Online counseling

Online counseling offers several advantages. These include:

• Increased accessibility: Online counseling fills an unmet need for clients located in areas traditionally under-served by traditional counselors. Rural residents, people with disabilities and expatriates, along with under-served minorities, often have an easier time finding a suitable therapist online than in their local communities.[2] It also makes counseling accessible to clients who face difficulties in keeping appointments during normal business hours,[9] while decreasing the number of missed appointments for in-person therapy.[10] Along with accessibility of therapists, online counseling also enables accessibility of information to the clients. In face-to-face counseling, information is stored only with the therapists. In online counseling, the transcripts of communications between the therapist and clients may be available to therapists as well as clients. This allows people seeking therapy to monitor changes in their own conditions.[11]
• Increased comfort and convenience: Online counseling can offer higher comfort and convenience for clients and therapists alike.[12] Therapists or clients may not need to travel for their sessions, which may be less expensive and more comfortable for all involved. In addition to the convenience, many people also enjoy the perceived confidentiality that comes with online counseling. They tend to feel more comfortable sharing information with their mental health professional and may feel less ashamed and powerless due to the removed environment.[13]
• Less expensive: Although most therapists charge the same fees for teleconsultations as they would for direct counseling, teletherapy can be relatively less expensive as it does not involve travel costs if both parties have internet access from where there are.
• Approachable treatments: Online access to therapy may help remove the stigma around mental health and can help individuals feel more comfortable with discussing mental health issues.[14]

Some of the disadvantages of online counseling include:

• Anonymity and privacy: Online counseling uses technology-aided devices and internet as the main medium for communication between the therapist and the client. All the personal and sensitive information of patients is stored on internet sites or devices. This increases the risk of data theft.[15] While online counseling can feel more private than face-to-face interactions, there is potential for breaches of privacy in online counseling.[13] For example, non-encrypted electronic Internet communications might be intercepted, and records could be accessed by family members or hackers.[15] In online counseling, there may be a lower risk of discrimination based on race, ethnicity, age or gender, because these factors can be more difficult for the therapist to perceive in an online context.[13] It is important to establish the safety of the site and verification of therapist or client before beginning an online counseling session.[16]
• Finding the right match for therapeutic needs of clients: Online counseling does not guarantee the right match for the therapeutic needs of the clients. Emotional and visual contact can be absent during online counseling sessions.[17] This absence may prevent therapists from sensing negative feelings like anger, terseness, or irritation in clients. It can also cause the sessions to be more straight to the point and less emotionally gradual, which can be beneficial or not depending on the client's need.[18]
• Establishing authenticity of therapists or counselors: Counselors and therapists are professional health care providers and hence require licenses to undertake clients for counseling as a part of their mandatory professional requirements.[19] Psychologists and professional health care providers also require licensing in the state or other governmental subdivision where they practice in order to take clients. As the internet allows clients to choose therapists all across the world, establishing legitimacy and authenticity of the therapists or counselors may be difficult.[20]
• Unreliable technology: Slow internet, power outages are some of the challenges that can arise from using technology for counseling.
• Requirement for digital literacy: The digital literacy of elderly adults is increasing substantially as six in ten seniors use the internet and 77% own a cell phone.[21] However, the elderly population continues to lag in their own adaptation to newer technological developments. International studies from 2009 to 2020 have come to show that older adults have lower measures of online communication and collaboration, digital safety, and positive attitudes on technology usage.[22]

Research from G.S. Stofle suggests that online counseling would benefit people functioning at a moderately high level.[24] J. Suler suggests that people functioning at a particularly high level, and who are well-educated and are artistically inclined, may benefit the most from using text-based online counseling to as a complement to ongoing psychotherapy.[25] Severe situations, such as suicidal ideation or a psychotic episode, might be better served by traditional face-to-face methods,[26] although further research may prove otherwise.[2]

Cohen and Kerr conducted a study on the effectiveness of online therapy for treatment of anxiety disorders in students and found that there was no difference in the level of change for the two modes as measured by the State-Trait Anxiety Inventory.[27]

As the main goal of counseling is to alleviate the distress, anxiety or concerns experienced by a client when he or she enters therapy, online counseling has strong efficacy under that definition.[2] Research has come to show that the effects and benefits online counseling has to offer is equivalent or comparable to in-person counseling.[28] This suggests that therapeutic effects can be available to patients without having to go into the office, wait in a waiting room, or even leave the home. Client satisfaction surveys have demonstrated a high level of client satisfaction with online counseling, while the providers sometimes demonstrate lower satisfaction with distance methods.[29]

Nutrition counseling specific to conditions is available by many consultants online using Skype or another face-to-face program. This is especially effective for people with a busy work schedule, and others who cannot make it to an office regularly. Online consulting for imbalances in blood lipid levels, blood sugar regulation, and other health conditions make it easier to manage when using nutritional approaches.[30][31]

The effectiveness of real-time video counseling for helping people to stop smoking is unclear.[32] Few studies compare the effects of video and telephone counseling on smoking cessation.[32]