Email, Chat Rooms and Skype for Online Counseling, Online Psychotherapy and TeleMental Health Care: The Automobile Analogy

Online CounselingThe analogy that comes most readily to mind when I think about the current state of affairs with telemental health is akin to what I imagine as awakening 100 years ago to a shiny new car in my driveway. I’d probably jump in, start her up, and zoom off – except that 100 years ago, none of us would’ve had a driveway.

Cars would have been a novelty because the automobile wasn’t mass produced by Henry Ford until 1913. (It wasn’t invented until 1880.)

Back in 1910, automobiles were just beginning to be mass-produced, roads were not paved, driver’s licenses were not issued, and people were experimenting with their new automobiles by driving everywhere they could, along dirt roads, over fields, and yes, into ditches.

It took a few decades for cars to be made safer, roads to be built,  traffic rules driver’s licenses were required to protect public safety. Even today, driving is more hazardous than walking.

Video Clip That Clearly Demonstrates What’s Happening

For a quick 10-minute video clip that illustrates how this relates to email, chat rooms or Skype for online counseling or online therapy,  just look here:  MP4 version or FLV version.

The same and much more is true of us all with our telecommunication technologies. Many of us are still excited about our Internet connections, email exchanges, and the possibility of  seeing each other in novel ways across distance using video.

In our excitement about connecting online, we sometimes forget we don’t really know the person with whom we are communicating. We don’t know a wide range of important things about people we meet online or their living  circumstance.

What other kinds of problems might occur?

Early research has clearly shown that people tend toward misrepresentation an exaggeration online. We also have no idea of who else might be within reach or earshot of the person approaching us for assistance . We don’t know the repercussions of the contact trail they may leave behind. Potential clients and patients also haven’t been educated in how they may technology to hurt themselves — and neither have most of us.

Many mental-health practitioners are strangers to technology, and will readily voice a dislike or lack of understanding when challenged with even the most basic of computerized functions. Yet some of these very same practitioners operate without consideration of the need to understand the tools they are encouraging the consumer public to use to make and sustain therapeutic contact. They fail to understand or inform their clients or patients of the “risks and benefits” of working through the Internet, yet think they’re delivering ethical care.

Even more alarming, they are cruising around the Internet, without regard for state law or ethical mandates without any formal training about telemental health, but rather, simply because they can. When challenged, their typical defense is that their colleagues are practicing online, so it must be okay.

Just because we have the ability to deliver exclusive services online in email, chat room or via public videoconferencing VoIP network such as Skype, utilizing those technologies for direct client or patient care isn’t yet prudent or professional.

Those are my views about online counseling and psychotherapy. What are yours? Can you provide additional information that might change my view? Please comment below.

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