About Therapy Online 

Photo by Pat Roles

Patricia Roles' Virtual Counseling Room
E-therapy or e-counseling is counseling over the internet using e-mail:

Some e-therapy sites offer therapy via synchronized chats, however, this site uses only counseling by email. The extensive access to e-mail has brought new opportunities to communicate online. Skype sessions are available, however, hourly fees apply. Patricia Roles also offers face-to-face individual, couple and family therapy for those who live in the Vancouver, B.C. area.

E-therapy or e-counseling is a way to receive counseling online at a distance through email:

It is a fast, easily accessible, cost effective, time efficient, way to access a professional from your own home at whatever time of day works for you. It can be particularly convenient if you travel or have a hectic life without time to think until the end of the day when your home is quiet. It is also accessible for those with physical limitationswho may find it challenging to leave the house, or for those who do not live near specialized counseling services.  Some individuals engaged in face-to-face therapy choose email or skype as alternatives when traveling.

E-therapy is not suitable for everyone's needs:

It is not intensive psychotherapy. It is not suitable for diagnosing or treating psychiatric illness. It is not an effective means of responding to crises such as: suicidal feelings, homicidal feelings, abuse, trauma, or acute psychiatric symptoms. 

If you are feeling suicidal, you need immediate support. In the USA, you can make a free call to the National Suicide Hotline at: 1-800-784-2433. Anyone worldwide with a mental health crisis can contact the Good Samaritans through their website at:

Mental Health Crisis Line - Samaritans: Help with Self-harm or Suicidal Feelings
Cyber Counseling via Skype:

Counseling from a distance is also offered with video conferencing through Skype. As this is in real face-to-face time, then the hourly fees apply.  



E-counseling Fees:
1 session: $65        (US funds)

3 sessions: $180      (US funds)

Face-to-face Office or Skype Sessions:

1 hour session: $140 (CDN funds) 

Payment can be made with your credit card via Paypal
Office Location: Vancouver
1210- 750 West Broadway, Vancouver, BC, Canada V5Z 1J2

What to Write in Your First Email Session:

Once you click below to begin an e-mail session, it will take you to a page with information about what is helpful to include.


How Online Therapy via Email Can Help:

Collecting thoughts by composing an e-mail brings critical thinking Reflection promotes clarity Writing about your dilemmas brings a therapeutic release in and of itself Writing allows expression of feelings and ideas Writing makes problems tangible and concrete as they become more visible in print Thinking and writing allows for discovery about the problems you are facing. Critical thinking generates new ideas and potential solutions when you feel stuck.

What to Expect from the Online Therapist:

The response to your email will include feedback through comments and questions to help you explore the problems more fully and to promote self-awareness, self-reflection and potential solutions. Questions and comments will be designed to help you express yourself, look at factors that precipitated or perpetuate the problem, how the problem got a grip on your life to become familiar and safe, how the problem has been an attempt to cope, and how to build on your strengths to find new possibilities for the future.

Therapy online is most suited to men and women who are:
  • seeking brief consultation about solutions to a particular problem

  • adapting to major family change and decisions before or after separation or divorce or family moves

  • dealing with the overwhelming feelings with multiple pressures or challenges in life 

  • working on personal growth, change or improved emotional well-being

  • needing guidance with life transitions, mid-life crises, career changes or loneliness

  • facing difficult decisions or adjustments

  • dealing with issues related to adoption, blended families, single parenting or step-parenting

  • desiring bereavement support with grief and loss brought about through death, pregnancy losses of miscarriage, stillbirth, abortion, relinquishing a baby for adoption, and other losses such as separation or divorce, disability, loss of fertility, loss of a special relationship or loss of a job

  • dealing with the relationship and communication challenges facing marital couples, partners or single parents parenting infants, children or teenagers, conflict between parents and teenagers, and contending with the stage of adolescence

  • managing stress of work or other life pressures and demands

  • wanting to improve marital or couple relationships, or family communication within your nuclear, blended or extended family

  • working through issues with your parents, extended family members, siblings or partner's family

  • surviving your illness, health crisis or living with a chronic health condition, a friend's illness or that of a family member such as child, parent or partner

  • care-giving for elderly parents while being a parent to your own children: balancing your needs and the needs of others in the sandwich generation

  • adjusting to having a baby, child or adolescent with a chronic or life-threatening illness, special needs, a disability or a health condition

  • coping with distress through weight or food issues on the continuum from anorexia, bulimia, or obesity through to eating disturbances, picky or fussy eating

  • living with family members suffering with eating disorders, especially parents who are supporting children, youth or young adults facing anorexia, bulimia or obesity

  • adjusting to adoption reunion or needing support as adoption triad members search for adoptees, birth siblings, or birthparents, or any issues related to birthparent counseling or the adoption triangle

Life's problems can interfere with relationships, happiness, home and work life, mental and physical health, and a sense of inner peace. Problems can overwhelm you to the point of feeling stuck, powerless, distressed, angry, sad, anxious, tense, or helpless. E-mail counseling may help you to clarify and articulate your concerns so you can begin to address issues in your life and sort out where to put your energy. It may assist you to regain a feeling of control, trust your decisions, explore potential solutions to problems, reflect on future possibilities, feel support, feel listened to, realize your own strength and resources, and promote a sense of well-being.

This approach to dealing with problems relies on a narrative story. The strength of e-mail therapy is that it is written , and this will appeal to some people and not others. Using the written word to express yourself can overcome obstacles for some who live with speech limitations or hearing impairment. This method of e-counseling requires that you are reasonably comfortable with reading and writing which does not appeal to everyone. Some people find it hard to put feelings into written words. Others might be perfectionistic and find that writing down thoughts, ideas and feelings takes an inordinate amount of time because of worry about finding exactly the right words or constructing the sentences perfectly. Grammar and spelling are not essential. It is important to be able to communicate the essence of your experience and needs. The method of counseling you choose to engage in needs to fit with your personality, comfort level and strengths.

I would encourage you to keep copies of the e-mails you send as well as those you receive. Often times people have a hard time recalling what actually was said in face-to-face therapy sessions, especially when emotions are intense. E-mail therapy sessions provide you with a permanent account of the written interaction both of what you described and the response. This can then can become similar to writing in your own journal. Writing about problems and feelings in journals is a well utilized therapeutic tool. You may also keep additional notes for your own recollection and reflection.

With e-therapy, you can take as much time as you need composing your email and rework ideas as they develop if you want. You are not bound by a time-limited face-to-face session to explain the difficulties you are facing. There is no rush. You have time to think carefully. With e-mail, you have the opportunity to compose the e-mail, save it and come back to it later to review before sending. You may find this process helpful for self-reflection.

Some people like the written aspect of e-mail communication as it takes away any barriers of face-to-face awkwardness that might arise if you need to describe sensitive or emotional material. There is a sense of anonymity with e-mail. Some people are able to say things through e-mail or voice-mail that they would not feel comfortable saying to someone face to face.

Overall, online counseling with email is a therapeutic process involving writing rather than face-to-face meetings. You may find this process helpful, depending upon the type of problems you are facing in your life. E-therapy is one alternative and is not a replacement for traditional face-to-face psychotherapy. You need to read all the information on this site to evaluate for yourself if it seems appropriate for you.

Art Therapy Over The Internet:

If you enjoy art as a means of communication and expression, it is possible to scan your artwork and attach it to your email. As a registered art therapist, I find art a wonderful avenue of expression of feelings, exploration of the impact of problems, and way to look at your strengths and potential solutions when you feel stuck with a dilemma, conflict or painful experience. I do not interpret your art. I encourage you to explore your own art and find your own meaning in your creations. You might want to consider art therapy over the internet as an addition or as an alternative to your written e-mail counseling session. Art therapy is a particularly effective way to work on issues such as grief and loss following separation, divorce, death, pregnancy loss or birth-mother relinquishment. If you do not have the ability to scan and attach art to your e-mail, then I can coach you with your own private art journaling process. You can inquire more about art therapy through the feedback email on this site.

Art therapy is available face-to-face in Patricia Roles' Vancouver office for individuals residing in Vancouver and the lower mainland. Art therapy is a particularly good way to express yourself, particularly in times of distress when talking may be hard. In art therapy it is the process not the art product that is important. You do not need to be able to be technically good at art to use art in therapy. In fact the less you worry about how the end result looks, the more therapeutic and freeing the process can be. The saying is that a picture says a thousand words. Art is a mirror into yourself and can help you learn about yourself as you find your meaning in art images you create. Using lines and color to make images can help you to understand what you are experiencing, provide a way to express thoughts and feelings, and to work find solutions to defeat the problem you are struggling with. For individuals who enjoy their creative side and have a comfort with the art-making, this medium can add another dimension to therapy. Children and youth tend to be attracted to art therapy rather than talking therapy, however, it is also just as useful for adults.

Online Counseling Support During Loss and Bereavement:

When you experience loss and grief, online counseling via e-mail is an easily accessible, private way to deal with all types of pain from loss. It can be especially useful for those losses where you may feel shame or guilt that can deter you from seeking face to face help. Those around you may feel that you should be "back to normal" and be past the grief, whereas the grief process takes a lot of time to process and can't be rushed. Each person is an individual and you need to take whatever time is necessary to move through the grief. There are may different types of losses in addition to loss through death that bring a grief reaction. Some types of other losses include birthmothers and birthfathers who have placed infants or children for adoption, miscarriage, stillbirth, loss of fertility, abortion, separation or divorce, loss of job, moving, bankruptcy, or loss of your own good health or the diagnosis or illness of another family member. Sometimes you can be experiencing a grief reaction and don't realize that you are coping with loss, perhaps multiple losses such as those that happen with separation and divorce. For instance, loss with marital separation may include not just the loss of the partner, but loss of time with children, change of homes or community, loss of identity, loss of financial resources, loss of contact with partner's extended family and potentially many more. Many times you might not realize the multiple losses that you are facing until you feel overwhelmed.

Online Support in Adoption Search and Reunion:

Adoption reunion between birthparents and adoptees is a complex situation that involves various losses. Although search and reunion can feel like a positive process, it can evoke unresolved feelings of loss related to the adoption for adoptees and for birthmothers and birthfathers. Adoptive parents may also fear the loss of their adopted children. There are other losses involved in adoption reunion such as unmet expectations and disappointments, searching and finding that the other person does not want to make contact, or finding the individual has passed away. Adoption search and reunion is full of highs and lows, adjustments, new relationships and effects on current family relationships for everyone in the adoption circle. As a reunited birthmother, my experience has helped me to understand the process and to coach others via e-counseling through this personal journey. If you are considering search and reunion, e-therapy may be a helpful resource as many individuals navigate this highly emotional path without much preparation.

Article written by Patricia Roles on Adoption Reunion:  Adoption Reunion - A Journey for Birthparents
E-therapy for Parents of Children or Youth with Eating Disorders:

As a parent of a child or adolescent with an eating disorder, you need support to help you and your family cope with the impact of the eating disorder on your life. It turns family relationships upside down as the eating disorder has so much power. You may react in fear with the life-threatening component of anorexia or bulimia and end up bargaining with the eating disorder to keep peace. This results in giving the eating disorder more power. Sometimes adolescents do not feel ready for professional help, and you are left trying to cope at home. If you do not have access to face-to-face parental or family therapy, then e-mail therapy may be one avenue of support to help you manage during this time of crisis. If you live in the Vancouver, BC area you can access face-to-face sessions with Patricia Roles who has over 30 years counselling families with children and youth suffering from eating disorders. She has training in Family Based Therapy (FBT) which is evidenced based and recommended treatment for children and youth or anyone living at home with an eating disorder.

You can read more about issues for parents in this article: Children and Youth with Eating Disorders,
Online Counseling for Individuals with Hearing, Visual, Oral or Physical Challenges:

Computers have brought an incredible expansion of opportunities for individuals with a variety of physical and sensory challenges. The internet now brings services, such as counseling, to your own home through email. If you are hard of hearing or hearing impaired, sign language interpretation is no longer a barrier with the internet. The strength of email counseling is that it relies solely on the written word. If you have visual, speech, or physical challenges that limit your access to face-to-face psychotherapy, e-therapy may be open up possibilities for you.

Book Review by Patricia Roles
Book Entitled: Online Counseling - A Handbook for Mental Health Professionals
Editors: Ron Kraus, Jason Jack and George Stricker

Online Counseling Handbook for Mental Health Professionals
Patricia Roles' Virtual E-counseling Room, MSW, RSW, BCATR
Registered Social Worker #03316
Registered Art Therapist #0075-R 

Therapy accessible face-to-face or via e-mail and Skype

          Skype address:  pat.roles         

Phone or Text: 604-375-9215



Patricia Roles, Virtual E-counseling Room, e-mailtherapy.com

Burnaby, BC, Canada

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