IEEE Technology and Society Magazine - December 2019 - 29

the U.K., especially the young [4],
but also reportedly because of the
Brexit referendum [5]).

it is considered to provide a vital
tool for emotional reparation. Given
that this form of online therapy is
an interactive form of therapeutic
writing, interventions delivered in
this environment may be quite
effective in encouraging clients to
express themselves more thoughtfully and insightfully. Having a written record also allows the client
to have some point of reference
in future exchanges and especially
when reviewing their work and evaluating some of the changes that
have been achieved.

Nonstigmatizing
Online therapy can also be effective
in significantly reducing some of the
social stigma associated with being
in therapy. It allows access to such
services in private without having to
visit a physical counseling service -
there is no chance of being seen in
the waiting room by others, be it by
other clients, staff, etc. Therapy can
adopt a very different form when
executed by the client in their own
home through a computer or other
such device.

The Bad
Inevitably, perhaps, there are several potential disadvantages with
online therapy. A number of limitations can be identified. Thes include
the lack (or even loss) of verbal
cues, and issues of security and
confidentiality, efficacity, good faith,
ethics, and boundaries, as well as a
number of challenges presented by
the technology itself.

Anonymity
As such, those clients engaging with
online therapy are offered some
degree of anonymity that may help
reduce such stigma and so prompt
them to seek support more readily,
confidently, and comfortably. Some
forms of online therapy can potentially help clients to communicate
more openly without any concerns
for bias such as gender, ethnicity,
physical appearance, age, etc. This
might help the client feel more comfortable with self-disclosure, which is
something that many might find
more threatening in a more traditional face-to-face therapeutic setting.

Lack (Loss) of Nonverbal Cues
With online therapy, verbal and
non-verbal cues and some body
language are sometimes not visible to the therapist. Verbal and
nonverbal interactions are key for
gauging what the client might be
feeling, thinking, and experiencing
in the "here and now." Traditional
face-to-face therapy relies at times
on both verbal and nonverbal
cues as a form of communication and as a way of gaining some
insight into the clients' feelings
and thoughts about their experiences and issues.
With online therapy, tone of voice,
facial expression, body language,
and eye contact are either completely missing or unclear, which might
be due to the low quality of service
provided by the network. This might
preclude the therapist from making
sense of such key cues.

Flexibility
Therapy that is delivered via the
written word, such as a series of
secure emails, can offer client and
the therapist alike a way to pay
closer attention to their thoughts
and feelings prior to expressing
them verbally. Clients may be more
comfortable communicating their
distress in this type of environment
as they are not affected by nonverbal cues.
Some find that writing during
times of heightened distress can be
particularly helpful for clients as
DECEMBER 2019

∕

IEEE TECHNOLOGY AND SOCIETY MAGAZINE

Security and Confidentiality
Therapists have an ethical responsibility to maintain their clients' confidentiality and with online therapy
there is an increased risk of this
confidentiality compromised particularly with therapy that takes the
form of the written word (email for
example). Most sites have appropriate software that protects confidentiality, but it is absolutely key for
practitioners to ensure that they do
research into, and then upgrade the
software used, in order to prevent
any inappropriate security breaches.
In the EU, the introduction of the
General Data Protection Regulation
(GDPR) in May 2018 has given therapists the opportunity to revisit and
or implement this vital aspect of
their work.

Efficacity
The efficacy of online therapeutic
interventions has come under scrutiny since, to date, there has not
been much formal research on this
way of working. Some professionals
fear that a lack of "proper" face-toface interaction might mean that
they might miss a vital clue, thereby
potentially putting their client at
more risk of being in crisis.

Bona Fide (Good Faith)
Potentially, a client working with
their therapist online has no assurances about their training and qualifications, and this could expose
them to exploitation from inexperienced, unqualified individuals purporting to be a bona fide therapist.
Therefore, it is essential that wouldbe clients be referred appropriately
to credible and established counseling services and independent therapists. Equally, the clients themselves should source the requisite
support through recognized and
established organizations such as,
in the U.K., the British Association
of Counseling and Psychotherapy

29



IEEE Technology and Society Magazine - December 2019

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