SUITABILITY OF ONLINE COUNSELING

It is vital to recognize that online counseling and mental health services are not for everyone. Key questions have been formulated to help determine if utilizing the Internet and other forms of communication technologies are amenable to a particular patient/client. Counselors can use the following questions to structure assessments with individuals who are exploring the option of using online counseling:

  • What type of communication method does the client prefer? Does he or she prefer using e-mails, chatrooms, or video conferencing?
  • How proficient and comfortable is the client using the identified form of communication technology? Does the client demonstrate sufficient knowledge in using computers and the Internet?
  • What type of access does the client have? Is his or her computer system compatible with that of the counselor? What type of Internet connection does the client have? Where is the client accessing the computer and Internet? Are privacy issues involved?
  • Is the client proficient in trouble-shooting computer and other technology issues that might arise?
  • How comfortable and knowledgeable is the client regarding online communication and relationships? Does the client enjoy communicating online? Does the client have any experience with online groups? What other activities does the client pursue online? What are his/her attitudes about the Internet?
  • How proficient and comfortable is the client with reading and writing? Can he or she type well? Is there any cognitive impediment that might hinder the client’s ability to communicate online? Does the client prefer face-to-face or phone communications? In the counselor’s opinion, would there be therapeutic advantages to using e-mails, instant messaging, chatrooms, or other forms of online communications even though the client might state he/she does not prefer a particular method? If using e-mail or text messaging, to what extent can the client express feelings and emotions in written form?
  • Does the client have any experience receiving counseling or any other type of mental health services? (Previous experiences may influence expectations, perceptions, and goals.)
  • Are there any factors associated with the online format that could potentially exacerbate client symptomology?
  • Does the client’s personality style, presenting problem, and/or diagnosis affect the suitability of utilizing online communications? (It is usually recommended that those with poor reality testing or who present with severe psychiatric problems [e.g., personality disorders, dissociative disorders, paranoia], suicidal ideations, or homicidal tendencies may not be appropriate.)
  • Is the client comfortable with delayed responses from the counselor if e-mails or text messaging is used?
  • To what extent might cultural issues affect the decision to employ online counseling? Obviously, shared language proficiency between the counselor and client is vital. How might the client’s cultural beliefs about mental health and counseling affect counseling?

It is not completely clear how personality type influences the proclivity to using online counseling. In a survey study of 176 college students, researchers found that those who were extroverted were more likely to have positive attitudes about obtaining help through online counseling compared with introverts [133]. In particular, extroverts were more likely to indicate a preference for online counseling involving the use of voiceover or video-conferencing formats; the authors speculated that perhaps this mode of online counseling most resembles traditional face-to-face counseling.

More research is needed to examine the relationship between personality types and use of online counseling; however, this study does indicate that personality may be a factor, and a clear assessment for each individual client is necessary.

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