Characteristics of e-therapy web sites
Recupero PR, Rainey SE;
Commented by , 26 Oct 2006
Background
An ever increasing number of persons with psychological problems as well as mental disorders are searching the Internet for information, advice, counselling, and treatment.
Aims of the study
To examine what a person seeking help for psychological problem or a mental disorder might find on the Internet, and how Web sites characterize their services and providers.
Method
The authors reviewed the content of 55 Web sites obtained with "Yahoo" and "Google", using the search terms "online counselling", "online therapy" and "e-therapy", and reviewed the sites' content for data in 7 categories: description of services, terminology for providers, providers’ qualification, terminology for service users, characteristics of clients, information for individuals in crisis, and information about confidentiality and security.
Results
Sites offering services by legitimate mental health professionals contrast with sites containing confusing information by providers with dubious background.
Professor Pull's comments
Communication technologies, such as videoconferencing, the Internet, and email, play an increasing role in many fields of healthcare, including mental health care. Most sites provide information on the origin, course, or treatment of specific disorders. Many sites also provide counselling, sometimes online, and advice for self-help. Some sites offer support and help for relatives, and offer the opportunity to meet and exchange experiences.
Some sites propose full online treatments for specific disorders, such as Fearfighter, an online program for the treatment of anxiety disorders.
Most Internet interventions are proposed as guided self-help programs on the Internet. Some of these programs are pure self-help programs, while others are adjuncts to conventional face-to-face therapy. The latter associate Internet education and Internet skills training with professional counselling that is either provided by telephone or by email or delivered in face-to-face sessions. While some of these interventions seem promising, randomized controlled studies are still the exception rather than the rule in the field.
On the whole, the Internet offers an astounding variety and wealth of information to physicians and their patients, some excellent, other of poor quality. Physicians as well as patients may be bewildered by the sheer quantity of information and by the fact that data or views are often contradictory. As shown in the article discussed here, some sites are excellent or very adequate while others are very poor and potentially dangerous.
Some sites are provided by highly qualified and internationally recognized experts, while others are put on the Web by persons with no or with a dubious background in the field of mental health and mental disorders.
On the whole, there is a need for expert guidance through the maze of information encountered on the World Wide Web. The main indicators of a site's good quality are related to the degree of disclosure that the provider is willing to share with a person, whether a client or a patient, including his or her profession and title (medical doctor, psychiatrist, psychologist), his or her areas of expertise, and the type of service he or she is offering (information, advice, counselling, psychotherapy).
In addition, the description of the site should contain statements for patients in crisis, such as patients at acute risk for suicide (e.g., referring patients to their doctor or to an emergency unit), statements on confidentiality (indicating in particular that at present total confidentiality cannot be guaranteed), and statements on the limit of help that may be expected online.