This FAQ covers some of the basic elements of the cybercounselling process, its benefits, and some ethical considerations from the perspective of Therapy Online. Worldwide Therapy Online Inc. was founded by Lawrence Murphy in 1994. We were the first individuals to use the Internet for the delivery of mental health services.

1. What is the process for registering clients and delivering cybercounselling?

• Agencies determine how clients become involved with the online process. Clients can either register on their own or be guided through the process over the phone. It is also possible for a client to be registered during an initial face to face assessment meeting with a counsellor.
• Once a client has registered with the agency they set up a PrivacEmail account. This is a secure encrypted web-based e-mail system that assures confidentiality of information.
• Clients send an initial information message along with their registration. When the client is assigned to a particular counsellor, the counsellor also receives the client’s initial message. The counsellor replies to this message.
• Counsellors inform clients when their reply is expected. Typically, a first session reply is expected within a week. In later sessions a counsellor may ask a client to take two or three weeks to reflect upon the counsellor’s e-mail before replying.
• Counsellors set aside time for replies to clients. For example, a counsellor might send a client an e-mail on a Tuesday and ask the client to get back to them within a week. They would tell the client that they had set aside time the following Wednesday to reply to them. Assuming the client follows through, the counsellor then replies on the Wednesday.
• These therapeutic e-mails (or therap-e-mails) are sent back and forth between client and counsellor and this is the counselling.

2. What client issues are indicated and contraindicated?

• The majority of issues that clients bring to face to face counselling are appropriate for online work.
• There are some issues that, in our opinion, are not appropriate for online work. We take this position because of the absence of research or because of limitations in one’s ability to respond online, and because of our conservative position when it comes to client care. These issues are:
  • Mental health issues that involve a serious distortion of reality (e.g.: schizophrenia)
  • Past sexual abuse being disclosed for the first time.
  • Suicide
  • Ongoing violence in an intimate relationship
• In addition, clients who have no affinity for computers do not make good clients for online work. That said, they tend to self-select out.

3. What are the benefits?

The benefits are numerous. They include:

A) Anonymity

• Clients disclose more quickly and more deeply than in face to face work
• Clients tend to be more honest online

B) Asynchronous Counselling Process

• Clients and counsellors can schedule their work with more flexibility; telecommuting is possible
• Clients can reply when they’re ready
• Clients have time for reflection. Typically clients have their one hour and then must recall what has happened. With text-based work the client can reflect repeatedly on the messages from the counsellor.
• Client and counsellor disabilities are overcome. These include the obvious physical disabilities. But they include social phobias and the like.
• The associated costs of parking, missing work, grabbing dinner, finding childcare are all eliminated for clients
• Problems with travel distance for clients are overcome. In addition, clients can connect with counsellors even when they are “on the road”.

C) A Permanent Record

• The written record is available for third parties like psychiatrists to review (with client consent)
• Counsellors are held to a very high level of professionalism because everything they write is recorded
• The written record gives assurance that clients will correctly interpret the counsellor’s meaning and intent in any given situation
• Affords a superior method for clinical supervision of counsellors
• Can be used as evidence of effort for clients who doubt their own skills and abilities

D) Power and Empowerment

• As a method is easier to help people to believe in their own abilities to make changes successfully.
• It has proven advantages for those who find face to face communication challenging. In particular, more men are willing to give counselling a chance when they can do it from their own home where they experience a higher level of control over the process.

4. What happens in cases where reporting of harm to self or other or child abuse is necessary?

Clients are required to provide all of their contact information prior to being considered for online counselling. Reporting, then, is no different than it would be in the case of a face to face client.

5. How do clients access online counselling?

The PrivacEmail system is integrated into an agency’s website. For the client, there is never an experience of leaving the agency’s home and moving to a third party. Integration means that agencies receive all client information confidentially. Therapy Online administrators are unable to access either client or counsellor records, files, or e-mails.

6. Do counsellors need specific training in order to do online counselling?

Yes. Practitioners are ethically obliged to be competent in the services they offer. Therapy Online provides two levels of certificate Cybercounselling training. Certificates of completion are issued by Therapy Online. Each level is 12 weeks in length and is only open to professionals who possess a graduate degree in a related field and two years of experience doing face to face counselling, or an equivalent combination of education and experience.

7. How long does it take to roll out PrivacEmail from contract signing?

This depends upon the state of the agency’s website, their technological ability and whether they have trained staff. The best case scenario is roughly 2 months. In cases where the agency requires their staff to be trained it will take 4 months (the length of the training)

8. Why Therapy Online?

• The Internet’s first online clinical counselling practice. We have been delivering counselling, training, and software solutions since 1994
• Co-authored the Internet's first online counselling ethics in collaboration the National Board for Certified Counselors. This work forms the basis for accepted online ethics today
• We have trained more than 900 helpng professionals aroudn the globe.
• Through our Research Institute we regularly publish in the academic literature. This includes our seminal 1998 work When Writing Helps to Heal: Emal as Therapy, which has been cited in the academic literature more than 250 times.
• Have provided training and consultation to individuals, not-for-profit agencies, and for-profit EAP’s in Canada and around the world