Characteristics of E-therapy web sites

Objective: This study examined what a person seeking e-therapy services might find on the Internet, and how e-therapy Web sites characterize their services and providers. Method. Using the search engines Google and Yahoo!, we obtained a list of 55 e-therapy Web sites, which we reviewed from May 2005 to September 2005. We used the search terms online counseling, online therapy, and e-therapy. We reviewed the Web sites' content for data in 7 categories: description of services, terminology for providers, providers' qualifications, terminology for service users, characteristics of clients, information for individuals in crisis, and information about confidentiality and security. Results: There was a wide range in the Web sites we accessed. Web sites often contained confusing information about the nature of the service offered and did not always specify qualifications of providers. Some providers did not appear qualified to provide the services the Web sites advertised. Other sites offered Internet-based services of legitimate mental health professionals. Most sites referred to users as clients rather than patients, and some sites specified criteria that would render prospective clients ineligible to receive services (e.g., suicidality). Some Web sites excluded individuals with specific diagnoses. Web sites were not generally proactive about providing resources for visitors in crisis. Less than half of the Web sites disclosed limits to client data security and confidentiality. Conclusion: Experiences with e-therapy might influence a patient's attitude toward traditional psychotherapy. With the wide variety in e-therapy services that are searchable on the Web, clinicians may want to be more aware of what their patients might encounter online.