Virtual Therapy

Marian Bacon had been feeling sad and agitated for years. She tried a therapist but felt she wasn't getting anywhere. "I was still in my rut," says Bacon, 37, a social-services worker. She went to the clinic at a local college where she studies but became too embarrassed to continue after spying acquaintances in the waiting room.

So she turned instead to an unlikely source: the Internet. Bacon, who lives in Memphis, Tenn., found her current therapist, who lives in Washington state, while trolling the Web. For the past year, they've been chatting twice a week in a private chat room. At $40 for a 50-minute session and dial-up service at $29 a month, Bacon considers her e-therapy a bargain. For one thing, the therapist, who operates on Pacific time, had an appointment slot open at the end of the Tennessean's long day. Though she has yet to meet her therapist in person, Bacon says they have become so close she thinks of her as "a mother."

Convenience, anonymity and low prices—these are the familiar virtues of cyberspace, even when it comes to online mental-health services. Online therapy sessions often cost half the price of office visits. Though many psychologists insist that the Internet is no substitute for in-person sessions, there's evidence that e-therapy may be an effective treatment for some. Large studies have not been published yet, but preliminary research suggests that patients can do as well—or better—on the Web as on the couch, says University of Texas psychologist Aaron Rochlen, author of several surveys of the research.

One new service, ReflectiveHappiness.com, which was launched last year by University of Pennsylvania psychologist Martin Seligman, provides a six-part education in positive thinking for a monthly fee of $9. Each month, its 10,000 subscribers receive instructions for an exercise designed to help them appreciate their strengths and stop dwelling on their weaknesses and painful experiences. For help, users can click on a "virtual partner," an image of an actor delivering lines based on the experiences of real people.

Subscriber Donna Ryan, 43, is a believer. She fell into doldrums after being laid off from a job she loved. But her mood turned around last summer with an exercise on Seligman's site called "Three Blessings." As instructed, each night for a week she wrote down three things that had gone well that day and why. One rainy day, Donna, a mother of three who works as an administrative coordinator in Philadelphia, was struggling to get out of her car with her briefcase and umbrella when her 7-year-old son grabbed an umbrella and rushed out of their house to usher her in. That night, when writing down why her son was so helpful, Ryan gave herself credit for "raising a thoughtful, considerate child." It was the first positive thought she'd had about herself in months.

A pioneer in studying positive emotions, Seligman says he created the site after his studies persuaded him that engaging in regular positive-thinking exercises could lift depression—even major depression. Seligman compared patients who did the exercises with those taking an antidepressant while receiving typical psychotherapy at the University of Pennsylvania's mental-health clinic. The exercises were introduced in group-therapy sessions. "I was astonished that the exercisers did significantly better," Seligman says. Sixty-four percent of the positive-thinking patients were no longer depressed a year later, compared to just 8 percent of those who received "therapy as usual" and medication. Another study, reported in American Psychologist last summer, has shown that the exercises can be effective on their own, without the group meetings. Still, Seligman says there's more research to be done. "Don't throw your pills away," he cautions. He still believes the best approach is to do the exercises along with therapy.