IEEE Technology and Society Magazine - December 2019 - 28

mental health services should also
be provided over the Internet, by a
computer-mediated human counselor, by some online self-therapy
available through a video channel
on some streaming service, or by
even by a "Mental Health bot"?
For the sake of discussion, let us
suppose then there are four ways of
delivering therapy and counseling
services:
Face-to-face (F2F);
Technology-mediated face-toface;
■ Guided self-help therapy; and
■ Artificial Intelligence (AI), i.e., a
"mental health bot."
■
■

This article takes the conventional method, face-to-face therapy,
as its baseline, and will be concerned firstly, with a discussion
of the advantages (the good), and
secondly with potential drawbacks
(the bad), of technology-mediated
face-to-face counseling or psychotherapy, or online therapy. This
typically might involve Skype, FaceTime, Zoom, WhatsApp, email and
in some instances, even text messaging. Thirdly, some comments
on AI-based and self-help therapies (the aesthetically challenged)
will be made. Finally, we conclude
with some remarks on the implicit
obligations on professional bodies to monitor technological progress against quality of treatment,
and their role and responsibility in ensuring that considerations
optimizing client health outcomes
should take precedence over bottom-line cost reductions.

The Good
For the purposes of this article, we
leave to one side whether or not digital technologies, such as social
media and SmartPhones, might be
the cause of mental health problems, e.g., through cyberbullying,

28

and other problems, such as visual
and cognitive impairment [3].
Instead, we begin with a discussion
of possible advantages of online
therapy: here we identify accessibility, convenience, affordability, nonstigmatizing, anonymity, and flexibility. We will discuss each in turn.

in comparison to sharing very personal information about themselves
face-to-face with another human
being, online therapy may be much
less threatening

Convenience
Online therapy is convenient. Both
practitioner and client are able to be
more flexible with one another
about timing and indeed the location of sessions. For example, if the
client or therapist is away on business, this flexibility could offer the
possibility that the therapeutic work
remains uninterrupted. Also the
therapist is able to extend their services right across the globe so
appointments could be scheduled
over 24 hours.

Accessibility
Seeking therapy to discuss personal
issues is sometimes not an easy
step to take. Firstly, it takes courage
to find someone in whom a prospective client can confide and sufficiently trust. For many people these
days, communicating via  smartphones or social media isn't a problem, but it remains an issue that
opening up about personal issues
can be so difficult.
Online therapy can, of course,
be more accessible to those who
wish to be supported in that way,
overcoming some of the barriers that might have otherwise precluded them from getting therapy.
For example, individuals who are
housebound due to physical or mental health issues; nursing mothers,
or those living in remote areas such
where trying to access face-to-face
support on a weekly basis is simply
a non-starter.
Accessing support in this way
can remove barriers to finding support. It can also provide a lifeline
for those uncomfortable sharing
with their families and/or those they
live with that they are in distress for
many reasons be it religious and or
cultural ones, or of shame and stigma (see below). In the 21st century,
this can include some men from an
older generation for whom seeking psychological support is akin
to "weakness," failure, or not being
able to "toughen up" and "just get on
with it" as might have been the case
for their forebears. For those who
are uncomfortable, or are suffering
from social anxiety or agoraphobia,
IEEE TECHNOLOGY AND SOCIETY MAGAZINE

Affordability
Therapy delivered online has been
shown to be more economical for
both therapist and client. In the
U.K., many struggle to afford the
therapy they so clearly need and are
often looking beyond state provision
of mental health services due to
lengthy waiting lists. In other countries, where health care is driven by
a profit motive and there may be a
hidden incentive to keep a client in
therapy as long as possible, private
therapy can often be beyond many
people's budgets and online therapy
is a cheaper and more manageable
option. Many therapists themselves
struggle to afford to rent suitable
space so this way of working helps
lower their overhead, commuting
costs, and administration procedures, when compared to more traditional face-to-face therapy services. While some might argue this way
of working reduces the human element of the work, it is one way of
meeting the costs of increasing
demands for mental health treatment, as both the incidence and
seriousness of mental health problems rise in national populations (in
∕

DECEMBER 2019



IEEE Technology and Society Magazine - December 2019

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