The Web: Online psychotherapy effective

Therapy for mildly depressed patients delivered over the Internet can be as effective as face-to-face psychotherapy, but experts told UPI's The Web that a relationship of trust must exist between patient and doctor for the treatments to take hold.

In an article published this week in the British Journal of Psychiatry, researchers at Linköping University in southern Sweden described a study involving 117 volunteers with "mild to moderate" depression. The patients partook in Internet chat sessions or group therapy sessions and used Web-based self-help materials.

Gerhard Andersson led the research team, which reported that the success rate for the Web-based program was the same as that demonstrated in face-to-face therapy in the past and that the online treatments decreased symptoms immediately.

Other researchers interviewed by The Web indicate that there have been similar results for telephone-based therapy in the past. "There is research that indicates that doing therapy over the phone is as effective as in-person therapy," said Karen Sherman, who holds a doctorate in psychology and is based near New York City. "One might consider online therapy an extension of this practice."

That said, the Swedish researchers cautioned that online therapy is not for everyone. For more depressed patients, prescription drugs, in addition to therapy, improved inner-dialogue and a change of lifestyle are needed. Nearly 40 percent of the patients who enrolled in the Swedish study dropped out, claiming the online therapy was too difficult for them.

One key factor is the relationship between doctor and patient, the researchers said.

"The success of therapy depends a lot upon how willing and engaged the client is," said Tina Tessina, who has a doctorate in psychology and has been practicing in southern California for 25 years. "So if that person responds better to online than to in-person, or is more willing to disclose in the online therapy, because if feels more anonymous, it can definitely be beneficial."

Some experts think, however, there may be too much faith in therapy, whether it is delivered online or in person.

"Taking any positive action to change brightens up our mood, because we are moving forward to do something about an area of our life that needs improvement," said Dwight Bain, an author and counselor who works with clients such as Toyota, DuPont and Bank of America, located on the Internet at StormStress.com. "Internet-based therapy could generate short-term results in mood for many people who are too busy to schedule a counseling appointment, or too exhausted, or too afraid to go through the process of trying to get in and see a qualified professional."

Often, mild depression is caused by the accumulated daily stress of life, career pressures, relationship issues, the consequences of past decisions, or even something seemingly trivial, like the traffic, Bain said.

The topic of online therapy has been reviewed by American researchers and European scientists.

An article written for the American Psychological Association -- and published by J.R. Suler of Rider University in the Journal of Applied Psychoanalytic Studies -- indicates that in the future a number of online psychotherapy specialties will emerge and that different approaches to therapy -- psychoanalytic, cognitive, behavioral, humanistic and the like -- may be offered over the Internet.

"I suspect the results of the study published in the British Journal of Psychiatry on Internet therapy being as effective as face-to-face, traditional therapy reflects people who know they need to work on an area of life," Bain said, adding that "quick access to answers moves them forward."

Sometimes, it seems as if everyone in America is either in therapy, or thinking about being in therapy, or watching TV shows that portray those who finished therapy. Relationship advice specialist Gilda Carle, who writes the "Suddenly Single" column for MSN's Dating and Personals channel, said the service was recently expanded to include personal consultations for the online visitors, because the audience "demanded it."

Carle, who holds a doctorate, said until she launched the expanded service, for a nominal fee, she was receiving "five-page letters from people desperate to find out how to proceed in their complex relationships -- both romantic and on the job."

She stressed, however, that the service is therapeutic, but really "not therapy."

Copyright 2005 by United Press International