"Online Therapy"

[Updated]Very little has changed on the landscape in the U.S., at least for licensed mental health professionals licensed in most of our 50 states. Today, nearly two decades after the initial establishment of guidelines, training, and access platforms for online mental health activities, there is still a '50-armed Octopus' of state-by-state regulations and law in the U.S. Meanwhile, there has been over a decade of demonstrated efficacy in online therapies, including support groups, computerized cognitive therapy programs, VR treatments for trauma, and more. We've arrived, within our respective states and professions, while much of the world - with better broadband than the US - growing in interest about 'online therapy', beyond HIPAA and state-by-state legal/licensing considerations. I continue to stress the importance of basics, like establishing a 'natural' and 'therapeutic' working relationship, with a good fit on goals and expectations.

My interest extends to psychologists' progress and challenges with things like Internet facilitated therapies and treatments, and in many situations much still can be reduced to the key 'therapeutic' ingredients such as Carl Rogers described (warmth, empathy, genuineness), well-honed online communication skills, training and supervision, and protections for, and definitions of, the relationship.

Privacy, confidentiality, identity verification, encryption, informed consent, 'good fit' on goals and methods, along with ongoing continuing education and continuing new research. These are some of the the necessary ingredients for truly effective 'online (psycho)therapy', along with the fit between the two participants and the chosen modality and technology.

Additional new and relevant references will be added regularly, along with breaking news.

APA Events (Asynchronously Live Reports)

[Disney World-Orlando-APA2012]
APA Convention 2012
Asynchronously Live from Orlando 

Transmedia Storytelling
Creating Engagement and Meaning in Organizations, Education, and Practice
Drs. Keely Kolmes, Jerri Lynn Hogg, & Pamela Rutledge

Virtual Reality Goes to War
Virtual Reality Goes to War: Innovations in Military Behavioral Health Care
Albert "Skip" Rizzo, Ph.D.

Howard Gardner: Multiple Intelligences
Theory of Multiple Intelligence: First 29 Years
APA Convention 2011
Asynchronously Live from Washington 

[Capitol Building at Dusk - APA 2011]

2011: eHealth Odyssey
Or... The Internet as an Instrument for Change
Lee M. Ritterbrand, Ph.D.

Avatar-based Treatments
Avatar-Based Recovery Using Immersive Virtual Environments
Ivana Steigman, M.D., Ph.D., Richard Wexler, Ph.D., Albert ("Skip") Rizzo, Ph.D.

Computerized Cognitive Based Therapies (CCBT)
Computerized Cognitive Behavior Therapies - Turning on, Tuning in, and (not) Dropping Out
Kate Cavanagh, Ph.D.

Psychology, Technology, Virtual & Augmented Reality
Innovative Technologies for Psychological Intervention, Consultation and Training
Drs. "Skip" Rizzo, Hunter Hoffman, Elizabeth Carll, Timothy Lacy, & Jon Cabiria

POKE ME: How Social Networks Can Both Help and Harm Our Kids
Larry D. Rosen, Ph.D.

Telehealth and Telehealth Licensure - Barriers and Possible Solutions
Drs. Marlene Maheu, Stephen DeMers, Dena Puskin, Joseph McMenamin, & Patrick DeLeon

Asynchronously Live From San Diego - APA Convention 2010

[San DIego]

Online Psychological and Mental Health Interventions
Here's a fresh look, circa 2010 (at the APA's 118th Convention) at the evidence supporting the value of online interventions ranging from open forum support groups to self-guided CBT programs, with new developments and research findings shared by a panel of experts. (Fenichel)

APA 2009: Asynchronously Live From Toronto


Internet: Pathway for Networking, Connecting, and Addiction

Virtual Psychology & Therapy

Future of Internet Media

Asynchronously Live from Boston: APA 2008


My Space, You Tube, Psychotherapy and Professional Relationships

Asynchronously Live from San Francisco: APA 2007

[San Francisco]
Psychology's Future / Characteristics of Social Interaction in Cyberspace: Impact of Modality

Asynchronously Live Reports - 2006
[114th Convention - New Orleans 2006]
Online Psychotherapy & Research | 21st Century Ethics | Media: Town Hall '06

Asynchronously Live Reports - 2005
[113th Convention - Washington 2005]
From the 113th American Psychological Association Convention:
Online Clinical Work

Asynchronously Live Reports - 2003
From the 111th American Psychological Association Convention:
Quality of Online Health Info

APA 2002
INDEX OF 2002 APA Convention Reports:
Cyber-affairs | Cyber-ethics | Cyberspace Travels for Psychologists

APA 2001
[San Francisco]
INDEX OF 2001 APA Convention Articles:
Behavioral Telehealth | E-biz of Mental Health | 2001: A Cyberspace Odyssey

APA 2000
[DC image] Asynchronously Live Reports on Psychology in the 21st Century

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General Reference - Research, Clinical Practice, Education

Assessing a Person's Suitability for Online Therapy
Online researchers and practitioners describe some challenges which have been identified in determining a person's suitability for "online therapy". Some basic issues and strategies for assessment and establishing an online therapeutic relationship are discussed. (ISMHO Clinical Case Study Group, March, 2001)

Clinical Applications of E-mail
Transcript of a live forum hosted by Behavior Online, with Craig Childress, Michael Fenichel, Robert Hsiung, Storm King, Kimberly Young, and John Suler (March 28, 1999)

CSG Report: 1/2 Decade of Online Clinical Case Study
A report from ISMHO's Clinical Case Study Group, summarizing a half decade of observations and exploration, and describing some of the latest clinical issues to be addressed by the group, with case examples and links to references and prior work by the group. (Fenichel, Jones, Meunier, et al, 2005)

Cyberspace Travels for Psychological Researchers, Educators, and Practitioners
Chicago, August 24, 2002
[ Description ] [ Asynchronously live presentation - full report ]

Devices in the Therapy Session: 'How Cell Phones Are Changing the Therapist-Patient Relationship' [New]
A note on the positive uses of 'sharing' life experiences by sharing device images, texts, etc. Having long experienced the benefits and 'grist for the mill' of having clients/patients share a meaningful experience - or interest - on a computer, it's clear the now-portable and ubiquitous 'devices' hold many secrets and examples of daily life. However, it must be added that there may also be value to concentration and focus within the 'therapeutic alliance' too; Age, focus of therapy, and modality (e.g., psychoanalysis vs. play therapy with children) is highly relevant. There are many tools and methods and the expertise of the therapist is yet another major component in outcomes. [See: 'Context and Perspective']
(New York Magazine/Science of Us, 26 April 2017)

Distance Therapy Comes of Age
A compelling new review of evidence we have in support of the value of online mental health services - across a multitude of platforms, tools and devices and a variety of modalities (e.g., chat, email, video, etc.). With some discusson too of the limits of "e-therapy" we have a balanced look at the challenges and potential. Complete with a bibliography for researchers.
From Robert Epstein, Scientific American, May/June 2011. [.pdf/Adobe]

From Couch to Keyboard: Cyber Therapy Booms
"But Many Question Security of Unregulated E-Counseling"
(WebMD, Feb.2001)

Healthy and Pathological Internet Use
Transcript of a live online forum with Michael Fenichel, Storm King, Steven Stern, Kimberly Young, and John Suler. Topics range from "Internet Addiction" to the benefits of text-based communication. (October 24, 1999)

Here and Now in Cyberspace
Some thoughts about the nature of the here & now online, and the implications for both social and therapeutic interpersonal communication. (Fenichel, 2002)

Internet Therapy Clicks for Patients
Online therapy consumers speak about their (positive) experience, online therapists discuss practical and technical aspects of online treatment, and some of the strengths and limitations are discussed. [See also: Getting Help on the Web]
(USA Today, 5-21-2001)

Myths and Realities of Online Clinical Work
Observations on the phenomena of online behavior, experience and therapeutic relationships

A 3rd-Year Report from ISMHO's Clinical Case Study Group: Michael Fenichel, John Suler, Azy Barak, Elizabeth Zelvin, Gill Jones, Kali Munro, Vagdevi Meunier, & Willadene Walker-Schmucker (2002)

On the Nature of Online Therapy and Communication
A capsule summary of a very interesting panel on where we stand and what we know in terms of online mental health service delivery, and the pros and cons of online communication.
With John Grohol, John Suler, Storm King, and Yvette Colon. (APA Convention Symposium, 2000)

Online Case Studies: Report of the ISMHO Millennium Group
A summary of 16 therapists' work across a number of modalities, all involving the Internet in some way or another. While many questions remain, a foundation is set for continuing work on developing models of training and practice.
(ISMHO Case Study Group, 2000)

Online Psychotherapy: Technical Difficulties, Formulations and Processes
A look at some of the practical and theoretical issues inherent in online clinical practice. (Fenichel, 2000)

  Online Therapy: Context and Perspective
Syllabus from presentations to colleagues and students in Moscow, February 2014. Here is an overview of two decades of research and practice findings regarding 'online therapy' and related services utilized around the globe. (E.g., therapy, help lines, support groups, chat, text/email support, etc.) The emphasis which was shared across audiences is the mantra of 'context and perspective'. We have many tools, many situations, many cultural and societal needs and prohibitions. But there are many ways to implement creative and responsive services online. An overview of technical and general issues.

Psychological Applications on the Internet: A Discipline on the Threshold of a New Millennium [.pdf]
A scholarly explanation of the various ways in which one can seek self-help, support, or active online treatment over the Internet, and a look at some of the advantages and disadvantages to this modality.(Azy Barak, 1999)

Psychotherapy and Clinical Work in Cyberspace
"Is it possible to do psychotherapy in cyberspace?" This question is explored in depth, with a look at the technical and conceptual issues involved in online communication and psychotherapy. Many original articles and references in this chapter of The Psychology of Cyberspace. (John Suler, 2000)

Q & A on "Online Therapy"
Considerations for online counselors and therapists, in response to a November 2000 interview by a graduate student in counseling psychology. Covers some of the hot issues under discussion by professionals, including ethical, legal, and practice issues. Still valid. (Fenichel, 2000)

Surfing For Peace Of Mind
A CBS Report highlights studies demonstrating - at the new century began - how many people went online looking for health information (60 Million in 1999 according to a Harris poll) and how 4 out 10 searches on the top sites were for mental health information. (March 2000)

Telehealth Resources for Psychologists (APA)
A decade later - a recently revised/updated compendium of related research as well as an extensive bibliography of articles on theory and practice issues, from the American Psychological Association (August 2010).

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