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Online Counseling
Cecille O. Sanidad, MA

Abstract Online Counseling, being a communication with a qualified, professional counselor/therapist by email or chat through a computer, has already received relatively successful reception in foreign countries; however, this development is new within the Filipino society. In the Philippine setting, utilization of online counseling services is being used by some schools. They made use of this service to intensify the implementation of the counseling services as it fully makes the most of their institutions resources and facilities. Unlike the other countries, it only provides information but lacks the usual structure of a therapeutic relationship. As a tool in the helping profession, technology is undoubtedly of big help. Innate to it, however, are certain concerns regarding client identity, counselor qualification, counseling relationship match, availability of services, assessment of services, and various confidentiality issues. This paper seeks to shed light on the nature of online counseling services, ethical standards, and counselor qualification. It provides insights on how online counseling started as well as some of the challenges counselors face right now in the area of online counseling. It further gives recommendations on how to better address other important areas in the proper management and supervision of guidance and counseling services, in general.

Keywords:

online counseling, counselor, ethical standards, assessment, counselor qualification, confidentiality

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Introduction Online Counseling as defined by Sunrise Counseling (2002) is the communication of a patient-clientele with a qualified, professional, counselor/ therapist through electronic mail (e-mail) or instant messaging. This may also involve the use of microphones and web cameras as enhancements. While the online counseling system has already received successful reception in foreign countries, the trend is not fully accepted in the Filipino society. The history of online counseling based on Grohol (2003) started in 1960s when communication with computers was first made possible through the creation of ELIZA, an MIT-developed software that was made to answer questions based on pre programmed word associations. The creation of ELIZA started the procedure whereby persons can communicate through the use of computers. The 1970s saw the rise of online support groups, made possible through local networking. These support groups mainly tackled rare diseases and illnesses with a social stigma. The support groups soon evolved into groups with more varying concerns. The main means of communication was through Bulletin Board Services (BBSs) which are very much similar to todays Bulletin Boards. Since it is locally based, the people using the BBSs were in close proximity allowing online relationships to be more intimate while maintaining an impersonal professionalism. Generally, members correspondence was time delayed and limited to a certain number of participants (as opposed to real time messaging currently available). In the 1980s the BBSs continued to prosper. There were already contenders such as: Prodigy, CompuServ, and America Online (AOL). These companies made it possible for Special Interest Groups (SIGs, the new name for certain support groups) to have no limits on participants. The 80s also saw the development of dungeons, real time messaging, online role playing, multiplayer, fantasy games (very much like the local area network games available today). After playing, the game heads could socialize with other people online. Through research, it was

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confirmed that these socializations gave the online users a sense of therapeutic well-being. The 90s saw the strong and swift development of the Internet in its current form. From simple support to socialization, the system evolved into an advice-giving forum. In order to efficiently address the large numbers of students in need of counseling services in the University level, universities started opening online advice giving systems through open computers with anonymous usernames. The first of these was Dear Uncle Ezra system of Cornell University (named after the University Founder, Ezra Cornell). Jerry Feist and Steve Worona, from the Cornell Counseling and Cornell Computer Services Departments, developed it respectively. The system allows campus personnel and students to answer Uncle Ezra inquiries from all over the university through two dozen computer portals strategically distributed around the campus. In 1995, Grohol started PsychCentral (a website that caters to mental health queries and concerns). This evolved into a chat room making use of web broadcasting system (WBS). Ivan Goldberg, a psychiatrist, furthered this endeavor with Depression Central in 1993. Both sites offered free help. Overseas, Befrienders International, based in UK, started the first telephone counseling service. In 1994, they became the first organization to make use of electronic mail as a medium of communication online. At the same time, David Sommers, an American psychologist started the first fee for service system. Unlike the free system pioneers, Sommers introduced a consultative and multiple session approach (much like a traditional psychologist). He initially handled 300 clients. From this point, the online counseling services continued to progress. In line with this, counseling through short messaging system (SMS) has been proposed. With the help of technology, the time and space barrier was breached, and psychological help was made available to the larger public.

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As a tool in the helping profession, technology is undoubtedly of big help. However, certain problems are inevitable as well. These include concerns in client identity, counselor qualification, counseling relationship match, availability of services, assessment of services, and various issues of confidentiality. The world still has so much to learn about the use of online technology as it relates to counseling. To date, in the local front, only a few schools implement an online counseling service in the country. In a country where shame is fully operative in peoples consciousness, online counseling could be one of the solutions in helping people who are afraid to lose face when exposed among their social circles that they are seeking counseling. The paper seeks to shed light on the nature of online counseling services, ethics, and counselor qualification. It also aims to present the groups learning on the issue as well as some recommendations on how to better address other important areas in the proper management and supervision of guidance and counseling services. Discussion Program development. The structure of online counseling in the United States and other countries resembles the structure of face-to-face therapy in having a beginning phase, a period of ongoing work, and a process of termination. Engagement, contracting and goal setting, and ongoing assessment are all features of online treatment as they are in face-to-face therapy. There are challenges which include taking clients who may not expect to pay for advice. Other problems include: (1) maintaining the therapeutic relationship in spite of the ease of leaving therapy online; (2) dealing with glitches without discouraging the client; (3) balancing the clients need for anonymity and the therapists practical and ethical need for identifying and contact information; (4) developing text-based communication skills that foster the therapeutic relationship; and (5) adapting to the flexibility and range of communication that are among the Internets greatest assets.
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In the Philippine setting, utilization of online counseling services is being used by only a few schools such as University of the Philippines in Diliman, Quezon City, Mapua Institute of Technology, and Colegio de San Juan de Letran. Services are employed to intensify the implementation of counseling services by using the most of their institutions resources and facilities. Unlike in other countries, online counseling in the Philippines provides only information but lacks the usual structure of a therapeutic relationship. Counselor qualification. A counselor using online counseling needs to have knowledge of Internet fundamentals. Such understanding will help the online counselors best take advantage of technologys many possibilities while also addressing and coping with its limits. Glitches are inevitable, and must be worked around. Hence, any online counseling must be done within the framework of the technical platform which will be used to deliver services. At the very least, the therapist needs to know how to operate the modality theyll be using: email, text-chat, videoconferencing, etc. What are some of the basics of online counseling? To begin with, a counselor needs a computer, or access to one. They also need an internet connection and a web browser. Other additional options include an email program, a chat program, a video conferencing program, webcam, a website, a domain name, a web-hosting account, and security software/hardware. Firstly, online practice is for those who are comfortable with it. If a person is deeply skeptical about making emotional connections through the written word in the absence of visual cues, then online counseling is not an appropriate choice. Being nervous around technology, a laborious typist, or feeling reluctant to explore the internet are examples of not being suited to the medium. Secondly, to be an online therapist, one must be comfortable with the Internet and reasonably skilled in typing, unless he/she already has voice recognition software that is used effectively. He/she should be an expressive writer. The client can be relatively unskilled on putting feelings into words but as the therapist, you must constantly be modeling the proper text-based
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expression of emotions. If the therapist has no authenticity, it will cause the client to question their authority or integrity, and the therapeutic relationship will be flawed. The best online therapists communicate in text as if the keyboard does not exist. The image that the client perceives is simply the presence of the therapist with the same rich personality, mediated by the same boundaries that would be maintained around the professional persona in traditional office setting. Consequently, one must have both the skills and the temperament to deal with these situations, using truthful feelings, and incorporating the clients reactions. Thirdly, flexibility is also essential. If a therapist can only work in a single way or if they believe strongly in a single approach by virtue of their training and experience, then they will not be able to adapt to online work. Since this field is in its pioneering phase, and its practitioners are still exploring its boundaries, client expectations of counseling are more fluid than with the traditional practice. Therapists need to be able to adapt with their clients. Service offered. Surely, there will be roadblocks in the development of online services and more research is needed to accurately judge the limits of treatments that could be offered. The existing literature in the field is generally positive, which may surprise some individuals. Some lines of research are declaring that there are significant impairments with online counseling. The ventures into the field so far have demonstrated that clients accept online services, and that those services tend to produce positive outcomes. It also provides practitioners with a revolutionary vehicle through which methods of assessment are for therapeutic purposes, appraising a persons suitability for a study program or a job, and for self-exploration. Perhaps the Internets most significant contribution in assessing are its flexibility in terms of time and space, provisions of quick and accurate scoring, availability of textual information and Web links pertaining to the nature of the assessment results. Furthermore, because of the special communication characteristics of people who use the Internet, such as anonymity, invisibility, a synchronicity, and lack of eye contact, human inhibition diminish; more candid responses
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may be anticipated as a result, thus, elevating the validity of the assessment. Certainly, we are a long way from confirming or disconfirming the efficacy and effectiveness of computer-mediated modes of treatment, but the current literature points in the direction of justifying the need for practicing online counseling. Ethical standards. Licensed clinicians (regardless of training), theoretical background, personal philosophies, cultural or religious beliefs, are obligated to follow laws and regulations that govern their profession in order to avoid potential professional violations and assuming legal risks A number of organizations in United States and United Kingdom have produced ethical guidelines regarding working on the Internet. The American Psychological Associations guidelines were quite basic (APA, 1997) and cautioned the practitioner to exercise care in this new medium. The American Counseling Association guidelines (ACA,1999), while making no explicit statement about international practice, made detailed recommendations about issues such as ensuring back-up for Internet clients and adhering to state regulations that militate against international work. Issues of security: The identity of the therapist. A key area of difficulty for the client obtaining counseling on the Internet is the establishment of identity and credentials of the person providing the service. These problems also exist in the real world, but in the cyberworld, they are made ever more complex. If a client uses a counselor from another country, then this problem is exacerbated. Questions arose: Is the person I am consulting registered with the professional body in his own country? What is the professional accrediting body of that country?

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Issues of security: The identity of the client. Just as the client-seeking treatment needs to have reservations about his or her therapist, the therapist must have reservations about the identity of his or her client too. There is no guarantee that the person involved in therapy is the client himself / herself, then there is a risk of a child posing as an adult, a male passing themselves off as female, and other forms of identification fraud. Issues of safety: Protection and redness of grievance. In a face-to-face transaction, or with an Internet transaction with a therapist within the same country, the client has legal procedures to protect them in case of suspected professional misconduct. There is usually an employer or professional organization with whom to lodge a complaint, and the client has to resort legal action. This legal protection largely disappears with international Internet transactions. Many sites state that their service is conducted under the laws of the country in which they are based. However, in practice, it would be difficult to enforce any legislation across international boundaries. Issues of confidentiality. In times of emergency or a threat to a persons well-being, online communications are an insufficient treatment for intervention. Following are some situations in which online consultation are not recommended: (1) if a client has thoughts of hurting or killing him/herself; (2) if a client has thoughts of hurting or killing another; (3) if a client is in a life-threatening or emergency situation of any kind; (4) if a client has a recent history of suicidal, violent, or abusive behavior; (5) if a client holds what others may consider unrealistic beliefs (delusions); (6) if a client sees or hears things that others dont (hallucinations); and (7) if a client is actively abusing alcohol or drugs. Issues of multicultural competence. It is reasonable to expect an online counselor that he or she will consider the implications of working with clients with different cultural backgrounds, as well as the competencies he or she needs to provide an adequate service for the clients.
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Issues of assessment. Research is required to establish whether people actually follow and act upon online tests, and to assess whether inappropriate feedback might have any negative effects on their lives. It is also possible that any test feedback might have immediate negative effects, regardless of any action people may take based on it. Conclusion Online counseling has been largely new to the researchers. For one, those of involved in the study have not experienced going online to hold a counseling session either as counselors or as clients. The research provides insight on how online counseling started as well as some of the challenges that counselors face in cybercounseling. For one instance, it has become apparent that counseling online involves not only the standard skills but technological skills as well. It may offer very little unless ones speed in typing is the second most crucial skill next to ones knowledge of theory when it comes to counseling online. Similarly, one must also be good in the proper selection of words. Facial cues and body language are not seen on the part of the counselor. Using the right words will help the counselor convey genuineness and openness effectively even without being seen. A heightened sensitivity corresponding to intuition would also be of great help in order to spot the missing details when reading a clients transcribed thoughts and feelings. This would help the counselor to effectively reflect on the clients issues and treatments. In the Philippines, whenever people hear about online counseling, their first concern is confidentiality. Certainly, there is nothing inappropriate in that fear since even if it is not online, confidentiality should be kept. It seems though that the tension is doubled when it comes to computer-based testing and counseling. Based on the reviews of online counseling sites, it seems that it is fairly safe given the procedures and instructions. It is safe in the sense that if you do as recommended, the patient runs no risk of getting their information publicly viewed. On a trust context, it is also important for the client to be confident that the counselor is
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adhering to the standards and that they are also doing their part in keeping all data confidential. In relation to Testing, one main concern is with regards to the use of accurate materials. We found out that some materials are not licensed in an online form; as such they cannot be administered at a distance. Finally, the study also uncovered that it is hard to evaluate online counseling programs because most of the time, it is still the online counselor who would be seeing the clients assessment of the relationship. Lastly, there is a need for the existence of cybercounseling. It shows that the world is big and that space should not limit the helping profession. Moreover, the preference of the clients count and that online counseling is sometimes a solution to specific client concerns. It provides the researcher with the insight about a seemingly insurmountable problem which eventually will reach a solution in the long run. In the past, looking for physical cues and facial expressions were central concerns. Now, with webcams and the use of emoticons along with computer slang, clients can express themselves better. This signifies that online counseling is continuously evolving and growing and that in time, other concerns such as confidentiality and testing would be overcome. Recommendations Based on the analysis of the data, the following courses of action are recommended to better address concerns in cybercounseling / online counseling: 1. That in order to be a good cybercounselor, one must also practices being a client online. This would give the counselor an insight on the needs and apprehensions of a client, seeking help online. This would also enable the counselor to practice / pace themselves in the use of various computer paraphernalia and computer language. 2. That a special training / educational program for those intending to do their counseling practice online be established. 3. That security codes and encryptions be used in keeping confidentiality.
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4. That a widespread information campaign be carried out to make people aware that an exchange of information online is fairly safe and remains confidential. 5. That all clients of online counseling should physically meet their counselors at least twice. Once, in the diagnosis part and once before termination. This will address testing concerns as well as other issues in evaluation. References American Counseling Association (1999). ACA Code of ethics. Retrieved from http://www.counseling.org/publications Gazley, J. (2005). Surf into my office. Retrieved from http://www.asktheinternettherapist.com/online-counselingarticle.asp. Grohol, J. (2003). Online counseling: A handbook for mental health professionals. New York: Elsevier Academic Press. Ingersoll, R., & McCluskie, K. (2001). Becoming a 21st century agency counselor: A personal and professional explorations. Canada: Brookes and Cole. Munro, K. (2006). Online counseling. Retrieved http://www.kalimunro.com/online_counseling4.html from

Piussi, L. P. (n.d.). Advantages and disadvantages of online counseling. Retrieved from http://www.1888articles.com/ advantages-and-disadvantages-of-online-counseling 09w65nr66a. html

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