Skype for the Psyche

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Anthony Russo /

Finding the right therapist can feel like a crapshoot. You’re at your most vulnerable, and all you have to recommend your new counselor is that the clinic is near your workplace and she’s available Tuesdays at 5:00 p.m. Online therapists like Carl Benedict, who has been counseling via computer chat since 2005, say it doesn’t have to be this way.

Potential customers evaluate Benedict’s approach on his website, where location is a nonissue. Some of his clients–like Gabriela, who lives 4,000 miles away–prefer the candor of instant messaging over face-to-face counseling, where “she sometimes edited what she was saying to avoid negative facial reactions,” writes Robert Epstein in Scientific American Mind (May-June 2011).

Distance therapy–via phone, video, email, chat, text, and tweet–has gained traction in the psychology community. Doubters “underestimate the warmth and depth of the connections that are formed,” writes Epstein. Even though dozens of studies, hundreds of articles, and thousands of e-clients evaluated since the mid-1990s leave little doubt that distance therapy works just as well as old-fashioned couch time.

A remote counselor offers a number of advantages. Commutes are not a factor, making schedules easier to juggle. Cost is lower. Patients with unusual disorders have access to far-flung experts. There’s no possibility of inappropriate sexual contact between client and counselor. Best of all, professional advice can occur in real time: “Imagine helpful periodic tweets from your therapist arriving within hours or even minutes of when you might have lost your temper or reached for a cigarette,” writes Epstein. For patients working to overcome behavioral demons like bulimia or alcoholism, a counselor who lives in their cell phone may be a lifeline.

The American Psychiatric Association maintains some reservations about e-therapy, recommending at least one in-person meeting before turning to IM or Skype. A very real concern is the potential for psychiatric scammers. Despite e-therapy guidelines established by the National Board for Certified Counselors, Epstein reports that a recent survey indicated “low compliance with standards.” So clients seeking e-advice should stay on high alert for frauds–just as they should with any new therapist, cyber or otherwise.

Have something to say? Send a letter to This article first appeared in the September-October 2011 issue of Utne Reader.

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