So why would any business person in their right mind resort to an internet shrink? Research shows that online therapy appeals to people who are embarrassed to talk about personal issues in face to face situations, or who fear the social stigma of seeing a therapist. Acute embarrassment is often referred as the most common reason for people choosing e-treatment. But there are also many other reasons why someone should resort to advice online. For example, he or she may be unable to access traditional therapy because they are home-bound, such as the elderly, physically disabled, or geographically or linguistically isolated. Online therapy is also an option for busy professionals and business people who can use the service from their office or home or even while they are on the move, for example on a train. This type of therapy may also appeal to someone who is seeking a hard-to-find expert.

Until the late '90s, only very few therapists were using the internet in the United States. As the internet and broadband have spread, however, e-therapy is now relatively common in North America and has also obtained a secure foothold in the UK market. For example, UK-based services such as www.OnlineCounsellors.co.uk, an online training programme for future e-therapists, and www.touchthesky.uk.com, a video learning therapy website for children and young adults affected by a learning disability, have already secured an important slice of the British market. The rapid spread of e-therapy technology however means that once again, the authorities have not had time to set up an official body to regulate the provision of e-therapy services. The appearance of e-clinics, however, is a sign that things are moving in this direction. These e-clinics are offering e-therapists online security, credit card billing services and active marketing, while allowing consumers a choice from a list of qualified therapists checked through references and professional bodies. Examples of e-clinics include www.Psychologyonline.co.uk and www.MyTherapyNet.com.

In many other sectors however, online fraudsters are the major challenge for the mental health e-industry. Consumers are advised to work with counsellors and therapists who are licensed or registered with a mental health professional body, such as Britain's Health Professions Council. These are therapists who would gladly provide their potential clients with their full name, office telephone number, license number and even physical location. More information on how to avoid online fraudsters can be obtained on www.ismho.org. ISMHO, the International Society for Mental Health Online, is a non-profit society formed in 1997, when the online mental health treatment industry started growing. Its aim is to promote the understanding, use and development of online communication for the international mental health community. ISMHO does not hold any official position about the benefits or otherwise of e-therapy. 

Online therapy is usually considered a way to seek instant advice in everyday life problems. People who choose it find it to be an ideal way to discuss life's challenges, family issues and anxiety problems. People who suffer more serious problems such as depression, eating disorders or sexual abuse also use it. Research has shown that alcoholics, gamblers or drug addicts are among groups that have shown improvements in their conditions after using online therapy. As broadband becomes more widespread, video-conferencing has become an increasingly popular way of communicating within the e-therapy industry. The visual connection allows the therapist to have access to non-verbal and cultural cues of communication, bringing the therapeutic relationship closer to the traditional one. Patients receiving treatment through video conferencing have reported high levels of satisfaction, according to some surveys. There is also scientific evidence that children with attention deficit hyperactivity disorder respond well to video conferencing, because they are excited by television. 

Continuous technological advances have made it possible for e-therapists to offer a wider variety of treatments, such as art therapy. This is a form of psychotherapy that uses art media as its primary mode of communication. The visual environment offered through video conferencing allows the development of such a creative therapeutic process. It' s no secret in the trade that electronic arts, such as digital photography, computer painting, scanner and photo software programs, can offer clients, even those with sensory and physical disabilities, new ways to express themselves creatively. 

So has the internet made face to face therapy redundant? Not so, warn the experts. For while virtual therapy may benefit certain groups of people and has a lot of future potential, especially when treating the disabled and children, the experts agree that it should not substitute traditional methods of therapy. The relationship created between the therapist and the client in face to face therapy, cannot be replicated in online therapy, even if there is visual communication. For although business people are increasingly making use of e-therapy, they know as well as anyone else that when confronting their problems, as in confronting their lives, there' s no more effective substitute than the real thing. Why else in the age of the internet is business travel still a growth industry?

Vicky Tsiaousi holds a BSc in Educational and Social Policy and a MSc in Art Therapy. She is registered with the Health Professions Council (HPC) and the British Association of Art Therapists (BAAT). She has worked for the Royal Edinburgh Hospital, Schools and Counselling Services around Greece and the UK. She is currently working with children with special needs and is also practising conventional (face to face) art therapy.