Mental Health & e-Therapy
Good mental health is the condition comprising emotional well-being, good behavioral adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life. When experiencing undue stress or other problems with their mental health, many individuals turn to psychotherapy for help. Although psychotherapy has traditionally been conducted in a clinical setting, today's information technology allows therapists to use the Internet in e-therapy, psychotherapy that is conducted over the Internet rather than in face-to-face sessions. E-therapy may be conducted using real-time messaging, chat rooms, or e-mail messages. Given the fact that many people find information and communicate through the Internet, e-therapy has become increasingly popular. However, much more research is needed to determine the efficacy of this type of therapy, the situations under which it works best, and the types of clients for whom it is best suited.
Keywords Chatroom; Electronic Mail (E-Mail); Electronic Therapy (E-Therapy); Information Technology; Instant Messaging; Mental Disorder; Mental Health; Norms; Postindustrial; Psychotherapy; Socialization; Social Construct; Society; Subject
When meeting a stranger at a party, I rarely reveal the fact that I am a psychologist. Too many times the conversation has quickly turned from the purely social to an attempt at a free diagnosis of self, friends, or family. I suppose this is just one of the hazards of the profession, as is the tendency to psychoanalyze things that do not require psychoanalysis. For example, last evening I was watching my favorite television show, which features a misanthrope well known for his curmudgeonly behavior with others. On more than one occasion I have been drawn into conversations with friends trying to sort out the character's problems as the writers bit by bit give the viewers more insight into his psyche. In the end, of course, I need to step back and remember that he is, after all, just a character on a television show. The writers either got the psychology right or they did not. However, diagnosing a character on a television show does no one any good. This, however, does not keep the other characters on the show from attempting to do so. In the latest episode, the character was listening intently to the current woes of his best friend. Trying to encourage the other man, the character remarked "interesting" at one point in the conversation. The friend took offense. "Why do you say interesting?" he asked. "Because I am interested," the character replied. "But you should have said 'good for you' or something else instead," replied his friend. Frankly, "interesting" was a perfectly reasonable response. However, the character's friend was looking for something else, and took the lack of what he deemed to be an appropriate response to be another example of the character's need for in-depth psychotherapy.
Although on one level, this story is merely about a fictional conversation between two fictional characters, on another level it is a good example of how the expectations of other people determine in part whether or not one is considered "normal" and whether one is considered to be mentally healthy or mentally ill. In another context or with other people, the comment that something was interesting might go unremarked. However, the expectation of the friend was that the character would say something inappropriate. Therefore, he interpreted the character's response as being inappropriate and further evidence of his lack of mental health. In fact, in many ways, mental health and mental illness are little more than social constructs. Through the process of socialization, one is taught to act in a way that is deemed to be acceptable and to act in a manner that is appropriate for the needs of the society.
Whether or not mental health and mental illness are social constructs or objective states, we treat them as if they were the latter—that is, with the attitude that the person with mental health issues needs to be treated so that he or she better conforms to the norms and expectations of society in the future. This is often done through psychotherapy, a generic term used to refer to any psychological service provided by a trained professional. Psychotherapy primarily uses communication and interaction to assess, diagnose, and treat the dysfunctional emotional reactions, ways of thinking, and patterns of behavior of an individual, family, or group. From a sociological perspective, this can be viewed as a method of socialization aimed at preserving the stability of society. There are a number of methods of psychotherapy, including the general categories of cognitive behavioral, humanistic, integrative, or psychodynamic. Typically, psychotherapy takes place in the office of a licensed psychotherapist. However, with the increasing advances in information technology today, new approaches are being tried.
In many ways, information technology has transformed our lives over the past few decades. As societies transition from being industrial —using mechanization to produce the economic goods and services within a society—to being postindustrial—primarily based upon the processing and control of information and the provision of services—we frequently find ourselves turning more and more to electronic communications media in general and the Internet in particular to communicate with others. In the workplace, this means a heavy reliance on such things as e-mail and teleconferencing rather than the more traditional written correspondence, faxes, or business travel and meetings. At home, this means such conveniences as the ordering of goods and paying of bills online. However, it is not only correspondence that is carried on over the Internet. One can easily use the knowledge base of a manufacturer to determine how to troubleshoot software or repair an appliance. Even medical sites are available so that one can learn about the possible diagnoses for one's symptoms or research alternative treatments. It is also possible on some sites to chat online with a physician or nurse practitioner by e-mail rather than going into the office. These two features of postindustrial society—greater reliance on non-face-to-face methods of communication and the ability to solve one's problem online rather than in person—have combined in the mental health professions to create a demand for psychological services over the Internet. This approach to psychotherapy has a certain logic to it. People are used to communicating electronically and to receiving their information over the Internet. By extension, chatting with one's therapist online is just the application of these principles in the arena of mental health.
This distance approach to psychotherapy using the Internet is known as e-therapy or online therapy. This is a form of psychotherapy that is conducted over the Internet rather than in face-to-face sessions. E-therapy may be conducted using real-time messaging, chat rooms, or e-mail messages.
E-therapy has a number of potential advantages including being more convenient than going to a therapist's office as well as being more private than going to an office and waiting in a public waiting room. In addition, e-therapy can provide a more convenient alternative for getting the help needed to those in rural areas where access to a therapist is exceedingly difficult.
There are a number of potential advantages to e-therapy. First, the Internet allows the therapy client relative anonymity and, perhaps, engenders a concomitant greater willingness to open up to the therapist for the very reason that he or she does not have to see the therapist's reaction. Further, it is theorized that more people needing psychological help might be willing to receive it over the Internet since they do not have to go into a therapist's office with the risk of being seen by others, fear of embarrassment, or unwillingness or inability to get to the office. In addition, e-therapy tends to be less expensive than in-office therapy, another factor that might increase the likelihood that it will be used by those who need it.
As attractive as e-therapy may sound to overly busy professionals in today's society, it is also not without its drawbacks as well. Despite the fact that many of us in the twenty-first century are used...
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