This post is in response to Happy Marriage, Happy Life by Susan Heitler

online therapy, marriage counseling

The internet is here to stay, and mostly that seems to be a very good thing. 

This past weekend, for instance, I realized that our home would need serious refreshing before our kids and grandkids arrive next month for their annual whole-family visit. How could I shop most efficiently for new wastebaskets, duvet covers, floor and table lamps, pillows to match our sofa, and sports equipment? On the web, of course. The internet enabled me within minutes to view a full range of options for each item. I even was able to carry my portable computer to each room to check that my purchases fit its current decor.

So if furnishings can be found online, how about love? Does online dating work?

Yes again. Online match-making has its hazards, not the least of which is dangerous folks who lie about who they are and even worse could prove threatening if you meet in person. 

At the same time, there's no disputing that many now-happy folks have found the love of their life via web-based matchmaking services.

If furniture and love now can be found online, what about psychotherapy?  

Apparently so. 

Each year an ever-higher percentage of my clients find me from my website. Whereas most people used to get the name of a therapist from their physician, now they turn to Dr. Google.

If finding a therapist works online, what about online therapy?

For a number of years now I have received requests for treatment from readers who live outside of Denver, and also outside the state of Colorado where I abide. When they asked if I would be able to work with them as a therapist via phone or Skype however, for years my answer had to be "No." Therapy via phone or computer was frowned upon by psychologists' ethics, and in some cases illegal.

The profession of clinical psychology had concerns about whether electronic connections could allow therapy to be as effective as in-person treatment. 

In addition, my psychology license entitled me to practice only within the state of Colorado. Other states have similar laws, the impact of which has been to bar therapists from working in any state other than the one in which they live and/or have obtained a professional license.

The times, however, are a'changing. Within Colorado, individuals now can obtain   treatment over Skype or by telephone from any Colorado-licensed therapist. For individuals and couples who live in rural areas with few if any therapists, these new rules can seriously enlarge ability to get help.

Enter the recent upsurge in interest in revising laws that block online therapy.

A change proposed in New York that would enable physicians to use telehealth options more broadly suggests that online options are likely to continue to expand.

The new rules that the Federation of State Medical Boards is proposing would make medical treatment via telephone and skype more feasible, and hopefully also eventually mental health treatment. The proposal would encourage licensure portability.

Are therapies via Skype and telephone expanding even with the current restrictions on online therapy help?

Delightfully, one of the leaders in offering online and telephone therapy services has been the VA. Many veterans live in rural areas where mental health services are scarce.  Yet, alas, many vets return from war zones with serious psychological impairments. To their credit, the Veterans Administration has launched forth to become a leader in telemental Health. 

According to testimony given by Robert Petzel, MD, the former undersecretary of health for the US Department of Veterans Affairs, the VA has provided telehealth mental health services to nearly half-million veterans via 150 medical centers and 750 community-based outpatient clinics. Hooray for the VA!

Are online therapy services a good idea?

Interestingly, NPR radio ran a story this week about the merits of therapy via telephone or the internet. Their report discusses the pros and cons of Skype therapy for folks who want counseling help without having to leave their home or office. Their overall assessment was definitely pro.

Still, consumers do need to beware. Online services often are offered by minimally trained and unlicensed therapists, as these counselors do not need to abide by the rules of more conservative mental health professional organizationss such as the professional associations of psychiatrists, psychologists, social workers and marriage and family therapists.

Still, online therapy of almost any sort can prove helpful to the many people who for whatever reason cannot go to a therapist's office. Even if therapists do offer services within reasonable geographic proximity, many individuals benefit when their therapy can be available without travel time—during an extended coffee break, a lunch hour, immediately after work or in the evenings.

What about online help for couples? Is there online marriage counseling?

CBS TV in New York recently ran an encouraging news story about online help for couples who want a better marriage yet are reluctant to spend the time and money for in-person couples counseling.

This news report stressed that marriage therapy online may be iffy, but marriage education online works very well.

I especially liked the CBS TV report as it included my own internet-based interactive communication and conflict resolution skill-building  marriage ed program, a program that's based on my Power of Two book and workbook. The TV program mentions as an example of how couples now can use the internet to gain inexpensive and ever-available help for couple stresses. 

Couples therapy poses challenges for telephone or skype treatment. It is difficult, for instance, for a couple to talk with each other when they have to keep their eyes on the computer screen.  Because online therapy can be iffy, the CBS TV program concluded that marriage education programs online so far appear to be the better option. 

What is the difference between marriage counseling and marriage education? does not offer marriage counseling or therapy. That is, it does not help couples to explore deeper issues, discover the role of childhood experiences in current difficulties, or even guide them through to resolution of specific current issues that have been breeding tensions.

online therapy, marriage counseling

What Power of Two and other marriage education programs do offer is skill-training. When couples learn to talk collaboratively, they can cease having arguments.  Instead of fighting, they learn to resolve their differences by cooperatively creating win-win solutions..

Marriage ed can be available online 24/7, with zero travel time to get there or back. The price is right also. PowerOfTwoMarriage for instance offers a wide variety of fun learning activities, email access to a real-person coach, and a full span of topics: what to do with anger, how to make win-win decisions instead one person dominating, and how-to's for more harmonious living—all for $18 a month, which is probably less than the cost per month of one evening out.

So while marriage counseling over the internet is still in its infancy, marriage ed can enable motivated spouses to make the leap from a marriage that's an endurance test to a truly gratifying love relationship.

How effective is online marriage coaching?

Very. A research study of the outcomes of an early prototype of yielded significant improvements in couples' abilities to enjoy their relationship with fewer fights and more satisfaction. 

Studies on the impacts of other marriage ed programs such as the ones described in the CBS TV report have obtained similarly impressive results.

The bottom line on online therapy.

For online therapy via skype and telephone to become more broadly available, laws limiting therapy practice over state lines need to be modified. 

In the meantime however, online individual therapy with less highly trained counselors already is proving helpful for many people. Online treatment with in-state mental health professionals is becoming increasingly available.

And for a couple, or even just one spouse, who is frustrated by marriage tensions and bumps, programs that offer coaching in the skills for marriage success can make an immediate difference.


(c) Susan Heitler, PhD
Source: (c) Susan Heitler, PhD

Harvard-educated Denver clinical psychologist Susan Heitler, PhD is author of The Power of Two book, workbook and online marriage education program.  To check out the web-based program with a free trial plus a free marriage assessment, click here.

Be sure to read the following responses to this post by our bloggers:

Happy Marriage, Happy Life is a reply by Susan Heitler Ph.D.

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