Millions of adults are addicted. Psychoanalysis and cognitive behavioral therapy are the most common treatment options. Usually, addicts attend sessions at a psychotherapist’s office or in specialized clinics and treatment centers. Self-help groups can be a complementary offer as well. During the past ten years, self-help programs with online assistance and counseling have become available, too. Psychotherapy through the internet – can that work?
Some important elements are missing
The great thing about one-on-one sessions of a patient and a counselor is the immediate interaction. Questions and answers, listening, body language, mimic, physical presence and energy are all elements of personal counseling that are missing on the internet. The patients don’t get the interaction with other addicts like in an addiction center and the intensity of a 24 hours-a-day therapy is also missing.
Five reasons why 90% of addicts never ever receive help
However, many statistics show that more than 90% of all addicts who recognize their problems, nonetheless, never start any conventional treatment. There are five reasons for it: Firstly, many addicts believe that they can’t afford it. Secondly, they don’t want to interrupt their jobs and family lives. Thirdly, a specialized treatment center isn’t available where they live. The fourth reason is that therapies aren’t available immediately. Waiting times can be three to nine months. The fifth and possibly most important reason is that many addicts don’t feel comfortable opening up to complete strangers. They are horrified by the idea of talking about their most intimate problems to somebody who they’ve never seen before.
Online help is accessible to everybody
For those five reasons, anonymous help through the internet – online counseling and self-help programs – can be an interesting alternative. Help is inexpensive, it can be integrated into patients’ normal lives, it is available everywhere and immediately and participants remain anonymous. Several conditions need to be met, though, in order for online help to work.
Preconditions for effective online help
Patients need to work through the program at least one hour per day during a period of several weeks or months. This requires a certain amount of discipline and addicts don’t always have this. As patients don’t talk face to face with a counselor, they need to read a lot of texts. They will be provided with a lot of checklists, questions and answers, quizzes, background information, exercises etc. Things that a therapist would normally tell them in individual sessions are brought across through pdf and mp3 audio files. Patients need to spend a lot of time reflecting their own lives. Therefore, being open-minded to ‘psychological approaches’ is another precondition for self-help programs to work.
High motivation is key to success
Patients must be motivated to see their problems from new angles. Psychoanalytical approaches ask participants to reflect upon experiences from childhood and adolescence. Not all addicts like this. Elements of cognitive behavioral therapy ask patients to try new behaviors, new attitudes and new strategies how to deal with their problems. Putting this into practice can be difficult if patients aren’t open-minded. The most important precondition to success is the participant’s high motivation. Highly motivated patients will use email communication and chat functions in order to have an active dialogue with the team of counselors available in self-help programs with online presence. In many cases, self-help programs can be an effective first step. Addicts receive many advices, tips and tricks and they start questioning their behaviors. Often, they become more open to visit a psychotherapist, a self-help group or a treatment center afterwards.
Lavario is an example of therapists offering self-help programs and individual coaching through email and chat functions. Participants download all material from the internet and can send all questions, problems, reports on progress etc. via email. Extensive answers are provided within two or three days. Lavario points out another advantage of online counseling. As online presence is global, patients can find help at times of the day when no therapist is available in their home towns. For example, Lavario’s head office is in Brazil. When an addict in London, Sydney or Delhi feels desperate and looks for help at midnight over there, the call center in Sao Paolo can still be available. 2 am in Los Angeles means that it’s daylight in Brazil already.
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By Frank Lavario
I am Frank Lavario, founder and author of the Lavario self help programs against addictions. My colleagues and I have been working a lot with addicts all over the world during. Sometimes we put our experience into short articles.