Sex Therapy
On Call
However, Coleman said, license jurisdictions are rarely
called into question unless a therapist is charged with some form of
abuse, or a local professional guild launches an investigation. " .
. . What you have is a regime that is in place to punish people
after the fact but that for all practical purposes does very little
in almost any profession," he said. He said he's unaware of any
cases that stemmed from a distance therapy relationship.
Privacy is also a concern. As with any Internet-based
exchange, there is always the risk that personal information will
appear in the public domain.
Brame, Michael's therapist, who works often with clients by
e-mail, said her clients are less concerned about the threat of
broad privacy breaches than about the possibility that a spouse or
child would accidentally open a sensitive e-mail. Nonetheless, she
said, she always advises clients against using a work-based e-mail
account, which can be filtered or monitored.
Barratt complains that online sex therapy provides little
accountability, for the therapist or the client. Therapists don't
know if a client is following advice. Clients don't know if a
purported therapist is qualified. Clients, he said, "don't really
know what they're getting. They know somewhere in their minds that
the therapist doesn't really know them. This is not really
therapy."
But some distance sex therapists say the lack of physical
contact sometimes makes therapy easier, because clients are more
comfortable in their own environment and therefore more willing to
share information.
"Although it may seem that the face-to-face is important, I
actually find that people are much freer when they're not
distracted," said Brame. She's a sexologist -- an umbrella term used
to describe a range of sexuality-related professions, including
therapists and educators -- certified by the American College of
Sexologists and a doctoral graduate of the Institute for Advanced
Study of Human Sexuality, in San Francisco.
"I know that for sex therapy," she said, "the hardest step
is going. The hardest step is actually facing somebody and speaking
about this stuff, because sex is such a private issue. It's just the
most intimate domain."
A
Stranger Who Cares?
There are few published
studies of distance sex therapy, and no sources interviewed for this
story were aware of any randomized, controlled, double-blinded
studies -- the gold standard for science. But one unpublished study,
conducted nearly two years ago as part of a doctoral dissertation at
York University in Toronto, suggests that online therapy of various
kinds may help some patients.
Stephen Biggs, a PhD candidate in clinical psychology,
surveyed 44 people who said they had received therapy strictly over
the Internet. Among these respondents, 16 percent said their therapy
involved sexual issues; ages varied and women outnumbered men.
Eighty percent (35) said they found the therapy experience somewhat
or very positive, but all said they would use online therapy again
and "reported that the therapist was empathic," he said.
"It's sort of funny," said Biggs, "but people get this
feeling of being cared for from this person they've never met."
© 2004 The Washington Post
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