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LETTERS: Badal Pal Internet helps communication between doctors and patients BMJ 2000; 320: 59 [Full text]

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Online medical advice : Some comments

Mark Griffiths   (4 January 2000)

Online medical advice : Some comments 4 January 2000
Mark Griffiths, Head of Psychology Psychology Division, Nottingham Trent University Send response to journal: Re: Online medical advice : Some comments	Online medical advice : Some comments I read with interest the letter by Pal (1) on the use of the internet in providing help and medical advice and have the following comments to add about online therapy more generally. The rise of online therapy is growing appears to be growing at exponential rates. Furthermore, its growth appears to outstrip any efforts to organize, limit and regulate it. It has been claimed that online therapy is a viable alternative source of help when traditional therapies are not accessible. Proponents claim it is effective, private and conducted by skilled, qualified, ethical professionals. It is further claimed that for some people, it is the only way they can get help from a professional therapist.Few people would dream of picking up the telephone and confessing all to a stranger on the other side of the world – yet this happens all the time on the internet. So what are the advantages of online therapy? Online therapy is convenient (i.e., it avoids the need for scheduling and the setting of appointments), cost effective, and overcomes barriers which may prevent people from seeking a therapist offline. For instance there are many different groups of people who might benefit from online therapy including those who are (i) physically disabled, (ii) agoraphobic, (iii) geographically isolated and/or do not have access to a nearby therapist, (iv) linguistically isolated, and (v) embarrassed, anxious and/or too nervous to talk about their problems face-to-face with someone, and/or those who have never been to a therapist before. However, the growth of online therapy is not without its critics. The main criticisms that have been levelled against online therapy include ethical and licensing considerations, its therapeutic effectiveness, the threat to confidentiality, identity problems (of both practitioner and client/patient), establishing client rapport, no face-to-face contact, and the lack of complete information. Therefore, any new developments involving online therapy should be monitored and researched carefully as to their efficacy, sensitivity and therapeutic potential. 1 Pal, P. Internet helps communication between doctors and patients, BMJ, 2000: 220, 59.