Anonymity of the internet aids online counselling services

By Carina Frey Apr 24, 2006, 4:17 GMT

Berlin ­ Anonymity can sometimes lead to closer understanding between patient and practitioner in psychotherapy.

If the person being talked to is not visible, it is easier for the client to speak about terrible experiences or problems.

Therapists are now exploiting this in their work and providing counselling over the Internet.

'Psychotherapy is treatment for mental or emotional illnesses,' explains Fredi Lang of the Association of German Psychologists (BDP) in Berlin.

Counselling, however, is about providing advice on how to deal with problems. On the internet, the terms psychotherapy and counselling are often misunderstood to mean the same thing.

The BDP instituted a quality control system five years ago to aid clients seeking online counselling.

Meanwhile, about 20 websites have passed this test and now bear an insignia with the text 'Counselling by Psychologists'.

To obtain the award, the site's operators must have a diploma in psychology, inform their clients about the limits of online counselling and the necessity of encoding any correspondence by email.

However, this method of quality control is not sufficient, according to Ragnar Beer, psychologist at the University of Goettingen.

Beer says only sites operated by universities provide serious counselling. 'Non-verbal communication is missing online. That makes counselling or therapy very difficult,' says Beer.

Beer believes that is why the internet is unsuitable for classical forms of therapy.

However, a new approach to counselling has developed called interapy. Researchers at the University of Amsterdam developed this internet platform for treating post-traumatic stress disorder.

Interapy involves clients writing about their experiences on the basis of written instructions. Four-fifths of participants were free of symptoms after counselling.

One reason for interapy's success is the close nature of the relationship between the client and the therapist.

'We noticed that from the very beginning there was a very intense form of contact,' says Beer. This is due to the anonymity the internet provides.

'Clients can envisage their therapist according to their own ideal,' says Beer and the distance between client and practitioner makes it easier to discuss past experiences.

The psychologists behind the website Theratalk at the University of Goettingen have had a similar experience.

Theratalk went online in 1996 and provides online counselling for couples. Therapist and clients communicate in a secure chat room with a time lag.

'Patients often say they can speak freely because they can't see the therapist,' says Beer who heads Theratalk. That was particularly advantageous in dealing with sexual problems.

The psychologists pose questions in the chat rooms once a day. 'The patient had the whole day to think about what he or she wanted to say,' says Beer.

Their experience showed that counselling which took place in real time put pressure on clients. Another advantage of the chat room was that all questions and responses could be reread.

But online counselling has its limits. A patient's mental health must be in stabile condition and personality disorders cannot be treated online.

In addition clients who are experiencing a mental crisis should speak to a counsellor face to face.