Online Psychotherapy: A Couch And A Mouse And Ethical Problems

Online Psychotherapy: A Couch And A Mouse And Ethical Problems

   Online Psychotherapy: A Couch And A Mouse And Ethical Problems   

“Welcome to travel inside yourself. If you need support in improving your health, well-being or quality of life and are looking for a psychologist, I invite you to take advantage from online therapy via the Internet. We use Skype for communication, thanks to which we can hear through headphones and see on monitor screens. “You don’t have time, but your interior needs it.

You want to talk about your problems, complain, get advised. Here you can open up, pour out sorrows, express desires. Sit comfortably in front of the monitor and write a letter to the psychologist. He reads, listens to your interior, tries to understand you and your problems.”

The fragments cited above come from websites offering the provision of online therapy and other forms of psychological assistance via the Internet medium. The scale of the phenomenon is surprising: after entering the phrase “online psychotherapy” in the Google search engine, approx. 500 thousand are displayed for this entry. related passwords and websites containing them.

This demonstrates the widespread and still developing use of the Internet as a form of client-psychotherapist communication in the therapeutic process via chat, e-mails, internet forums, and messengers.

What is this all about?

Psychotherapy is a type of psychological help or “a special type of interaction between an assisted and assisted person”  In psychotherapy, theoretical knowledge and skills of a psychotherapist are used in the process of helping mainly people (…) with psychogenic disorders, as well as those who have psychological consequences. In psychotherapy, the relationship that arises between the therapist and the patient is often used as intended as the primary means of treatment. Personality development, mental health and removal of the patient’s disease symptoms are treated as the main goal of psychotherapy”.

The above definition of psychotherapy does not explicitly specify whether the client-psychotherapist interaction can be indirect or only direct. By contacting the client via e-mail or a webcam, the psychotherapist loses the possibility of full therapeutic impact and impoverishes him significantly. Such a special kind of interaction between two people by distancing it in place and time affects the quality of contact, the entire  online therapy and the client itself.

The good of the client

Online therapeutic work with the client violates one of the basic ethical principles in the profession of psychologist, which is the principle of acting for the benefit of the client and not harming him – working with people, the psychologist is obliged to “take care of their well-being and protect against loss or minimize suffering”.

The question is, when contacting the client via e.g. e-mail, the therapist, in the most competent way, can act by the principle of primum non-nocere which principle should also guide the psychologist at work.

The above principle raises the issue of awareness of the limits of competences and tasks that go beyond them. There are no methods or special diagnostic techniques developed or modified for this type of therapy conducted through a medium other than a direct verbal channel. Toeplitz – Winiewska writes about the principle of respecting human rights and respect for his dignity as well as subjectivity – in indirect contact, which is online contact, there is a danger of treating the client objectively.

The therapist’s unprofessional behavior and increasing the asymmetry of the client-psychotherapist relationship may result not only from the psychotherapist’s advantage over the client, the client’s suffering, the expectation of help but also from the physical distance between the client’s home and the office. The customer may feel that he is treated as a “petitioner”, who must pay a strictly specified time for providing the service.

Return to life

In the event of termination of the therapeutic process, an important task for the psychotherapist and the challenge for the client is to introduce him or her to real life. Virtual space can hinder this ethically important last phase of therapy because this contact does not take place directly, but via the device, which may suggest little value for the actual functioning of the client.

There is also a problem that the issues raised during therapeutic meetings can be difficult for the client to implement in personal and social life. Online contact can sustain the client’s symptoms of a specific mental disorder due to “unreal” communication, detachment from a commonplace time.

Online therapy does not solve but intensifies the problem of people, e.g. with social phobia, who have chosen this form of therapy due to the lack of the need to contact other people – the therapeutic effect, in this case, does not help, it even harms the client, and therefore stands in opposition to Art. The PTP Code of Ethics and Professional Psychologist according to which “when performing professional activities, the psychologist always strives to make contact with him helpful to another person or a group of people”.

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Nirmal Anandh
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