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Some find the
answers to their
problems from
psychologists on
the Internet.

MARK SAUER

SPECIAL TO THE JEWISH NEWS

aving marital
problems? Feel-
ing depressed?
Got an eating
disorder? A prob-
lem with self-es-
teem?
You might
consult a psychologist at, say,
$100 an hour. Or you could ven-
ture onto the Internet and take
a chance at e-mailing your way
to mental health for a lot less.
Call it cyber-couch.
Dorothy Litwin calls it
Shrink-Link, an Internet "page"
on the World Wide Web offering
quasi-psychotherapy for $20 a
pop.
But don't call it actual (or even
virtual) therapy.
"I would not characterize it
that way. And I'd hate to say
we're giving advice because psy-
chologists don't like to give ad-
vice; we want people to arrive at
their own solutions," said Ms.
Litwin, a licensed psychologist
with a practice in upstate New
York.

Mr. Sauer writes for Copley
News Service.

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"But, basically, we are giving
advice. We're comparable to Ann
Landers."
Shrink-Link, which hung
out its electronic shingle in
February, gets about 20 e-mail
requests daily, Ms. Litwin
said. (The Internet address is
http://www.westnet.com/shrink)
For each "valid question,"
those that are not frivolous and
can be dispatched without com-
plex, long-tee in therapy, the fee
is $20, payable by credit card.
Ms. Litwin, who fields the
questions with the help of three
other psychologists and a psy-
chiatrist, is not alone in testing
the mental-health market on the
new medium.
A New York social worker is
completing a four-month group-
therapy experiment in which
eight troubled souls share inti-
mate details of their lives
via the Web, even though they
have never met face to face. (Her
conclusion: For group therapy,
the electronic medium is "viable,
with some reservations.")
And many on-line bulletin
boards have for years featured
self-help chat groups.

But those were free.
With the preponderance of
mental-health-care providers in
this country, it was probably in-
evitable that some form of for-
profit mental-health service
would surface in cyberspace.
Self-help psychological soft-
ware, helping the user to deal
with such problems as overeat-
ing, depression and poor self-es-
teem, have been available for
several years. But the Internet
approaches feature live people
interacting electronically.
"There are a number of new
Web pages coming out, or al-
ready up and running, and
the question is whether this is
advice or counseling," said
Marlene Maheu, a San Diego
clinical psychologist who is ex-
amining the new services on be-
half of the 132,000-member
American Psychological Associ-
ation (APA).
Mere advice, like that dis-
pensed on radio talk shows and
in newspaper columns, is a far
cry from therapy, Ms. Maheu
said.
The APA takes ethical um-
brage with the notion of people
paying for psychotherapy that
takes place electronically rather
than in the traditional setting of
the therapist's office.
"This presents real problems
for the APA because of the po-
tential for abuse," said Maheu,
who helps edit an on-line vs. psy-
chology magazine called "Self-
Help"(http://ww-w.well.com/user/
selfhelp).
Among the concerns: Who is
actually doing the therapy? How
could state licensing require-
ments be enforced across state
lines? And what if exaggera-
tions, figures of speech, even
threats — understood when ut-
tered in person within the con-
text of voice inflection, facial
expressions, etc. — are taken lit-
erally over e-mail?
If, in a moment of excitement,
a patient declares in traditional
therapy that he or she "wants
someone dead," Ms. Maheu said,
the intent might be quite differ-
ent than if that same message
were sent via keyboard and com-
puter.
"The consumer has to be pro-
tected," she said. "Whether we
will issue guidelines on this,
when that will be and what they
might say, I have no idea now."
One psychologist who has tried
to profit (unsuccessfully, so far)
from a form of electronic psy-
chology is Ross Goldstein of San
Francisco.
His 900-number telephone
"solutions line" was discontin-
ued when advertisements in the
Bay Area failed to attract

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