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Link to a shrink: Web users flock to online therapy

(CNN) -- Psychological therapy has become part of the national consciousness in the United States, and now it's just a mouse click away, thanks to the Internet.

A Harris poll found that nearly 100 million adults searched the Web for mental health information in 1999.

"The online work is great because there are so many people who will not go to a face-to-face counselor," said Joshua Kates, online marriage counselor. Online therapy lowers people's defenses, making it easier to understand what the basic problem is, he said.

About one-third of those who make a first appointment for traditional counseling never show up or never return after the first visit, according to the American Psychological Association. But there is concern in the field that online therapy is an inadequate substitute.

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"I don't think that online therapy will ever substitute for face-to-face, in-person treatment," said Dr. Lisa Mellman, associate clinical professor of psychiatry at Columbia Presbyterian Hospital.

Mellman believes that therapists work with the verbal as well as the non-verbal communications -- tears, silences -- that can't be read over the Internet.

While the cost of online sessions can vary, from $25 for one question and $50 to $90 for an hour-long chat, mental health experts say cybertherapy is generally more affordable than traditional methods.

And for Martha Ainsworth, it provided a welcome relief from depression. Feeling anxious over a major career change, Ainsworth sought therapy online five years ago. As a consultant for church organizations, Ainsworth was alone and on the road traveling a lot.

"I was in a period when I needed a lot of emotional support, and all I had to do was go to my computer to get it," Ainsworth said. "I didn't have to try to get it all out in a 45-minute time frame. So if it was in the middle of the night and I felt like saying something, I could get up in my pajamas, sit down at the computer and pour my heart out."

Ainsworth exchanged e-mails with her online therapist almost daily for more than two years, but Mellman raises concerns about the qualifications of online therapists.

"It can be very dangerous, certainly," Mellman said. "One of our residents told me that he ran into a former friend from college, who told him that he was conducting 20 hours a week of online therapy. And this gentleman had zero mental health training."

Because there are no national or international licensing laws for therapists, and the Internet crosses geographic boundaries, there are no safeguards for online imposters. Mellman believes the safeguards ensuring privacy aren't much better.

"One of my colleagues said that the Internet has the confidentiality of a postcard, and I thought that was a very apt analogy," she said.

Your secrets are safer online than if you walked into a therapist's office, according to online psychologist Dr. John Grohol. To see a psychiatrist or psychologist, you must get authorization from a general physician first. This means going through managed care or an insurance company and making it part of your health record.

Under these circumstances, e-therapy is flourishing. Some therapists are joining forces with online companies like HelpHorizons.com and here2listen.com, which claim to offer state-of-the-art technology, high security and offline office support. And Ainsworth was so pleased with her experience that she started a Web site called Metanoia.org. The site provides a directory and educates consumers on what to expect from an online therapist.

"My outlook on life is very different now than it was five years ago," she said. "I have really taken control of my life. I feel good about myself. These are things that are new to me."



RELATED STORIES:
Mood music for the cyber set
September 8, 2000
Virtual rat roams college classrooms
May 30, 1996

RELATED SITES:
Marriage Matters
Presbyterian Hospital Psychiatry Services
American Psychological Association
Psych Central
HelpHorizons.com
here2listen.com
Metanoia.org


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