Chapter 15: Internet-Based Counseling
Chapter Overview
The author highlights the important considerations for the mental health practitioner considering Internet-
based work. Included is a thorough discussion of Internet counseling modalities, online counseling
considerations, ethical and legal issues, professional standards and accreditation, informed consent, online
counseling skills, client assessment, and multicultural considerations.
Key Words
Telecounseling – Technology assisted counseling with the use of either a telephone or computer.
Encryption – Ordinary converted into a code.
Informed Consent – Share with client the parameters of confidentiality.
Multiple Choice Questions
1. The book discussed several synchronous counseling modalities. Which of the following is not a
synchronous counseling platform?
a) Video conferencing
b) Virtual reality counseling
c) Chat counseling
d) None of the above
2. Which one of the following is not a required element of an Internet-based counseling informed
consent according to the ACA Code of Ethics (2005).
a) The risks inherent in counseling
b) Explanations about the process of counseling
c) Explanations about the technical limitations of internet-based counseling
d) All of the above
3. Spacing and pacing refers to a technique used in text based counseling whereby the counselor does
what?
a) Controls the flow of the session with punctuation and spacing of text
b) Allows the client to control the session through punctuation and spacing of text
c) Uses silence to achieve therapeutic intensity
d) None of the above
4. Which one of the following is a major criticism of asynchronous counseling work?
a) Unequal access to the technical elements of the work
b) Technological failure
c) Counselor error stemming from lack of verbal and facial cues
d) Non-professional nature of the sessions
5. Currently, several ethical issues face Internet-based counseling. Which one of the following ethical
concerns has the most profound legal implications for counselors?
a) Lack of insurance reimbursement for online services
b) State license and jurisdictional issues due to lack of reciprocity
c) Encryption issues
d) Both a and c
6. Which one of the following is a popular use for computer-assisted counseling?
a) The treatment of alcoholism
b) The treatment of grief
c) The treatment of anxiety disorders
d) The treatment of somatoform disorders
7. What populations may be underserved by Internet-based counseling work?
a) Minority groups
b) Individuals with limited education
c) Older individuals
d) All of the above
8. Identify which of the following is a strength of Internet-based counseling?
a) Availability
b) Lack of regulation
c) Ability to serve individuals from across the country
d) Shorter treatment times
9. It is recommended that counselors considering Internet practice need to do what?
a) Buy the appropriate technology to begin
b) Receive additional training prior to beginning a Web practice
c) Find a web-based supervisor
d) None of the above
10. Liability in Internet based counseling is
a) Lessened due to the medium
b) Similar to FTF counseling with a few modifications
c) The same as FTF counseling
d) None of the above
11. Video-conferencing most often involves what?
a) A client talking to a practitioner from home, practitioner in an office
b) A client talking to a practitioner from an office, practitioner in another office
c) A client talking to a practitioner from home, practitioner in an office
d) Any of the above
12. Modern encryption technologies make Internet-based counseling:
a) A failsafe and secure activity
b) A feasible endeavor with the proper education and software
c) A risky activity at best
d) A serious threat ethically for the mental health counselor
13. Seeing clients on the Internet who choose to remain anonymous is:
a) A viable way for some clients to seek help
b) An ethically risky practice for the practitioner because of identity and emergency issues
c) Should never be done except in cases where the counselor is anonymous too
d) Is becoming a less and less popular practice
14. Which of the following Internet counseling modalities is believed to be the most similar to face to
face counseling?
a) E-mail counseling
b) Chat based counseling
c) Video based counseling
d) Message board counseling
15. It is recommended that counselors working via the Internet do what in regards to social networking
sites.
a) Take their personal information off all of their networking sites
b) Not participate in these sites
c) Participate freely and decline clients as “friends”
d) Develop a social networking policy and explain this to clients
Activities
1. Search the Internet for online counseling practices. Select one and determine if it meets the
professional practice standards outlined in the ACA Code of Ethics (2005). What strengths and
weaknesses do you see?
2. Locate and visit a mental health bulletin board, discussion board, or listserv. Determine if it is self-
help, support group, or a practitioner moderated site. What type of information is being shared? Would
you recommend this site to a client? Why or why not?
3. Select a software package or program discussed in this chapter. You may choose an e-mail provider,
messaging software, video sharing program, or virtual reality platform. Research this site completely to
determine if the parameters of confidentiality necessary for counseling are met. Describe how they are or
are not sufficient and what steps you could do to improve this if needed.
Discussion Questions
1. One of the most compelling things about the Internet is the comprehensive nature of information
available to the worldwide public. Take about 20 minutes and use multiple search engines to locate
information about yourself on the Internet. Answer the following questions:
• What did you learn about yourself?
• Was that information located posted by you? If not, how did it get there?
• If you were a client, would you want your counselor to know all of this and include it in their
assessment of you? Why or why not?
2. Culturally competent assessment and treatment is an ethical requirement. How can you assess cultural
parameters in Internet-based work? Describe how you would do this for each of the Internet based
counseling modalities discussed in the chapter.
3. You are an online counseling practitioner who utilizes chat and video counseling modalities. As such,
you advertise on the web and are wondering if you should use your personal Facebook page for
professional as well.
• What advantages do you see in using your personal Facebook page for professional purposes?
• Can your page be used for both personal and professional use?
• Assuming you did decide to use your Facebook page professionally, you would need to develop a
social network policy. What would this policy say and why?
Multiple Choice Questions – Answer Key