Site Offers E-therapy

By Christine Walewski, 

Therapy via e-mail has received some negative attention over the past few years from those who favour the more traditional face-to-face method of psychotherapy. Despite this, there are still a lot of sites out there that offer the service. Sites vary in areas of specialty, approaches to therapy and cost. Treatment is offered either per minute, per session or as a bundle fee. Some therapists offer e-mail or online chats in addition to face-to-face counselling.

Patricia Roles, a Vancouver-based counsellor who works both in the eating disorder program and as a social worker at BC Children's Hospital, launched a year-and-a-half ago; her service involves e-mail only. Roles' background is in family issues, however she handles a variety of relationship problems online as well.

"E-mail has become so widespread that now it's so accessible and efficient and the anonymity adds something that you can't get in face-to-face," she said. "You can access people from all over the world, especially people from small communities or rural areas." She initially got the idea from the narrative letter writing treatment she incorporates in the face-to-face therapy she does at the hospital. A series of interviews are carried out with the client, followed by the therapist's response to the client via a letter, which allows the client to reflect on their problems.

Roles says those who would otherwise be embarrassed and tentative about discussing their problems with a stranger could seek e-therapy as a solution. Here, the client is in charge and divulges only what they choose to rather than feeling obligated to respond to questions in person. Roles says the writing itself serves as its own therapy.

"Any time you write something and reflect on it, you're enhancing your critical thinking," she said. "When you write about a problem it helps you to clarify things because you have to articulate them to someone."

Also a potential barrier to asking for help is the perceived commitment involved. As a result, Roles offers an initial inquiry for US$10. Additional sessions cost $30 or $45, depending on the length of the response requested.

"People can tentatively put out a feeler and see if this is something that they want to do or just get a consultation without making a big commitment," she said.

Roles suggests a first-timer to visit a site as if it were their first visit to a therapist's office to get a feel for their style. She offers guidelines for composing the initial e-mail.

In response to those who criticize e-therapy in favour of the traditional method, Roles says that e-therapy is not meant be a replacement for intensive psychotherapy and is not suitable for treating crises, such as suicidal feelings or abuse. For problems of a less serious nature, she says both methods of treatment have pros and cons.

"There's a trade-off there. I think that sometimes yes, you can read someone's emotions when they're in the room, but (via e-mail) people tell me the problem more clearly than I would probably get in a verbal session," she said. "I'm amazed at what you pick up in people's writing that you wouldn't get face to face."

As for the notion that the therapist/client relationship is depersonalized via the online method, Roles says she has developed a personal connection with many of her clients. She says that although the majority of her clients are not ongoing, many send her updates and feedback on how they're doing since treatment has ceased.

If you are going through a tough time, e-mail counseling can be one resource to help you cope. Online counseling is available on this site via e-mail with Patricia Roles who is a registered social worker with over 30 years counseling experience. This is an alternate way to get professional help and support over the internet without leaving your own home. It is less expensive than face-to-face counseling.

Face-to-face counseling is also available for individuals, couples and families living Vancouver. 

Contact number: 604-375-9215

Find out about the cost of e-therapy sessions fees
Find out more about e-therapy with Patricia Roles


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,, Vancouver, BC, Canada

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