Like I'm working on a psychiatric hospital, I think that the face-to-face therapy could be better. When you are in face-to-face diagnostic interview, you have maybe more chance to help and talk with the patient than if you're on a computer interview (which distance you physically). You can create a better link of confidence, especially with patients that suffer of anxiety or mistrust for instance. The human contact is important.

I hope it will help you :)

In some recent systematic reviews, it is indicated that e-therapy is both cost-efficient and clinically efficacious (see links below). Still, many studies conducted are methodologically flawed, and does not always include a suitable control group. That is: They use "waiting list-groups" instead of traditional face-to-face psychotherapy as a comparison. Also, these systematic reviews do not focus explicitly on just visual psychotherapy - but a range of different types of e-therapy.

I would think that even though face-to-face therapy could be better, often it is not available, and for some people - computerized therapy might be a good alternative and work better for some disorders (social anxiety?) etc. Perhaps for some groups, the distance even might make it easier to talk than face to face?

Read more in for example:

http://www.ncbi.nlm.nih.gov/pubmed/22858538

and

http://www.ncbi.nlm.nih.gov/pubmed/21085550

So far not yet, maybe. People still are not "digital", still need the touch, which may soon change. When the tactile experience is der only in the brain(and do not need the tactile sense), then yes the "e-therapy" will be a reality.

According to littérature, therapeutical alliance is very similar when face-to-face and visuo-conference are compared (in fact the therapists were the ones that saw a difference in alliance, but the patients did not). Efficacy of the intervention was also similar. This means would have to be combined with regular visits for pharmacotherapy. Here is a good reference that would discuss this subject: Assessment of the therapeutic alliance in face-to-face or videoconference treatment for posttraumatic stress disorder. Vanessa Germain, André Marchand, Stéphane Bouchard, Stéphane Guay, Marc-Simon Drouin. Cyberpsychology, Behavior, and Social Networking 02/2010; 13(1):29-35.

Yes, it definitely is effective. There have been several systematic reviews indicating effectiveness. From my clinical experience I also think that for some people and in some circumstances it can be even more effective than in-person therapy. For example some people with anxiety disorders may drop out of therapy because of performance anxiety, ie "I'm too embarrassed to go back and see my therapist because I haven't done my homework", and they may do much better with a structured internet based treatment which they can go through at their own pace. Which reminds us that it might not be our amazing therapeutic skills or ability to form an alliance which is the important factor assisting that particular client to change. Of course it very much depends on the individual and the type of presenting problem; I can't imagine this working for someone with borderline personality disorder, for example. Though I could be wrong! There have also been qualitative reports of some clients preferring video to in-person consultations with psychiatrists, because they feel less threatened with the greater sense of distance. Also the clients like the fact that only one person can talk at a time (this is due to the half-duplex audio when both parties are on speaker phone), so there is less interruptions and more turn-taking in the interaction. Video consultations would not work as well for all types of therapy; I think it would be difficult to use action methods.

Yes, the (slowly) increasing research suggests that online counselling can be equally effective as it's f2f counterpart. (Taylor & Francis carry a number of titles of online counselling research based outcomes)

I have been working online now for over 10 years offering asynchronous (email) and synchronous (using 'real time chat') and like Victoria, I can offer anecdotal 'evidence' from client feedback that they found it to be helpful in addressing difficulties.

There are limitations to online working and issues such as presenting problems and risk need to be carefully thought out and approached to ensure that working remotely is the most suitable option for clients, so the assessment process is especially important.

Drawbacks include the need to be computer literate and to have a good handle on things like confidentiality, data protection, online security etc along with being able to impart this information to clients in a way which is easily accessible, so like assessment, contracting is another key issue - which also includes legal aspects (e.g. jurisdiction, intellectual property rights) which differ from f2f work.

In the UK counsellors/psychotherapists who are members of the BACP are expected (under the Ethical Framework) to have specialist training for their online work, which given the above, makes a lot of sense and reduces the risks of working using technology.

For some clients the psychological barriers to accessing f2f therapy is overcome using an online medium, for others it is convenience or a seamless way of communicating (as they have grown up with/grown into this medium), there's the reduced costs and travel time and of course that emails can be sent at any time of the day or night which fits into some lifestyles and working patterns (e.g. shift workers).

This way of working is still developing and as technology continues to advance it becomes harder to pin down comparatives between f2f and online (the online definition goalposts keep moving) however, imho there is definitely a place for it and a demand for these services.

If you would like some specific research references let me know........

For example, a 2008 meta-analysis of 92 studies found that the differences between Internet-based therapy and face-to-face were not statistically significant (Journal of Technology in Human Services, Vol. 26, No. 2).Similarly, a 2009 review of 148 peer-reviewed publications examining the use of videoconferencing to deliver patient interventions showed high patient satisfaction, moderate to high clinician satisfaction and positive clinical outcomes (Clinical Psychology: Science and Practice, Vol. 16, No. 3).

In addition, a 2010 study in the Journal of Clinical Psychiatry (Vol. 71, No. 7) found that videoconferencing can be successful in treating post-traumatic stress disorder. In that study, researchers compared the effectiveness of 12 sessions of anger management therapy delivered via video to in-person delivery of the same treatment to 125 rural combat veterans with PTSD. The researchers found that the video-based anger management therapy was just as effective as the face-to-face care.

SOURCE: http://www.apa.org/monitor/2011/06/telehealth.aspx

Online psychotherapy if viewed as a serious educational awakening of the client is similar to medical practice seeing patients online. Depending on the content, how comfortable the patient and therapist are in that setting. Similarly, to education, medical sessions. Equally there are still personality contrasts that may not work, however, if cameras incorporate entire person and their entire self is visible then psychotherapist should still note important issues and state of patient.

The VA in the US has been using remote therapy with veterans for a number of years. I don't have the citation, but there are papers describing the impact it has had along with the financial benefits realised. They have expanded their footprint in remote therapy to develop a suite of mobile apps as well.