For the first time in history, a new variation on classical psychotherapy is being explored: traditional face-to-face interactions between patient and therapist are being substituted by e-mail interactions. The question is, can therapy conducted via e-mail really be an effective substitute for in-person therapy?
While the answer is somewhat unclear, the results look promising: a recent study conducted by Queen's University, Kingston, revealed that 12 weeks of Cognitive Behavioral Therapy (CBT) conducted over e-mail improved symptoms of anxiety in adults who suffer from Generalized Anxiety Disorder (GAD).
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CBT is considered to be the gold standard of treatment techniques for anxiety disorders. The positive performance of this study indicates that CBT via e-mail is a more effective method for relieving anxiety symptoms versus no therapy at all. However, whether or not CBT via email is more effective than in-person CBT remains unclear. The good news is, this new e-mail technique for psychotherapy can prove to be a useful alternative to in-person care when services such as CBT are unavailable.
Psychotherapy has been the most popular method for the treatment of mental distress since the 1800s when the founder of modern psychology, Wilhem Wundt, formed the first formal theory for identifying and treating mental illnesses. For many centuries since then, patients have been interacting with psychoanalysts for treatment from various psychological ailments.
Unfortunately, less than one third of adults in America diagnosed with a mental disorder receive treatment, according to National Alliance on Mental Illness. There are many obstacles that prevent people from getting help, especially for those who live in secluded areas or urban areas where there is no accessibility to treatment due to a shortage of mental health professionals. In these situations, online CBT can be a helpful substitute.
E-mail Therapy Limitations
Although therapy via e-mail has the benefits of not needing direct access to a mental health professional, it is still limited by computer and Internet access. Timing of interactions between patient and therapist over e-mail also restricts the patient's ability to ask questions about the material and the therapist's ability to judge the patient's responses to therapy.
While online therapy could be an effective method to deliver treatment to patients who have no access to in-person care, it has not yet been determined whether e-mail can be a suitable replacement for face-to-face interaction. There is simply not enough information about the effectiveness of e-mail therapy versus in-person care.
More About the Study
Conducted by the Queen's University, Kingston, the study enrolled 62 Farsi-speaking adults who were diagnosed with generalized anxiety disorder. The participants lived in Iran and were diagnosed through an hour-long online interview. The study excluded patients who were seeking treatment elsewhere, using medication, and those who experienced suicide ideation. The participants were then randomly divided into one of two groups with 31 participants in each.
Both groups filled out a questionnaire, called Beck Anxiety Inventory (BAI), which measured individual levels of anxiety. Lower BAI scores indicate lower levels of anxiety. The average scores at baseline were about 42 for both groups. The first group then participated in 12 weeks of CBT by e-mail while the other group received no treatment.
After 12 weeks, only the group that received treatment had substantially improved BAI scores. These were the results:
• The CBT online group BAI scores: 19 after 12 weeks and 20 after 6 months
• The no treatment group BAI scores: 43 after 12 weeks and 44 after 6 months
A future study will need to address the costs and benefits of each method and compare the two techniques. In the meantime, however, CBT via e-mail provides a unique opportunity for those individuals who would otherwise have been unable to receive treatment.
Date of original publication: June 28, 2013.
Updated on January 03, 2016 .
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