Online Cybertherapy Project

I have chosen to post my individual cybertherapy project on my blog. I began my project by "Googling" free online therapy. I have many selections to choose from and I began to select some I realized that they were not actually free. There were hidden costs or requests for a credit card number to "hold" a clients spot. So I began a search again and I stumbled upon Carl Benedict, a licensed therapist who provides theraputic online services. Although he too charges for sessions, I emailed him and asked him if I could as him a series of questions for a project I was working on for graduate school. He obliged happily. Below are a list of the questions that I asked him with his responses. I hope you enjoy his honest and helpful information as much I did. If you would like, you can visit Carl at his wedsite: http://www.serenityonlinetherapy.com/.

Thanks! Jillian

1. What are you qualifications? How do you present these qualifications online in a way that can be proven (not to suggest you do not have adequate qualifications, but if someone asks you for them how do you show them?)

I am an LCPC in the State of Maryland. I show my actual license on my web page and list the phone number of my licensing board. You can review my other qualifications on my web page: http://serenityonlinetherapy.com/credentials.htm

2. What has been the most successful way for you to advertise your services?

I do not advertise per se. I have listed my website and services with dozens of other mental health related websites that allow me to list for free. In addition, I paid close attention to Search Engine Optimization (SEO) principles when designing my website to make my website search engine friendly..

3. Are all services free? If not what are the costs? Do you accept insurance?

I do not offer free services. I do not accept insurance. I charge $50 for a 60-minute real time chat therapy session in an encrypted and access-controlled IMing chat room.

4. What type of therapy do you most commonly use? Why?

My approach is mindfulness-based cognitive behavioral therapy, which is easily taught in a text-based chat room.

5. What are the safety parameters set up for both you and the client?

The most important safety measure is to screen clients carefully. I will not take on clients who are unstable. Most of my clients are functioning people who for various reasons find online therapy preferable. So, I do not take on any clients who have a history or present with SI or HI. In addition, I have a "In Crisis" page that each client agrees in advance to follow if they are unable to get a hold of me and they become suicidal. Fortunately, since I screen my clients carefully, none of my clients have ever had to use this page. Here is the page: http://serenityonlinetherapy.com/incrisis.htm

6. Have you found there to be ethical issues? If so, how have you handled them?

Well, I follow the guidelines of the National Board for Certified Counselors and Center for Credentialing and Education, Inc. for Internet
Counseling (http://www.nbcc.org/AssetManagerFiles/ethics/internetCounseling.pdf and the guidelines of the International Society for Mental Health Online (ISMHO) for online mental health (http://www.ismho.org/suggestions.asp). So, I believe my practice follows the highest ethical standards.

An important issue, however, is offering online counseling to clients in other states or countries, which I do. This is a gray area, and certainly the most important issue for the future of online counseling. I believe when I am doing online counseling in Maryland, even with a client in a different state, that the client is protected by the standards of my licensing board, which is why I list my board's phone number.


7. Please describe your process from when a client accesses your services to when you terminate. How long do sessions usually last? How do you know if a client is really ready to terminate?

I have clients fill out an extensive online questionnaire (actually two questionnaires) that provide an extensive history. Really, it is the same questionnaire I use where I work my day job as a therapist doing about 24 face-to-face counseling appointments per week. I will not take on clients who refuse to fill out my questionnaires. I then assess if the person is appropriate for online counseling. If they are not, I explain why and make recommendations as to where they can get appropriate help. If the person is appropriate, we set up our first appointment for the next weekend. Clients usually tell me when they are done. Online chat therapy is very focused...much more so than face-to-face therapy. Much less transference. Clients usually know what they want help with and usually know when they have gotten the help they need. Most clients are ready to terminate within ten sessions, but I have a few that simply like having a therapist available to them on an ongoing basis. Most of my clients have money. Many are professionals. For them, my rates are cheap and the convenience of online therapy appeals to them.

8. How do you handle knowing what to say and when to say it? For example: how do you know when to pause, actively listen, interject, give advice?

As to what to say, that is pretty easy if you are an experienced therapist. It really is not that much different from face-to-face therapy other than the lack of non-verbal’s, so I often must stop and ask the client how they are feeling or how they are doing right in this very moment. As I mentioned, chat therapy is very focused. There is little chit chat or transference issues. We simply define the problem than work on solutions. I think my style of therapy -seeing myself more as a coach and teacher than "psychotherapist" - works well online. I am empathic but also highly directive.

9. Overall, do you feel online therapy is effective?

For the right client, online chat therapy is every bit as effective, and sometimes even more effective, than face-to-face therapy. For the wrong client, online therapy can be disastrous and even dangerous. Again, the key is to screen clients carefully.

10. How do you feel about online group therapy?

I love to do group and couples therapy face-to-face, but I have not done any online yet and do not expect to do so. So, I have no experience with that or opinions on its effectiveness.