Abstract
BackgroundThe provision of psychotherapy over distance using technology is a growing market reaching many patients and therefore the risks and benefits need to be known by all psychotherapists whether they themselves practice online or not. This comprehensive review of the main ethical arguments for and against different forms of online psychotherapy aims to enhance discussion of ethical issues in this growing area.MethodsA search of three databases (PubMed, PsycINFO, Web of Science) was conducted in August 2019 using a specific search protocol yielding 249 publications.ResultsOf 24 ethical arguments in favor of online psychotherapy and 32 against, the top five ethical arguments in favor of online psychotherapy were (1) increased access to psychotherapy and service availability and flexibility; (2) therapy benefits and enhanced communication; (3) advantages related to specific client characteristics (e.g. remote location); (4) convenience, satisfaction, acceptance, and increased demand; and (5) economic advantages. The top five ethical arguments against engagement in online psychotherapy were (1) privacy, confidentiality, and security issues; (2) therapist competence and need for special training; (3) communication issues specific to technology; (4) research gaps; and (5) emergency issues.ConclusionsThe findings may be of help to practitioners in deciding whether to engage in online psychotherapy, and in informing patients about risks and benefits, improving ethical guidelines, and stimulating further ethical discussion. The findings are argumentative and qualitative in nature, and further quantitative research is needed.
Highlights
Technological innovation has led to rapid change in many professions, bringing both benefits and challenges
Since the late 1990s, a growing body of research has addressed issues related to online psychotherapy
The aim of this review is to summarize the main ethical arguments for and against the provision of online psychotherapy to further ethical discussion within the relevant professions, and to facilitate the development of comprehensive ethical guidelines to underpin the practice of online psychotherapy
Summary
Technological innovation has led to rapid change in many professions, bringing both benefits and challenges. The term online psychotherapy encompasses all such terminological variants, including telepsychology [see [2]], telepsychiatry [see [1]], online counseling [see [3]], behavioral telehealth, telemental health [see [4]], internet therapy [see [5]], internet counseling, online practice, online therapy, e-therapy, cyber-counseling, cyberpsychology, e-social work [see [6]], and emental health [see [7]]. The provision of psychotherapy over distance using technology is a growing market reaching many patients and the risks and benefits need to be known by all psychotherapists whether they themselves practice online or not This comprehensive review of the main ethical arguments for and against different forms of online psychotherapy aims to enhance discussion of ethical issues in this growing area
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