New eTherapy sites work within
State Lines
Two new eTherapy mega-sites are restricting their online counseling offerings to clients who live in the same state as the therapist. Until now "Online therapy" sites have taken clients from anywhere in the world. That's the point of the Internet, right? Political and geographical boundaries become meaningless. A therapist in Virginia can see a client in Alaska and provide the same services that they would provide to someone closer to home. This can be a real advantage for the client in Alaska, especially if they live far from traditional mental health services.
Regulatory bodies have struggled with a variety of issues raised by the growth of the Internet. Offshore gambling sites routinely offer their services to customers in jurisdictions where these services are illegal. A jury in U.S. District Court in Manhattan convicted Jay Cohen, 33 of breaking a federal law by accepting wagers on sports events. Cohen ran a company called "World Sports Exchange" in Antigua which took bets over the telephone and Internet. The company claimed that it broke no laws because the gambling took place legally in Antigua. The court disagreed.
Where does "Online therapy" take place? Most therapists assert that it takes place in their own state or province. This is where they are licensed, and they are subject to the rules of their state or provincial licensing board. The courts have not decided this issue - and it is one reason that many therapists have avoided practicing Online. These new sites provide a safer environment for cautious therapists. Therapist and client are in the same state and subject to the same laws.
The sites:
eTherapy.com
(no hyphen)
The developers of this Miami-based site claim to have contacted licensing boards
in all 50 states in the U.S. in order to follow their laws and
regulations. They have used the company Allcare
to recruit therapists, they verify the credentials of all potential therapists, and they require
therapists to complete their training course that teaches the differences
between "etherapy" and psychotherapy. Two psychologists who were
marketing the site to other psychologists at the American Psychological
Association 2000 Annual Convention stated that they have even had discussions with
APA about their site before its launch. (Don't look for
an APA endorsement any time soon. The organization seems to be moving
slowly on this front.) An excerpt from the site:
eTherapy.com intends to reach this population [people with mental disorders who won't seek help] and open a therapeutic door to the masses through education, awareness, destigmatization, cost-effectiveness and confidentiality by deploying a variety of interactive services and content. Our unique functions and features will empower the user with knowledge, choice, convenience and cost efficiency. For mental health professionals and providers, a seamless online healthcare delivery system will drastically reduce administrative, overhead, advertising and associated costs, and give them access to a much larger client base. (eTherapy.com 8/00)
Counselcenter.com
This site is based in Canada and has a similar structure. Clients seeking
Online therapy are directed to therapists who are licensed in their state or
province. The site claims:
Although there are sites attempting to offer similar services, CounselCenter.com will be the first and only site on the Internet to provide clients with private, secure for-pay sessions with licensed psychologists, counselors, and therapists practicing in compliance with local jurisdictional regulations. This means that no psychologist or therapist on our site will be practicing in a jurisdiction where she or he is not licensed (a crime and grounds for loss of license in most places), nor illicitly sharing a percent of revenue with non-licensed "partners" (ditto). (RhonaOnline.com 8/00)
A closer look reveals interesting relationships with other sites that might make some therapists uncomfortable, however. The site appears to be a spin-off from Rhona.com - a site featuring "relationships counselor" Rhona Raskin. If Counselcenter.com is going to be a serious player in etherapy it will need to separate itself from it's roots in Rhona.com, in my opinion.
Is this the future of Online therapy? I'm not sure. I believe that sites that offer services across jurisdictional boundaries will continue to flourish in the near term. It's much easier to offer a wide range of therapists and services if you are not limited by state and provincial laws. The courts may not be kind to these sites in the future, however. If courts rule that these services can only be offered within most states, then sites like eTherapy.com will succeed in the long run. It's possible that these two sites give us a glimpse of the future of eTherapy. Of the two, I'd bet on eTherapy.com to be successful.
- CounselCenter.com - the new site from Canada
- Rhona.com - a sister site to CounselCenter.com
- eTherapy.com - possibly more promising
- ConcernedCounseling.com - one of the largest cross-jurisdictional sites
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