Online Counseling: Advantages, Disadvantages and Ethical Issues

Published: May 17, 2022
online couseling effectiveness ethical issues covid 19
Sofia Kiriakaki
Maria Tzovanou
Anastasia Sotiriou
Maria Lampou
Eleni Varsamidou

The present research aims to study some aspects of online counseling. More specifically, the possibilities, the difficulties, the effectiveness, as well as issues of ethics, which are raised through the internet practice, are being explored in the light of the mental health specialists that provide it. In addition, it is being examined the way in which covid-19 pandemic affected its demand. In order to conduct the research, a questionnaire was completed by 25 Greek experts who provide online counseling services. Then, their answers were quantified and compared with the data of the existing bibliography. The findings are in accordance with it on pros, cons, demand during the pandemic, and the effectiveness of online counseling compared to the in person one. However, a differentiation was observed, concerning the most prevailing way of conducting online counseling and the counselors’ perception of protection of their personal data. Restrictions such as the type of the sampling and the online giving of the questionnaire could affect the results of the research. Future studies could lead to further conclusions, by taking into account the findings and the limitations.

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Andrews, G., Davies, M., & Titov, N. (2011). Effectiveness randomized controlled trial of face to face versus Internet cognitive behaviour therapy for social phobia. Australian & New Zealand Journal of Psychiatry, 45(4), 337- 340.
Barak, A., Klein, B., & Proudfoot, J. G. (2009). Defining internet-supported therapeutic interventions. Annals of behavioral medicine, 38(1), 4- 17.
Barnett, J. E., & Scheetz, K. (2003). Technological advances and telehealth: Ethics, law, and the practice of psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 40(1-2), 86–93.
Barnwell, S. S. (2017). The accidental Telepsychologist: Creating opportunities in burgeoning Field. Career Paths in Telemental Health, 131-138.
Bartle, R. A. (2010). From MUDs to MMORPGs: The history of virtual worlds. In J. Hunsinger, L. Klastrub, & M. Allen (Eds.), International handbook of internet research (pp. 23–39). New York: Springer.
Bauman, S., & Rivers, I. (2015). Mental health in the digital age. Springer.
Bhuvaneswar, C. G., & Gutheil, T. G. (2008). E-mail and psychiatry: Some psychotherapeutic and psychoanalytic perspectives. American journal of psychotherapy, 62(3), 241-261.
Bian, S., & Miller, J. (2020). Online Psychological Counseling: Is It Really Effective?.
Bolton, J. (2017). The Ethical Issues which must be addressed in online counselling. Australian Counselling Research Journal, 11(1), 1-15.
Chandras, K. (2000). Technology-Enhanced Counselor Training: Essential Technical Competencies. Journal of Instructional Psychology, 27(4), 224-227. Retrieved ,14 May, 2022, from
Dores, A. R., Geraldo, A., Carvalho, I. P., & Barbosa, F. (2020). The use of new digital information and communication technologies in psychological counseling during the CoViD 19 pandemic. International journal of environmental research and public health, 17(20), 7663.
Efstathiou, G. (2009). Students' psychological web consulting: Function and outcome evaluation. British Journal of Guidance & Counselling, 37, 243-255.
Erbe, D., Eichert, H. C., Riper, H., & Ebert, D. D. (2017). Blending face-to-face and internet-based interventions for the treatment of mental disorders in adults: systematic review. Journal of medical Internet research, 19(9), e306.
Finn, J., & Banach, M. (2002). Risk management in online human services practice. Journal of Technology in Human Services, 20(1-2), 133- 153.
Finn, J., & Barak, A. (2010). A descriptive study of e-counsellor attitudes, ethics, and practice. Counselling and Psychotherapy Research, 10(4), 268- 277.
Fitzgerald, T. D., Hunter, P. V., Hadjistavropoulos, T., & Koocher, G. P. (2010). Ethical and legal considerations for internet-based psychotherapy. Cognitive Behaviour Therapy, 39(3), 173–187.
Fleming, D. A., Edison, K. E., & Pak, H. (2009). Telehealth ethics. Telemedicine and e-Health, 15(8), 797-803.
Gamble, N., Boyle, C., & Morris, Z. A. (2015). Ethical practice in Telepsychology.Australian Psychologist, 50(4), 292-298.
Griffiths, M. (2001). Online therapy: A cause for concern? Psychologist, 14, 244- 248.
Grohol, J. M. (1998). Future clinical directions: Professional development, pathology, and psychotherapy on-line. In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, interpersonal, and transpersonal implications (pp. 111- 140). Academic Press.
Grohol, J. M. (2004). Online counseling: A historical perspective. In R. Kraus, J. Zack, & G. Stricker (Eds.), Online counseling: A handbook for mental health professionals (pp. 51-68). Academic Press.
Grumet, G. W. (1979). Telephone therapy: A review and case report. American Journal of Orthopsychiatry, 49(4), 574-584.
Haberstroh, S., Duffey, T., Evans, M., Gee, R., & Trepal, H. (2007). The experience of online counseling. Journal of Mental Health Counseling, 29(3), 269-282.
Harris, B., & Birnbaum, R. (2015). Ethical and legal implications on the use of technology in counselling. Clinical Social Work Journal, 43(2), 133– 141.
Holmes, L., & Ainsworth, M. (2004). The future of online counseling. In R. Kraus, J. Zack, & G. Stricker (Eds.), Online counseling: A handbook for mental health professionals (pp. 257- 269). Academic Press.
Hunt, S. (2002). In favour of online counselling?. Australian Social Work, 55(4), 260- 267.
Kiropoulos, L. A., Klein, B., Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008). Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?. Journal of anxiety disorders, 22(8), 1273-1284.
Koocher, G. P. (2007). Twenty-first century ethical challenges for psychology. American Psychologist, 62(5), 375.
Kotsopoulou, A., Melis, A., Koutsompou, V.I., & Karasarlidou, C. (2015). E-therapy: the ethics behind the process. Procedia Computer Science, 65, 492-499.
Kraus, R. (2011). Ethical Issues in Online Counseling. In R. Kraus, G. Stricker & C. Speyer (Eds). Online Counseling: a handbook for mental health professionals. Academic Press, 85-106.
Leibert, T., Archer, A., Munson, M., & York, Y. (2006). An exploratory study of client perceptions of internet counseling and the therapeutic alliance. Journal of Mental Health Counseling, 28, 69–83.
Lessa, N. (2013). Online therapy: The next generation. The 45th Annual Addictions Institute Conference. Retrieved from
Li,Lau, P., Jaladin, R. A., & Abdullah, H. S. (2013). Understanding the two sides of online counseling and their ethical and legal ramifications. Procedia - Social and Behavioral Sciences, 103, 1243 -1251.
Lovejoy, T. I., Demireva, P. D., Grayson, J. L., & McNamara, J. R. (2009). Advancing the practice of online psychotherapy: An application of Rogers' diffusion of innovations theory. Psychotherapy: Theory, Research, Practice, Training, 46(1), 112.
Mallen, M. J., & Vogel, D. L. (2005). Introduction to the major contribution: Counseling psychology and online counseling. The Counseling Psychologist, 33(6), 761-775.
Mallen, M. J., Vogel, D. L., & Rochlen, A. B. (2005a). The practical aspects of online counseling: Ethics, training, technology, and competency. The counseling psychologist, 33(6), 776-818.
Mallen, M. J., Vogel, D. L., Rochlen, A. B., & Day, S. X. (2005b). Online counseling: Reviewing the literature from a counseling psychology framework. The Counseling Psychologist, 33(6), 819 871.
Manhal-Baugus M. (2001). E-therapy: practical, ethical, and legal issues. Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society, 4(5), 551–563.
Maples, M. F., & Han, S. (2008). Cybercounseling in the United States and South Korea: Implications for counseling college students of the millennial generation and the networked generation. Journal of Counseling & Development, 86(2), 178-183.
Martin, A. C. (2013). Legal, clinical, and ethical issues in teletherapy. In J. S. Scharff (Ed.), Technology and mental health. Psychoanalysis online: Mental health, teletherapy, and training (p. 75–84). Karnac Books.
McDonald, A., Eccles, J. A., Fallahkhair, S., & Critchley, H. D. (2020). Online psychotherapy: trailblazing digital healthcare. BJPsych bulletin, 44(2), 60-66. 2019.66.
Μouratoglou, Ν. (2017). Διαδικτυακή Συμβουλευτική: Διερέυνηση απόψεων συμβούλων σταδιοδρομίας αναφορικά με την εφαρμογή της. [Online Counseling: Investigating the views of career counselors regarding its implementation]. [Diploma Thesis, School of Pedagogy and Technological Education].
Novella, J. K., Ng, K. M., & Samuolis, J. (2020). A comparison of online and in- person counseling outcomes using solution-focused brief therapy for college students with anxiety. Journal of American College Health, 1-8.
Papanis, Ε., & Balasa, Α. (2011). Συμβουλευτική μέσω διαδικτύου και επικοινωνία. [Counseling via internet and communication]. Κυριακίδη.
Pontier M., Siddiqui G.F. (2008) A Virtual Therapist That Responds Empathically to Your Answers. In: H.Prendinger, J.Lester, M.Ishizuka (eds) Intelligent Virtual Agents. IVA 2008. Lecture Notes in Computer Science, vol 5208. Springer.
Reynolds Jr, D. A. J., Stiles, W. B., Bailer, A. J., & Hughes, M. R. (2013). Impact of exchanges and client–therapist alliance in online-text psychotherapy. Cyberpsychology, behavior, and social networking, 16(5), 370- 377.
Richards, D., & Viganò, N. (2012). Online Counseling. In Z. Yan (Ed.), Encyclopedia of Cyber Behavior (pp. 699-713). IGI Global. http://doi:10.4018/978-1-4666-0315-8.ch059
Richards, D., & Viganó, N. (2013). Online counseling: A narrative and critical review of the literature. Journal of clinical psychology, 69(9), 994-1011.
Rummell, C.M., & Joyce, N.R. (2010). "So wat do u want to wrk on 2day?": The ethical implications of online counseling. Ethics & Behavior, 20(6), 482- 496.
Sampson Jr, J. P., Kolodinsky, R. W., & Greeno, B. P. (1997). Counseling on the information highway: Future possibilities and potential problems. Journal of Counseling & Development, 75(3), 203-212.
Sayers, J., (2021). Online Psychotherapy: Transference and Countertransference Issues. British Journal of Psychotherapy, 37(2), 223-233.
Spek, V., Cuijpers, P., Nyklícek, I., Riper, H., Keyzer, J., & Pop, V. (2007). Internet- based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological medicine, 37(3), 319–328.
Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical Issues in Online Psychotherapy: A Narrative Review. Frontiers in psychiatry, 10, 993.
Suler, J. (2001). Assessing a person's suitability for online therapy: The ISMHO clinical case study group. Cyberpsychology & behavior, 4(6), 675-679.
Suler, J. (2008). Cybertherapeutic theory and techniques. In A. Barak (Ed.), Psychological Aspects of Cyberspace: Theory, Research, Applications (pp. 102- 128). Cambridge: Cambridge University Press.
Suler, J. (2011). The psychology of text relationships. Online Counseling, 21- 53.
Sussman, R.J. (2004). Counseling over the Internet: Benefits and challenges in the use of new technologies.
Tanrikulu I. (2009). Counselors-in-training students’ attitudes towards online counseling. Procedia Social and Behavioral Sciences, 1(1), 785- 788.
Valentine, L., McEnery, C., Bell, I., O'Sullivan, S., Pryor, I., Gleeson, J., Bendall S., & Alvarez-Jimenez, M. (2020). Blended digital and face-to-face care for firstepisode psychosis treatment in young people: qualitative study. JMIR Mental Health, 7(7), e18990.
Zack, J. S. (2008). How sturdy is that digital couch? Legal considerations for mental health professionals who deliver clinical services via the internet. Journal of Technology in Human Services, 26(2-4), 333-359.
Zur, O. (2012). TelePsychology or TeleMentalHealth in the Digital Age: The Future is Here. California Psychologist, 45(1), 13-15.
Wells, M., Mitchell, K. J., Finkelhor, D., & Becker-Blease, K. A. (2007). Online mental health treatment: Concerns and considerations. CyberPsychology & Behavior, 10(3), 453-459.
Witt, K. J., Oliver, M., & McNichols, C. (2016). Counseling via avatar: professional practice in virtual worlds. International journal for the advancement of counselling, 38(3), 218-236.