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Sign on to Telepsychotherapy

New research is showing that online therapy can be effective.

Psychotherapy can perhaps be considered to have begun on a couch. The decision sprung from early beliefs about what position would elicit the most useful information. The couch permitted no visual or other cues, but instead a process of transference that was in keeping with Freud’s ideas, one of which was the use of projection and the other his dislike of being looked at..

These ideas were soon challenged by a variety of psychotherapists who thought that it was important to be able to look at each other when exchanging intimate and personal information. Gestures, body language and facial expressions became part of what was considered interpersonal communication. As much work, including my own[1], demonstrated, the depth and importance of eye contact, the physicality of psychotherapy began to be further considered and enhanced.

Today there is an innovation that is keeping with contemporary technology. It has been named telepsychology or tele-psychotherapy and involves doing therapy via the visual apps available for social connections . As Facebook and others have been discovered not to be very secure, extremely secure connections have been developed in keeping with the necessity for confidentiality of the ethical code.

This modality has its strengths and weaknesses, but has been shown in preliminary studies to be effective. It is useful for clients who live in small towns and do not want to be seen going to a therapist’s office. In fact, it is useful for anyone who wants to keep their participation in therapy completely confidential. Finally, for individuals who live in areas that do not provide much access to excellent therapy or to those who specialize in particular issues such as feminist therapy, multicultural issues, adolescents, couples or family therapy, to take a few examples, they now have access to the entire spectrum of experts. If a therapist in your area does not speak your native language, you will find someone online who does. You may be in Kansas and find that your ideal therapist is in Costa Rica. No problem!

Any competent therapist will offer a free consultation and any prospective client should take advantage of these sessions with about three different therapists in order to determine a “best fit.” Someone with whom you resonate and who understands you is much more important than the school of therapy that they practice. The focus should be on you and your issues and not on predetermined rules.

I think that this new modality will be most effective for the younger generations, who are already conditioned to spend much or most of their intimate contact online. If any of these conditions apply to you, you might want to try tele-therapy. If you do, be sure to use an online service that follows APA ethical standards,such as Psychology Today or Good Therapy. Either site will explain the process to you. I would be quite interested in hearing from those of you who try this form of therapy how it works for you. If I get enough responses, I will include them in a future blog.


[1] Kaschak, E. (2015), Sight Unseen: Gender and Racethrough Blind Eyes, Columbia University Press.

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