Sunday, January 23, 2011

In the news: Skype Counseling with homebound elderly

I was excited to see this article in the news today about a research project that offers laptops to elderly people at risk for depression, where they have access to therapy via Skype. Social Work researchers at the University of Texas-Austin have brought laptops to the homes of seniors over 60 who are socially isolated.  This project offers an opportunity for evidence in how to support people who may be hard to reach because of isolation or illness.

I am lukewarm, generally, on the issue of internet-based therapy.  Many licensed (and unlicensed) therapists are offering counseling services via webcam, email, and even in Second Life.  Many have ethical practices, waivers,* see only those who are not in acute crises, and are well-educated in issues related to counseling via distance.  This may be a responsive option for people with social anxiety/agoraphobia, who are geographically isolated, or have a specialized need that might be more available when they have a wider variety of therapists from which to choose. Our professional organizations are still overly-vague on the issue of internet-based services, although many good articles have been written on the topic.

The difference between this research project and online therapy is that (I assume) there has been an in-person assessment for appropriateness of fit, and the workers are still in the community should an acute need arise.  My view is that we need more professional clarity and regulation about social work via distance before it can be a broad credible option, or some professional education for consumers about what to look for in an online counselor.  What do you think?

*I do not know or endorse this Licensed Clinical Social Worker, but saw she offered a more thorough list of the risks of online therapy than many social workers offering e-counseling.


  1. I like the concept and have come to realize that some of my more meaningful and constructive relationships with people whom I no longer have much direct contact with can and does happen via internet. It is a viable form of developing and maintaining supportive community, especially for those who are in isolation for whatever reason. However, as you indicated, having direct access for something acute would be critical. Thanks for sharing.

  2. My mother was a part of the UT Austin study. I think it definitely benefited her in some ways, but the study only lasted six sessions, which I don't believe is long enough to get an accurate gauge of whether or not it has helped someone. It was great while it lasted, but then they didn't refer her to another counselor after the study was over. I felt it was a bit unethical to just leave someone without any other resources. I'm not sure if they do follow ups.

  3. Agreed! It is unethical to not refer someone out who needs continuation of care. I don't know the particular treatment termination of this study, but typically counseling includes a termination protocol that includes providing additional referrals if needed. I am sorry you feel like it didn't happen with your mom. Have you been able to identify resources in the community where she can get more help?