Virtual Therapy

The Internet can also be an effective option for recovering addicts who seek support from others in the same situation but are uncomfortable attending 12-step groups. For $1,200, eGetgoing.com gives alcoholics 12 weeks of group counseling. The sessions meet as a videoconference, but only the counselor is visible. Patients can communicate with the group over the computer, but they can only directly e-mail to the counselor. "It's engaging," says CEO Barry Karlin. "It's like watching a movie." The program has attracted more than 1,000 participants so far, and only 19 percent drop out of the program on average—much lower than the 60 percent dropout rate traditional in drug-addiction treatment, according to the Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services. Initial surveys of past participants have found that nine months after completing the program, 80 percent report that they've stayed sober. A full-scale study will be completed this year.

For those who are shy or self-conscious, being invisible can help them to open up. "People are just uncomfortable with that face-to-face encounter," says Carone Sturm, publisher of Capalo Press, which sells an alcoholism-recovery program that is entirely online. "Some days we get 2,000 hits on the discussion forum. They love that they can go somewhere safe and anonymous and get help."

Online patients have the same range of difficulties as any patients, says Gerry Smith, an executive at the Toronto benefits firm WarrenShepell, which offers both kinds of therapy as part of the company's package of employee-assistance programs. Some opt for the online treatment because writing helps them clarify their thoughts. And they can hold onto the e-mailed responses from therapists and look at them when they need a boost. "They love that they can carry the e-mails around with them," says Smith.

There are different types of e-therapy, but patients should always check credentials, says John Grohol, publisher of PsychCentral.com. They should also take note of how thoroughly an e-therapist questions their state of mind: ethical e-therapists say that they won't take a suicidal patient since they can't easily arrange emergency help.

Though some psychologists believe in the power of online treatment, not everyone is a fan. The most frequent argument against e-therapy is that patients improve most in a strong relationship with a therapist experienced at reading faces and other nonverbal communication. "A person's hygiene, the way she dresses, these are all cues that can't be assessed online," says Lisa Cohen, a clinical psychologist at Beth Israel Medical Center in New York, adding that online therapy shouldn't replace an in-person evaluation and psychotherapy.

But Bacon is happy with her progress. She will complete her bachelor's degree next year and plans to attend graduate school. She credits her e-therapist with helping her recover from the memories of an earlier sexual assault in a foster home. She's even been able to cut back on her medication. "I'd recommend online therapy to anyone who isn't suicidal," she says. In fact, Bacon was so inspired that she's decided to pursue a career in mental health herself. "I want to help kids like me," she says—whether they're online or on a couch. 

© 2006