online counselling issues
Meaghan Flannery · 3/19/99 at 1:45 PM ET
Hi John... What a huge topic! We may have to discuss this in stages. Firstly some background context defining my work. I have separate concerns relating to my email counselling service for individuals compared to my private online group. In my efforts to explore the viability of email counselling in view of lack of cohesive ethical guidelines, I decided to provide volunteer counselling. I average contact with generally 15 clients per week. Certain clients I respond to daily whilst others weekly or at time intervals inbetween. I instruct clients as to confidentiality concerns and the ability of email to be intercepted. Most clients choose to use a web based email address or delete mail received. Client difficulties range from severe 'self' concerns (ie. axis II) through to general interpersonal difficulties. The latter extends well to the email medium. I am still evaluating the former. For these clients I am aware of the importance of 'doing no harm'. I ascertain whether they are in therapy, why they do not have f2f therapy and attempt to provide a framework which will enable them to seek f2f. Much of this is merely supportive although I have been pleasantly surprised with the growth of some of my clients. Intensive email correspondence has enabled some of my clients to establish a degree of interpersonal connectedness that enables them to self discover. Email correspondence becomes less symbiotic. I will be interested to see whether giving the client control in dictating the frequency of response does lead to sustained 'maturation within the relationship'. Disasters up to date... losing ISP access and not being able to communicate the reason for my absence. I have circumvented this by establishing a site where I log in daily. Clients are aware that if I don't log in then I am unavailable. Another major concern occurred when a client, unbeknownst to me, used my responses as her own when she set up as a 'rape counsellor'. We were able to work through her acting out and resolve this dilemma. However it certainly raises concerns as to the inappropriate dissemination and use of my responses beyond what I intended. Anyway John this has merely scratched the surface. I certainly look forward to your critique. I am aware that removing payment for service avoids many concerns, however it also (from a personal perspective) enables a certain freedom that has been quite revealing in evaluating the use of email as a therapeutic medium.
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