We are in a new age of therapy and coaching: Where practitioners once counseled their patients on-on-one (remember the iconic therapist’s couch?) it is now increasingly done online. The couch has transformed into a Skype video screen, or, in other cases, text on a phone screen.

Dr. Pat Williams, psychologist, author, and a master certified coach, says that a downside to handling such cases online is the inability to actually see or be with the patient to assess their condition. “That concerns me,” he says, acknowledging also that a new generation prefers to handle all of its business online.

“The challenge in online coaching is that people send emails and if, in those emails, a different font is used or the grammar isn’t good, this online content can be misconstrued.”

This is cause for caution. Non-verbal cues that arise from text-based communication often provide valuable information during conversation: How is the person sitting? What are they doing with their hands? Are they looking at you when they speak? What is their overall demeanor? Because of this, miscommunication may be more likely with interactive email communication.

Another downside to online therapy: anonymity. Many people avoid treatment for reasons of shame or privacy. Adding to the problem is the fact that some online therapists do not require patients to fully identify themselves. What if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient?

In short, says Dr. Williams, anyone involved in administering online care needs to be careful of giving advice to a person in a fragile state. “You should be able to pick up that frame of mind from a posted statement.” But what if someone texts a disturbing statement and the counselor texts back, asking if the person is thinking of harming himself, and doesn’t hear back?

“How do I know when they’ll get back to me? It’s not the same as a phone call,” Williams asserts.

Generally, he advises, be careful of what you put out there as a healthcare professional and where you put it. Don’t post advice to someone on social media sites such as Facebook. Find a secure way to communicate and outline parameters ahead of time so there are other communication options open to you if you feel a problem exists.

The online world presents many benefits and challenges. Know these ahead of time before offering online counseling. Otherwise, if something happens to your patient, you could be sued for what you posted or texted.

Download PDF

About the Author

Avatar photo

CPH Insurance

Over the last decade, more than 500,000 people chose CPH Insurance for liability insurance. Because our business is specialized, we are able to focus on your liability needs in a way that bigger companies are not. Our team of associates represent over 50 years of collective experience in this field, and we are able to serve a large client base while maintaining a small-office approach.