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Online therapy: Where we are and where we need to go

The following post is the abstract from a poster presentation at the 122nd annual Convention of the American Psychological Association presented by MSP Core Faculty member Dustin K. Shepler, PhD and MSP doctoral students: Melanie Ho, Priscilla Zoma, and Jessica Dluzynski.


Title: Online therapy: Where we are and where we need to go

Authors: Ho, M., Zoma, P., Shepler, D. K., & Dluzynski, J.

Presentation Type: Poster

Summary (250-500 words): Include statement of problem, subjects used, procedure, results and conclusions.

Ethical considerations related to conducting therapy online; such as honoring client confidentiality, doing no harm and evaluating the risks and benefits of online therapeutic intervention have previously been compared to traditional methods (e.g., Corey, Corey, & Callanan, 2011). Recognizing that ethical guidelines associated with providing online therapy have gained relative consensus (APA, 2013), it becomes important to consider whether online therapy is effective in assisting clients in alleviating their symptoms. This presentation is meant to review the effectiveness of online therapy. Practitioners considering expanding their practice to include online therapy and those interested in including online therapy research in evidence-based therapy classes may be particularly interested in this presentation.

Advances in technology have shifted from communication through email, to instant messaging, chat rooms and video conferencing. These advances in technology increase ease in communication between clients and therapists between session as well as offer an additional modality in which therapy may be conducted. Establishing rapport and the relationship between the client and the therapist is essential for effective therapy. Previous research has reported a positive correlation between acceptance of online therapy and familiarity with the technology (Alleman, 2002). Furthermore, it is important to consider how key therapeutic factors (e.g., empathy, creditability, and alliance formation; Norcross, 2011) are present in online therapy. Traditionally, nonverbal behaviors help to establish a relationship within the therapy room such as leaning toward a client and eye contact (Dowell & Berman, 2013). Can the same type of bond occur online?

Relevant literature regarding the state of online therapy services is reviewed and key findings are highlighted. For example, studies that have evaluated alliance in online therapy have reported no difference in alliance between therapy provided online and face-to-face. In fact, individuals reveal personal information in less time when compared to traditional therapy methods. Cook and Doyle (2002) attribute this phenomenon of quickly revealing personal information to disinhibition and anonymity offered by online interaction. The therapeutic process may also be facilitated by lessening social stigma associated with attending therapy. Indeed, the goal of face-to-face therapy is to assist the client with various psychological distresses and therefore online methods must maintain the same focus (Richards & Vigano, 2013). Simpson, Bell, Knox and Mitchell (2001) and Simpson, Deans, and Brebner (2005) have reported client benefit from online therapy. In particular, previous research has indicated client gains through online therapy in the treatment of eating disorders, depression and anxiety. These studies utilized not only video conferencing but also the use of instant messaging and email.

Clinicians attending this presentation will learn of the most current findings regarding therapeutic effectiveness of online therapy. They will be better prepared to evaluate relevant findings and determine whether their own clients and practice may benefit from expanding current services to include online therapy after learning more about empirical findings supporting the use of online therapy. In addition to reviewing empirical findings regarding the effectiveness of online therapy, implications for practitioners hoping to translate evidence-based practices to an online format will be discussed.