Therapy by Internet May Be More Effective Than You’d Think

Future Tense
The Citizen's Guide to the Future
Aug. 1 2013 11:10 AM

Therapy by Internet May Be More Effective Than You’d Think

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A box of tissues

Photo by John Moore/Getty Images

A soothing voice, the offer of a tissue, a gentle hand on the back—can you imagine the experience of going to a therapist without these comforts? We may be nearing the days when face-to-face human sessions are replaced by cyber-therapy, but at least it won’t look anything like ELIZA.  

A new study out of the University of Zurich treated groups of patients suffering from moderate depression with two types of therapy—traditional, face-to-face counseling and a modified form of cognitive behavioral therapy administered through written tasks on the Internet. Patients underwent a series of eight sessions and were then evaluated for improvement. And guess what—the Internet sessions won.

I mean, technically, patients from both groups “won”—the degree of depression fell significantly in both groups. However, according to the university’s website, “At the end of the treatment, no more depression could be diagnosed in 53 percent of the patients who underwent online therapy—compared to 50 percent for face-to-face therapy.” Perhaps what’s more interesting though is what happened after the sessions. Three months later, depression continued to decline in individuals of both groups, but 15 percent more of the cyber-therapy group saw improvement.  

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It’s easy to dismiss such findings outright because they show yet another example of humans distancing themselves from traditionally face-to-face activities. But there might actually be some benefits to consider here.

When participants were given satisfaction surveys after the treatment, 96 percent of the online group rated contact with their therapist as “personal,” compared with 91 percent of the face-to-face group. That at least means remote psychoanalysis isn’t necessarily robotic psychoanalysis. Furthermore, patients from the online group said they continued to reread correspondence with their therapist after the sessions were over. The researchers don’t say whether it’s likely this had an effect on the online group’s superior post-session results, but having records of your sessions that could be pulled up at any time seems like a considerable benefit. In contrast, face-to-face patients leave their sessions with only a memory of what was discussed.

Certainly, it’s not all positive. As anyone who has ever gotten into a text-fight knows, non-spoken words are easy to misconstrue. I suppose it’s possible that communicating with your therapist by email or chat room could lead to some mental breakdown-causing misunderstanding. Skype seems the obvious answer to this question, though it sort of negates the premise of the study—typed vs. spoken communication. Furthermore, any psych undergrad will tell you this study raises all sorts of huge ethical questions. For one, who wants to submit their deepest emotional troubles to NSA review? Where does HIPAA come in? Does counsel-by-computer handicap psychological professionals by removing non-language cues like body posture and tone of voice? Does never meeting your client decrease accountability in the case of misdiagnosis, prescription of drugs, or suicide?

All of that aside, if medical doctors can telecommute to your hospital bedside, what’s to lose by Internet therapy? Aside from the end-of-the-session hug, of course. But we have robots for that.

Future Tense is a partnership of SlateNew America, and Arizona State University.

Jason Bittel serves up science for picky eaters on his website, BittelMeThis.com. He lives in Pittsburgh. Follow him on Twitter.

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