I’ve often wondered how technology will effect therapy – even digital photography with art therapy, or creating art through Photoshop – using original or borrowed images. Those present their own concerns – but I see web-therapy presenting with so many more issues.

Some issues present themselves before therapy would even begin. “Secure” websites are hacked all the time. It’s hard to imagine being able to guarantee someone’s information as being safe. Also.. how do we as therapists safeguard ourselves? Just as our clients’ information could be hacked – so could ours. Will liability insurance cover web-based therapy interventions? How does the client know they’re getting a licensed therapist? What happens on shared computers in someone’s household? What if there’s an emergency? Or a suicide risk? Who do we contact? ..and how?

Within the sessions.. how does the therapeutic relationship change if you never see your client? Can you be sure they are who they propose to be? Can you sense lying, or denial? Without being able to look in their eyes, or see their movements, or even if they are hygienic.. how do we measure those symptoms that so heavily rely on sight? Fidgets? Tics? Inappropriate laughter? Staring? Dissociation? Self-Injury? Eye contact? Attending to inside stimuli?

There are so many factors that lead me to believe that web-based therapy should only be used in extreme circumstances. Generally, I could see this system being wrought with complications – both for client and therapist.