Information for Journalists     Press Kit

Permission is granted to excerpt quotes from this page or elsewhere on the site.

To contact someone to interview about e-therapy, please contact the contact Dr. John Grohol.

In 2000, I began a wonderful new career that is challenging and extremely time-consuming. After maintaining this site in my spare time for 9 years, I am no longer able to maintain it regularly. As a result, I no longer give interviews to the press. I have not been closely involved in the field of e-therapy for several years. The remainder of the information on this page dates from around 2002 and has not been updated since then.

As the only independent consumer watchdog of e-therapy, I have talked about warnings for consumers:

dangers and risks of e-therapy

potential benefits of e-therapy

how to avoid dangerous imposters

who should not attempt e-therapy

how not to get ripped off when seeking e-therapy

It is unethical for a therapist to ask a patient to talk to you.
A therapist who asks a client to speak to you risks losing his or her livelihood. Therapists professional codes of ethics specifically prohibit this. Please do not ask therapists to betray their ethics by asking them to provide a patient for you to interview.

Metanoia and ABCs of Internet Therapy are not a business. It is a private, personal effort, which I do on my own time. This is a completely voluntary, objective consumer review; it is not an advertising service, and not a clinic. Please do not state otherwise in your story!

Why is e-therapy important?

E-therapy directly addresses a major problem uncovered by the Surgeon General's Report on Mental Health (1999): while one American in five has a diagnosable psychological problem, nearly two-thirds of them never seek treatment. The primary reason is stigma; many people are just too embarrassed to talk to a therapist. These same people may see the Internet as a more private, less intimidating way to approach a counselor for help.

Even for those who attempt to seek face-to-face treatment, "the complex and fragmented mental health service delivery system can create barriers to a full range of appropriate services." HMOs and the mental health industry have made it difficult for people to get the care they need. People turn to the Internet for help when traditional systems fail them.

• E-therapy can be a viable alternative source of help
  when traditional psychotherapy is not accessible -
  if it is approached with appropriate caution.

• 4 Things You Should Check Out
  before consulting a therapist online

• Who shouldn't seek e-therapy

• E-therapy is not psychotherapy.
  E-therapy should not be compared to psychotherapy.
  E-therapy is not a substitute for psychotherapy.
  If you can visit a therapist in person, you should.
  But if you cant visit a therapists office, e-therapy can be
  a helpful and effective alternative in certain situations.

An Interview with Martha Ainsworth

This interview contains many of the questions most frequently asked by journalists. There is a lot of other information available to you on the rest of the site which you should also read. If you are writing a story about e-therapy, feel free to quote me from this page.

Frequently asked questions:

1. Who is Martha Ainsworth?
2. What is the relationship between Martha Ainsworth, Metanoia, Credential Check and Mental Health Net?
3. How did you get involved with "e-therapy"? Why did you start this web site?
4. How many therapists are offering e-therapy? Is the number increasing or decreasing?
5. What was it like to work with a therapist online?
6. Is "e-therapy" effective?
7. How can you possibly do counseling when the therapist cant see the patient?
8. How can you form a relationship with someone just on the basis of typing words?
9. What are some advantages of e-therapy?
10. What are the risks of e-therapy?
11. Is there anyone who shouldnt use e-therapy?
12. What should a consumer look for when considering e-therapy?
13. Is "e-therapy" ethical?
14. What do you see for the future of e-therapy?
15. Will e-therapy replace traditional therapy?
16. Can you refer me to any e-therapists I could interview?
17. Can you refer me to any opponents of e-therapy I could interview?
18. Can you refer me to any e-patients I could interview?
19. Are there any other online resources I should investigate for my story?

Who is Martha Ainsworth?

• e-therapy consumer watchdog
• mental health consumer advocate
• founder of Metanoia, a mental health consumer advocacy and education website
• by day, the Community Producer for Beliefnet.com
• a specialist in online communication since 1982

As a private individual, Im interested in breaking down barriers that keep people from getting the help they need. Using the Internet is one way of dissolving those barriers. I have a background in crisis intervention, and in leading self-help support groups, both of which Ive done online since 1982. It always frustrated me when a person could benefit from the help of a professional therapist but cant, or wont, go for a face-to-face appointment. I always wished that therapists could be available online, to make it easier for people to get help. And now some of them are.

• The ABCs of Internet Therapy (this site)
• How to Choose a Competent Counselor (consumer-to-consumer tips the professionals wont tell you)
• Suicide: Read This First (a suicide prevention website)

I am also a founding board member and 2002 President of the International Society for Mental Health Online, and co-chaired a committee working to establish ethical standards for mental health practitioners on the Internet.

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What is the relationship between Martha Ainsworth, Metanoia, this website, Credential Check and Mental Health Net?

Metanoia is/was my private internet consulting practice. I started this website as a personal project. It has always been a personal effort and has never involved any money. I am no longer an internet consultant but have retained the domain name as my personal website.

In the course of developing this website, I realized that there is a need to verify the credentials of Internet therapists and make sure they are who they say they are. To a limited extent, I do that for e-therapists listed on this site. However John Grohol, Psy.D., who was then the director of Mental Health Net, proposed that I work with him to offer a more extensive credential checking service. We operated that service for about two years. Now that Dr. Grohol is in a new job, I no longer have any relationship with Mental Health Net.

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How did you get involved with e-therapy? Why did you start this web site?

This website evolved both from my long-standing interest in mental health consumer advocacy and from my own personal experience with e-therapy.

In the process of working with an e-therapist myself, I recognized that e-therapy presents both risk and opportunity. I felt very strongly that consumers need to be educated about both, to have a better chance of finding help online. I wanted to tell people that help is available online; but I also wanted to tell people about the risks and how to minimize them. Consumers should know how to make a responsible choice, and they need an independent, non-commercial, screened list of e-therapists to choose from. So my guide to e-therapy was launched.

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How many therapists are offering e-therapy? Is the number increasing or decreasing?

The numbers above are a "best guess." The exact number is unknowable and probably changes daily.

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What is it like to work with an e-therapist?

Click here for a first-person account from an e-patient.

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Is e-therapy effective?

E-therapy can be a viable alternative source of help
when traditional psychotherapy is not accessible,
if approached with appropriate caution.

Its effective; its private; its conducted by skilled, qualified, ethical professionals; and for some people, its the only way they can get help from a professional therapist.

Its NOT THERAPY and it should not be compared with therapy. Virtually no one who does this work thinks that e-therapy is a substitute for therapy. The point is, therapy or not, IT HELPS some people. Emotional support, interactive journaling, psychoeducation, guided self-help, customized information and advice are all types of helping which, though they fall short of "therapy," are effective ways of caring.

E-therapy is especially helpful for people who are too embarrassed to call a therapist or go to a therapists office. American society still attaches stigma to counseling. Many people do not want to admit to themselves that counseling is acceptable; they believe that if they see a counselor it means that something is wrong with them. The people who use e-therapy most are people who have never tried therapy before and are a little nervous about it; they feel safer talking to someone from the privacy of their own computer.

E-therapy directly addresses a major problem uncovered by the Surgeon General's Report on Mental Health (1999) which stated that while one American in five has a diagnosable psychological problem, nearly two-thirds of them never seek treatment.

Furthermore, even for those who do attempt to seek treatment, the Surgeon General's Report stated that "the complex and fragmented mental health service delivery system can create barriers to a full range of appropriate services." The mental health industry has made it difficult for people to get the care they need. Many turn to the Internet when traditional systems fail them.

E-therapy is very effective for many people. Research has shown that the technique of psychotherapy is not as big a factor in your healing as the "therapeutic alliance" you form with your therapist. It is the relationship between you that heals. It is quite clear that it is possible to form deep and meaningful relationships even on the basis of text-based correspondence. These relationships can be very healing.

Theres tons of information about mental health on the Internet, and thats a very good place to start. But sometimes, reading by yourself is not enough; you need to interact with another human being. Support groups can be a wonderful source of help, but sometimes they arent enough either. Sometimes you need a professionally trained counselor to help you cope with a problem. Psychotherapists can be there for you, and now some of them can be there for you on the Internet.

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How can you possibly do counseling when the therapist cant see the patient?

It is a challenge, and this is one reason why e-therapy is not appropriate for people with serious psychological problems. In certain situations, a therapist needs visual information. However, for many of the "walking wounded" who are trying to cope with everyday change and loss, e-therapy can be a good first step.

Its been shown that for some people, lack of visual contact is actually an advantage. They will actually reveal more about themselves by writing online, than if a therapist were with them in person. People have different preferences about communication--for instance, people choose different styles of getting the daily news: some prefer to read a newspaper, others watch television, others look on the Internet. In the same way, people have different communication styles. While some people are very comfortable talking, others might find that its easier to express deep feelings in writing. Those people can do well with e-therapy.

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How can you form a relationship with someone just on the basis of typing words?

Online relationships can have a remarkable intensity and intimacy, that is very real, and not imaginary. Many people reveal intimate thoughts and feelings much more easily over the Internet than they do face to face. Theres great power in the written word. Have you ever read a really good book and you get so engrossed in the story that the characters come alive for you? What about reading a love letter? Or even a Dear John letter? People feel very deep emotions through the written word and very deep connections to other people.

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What are some advantages of e-therapy?

Working with a therapist by e-mail has some nice features. For one thing, you dont both have to be in the same place at the same time. That means you can write to your therapist whenever you feel like it, even if its in the middle of the night and youre in your pajamas. You dont need to wait for an appointment; you can write whenever its convenient for you. Another nice thing is that you can save the e-mail from your therapist, and go back and read it whenever you feel like you want to connect. Its like having a hug inside your computer thats waiting for you whenever you need it.

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What are the risks of e-therapy?

Therapists are there to help you, but you have to take responsibility for yourself. If you are a responsible consumer, if you do some research at my website, and if you are honest with the therapist, there should be no significant risks, no more than with face-to-face therapy.

The biggest issue in e-therapy is one of mutual trust. Without being together in person, the patient doesn't automatically have information about the therapist, and the therapist doesn't automatically have information about the patient. Both of them need to take steps to gather enough information about the other, to feel secure that the relationship is bona fide.

Everyone agrees that e-therapy is not the best way to help people with serious psychological problems. The major risk of e-therapy is that someone will use it who shouldn't use it, and will successfully conceal a serious psychological problem from the therapist. Although e-therapists use various techniques to discover information about their e-patient's condition, it is possible that without a visual connection they could miss something important.

To be fair, it is also possible that even with a visual connection, the therapist could miss something. Every day, in-person patients successfully conceal important things from their therapists, such as suicidal feelings, addictions, and serious symptoms. In-person therapists don't necessarily know everything either.

What if a patient is suicidal - and the therapist is not geographically local? To be fair, in-person therapists are not necessarily more effective at preventing suicides. In fact, e-therapists may be MORE effective, because the disinhibiting quality of online communication makes it more likely that a suicidal patient will confess those feelings to an e-therapist sooner. Therefore the e-therapist may have earlier opportunity to take action.

Is e-mail confidentiality (or the lack thereof) a major risk? It's no more an issue online than it is for face-to-face counseling. The majority of e-therapists today use bank-like safeguards to technologically protect their communications with their patients. There are human error risks; however these are pretty much the same as for face-to-face therapy, and can be minimized with appropriate cautions.

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Is there anyone who shouldnt use e-therapy?

E-therapy is not for everyone.

1. Its not for people who are in the midst of a serious crisis. If you are feeling suicidal, there is some help for you on my website; but probably the best thing is to get off the computer and pick up the phone, and call a mental health hotline, such as 1-800-SUICIDE.

2. You should be comfortable expressing yourself in writing, if youre going to receive e-therapy by e-mail, web messaging or chat. If not, look for a therapist who offers videoconferencing or Internet phone.

3. You should be willing to reveal your feelings to the therapist. Of course, people withhold things in face-to-face therapy too, but that really is counterproductive to getting help.

4. If your situation is very complex, or you have some really tough problems, e-therapy is a short-term solution at best. If a therapist feels you need more help than they can give you, theyll tell you so, and theyll refer you to another source of help. For some people a few sessions with a therapist online is all they need; but if it turns out to be appropriate, and if its possible, most online counselors would like for you to see a therapist face to face.

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What should a consumer look for when considering e-therapy?

If you think youd like to consult a therapist online, the first step is to come to my website, The ABCs of Internet Therapy, http://www.metanoia.org/etherapy.

1. Is e-therapy right for you? E-therapy is a good option for many people, but not everyone. There may be other, better ways for you to get help.    [MORE INFO...]
   
   
2. Who is this therapist? Make sure the therapist is qualified to help you. Verify their credentials, or check that their identity and credentials have been verified by a neutral third party. Get real-world contact info to use in case of computer failures.
   
   
3. What will you get? Make sure youll actually get a personal reply, and how long it will take. Find out in advance how much the therapist charges, and what forms of payment they accept.
   
   
4. Protect Your Privacy: You must take steps to keep your e-therapy private. Keep your e-mail safe from prying eyes. Dont write to a therapist from your workplace, because your employer can read your e-mail at work. For extra privacy, use secure web pages or encrypted e-mail.    [MORE INFO...]

If all those things check out, you should feel pretty confident that youre in good hands.

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Is e-therapy ethical?

The psychotherapists who practice on the Internet are among the most ethical people I know. They are skilled professionals who take their sacred duty as healers very seriously. They dont harm people. They help people. They are pioneers who saw a need, who took a risk, who reached out to help.

Every day, hundreds, maybe thousands of people form relationships via the Internet with professional psychotherapists and these people are being profoundly helped by this process. That is a fact. Ethical codes are beginning to catch up to this reality. Its another way of helping people some of whom have no other source of professional help.

People are going to continue seeking help and advice on the Internet. If ethical, credentialed therapists arent out there, people will take the advice of whoever is out there. I think ethical therapists practically have a duty to be available on the Internet.

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What do you see for the future of e-therapy?

1. If e-therapy is to survive, telemedicine laws must be addressed to clarify the legal ramifications of therapists in one state working with patients in another state. There is no question in my mind that interstate relationships should be allowed; to do that, some type of reciprocal licensing or national licensing is needed. In the meantime, many therapists are continuing to provide help across state lines, because it is so sorely needed.

2. As current research studies are completed, and more large professional organizations modify their ethical codes to account for this new practice (as several have done already), e-therapy will become more normalized. It may be regulated within the U.S., and hopefully voluntary international standards will be established.

3. As the technology and bandwidth improves, look for increasing use of Internet videoconferencing in e-therapy. I think that will be a fundamental change. Many people will continue to prefer asynchronous text-based communication, but videoconferencing will open e-therapy for those who really want visual contact and talking as opposed to writing. Videoconferencing has already proved effective in hospital settings where there is access to expensive equipment. Most of us who just have a little web-cam on our PC cant achieve a good enough result, but it will happen eventually.

4. E-therapists must explore ways of making their online practices profitable. Several large commercial online clinics were formed a few years ago in an effort to achieve profitability. Unfortunately, most collapsed in the dot-com bust. The online clinics offered better technological support at a lower cost for the therapist, and ultra-secure, web-based messaging systems for confidential communication between therapists and clients. They also offer(ed) credential screening which guarantees that their clinicians are qualified professional psychotherapists.

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Will e-therapy replace traditional therapy?

No, e-therapy will never be a substitute for the tried and true face to face mode of psychotherapy. But it will continue to be an alternative for those who have no other access to psychotherapy, who cannot meet with a therapist face to face.

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Can you refer me to any e-therapists I could interview?

No, sorry.

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Can you refer me to any opponents of e-therapy I could interview?

No, sorry.

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Can you refer me to any e-patients I could interview?

No, sorry.

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Are there any other resources I should investigate for my story?

Best Practices in E-Therapy - John Grohol, Psy.D., an authority on e-therapy, and founding president of ISMHO. Definition and scope of e-therapy, legal and licensing issues, confidentiality and privacy. Dr. Grohol is an important person to interview, for information about current trends and developments. Dr. Grohol is an authority on research and development related to e-therapy.

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