E-therapist experiences and perceptions of using email to interact therapeutically

Email usage for mental health services is on the rise. However, research in
this area is scarce and focused on its effectiveness. Although preliminary etherapy
effectiveness research shows positive results, little research exists
that explores e-therapy practice. Thus literature relies on face-to-face
therapy theories to make sense of e-therapist processes. However, the
perceptions and processes of e-therapists may be affected by the differences
in mediums. This study aimed to further the understanding of e-therapy
practice by exploring e-therapists' perceptions of how they interact
therapeutically. The qualitative methods of Interpretative phenomenological
analysis were used. The author conducted semi-structured interviews with 12
e-therapists who used CBT techniques, six interviews were conducted via
email and six via computer-mediated telephone. Email and telephone
transcripts were analysed separately for recurrent themes. Major themes that
arose from both telephone and email interview analyses addressed how etherapists
perceived the differences between face-to-face and email therapy
interaction affected their practice, specifically the absence of face-to-face
contact resulted in a sense of loss of traditional therapy concepts, immediacy
and presence. Other themes referred to e-therapist intentions of forging and
strengthening therapeutic relationships via email by using email's time delay
to thoroughly consider and edit responses, its boundary flexibility to adhere
to client needs and preferences and its textual nature to better understand
client issues. One major theme which arose from the email interview data
referred to participant preferences for email over face-to-face interaction,
highlighting that they viewed the distance from clients and the process of
writing as enabling them to construct higher quality therapy responses.
Implications of these findings were that e-therapists perceived that while
some email-specific aspects caused challenges, others were facilitative in
their therapy practices. New e-therapy processes were discussed in the
context of current literature. However further e-therapy-specific and clientfocused
research is needed.

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