Online psychotherapy works. Sessions conducted between patient and therapist via the internet can be just as effective as face-to-face treatment. But it’s not for everyone and, because there’s lots of money to be made, it’s difficult to be sure about the quality of what's being offered.

For instance, in the case of Dutch people living abroad - and indeed expats of other nationalities - it makes sense to choose internet therapy. Such services means that expats can deal with their addictions or psychological problems in their mother tongue and, because the sessions are conducted via e-mail, time differences aren’t a problem either. Internet therapy can also suit people in their home country if, for one reason or another, they don’t want to visit a psychologist or psychiatrist in person.

Online therapy - 4 pointers

• Reliable online therapy institutions are often allied to national healthcare services. This information should be clearly visible on the home page.
• The success rates should be published on the site, with references that can be checked.
• Health-care insurers usually cover bona fide institutions. Never pay direct.
• Contact with the therapist must remain strictly confidential; protected by a login name and password chosen by the patient.

Professor Pim Cuijpers, a psychologist at Amsterdam’s Free University, is also perfectly happy with the meteoric rise of online therapy: “Not only because it offers effective treatment, but also because all sorts of simple tests can be carried out during the course of the treatment with the result that it becomes more tailor-made… Patients can also be very effectively supervised in their assignments…that’s why I’m very positive about the development.”

Not online
However, Professor Cuijpers admits online therapy is not for everyone. People who don’t have access to or can’t use computers are ruled out, as are people who don’t speak the language of the therapist well enough. And, in cases of serious depression where there is a risk of suicide, it’s important that the therapist can see the patient. He argues, therefore, that treatment options which offer traditional face-to-face sessions should remain available.

Therapist Stijn Bornewasser from Interapy Netherlands in Amsterdam has treated a number of Dutch people living abroad. He says their lives as expats heighten their susceptibility to psychological problems.

“Constantly being in the company of one’s family or partner can be depressing. There’s an endless stream of new faces: expat life is made up of comings and goings. People who have lived abroad for some time can get tired of always having to make new friends whom they lose after a few years. Then, there are the guests: family and friends fly halfway across the world and then don’t stay for a few days but for three weeks…”

Loneliness, stress, burnout, alcoholism – all lie in wait. What could be more attractive than one’s own personal therapist, whenever it’s convenient and in the comfort of your own home?

Career
That’s not only true of expats but also of people still resident in their native country. People who know they need help but, for example, don’t want their boss to find out about their addiction or that they may be halfway to a burnout. That could damage their career. Online therapy attracts many people who in days gone by may never have approached a psychotherapist for help.

Quality
There’s one big danger with online therapy: it’s difficult to tell the good from the bad among the thousands of online psychotherapists. This treatment doesn’t come cheap, either, with a relatively simple course for alcohol addiction costing about 1500 euros, and ones for depression coming in at over 2200 euros.

Reputable institutions offer courses of treatment covered by Dutch health insurance, but Professor Cuijpers warns that the chances of being taken for a ride are high. With this in mind, he is pushing for a quality hallmark to be introduced for institutions offering online psychotherapy.

* lead photo by Frippy on Flickr, used under Creative Commons licence