Telephone and internet counselling are becoming more easily available, but they may suit some people better than others. Some of these treatments are also controversial.

Over the phone

• Telephone counselling can be used on its own, or alongside face-to-face counselling.
• It can be used to help people who are in remote areas, or who cannot easily get to centres due to ill-health or mobility difficulties.
• If there is a long waiting list for other therapies, tele-health may be a useful way to keep in touch and provide reassurance.
• Telephone therapy trials have included counselling, cognitive behaviour.
• Therapy, reminders to take medication, follow-ups after hospital discharge, and even hypnotherapy.
• It seems to be effective in helping people with mild to moderate depression, especially in the early stages of treatment.
• People with severe communication difficulties, or with poor motivation, may not benefit.

Over the internet

• Therapies may be given by email, using videoconferencing, on message boards, or using a live chat facility.
• May be suitable for people who move around a lot with their work, or for people who prefer to write emails instead of talking face-to-face.
• Lack of non-verbal clues such as facial expression or other body language may make it difficult for the therapist to work out how the client is really feeling.
• If the therapist is unable to hear the client's voice, they might miss changes in tone, so may not realise the client is anxious, depressed, or agitated.
• It's easy to misunderstand what people are trying to say when they communicate via email. A joke can look like an insult, for example.
• There can be a long period of time between sending an email and getting a response.
• Avoid therapists who don't use their real name, and who don't give you full details about their qualifications or memberships of professional bodies.
• Think about your privacy: use secure sites, and password-protect your email. Remember that message boards are not necessarily private.

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Updated: 07/02/2012