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Suler, J.R. (2001). Psychotherapy and Clinical Work in Cyberspace. J. Appl. Psychoanal. Stud., 3(1):95-97.

(2001). Journal of Applied Psychoanalytic Studies, 3(1):95-97

OriginalPaper: Contemporary Media Forum

Psychotherapy and Clinical Work in Cyberspace

John R. Suler, Ph.D.

Is it possible to do psychotherapy in cyberspace? Let me address that question by telling a joke. And this is one I made up myself: How many psychologists does it take to do computer-mediated psychotherapy? … None. The computer can do it all by itself.

The reason why that joke is (or is not) funny is important. Maybe, like many jokes, it reveals something we are a bit anxious about. Are computers and the internet taking over our lives? Are human relationships being infiltrated and dehumanized by machines? Will really poor computer-mediated psychotherapy replace the tried and true methods of traditional psychotherapy? We could certainly make those arguments and we should be on the lookout for those possibilities. On the other hand, computers and the internet do offer many new, enriching forms of human interaction. Perhaps that includes new and enriching forms of that special kind of human interaction called psychotherapy. On the road to reaching that possibility, we must grapple with some rather complex issues.

First of all, is it ethical to attempt psychotherapy in cyberspace? If the therapist is communicating with the client through typed text (as in e-mail, chat, and message boards), all sorts of valuable information—like physical appearance, body language, and tone of voice—are missing. That easily could pose problems in making an accurate diagnosis and evaluating the treatment, which often rely on f2f behavioral cues. Without f2f cues, the therapist also may not be able to verify the identity of the client.

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