ProgCare Blog

Internet Therapy May Be More Effective Than You’d Think – Studies Reveal

admin — Mon, 01 Jun 2015 19:55:03 +0000

A soothing voice, the offer of a tissue, a gentle hand on the back—can you imagine the experience of going to a therapist without these comforts? We may be nearing the days when face-to-face human sessions are replaced by cyber-therapy, but at least it won’t look anything like ELIZA.

A new study out of the University of Zurich treated groups of patients suffering from moderate depression with two types of therapy—traditional, face-to-face counseling and a modified form of cognitive behavioral therapy administered through written tasks on the Internet. Patients underwent a series of eight sessions and were then evaluated for improvement. And guess what—the Internet therapy sessions won.

I mean, technically, patients from both groups “won”—the degree of depression fell significantly in both groups. However, according to the university’s website, “At the end of the treatment, no more depression could be diagnosed in 53 percent of the patients who underwent online therapy—compared to 50 percent for face-to-face therapy.” Perhaps what’s more interesting though is what happened after the sessions. Three months later, depression continued to decline in individuals of both groups, but 15 percent more of the cyber-therapy group saw improvement.

It’s easy to dismiss such findings outright because they show yet another example of humans distancing themselves from traditionally face-to-face activities. But there might actually be some benefits to consider here.

When participants were given satisfaction surveys after the treatment, 96 percent of the online group rated contact with their therapist as “personal,” compared with 91 percent of the face-to-face group. That at least means remote psychoanalysis isn’t necessarily robotic psychoanalysis. Furthermore, patients from the online group said they continued to reread correspondence with their therapist after the sessions were over. The researchers don’t say whether it’s likely this had an effect on the online group’s superior post-session results, but having records of your sessions that could be pulled up at any time seems like a considerable benefit. In contrast, face-to-face patients leave their sessions with only a memory of what was discussed.

Read full article here…

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Online Therapy Attracts More Clients

admin — Sun, 17 May 2015 18:21:14 +0000

Dr. MG Lazarus

As psychological anonymity being the major pulling factor more and more clients or mental health patients turn to online therapists for counseling or psychotherapy service. Dr. MG Lazarus speaks from his own experience.

“Converting the bedroom into therapy room isn’t the most attractive factor as I expected, it is the psychological anonymity, I am sure.” Dr. MG Lazarus who has been running online counseling and psychotherapy clinic since 1996 is convinced that patients prefer to keep their face masked for them to comfortably narrate their sensitive story. Clients feel less intimidated, non-embarrassed and uninhibited while taking online therapy, which is what the very first challenge of a therapist giving face to face session. Dr. Lazarus confirms, this challenge is easily bypassed using the online media.

The online counseling website gives two options to clients – facility to submit an offline message with client’s contact details, and a live window through which the client can converse with the therapist in real time without revealing own identity. Dr. Lazarus explained that more than 70% of his clients choose the second option as it is instant and anonymous. Mostly clients prefer to get an immediate answer to their distressing question. However, the anonymity factor undoubtedly plays a catalyst role on attracting more clients to online therapy as reiterated by Dr. Lazarus.

Psychologist Nils-Günter Schultze explains that psychological anonymity is the superior factor on attracting clients towards web portals. The other factors, according to him, are protection of self assurance, projection, willingness to change, and accessibility. Dr. Lazarus explains that psychological anonymity and accessibility are the two key factors that prompt clients to take online media for therapeutic needs. The veteran therapist indicated that the number of clients seeking counseling service has doubled since he introduced the live chat facility in his site since early 2007.

This is a PRLOG feature published in 2009.

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Behavioral Addictions

admin — Fri, 08 May 2015 19:01:38 +0000

BEHAVIORAL ADDICTIONS

Tracie Timme – Online Counselor and Therapist

This paper explores behavior addictions, what they are, if it is thought that they exist, the similarities and differences between behavior addictions and substance addictions, thoughts about behavior addictions according to the diagnostic criteria in the DSM-IV-TR, and what types of treatments are used for behavioral addictions and how they work. Most see addiction as, just that, addiction, no matter what one is addicted to. There is a hypothesis for the neurobiology of addiction, and that is that there are manipulations on the structural and molecular levels that are unchangeable, due to the synaptic plasticity of the dopaminergic reinforcement system (Spanagel & Heilig, 2005).

People have all kinds of addictions for many reasons. Some people (women) like to shop when they get upset, shopping makes them feel better. Others like to eat when something goes wrong. Regardless what the reason is, people do things that make them feel better. No matter what “addiction” people have, it all boils down to the way it makes them feel. Substance or behavior, they get relatively the same rush.

Behavioral addictions are defined as being similar to that of a drug addiction. Behavioral addictions are issues like pathological gambling, kleptomania, intermittent explosive disorder, pyromania, compulsive sexual behavior, compulsive computer use, and compulsive buying (Frances, Miller, & Mack, 2005). People get some kind of rush doing these things, they enjoy them.

Behavioral addictions would exist because people get a rush from doing something. They get an excited feeling to want to do it more and more, it makes them feel good. These feelings come from getting an adrenalin rush and the feel good hormones dopamine, ocytocin, and vasopressin (Reynaud, Karila, Blecha, & Benyamina, 2010). Therefore people who have behavioral addictions would want that feeling to continue, so they would be addicted to that feeling. Just like a person is addicted to the high they get from a substance. They want it more and more and over and over again.

Behavioral addictions and substance addictions differ because you ingest substances, so you are adding outside chemicals that affect the chemicals inside, to your body. Behavior addictions you are not adding anything to your body, you are doing an action that increases the chemicals you already have.

Similarities between substance addiction and behavioral addiction are multiple or spur-of-the-moment participations in a behavior regardless negative consequences, lack of control over the behavior that is the issue, the need or yearning prior to participation in the problematic behavior, and a carefree quality during the participation of the problem behavior. They also share similar features such as withdrawal, tolerance, many attempts to cut back or stop that are unsuccessful, and hindrance in major life functioning areas (Frances et al., 2005). Addictions of all kinds also have in common GABA and glutamate, opioid, cannabinnoid, and noradrenaline and serotonin, which are neurotransmitter systems. Implicated in the addiction process as well are the dopaminergic and oxytocinergic systems, which are regulated by the corticotrophin system (Reynaud et al., 2010).

The DSM-IV-TR (2000) places behavioral addictions under the impulse-control disorders category. Their definition of impulse-control disorder is the inability to have control over impulse, temptation, or drive to do something that is harmful to self or others. For most of the disorders they describe that the person has a rise in tension or arousal before the act, then while acting they feel gratification, relief, or pleasure. When they are finished with the act they may or may not feel self-reproach, guilt, or regret (APA, 2000). Gambling, compulsive buying or computer use, and kleptomania only cost a lot of money. However, these four things could lead to harming one’s self or turning to robbery, therefore could potentially hurt others as well.

Treatments that are used for behavioral addictions are similar to those used for substance addictions (Frances et al., 2005). Some pharmaceuticals, according to Frances et al., (2005) that are used are antidepressants like clomipramine. This drug given to patients helped to improve their actions. Fluvoxamine gave mixed responses. Paroxetine had no significant improvement in patients. Another treatment that is used for alcohol dependency was given to patients with urges to gamble, opioid antagonists showed to decrease gambling thoughts, urges, and behaviors when given in higher doses. Mood stabilizers improved behaviors over placebo. Atypical antipsychotics showed no improvements. Psychotherapy helped the patients to change their thinking about behaviors through cognitive therapy. Imaginal desensitization had more positive outcomes over a one month to nine year period (Frances et al., 2005).

People that have behavioral disorders should seek assistance for their problem. In many ways it is just like having an addiction to a substance. Behavioral addictions can lead to harm of self and others, just like a substance addiction can. People can get so addicted to the way they feel when they engage in the behavior; they can become just as violent as substance addicts to be able to partake in the behavior that makes them feel so good.

About the Author: Tracie Timme is a practising Online Counselor and Therapist at ProvenTherapy.com.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (DSM-IV-TR) (4th ed.). Washington, DC: Author. ISBN: 9780890420256.

Frances, R. J., Miller, S. I., & Mack, A. H. (Eds). (2005). Clinical textbook of addictive disorders (3rd ed.). New York: Guilford.

Reynaud, M., Karila, L., Blecha, L., & Benyamina, A. (2010). Is love passion an addictive disorder? The American Journal of Drug and Alcohol Abuse, 36(5), 261-267.

Spanagel, R., & Heilig, M. (2005). Addiction and its brain science. Addiction, 100(12), 1813-1822.

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Online therapy – the third wave?

Matt Butler — Thu, 07 May 2015 23:36:32 +0000

Therapy purists will, no doubt, protest but it must be said that online therapy has many potential benefits over the traditional face-to-face mode. From the client’s perspective you can undertake psychotherapy from the comfort of your own home at a time and price to suit. Clients have the opportunity to browse potential therapists, check their prices and professional profiles, check recommendations and therapist availability. Therapists can access clients drawn to the platform from anywhere in the world going well beyond their usual geographical boundaries and benefit from the promotional activities of the site as whole.

But beyond the relatively obvious benefits of convenience, choice and comfort, online therapy also holds some unforseen benefits relating to the efficacy of psychotherapy. For example, this mode means that users – clients and therapists – potentially have access to a verbatim record of sessions. This means that learning can be enhanced as clients can look back over the content of sessions thereby reinforcing therapeutic insights. Professionals also gain by having the same record – obviating the need to keep separate notes – also useful for supervision on which to base their own learning and service improvement (see, for example, Godleski et al 2012; Wagner et al 2013).

The first wave of therapy in mental health centred on the industrial model – asylum based ‘care’, haphazard and largely non-therapeutic. Psychotherapies and drugs improved the situation from the 1950’s on and the most recent advancements have been in well evidenced therapies such as those used in IAPT (Improving Access to Psychological Therapies) services in the UK National Health Service (see: Layard ”The Depression Report” 2006). Such therapies are a major advancement in treatment for anxiety and depression but are still largely delivered in a traditional health service delivery model – i.e. professional centric rather than client centric.

Online therapy offers a third wave of therapy delivery in mental health which puts the client at the centre of the model. The development of apps and other approaches such as email therapy means therapeutic interventions can be carried out remotely ‘in vivo‘, for example undertaking behavioural experiments or graded exposure. With such potential flexibility we argue that it is increasingly hard to see traditional delivery models remaining so centrally relevant, indeed as society becomes ever more internet centric it is likely that where they can, clients will vote with their feet seeking therapy online first.

Another manifestation of the digital revolution? We think so when it seems like only a short time ago it would have been hard to imagine something like counselling and psychotherapy to be so well suited to digitisation.

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