What is eTherapy?:

Online therapy is a new type of psychotherapy. Online therapy uses the richness of language to help bring about change in the client's life. Language, whether it be written or oral, is the core component of communication. While some might suggest that communication is best achieved via spoken dialogue only (and indeed, suggest that psychotherapy can only be conducted via the spoken word), there is little empirical evidence to back up such a supposition. In order for psychotherapy to be effective (no matter what its type), communication needs to occur and a relationship between the client and therapist must be established. Nothing about online therapy makes these two components any more difficult to achieve. Nor does their achievement come at a cost in terms of quality or understanding.

Online therapy reaches out to the majority of people who would never seek professional mental health services. Traditional psychotherapy, as a general means of change available to nearly anybody (as envisioned by the late President Kennedy via his initiation of the community mental health center system), has largely failed. The U.S. Surgeon General's Report on Mental Health in 1999 showed that the majority of people who have diagosable mental disorders do not presently seek out or obtain professional treatment. This despite the huge treatment advances made in the past decade to help cure many mental disorders within a few months. Online therapy offers a valuable new modality to reach out to a larger group of people concerned about issues of confidentiality and privacy.

Online therapy is potentially more secure, confidential, and private than traditional face-to-face therapy. Because of the unique qualities of the e-therapy, therapeutic change can take place in an anonymous or pseudonymous context. This provides a level of security and confidentiality that cannot be matched in the real world. I've worked in clinics where confidentiality was regularly breached because of thin walls, open doors, files sitting on doctor's and therapist's desks while they went on a break or to lunch, entire filing rooms gone unlocked and unmonitored, and the continuing breach of a client's privacy by third parties, such as insurance companies. For online therapy, you don't have to worry about any of these regular breaches of your privacy, especially since online therapy doesn't require personally identifying information in order to work. After all, therapy is about fostering change in people, not demographics.

Online therapy can be a more powerful, quicker change agent than traditional psychotherapy. As others, such as King & Suler, have pointed out, the online modality pulls for greater projection and psychodynamic characteristics which often enhance the power of the therapy. Also, as has been well written about and documented, people in online therapy tend to get to the point more quickly and do not spend sessions wasting time talking about issues of little relevance to the reasons that brought them into therapy. In traditional face-to-face therapy relationships, entire sessions can be spent discussing issues that have no impact on the person's actual diagnosis or disorder. A great deal of a professional's time can also be spent on non-therapy issues, such as payment, rescheduling appointments, tedious record-keeping on paper forms, and "shooting the breeze." While some of this also takes place in online therapy, it does so to a much lesser extent and to a much smaller overall percentage than in face-to-face therapy.

Best Practices: Best Practices of eTherapy
Clarifying the Definition of e-Therapy
John M. Grohol, Psy.D.
May 2, 2001


Wolfleg Counseling has been providing psychotherapy and mindfulness based cognitive therapy to clients for more than twenty years in the Iowa City, Coralville and surrounding area. We have helped many people who suffer from depression, anxiety and stress. We believe all people can learn to calm themselves to the degree that they can hear a deeper, clearer voice of knowing within themselves that will lead them to solutions for and insights into their own challenges. We see our job as supporting and encouraging this self discovery.