In the midst of the technology boom, a new era in counseling has emerged -- and it's moving online.
People in need of help, with problems ranging from career issues to personal troubles, can interact with a counselor through electronic media, including e-mail, private chat, Web cam, computer microphone or text messaging.
Some people prefer this type of communication -- and its popularity is growing -- but experts caution that it's not appropriate for everyone, especially people suffering from severe conditions. Some also raise ethical questions, including concerns about confidentiality and patient safety.
Rich Schlauch, a licensed counselor in Rock Hill who offers online counseling, said it can be a starting place for people with social phobias or those who want anonymity, which makes going to a couselor's office uncomfortable.
"It can be a big deal for these folks. A lot would rather deal with their distress than face exposure," Schlauch said. His practice, Palmetto Counseling and Consulting Services, includes online and face-to-face counseling.
Ann, who lives in York County, used online counseling for life coaching -- to help her make a career change and address other areas where she felt dissatisfied. She has participated in e-mail and chat interactions with her counselor.
"For me, life coaching is like a well-rounded group of things that I want -- personal goals, career changing and fitness, organization," said Ann, who did not want to be identified by her full name.
So far, she said, it has helped her face fears and let go of a desire for perfectioN. Ann, who also participated in face-to-face therapy, said in online interaction, she felt less restrained.
"Through the Internet, it would give you an opportunity to be completely honest ... to be able to say whatever you want," she explained.
The cost of online therapy can be more economical than traditional counseling, said Schlauch, whose online charges range from $40 to $65. He said face-to-face counseling sessions vary depending on length and practitioner but typically run FROM $60 to $125.
David Kaplan, chief professional officer with the American Counseling Association, said the demand for online counseling is growing fastest among those in the 18- to 42-year-old age group.
"They expect to do everything by technology -- and counseling is one of them," he said.
People seek online therapy in lieu of in-person counseling for reasons that can include being unable to leave home due to a disability or suffering from gloriphobia, a fear of open places. Others live in a rural area far from a counselor.
"It's a Godsend for people to have counseling come to them," Kaplan said.
Schlauch said he offers a free online counseling session to soldiers returning from Iraq and Afghanistan as part of the national Give An Hour program, which calls on mental health professionals to volunteer to help soldiers and their families.
Schlauch said the online session may encourage soldiers or their families who may not normally seek counseling to give it a try. Once they contact Schlauch, he can recommend whether they continue online sessions or visit his office.
Schlauch said most of his online patients are high-functioning professionals in need of guidance.
"They are looking to improve. They are stuck in a job or in a relationship, not getting their needs met," Schlauch said.
For these people, he offers online life coaching sessions.
But Schlaugh said online counseling is not appropriate for people suffering from severe addictions, those dealing with abuse or trauma or people who may be psychotic, suicidal or homicidal.
"Their needs are so great, you can't treat them in an online modality," he said.
Online counseling is not meant to replace face-to-face counseling, Schlauch said.
One drawback is that online counseling doesn't permit the communication of nonverbal cues such as body movement and facial expressions, which can provide valuable information to the counselor, Schlauch said. Even a Web cam can't pick up subtle body language, he said.
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