Online therapy: A therapist's guide to expanding your practice

Journal of Marital and Family Therapy, Apr 2006 by Todd, Tracy

Derrig-Palumbo, K., & Zeine, F. (2005). Online therapy: A therapist's guide to expanding your practice. New York: W. W. Norton, 336 pp., $34.00.

Are you considering some form of online therapy for your practice? What exactly does online therapy mean? E-mail, chat rooms, instant messaging, web cameras? Regardless of your foray into electronic-based counseling, Online Therapy: A Therapist's Guide to Expanding Your Practice, is an excellent resource for experienced therapists moving into the 21st-century of psychotherapy.

Organized into three major sections, the book addresses a wide range of issues relevant for clinicians who may be incorporating on-line components in their practice. Part I addresses psychotherapy models (e.g., solution-focused, narrative therapy) most conducive to delivering online therapy services. Interviews with significant representatives of each model offer thoughtful perspectives toward online therapy. For example, Albert Ellis presents his opinions about the possibility of using rational emotive behavioral therapy through an online format. Part I also provides answers to common questions, offers clinical guidelines, and includes a brief discussion about the efficacy of online therapy.

Part II is the backbone of this book, providing a thorough discussion about establishing an online practice. Business, legal, and ethical issues are all addressed in a comprehensive way. Derrig-Palumbo and Zeine guide readers through the maze of considerations of beginning an online practice. Furthermore, they address the various possibilities of web-based counseling: e-mail, audio conferencing, electronic clinics, videoconferencing, and chat rooms. Of vital importance is the excellent discussion of the perils when using free or public domain technology (e.g., Yahoo, AOL) that may not protect client confidentiality. The discussion of legal issues is also excellent, addressing such matters as conducting psychotherapy across state lines, payment for referrals when using referral services, and the required documentation for conducting online therapy services.

Part III provides almost 70 pages of appendices filled with excellent information for consideration before going online, including computer selection, the skills and programs necessary for online therapy, online therapy guidelines from various professional associations, and additional online therapy resources.

My only complaint about this book relates to its organization and a sometimes-confusing target audience. The authors go to great lengths justifying the utility of online therapy and assuring readers that online therapy is not replacing face-to-face psychotherapy. The title presupposes a target audience well beyond such concern. Purchasers will likely be past contemplating whether their therapy style is conducive to online therapy. They may want to skip Part I and get into the essentials of online therapy included in Part II and the Appendices.

Those limitations aside, Derrig-Palumbo and Zeine have made an excellent contribution to this growing area of psychotherapy. They do a nice job challenging the assumption that psychotherapy suffers when not conducted face-to-face. Eloquently, they lay out historical examples of conducting therapy via letters and telephone calls. They even point out some significant advantages of using text as an important method to help clients work through issues, noting, "Some clients have reported that text messaging gives them time to collect their thoughts prior to typing a response. The alleviation of a perceived need to immediately respond allows additional time for reflection, which can be quite beneficial" (p. 50). Private practitioners and some training program faculty will find this is an essential work to survive the next generation of psychotherapy-a generation where today's children, comfortable with an electronic medium, will undoubtedly demand some form of an online complement to psychotherapy services.

Tracy Todd, PhD

Brief Therapy Institute of Denver, Inc