There is online marriage counseling available out there, but the officials doing the licensing appear to be in a quandry about licensure and definitions at this point.
At this point, the issues appear to be about e-mail, or phone counseling, but not about web conferencing or video counseling, which appears to be so new that it is not being discussed. I did find a website of one couselor offering vidoe conference counseling.
For example, if I am licensed in Illinois (I am not, but my wife is), and she works with a couple in Nevada, is her license applicable?
As a domestic violence educator, I have used the John and Julie Schwartze Gottman model as a tool to help my clients find a way to move from power and control relationships to relationships that offer choice.
So I checked to see what the Gottman Institute had to say about online marriage counseling.
"Q. I live in another state. Can I do therapy with a Gottman trained therapist over the phone?
A. No. Because licensing for therapists differs from state to state, our therapists cannot do therapy over the phone. In addition, the Gottman Method™ relies extensively on visual as well as verbal cues, so to conduct this therapy ethically therapists need to see as well as hear you. If there is not a Certified Gottman Relationship Therapist in your area, we suggest that you consider coming to our couples workshop or arranging for Intensive Marathon Therapy in Washington."
So the Gottman's are pretty blunt about the idea of online marriage counseling.
The National Directory of Marriage and Family Counseling has the following to say about online marriage counseling."
The Internet has revealed itself as a mediator between therapists and clients as online counseling websites surface all over the web. Online counseling, sometimes called E-therapy or cyber-counseling, is when a professional offers emotional support and advice over the Internet. Possible mediums of communication include e-mail, instant messenger, or Internet phone....
Advocates of contemporary online counseling claim it is effective when traditional means of counseling are unavailable, i.e. one lives in a remote location or has financial restraints and issues. For some people, the anonymous and private reality of online counseling is very appealing. A benefit of online counseling for the counselor includes no office space to rent and email relations that allow a convenient response time. Online counselors agree E-therapy is not for people who exist in a state of crisis and further, one must be comfortable writing and expressing their emotions with the written word. Some people who have tried e-therapy say it’s a little like keeping a journal. You can write at length, and explore your thoughts and feelings. Online counseling costs, on average, about $40 per session.
Critics of online counseling argue that it will never replace traditional, face-to-face relationships. These critics state that online counseling does not afford a therapist the ability to interpret their clients’ body language, facial cues, and tone of voice–since all of these aspects are absent in an online counseling session. Online counseling, some protest, lacks the integrity of the relationship formed between a client and therapist. Additionally, psychotherapy across state lines becomes a grey area in regards to state licensure. In Minnesota, for example, the license restricts therapists to business conducted only in Minnesota. The majority of liability insurance companies will cover online work as long as it is conducted within the bounds of the psychologist's license. Thus far, there have been no legal challenges.
Because online counseling is a relatively new form of therapy, regulations have yet to be established. The International Society for Mental Health Online (http://www.ismho.org/) has published ethical guidelines to assist professionals in the development of ethical e-counseling practices.
The official stance by the psychotherapy community is still in question in regards to the efficacy or non-efficacy of online counseling.
“Studies investigating the long-term effectiveness of e-therapy for the treatment of specific disorders or conditions are currently lacking. As a relatively new treatment modality, e-therapy has not yet progressed to the status of an empirically validated therapeutic medium. There is a need for additional research into the risks and benefits associated with e-therapy in the treatment of various conditions.”
Excerpted from The American Psychiatric Association (http://www.psych.org)
The most popular reason for online counseling is, for the therapist and the client, the convenience. According to the Surgeon General’s report on Mental Health (1999), one in five Americans has a diagnosable psychological problem while nearly two-thirds of them never seek treatment. For those people that are too busy, or who may feel embarrassed or uncomfortable seeing a therapist, online counseling offers a variation on the traditional scope of counseling."
The National Directory of Marriage and Family Counseling.
So you get a sense of how online marriage counseling is viewed by the Gottman's and the pros and cons from the National Directory.
I wonder what the Gottman's would say to video conferencing which would allow folks to see each other with web cams?
I know that technology is available, but I am not sure how secure it would be.
Then the therapist could see the non-verbal communications, and perhaps record the session for review and comment later, but that is not very time efficient for therapists.
Perhaps online marriage counseling would be appropriate for part of the counseling experience, with the remainder of sessions happening in the the counselor's office.
You know, as of this writing, October of 2009, 1 in 8 marriages are between folks who met online.
So the match making folks are finding their way to the internet, I imagine online therapists will follow soon with tools adapted to this medium.
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