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BellaOnline's Mental Health Editor

Does Online Therapy Work?

Skype therapy is the new big thing. It seems like such a wonderful idea. I mean why not? Who wouldnít want to have a cozy, comfortable therapy session from his or her own home? Skype treatment opens up options that otherwise would not be possible. You can consult with specialists who are not available in your area. If you have anxiety, you can get help in a way that feels safer and less frightening. On a rainy or snowy day, you donít have to go out.

Since my book, Running on Empty, came out over a year ago, I have received a tremendous number of requests from around the world for Skype consults and Skype treatment about the topic of my book, Childhood Emotional Neglect. Before this, I had never given much thought to providing professional services online. Suddenly I was faced with making some decisions about its effectiveness.

I did some research to determine if other professionals and clients have found online treatment to be helpful. I found scores of articles, interviews, and postings about how amazingly convenient and effective it is. I consulted with my local Psychology Licensing Board. I talked with colleagues. In the end, I decided to give it a try.

But it didnít last long. Not because it felt wrong or useless. Quite the contrary; I think the answer is complex. I donít see online therapy as clearly good or bad. In fact, I really only had one major concern about it, which is this: something is missing.

When you are sitting in a therapistís office, there is a certain indescribable connection that happens. Itís a mutual sharing of subtle personal, emotional and behavioral cues and expressions. Back-and-forth, the therapist and client read each otherís reactions to things. When two people are physically in the same room, there is an energy that passes between them. There is a rich, complex subtext to every sentence. There is a meaning to every subtle twitch of the corner of the mouth or eyebrow; a slight shift in position, a tremor of the foot. There is a feeling of understanding and a connection; a joining of the minds, a linking of thought, feeling and behavior that is largely unconscious, but which can be almost tangible. Itís a synergy that is difficult to put into words but which, I think, is very useful to the healing process.

The synergy I described above is useful, yes. But is it essential? I canít say for sure. Can true therapeutic progress happen with an internet version of that synergy? I donít know the answer to that question.

Here is my main point about Skype treatment:

If you are looking for a specialty or service which isnít otherwise available to you, then it may make sense to try Skype treatment. But I recommend that you go about it with eyes wide open. Know that one very important ingredient of psychotherapy may be absent or watered down in your treatment. Discuss it openly with your therapist.

Online therapy is becoming so popular that surely there will soon be some formal research to study its utility and effectiveness. In the meantime, if at all possible, I suggest that you will get the best results and the most in return for your investment of time, energy and money by going to your therapistís office to meet with him or her in person.

But, in reality, probably the most powerful ingredient in any treatment, no matter its form or location, is your own motivation to change.

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