Therapy Online: A Practical Guide


Kate Anthony & DeeAnna Merz Nagel

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  • Also by Kate Anthony:

    Technology in Counselling and Psychotherapy: A Practitioner's Guide (edited with Stephen Goss)

    The Authors:

    DeeAnna Merz Nagel and Kate Anthony are both former Presidents of the International Society for Mental Health Online (ISMHO). The combination of their experience presents a breadth of knowledge about online counselling and supervision, encompassing publications, presentations at international, national, regional and state conferences, consultation with many organizations, teaching and facilitating online counselling and supervision, and participating in international, national, regional and local organizations.

    Kate Anthony, MSc, FBACP is a psychotherapist, consultant and international expert regarding online counselling and the impact of technology on mental health. She runs, a training company for mental health practitioners who wish to work with clients online, and is joint-CEO with DeeAnna of the Online Therapy Institute. She is a published expert on such topics as the use of email, bulletin boards, IRC, videoconferencing, stand-alone software and more radical innovative use of technology within therapeutic practice, such as virtual reality. She co-authored the 1st, 2nd and 3rd editions of the BACP Guidelines for Online Counselling and Psychotherapy (Including Guidelines for Online Supervision). She presents internationally at conferences and is co-editor of Technology in Counselling and Psychotherapy: A Practitioner's Guide (2003). Kate was awarded Fellowship of the British Association for Counselling and Psychotherapy in 2008.

    DeeAnna Merz Nagel, LPC, DCC is a psychotherapist, consultant and international expert regarding online counselling and the impact of technology on mental health. She specializes in text-based counselling and supervision via chat and email. DeeAnna's expertise extends to assisting individuals and families in understanding the impact of technology in their lives, from normalizing the use of technology and social media to overcoming Internet and cybersex addictions. Her presentations and publications include ethical considerations for the mental health practitioner with regard to online counselling, social networking, mixed reality and virtual world environments.


    View Copyright Page


    To P – one and the same in our own different way ^_^, my godson Jamie (it's your turn, lol), and in loving memory of my father Nick Bartlett, sorely missed:o(

    To Pete – my constant, to ma & pa – my foundation, to MJ – my rock. To JA (you know why – waaaay back to now) and to my goddaughter Savannah – young but wise soul [smiling] … btw S – your mama thinks you & I are alike in some ways … :)

    And finally to the critters – Bikkit, Bunky, Tula, Reva, Licky and Allsorts … (Reva says ‘Friend Me’ via Catbook app on Facebook!)


    In the mid 1990s, I was part of a counselling service that offered ‘Phone Counselling’. I selected a schedule of times I would be available by phone for individuals calling into the service for a counselling session. The sessions were conducted over the phone. The client called in on a ‘976’ line and gave the operator his or her credit card number. The call was then transferred to my phone number and I did ‘phone counselling’. The client was charged by the minute.

    While telephone counselling had been around for 35 years, for our service, there were legal and ethical issues that cropped up that had not been considered. That, and the fact that the ‘976’ lines were sometimes used by psychics and escort services, gave it a less than ideal reputation. The service closed only months after it started.

    Here we are – just 15 years later. This is a fascinating time for mental health practitioners around the world. Everyone from four-year-olds to seniors uses the Internet. This means potential clients in the general population are becoming more sophisticated in regard to seeking emotional or relationship help. They research their symptoms on the Internet and learn about DSM diagnoses and a myriad of treatment alternatives.

    Further, with the increasing interactivity of the Internet there is an expectation of instant connection and services rendered. People can ‘twitter’ a question and get an immediate response from a myriad of experts and non-experts on social networking sites. This desire for and expectation of instantaneous response in our day-to-day communications leads potential therapy clients to expect the same when it comes to mental health treatment. Many would like to connect to a therapist quickly and participate in therapy in a way that serves them and their schedule. Increasingly, the time taken to travel to and from a therapist's office for a face-to-face session is viewed as an extraordinary waste of time.

    As a profession, we must respond to the global socio-cultural changes in our client base if we are to survive. For years, we have challenged existing therapeutic theories but until now, we have not changed our delivery model. The culture is asking us to do that now.

    The fact that you picked up this book means you know it too.

    This is an amazing book. Not only is it filled with interesting history about the Internet and online therapy Kate Anthony and DeeAnna Merz Nagel have provided a solid roadmap for you to follow as you dip your toe into a new way of delivering psychotherapy services.

    You will finish this book with a concrete understanding and a wealth of ideas about:

    • The dos and don'ts of online therapy
    • The theory that underpins the work
    • The ethical considerations of how to decide if a client is a good candidate for online therapy
    • How to attract more new clients by offering more technological alternatives to traditional therapy
    • How to market your services
    • How to seek further training, supervision, and do research online
    • How to use technology to enhance the therapeutic experience of your clients
    • How to use social networking for professional growth.

    This book is filled with step-by-step instructions, examples and a strong verbatim case study of the whole therapeutic process, from intake to ending. It is a book that you will refer to again and again if you decide to expand the way you currently offer therapy services. Whether you are new to online therapy or are a veteran, there is much to learn from this book.

    Online therapy is not just an idea for the future. Its time has come.

    I wish you continued success in your journey to make a difference in the lives of others.

    CaseyTruffo, MFT

    CEO and Founder of The Therapist Leadership Institute and Bea


    The authors would like to acknowledge the help and support during the development of the book of Stephen Goss, Tom Merz, Casey Truffo, the dedicated team at SAGE, friends, family and the many colleagues in both the online and offline world too numerous to mention, but particularly the members and friends of the Online Therapy Institute.

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