give some determinants about payment or bank receipt but also this issue can change from one company to another. In addition to that we gave extra ethical dilemmas. For example; giving the informed consent or signed to this form is harder in online therapy compared to face to face therapy (American Psychological Association, 2010). Other issue is keeping records and fees because most of the companies are not supported by many insurance company so when you decide online therapy, first you should check insurance company otherwise you have to pay all sessions.
Furthermore, therapist should provide safe and confidential online platform which people share emotions, thoughts and deeply personal stories but in online therapy client cannot find this platform. For instance; when you engage online therapy another person different from therapist can be found in the therapy setting without your conscience. The other issues is anonymity. When client decide online therapy, they should be careful about entering the personal information because these information can spread very fast in the online platform also online therapist should consider security for this reason they can put password. Moreover, nowadays; hackers are widely available in cyber platform. And, when client enter the personal information like age, gender, country or bank account to online companies or site for online therapy, hackers can steal these information. Also, hackers can use them for damaging to clients such as they can access client’s bank account or they can share client’s personal information publicly to see (Shaw & Shaw, 2006). This issue resulted with damaging informed consent and privacy of clients (American Psychological Association, 2010). Besides, competence is another ethical dilemma we need discuss. Online therapist must have to licence and necessary training in their practice (American Psychological Association, 2010).
Following ethical dilemmas, teacher mentioned about legal requirements. She gave example that is imagine online therapy company be found in Cyprus and you work with them. Also, your client live in US. One day, something is happened about legacy, what are we going to are we judge Cypriot legal requirements or are we judge US legal requirements. Teacher said no answer because we do not know any information about legacy. One student talked we should report Cypriot legal requirements because company setting in Cyprus. Another student answered we cannot judge Cypriot legal requirements because Cyprus has not legal procedure. Besides, teacher told we should consider harming to clients. For example, you are in session and client is talking about any kind of traumatic events or any kind of paralysis. Then, internet connection problems appear suddenly this leads ethical violations. Also, she added we should care competence and beneficial or not beneficial points. We think legal requirements are basic component of online therapy so we can solve this problem or we can apply regulations about online therapy.
Moreover, we discussed about ethical dilemmas and legal requirements. As we can see above; online therapy has not enough ethical dilemmas although it is very common today and some cases it is very effective when we take into advantages. For this reason, personal responsibilities are very important at this point. Online psychologists should use virtue ethics. (Heinlen et al., 2003). According to virtue ethics, therapists should make a plans and appropriate judgments this is also known as prudence. Second one is integrity. Online therapists should internalize whole ethical dilemmas then apply their professional life or session. Third one is respectfulness that is about online psychologists should respect their client’s privacy, confidentially, rights and dignity. Last one is benevolence. Therapy should be beneficial for clients but in online therapy client may not be sure about online therapy is right tool for them so therapist should prove their licence or licence number. However, for some situations online therapy should be beneficial for the client but for a short-time period (Mallen et al., 2005).
Finally, in the life settings we should find quick and effective solutions for our psychological and vital problems at this point online therapy widely used many of the peoples. Those who want to take benefit of online therapy, they can contact many sites or companies (7 Cups of Tea, Talk space or P-therapy) via audio messaging, and Skype, video conferencing etc. included psychologists or psychological counsellor who completed undergraduate psychology training. As we can see above, some situations it can be more beneficial for example; feeling stress and loneliness, need to opinions of expert one or when you do not know about your problems. Other side, we cannot online therapy in cases which are suicidal, included criminal acts or need medication treatment. Furthermore, there are many advantages and disadvantages as we mentioned earlier.
Last but not least, online therapy has not enough information and research about ethical dilemmas so online therapist should consider virtue ethics (prudence, integrity, respectfulness and benevolence) because personal responsibilities are more important. From our point of view; online therapy can be effective in many situations for clients but we should careful about it. Because many answers are not clear. For instances; how can we trust the therapist's licence? , how should we pay sessions? , how we can be sure our problems will be hidden? … With the aforementioned reasons, we think that real therapy is more helpful, safe and conventional instead of online therapy.
So Perhaps after 10 years, our thought can be chance and we think that online therapy is a very effective method for humanity. But for this, online therapy should complete some missing aspects for example ethical dilemmas, legal requirements etc. When online therapists make their work more comprehensive and consistent, clients will not hesitate about choosing online therapy. Also, online therapy should give guarantee of privacy, confidentiality. On the other hand, when consultants cannot be sure of the privacy principle, it is difficult for the person to express himself or herself, and the feeling of someone other than the therapist may bring the event to a more dangerous dimension. Besides we do not think that it will be a very useful work if the solutions to the problems cannot be provided.
References
Abbott, J. A. M., Klein, B., & Ciechomski, L. (2008). Best practices in online therapy. Journal of Technology in Human Services, 26(2-4), 360-375.
American Psychological Association (2010). Ethical principles of psychologist and code of conduct. Retrieved March, 13, 2017, from http://www.apa.org/ethics/code/index.aspx.
Anthony, K., & Nagel, D. M. (2010). Therapy Online: A Practical Guide. Los Angles, CA: SAGE Yayınları.
