Before You Get on the Virtual Couch
Metanoia.org
Background: Martha Ainsworth, a Web designer, mental health advocate and former counselor, founded Metanoia after searching for information about online therapy back in 1995. Once a novelty, e-therapy is now a staple of Web activity that is largely unregulated and uncharted. Ainsworth’s site attempts to give consumers some navigational help, while also acting as a watchdog.
What Works: This is the place to go to learn how e-therapy is conducted (by e-mail, mostly) and when it’s appropriate. The site explains, for example, that online therapy is not a substitute for face-to-face psychotherapy nor a solution to any serious crisis, such as suicidal feelings or major depression. Ainsworth answers fundamental questions--Is this therapy? Is it effective? Is it confidential?--head on, and identifies people for whom e-therapy makes sense, such as those living in remote areas, or simply too embarrassed to come clean with a therapist in person. Best of all, Metanoia reviews specific e-therapists’ sites, giving them one- to four-star ratings, listing prices and checking credentials.
What Doesn’t: Ainsworth is a believer in online therapy; she has benefited from it herself, and her site seems slightly more promotional than critical. According to Metanoia, for instance, 90% of those who try online therapy say they are satisfied with the experience. But what happened with the other 10%? Were they merely unimpressed with the e-mailed advice they got--or were there serious breaches of confidentiality, trust or ethics? You won’t find good answers here. And for all the helpful ratings and encouragement the site gives, it offers no examples of exactly what an e-therapy exchange looks like. Metanoia could use an Ask the Therapist feature, with sample questions and answers. An online consultation can cost $35 or more. Let’s see what we’d be paying for.
Psychcentral.com
Background: A psychology researcher, John Grohol has been listing and tracking mental health sites since 1995. Psychcentral is meant to give consumers an overview of what’s out there, a guide to “the most useful Web sites, newsgroups, and mailing lists online today in mental health, psychology, social work and psychiatry.”
What Works: The best feature on Psych Central is Mental Health and Psychology Resources Online. This page lists hundreds of mental health Web sites, grouping them in useful categories such as “anxiety and panic,” “parents and children,” and “alcohol and substance abuse.” Within each category, Grohol lists not only general information sites but support groups, books and frequently asked question (FAQ) pages. He adds a sentence below each link letting you know something about what’s to be found there. Psych Central also includes an “articles and essays” section with editorials about controversial subjects, such as electroshock therapy and the risks of online therapy.
What Doesn’t: Grohol’s site is as much a vehicle for self-promotion as it is a consumer guide. He advertises his book, he devotes considerable space to what he calls his “editorial ramblings,” and he lists live chats--hosted by himself. He spends less energy doing evaluations of outside resources. About the mailing list called “controlled drinking,” for example, he tells you how to sign up, but nothing about the content or philosophy of the online source. He describes the support group alt.recovery as a “newsgroup on general topics in recovery.” Such as? You’ll have to spend some time in the online group to find out.