Although confidentiality concerns are compounded with online communication options, these results strongly suggest that video conferencing has usefulness beyond training and business meetings. One would suspect its application will be more valuable in programs where clients are able to self-select online versus in-person options, and possibly to utilize a combination of both options. Research which randomly divides subjects and exposes them to one of two treatment protocols can obscure the potential benefits of matching individuals to the most effective protocol. In the absence of definitive assessments, self-selection by the client is the most efficient approach to treatment matching.

I'm wondering if online treatment would work for alcoholics? What does everybody think?

Uh-oh. I better get a degree as a webmaster... Doug Moser, M.A.

“Direct human contact has no substitute: I totally believe in diversity of approach for the same condition; each approach on its own is useless or as effective as the percentage of energy & effort invested by the one in need. That is the amount of probable effectiveness for the impersonal approach. The deepest evidence of healing and /or manageability in the human struggles is only consummated by the interaction of two or more”. (EA)

Such nonsense. Most addicts would have sold their computor for drugs. As addiction negatively affects relationships, it stands to reason that a computer relationship does not build the social skills, support systems nor relationships that are essential to the healing process. What kind of research is this. Good grief!

Whatever works!!!!!!!!!!!!

There are several factors that are of concern regarding on-line counseling for addiction. One is related to the intended outcome of the counseling. Is this related to treating the disease of addiction or is it related to harm reduction? Also, is the "client" encouraged to remain abstinent during and after treatment or is that even a component of the treatment? If abstinence is a component of this treatment, how is this measured on-line? Is the issue of suicidal ideation identified and effectively treated on-line? If so, how? There are too many issues related to effective treatment of the disease of addiction to alcohol and other drugs to take the risks to experiment with a treatment that may fail the one opportunity a client has to actually recover with help. This is the type of research that is exciting to the researchers at the expense of those for whom it does not work. What ever happened to ethics in the treatment profession?

Yet another CRC boondoggle. No need to re-hash the cons of this disaster in waiting. My biggest concern is companies like CRC and health insurance companies will use this to cut their overhead at the expense of the clients. Haven't we seen them do that enough already?

I agree with Jeanette and Jim T. Online counseling presumes first, a significant degree of honesty which can be masked at the keyboard. Second, there is more at stake when treating medication assisted treatment patients, especially those with any number of co-occurring disorders. What practitioner would want to stake the safety of patients and/or his/her reputation on an emailed note? The value of face-face groups or individual counseling is that you can't hide, intentionally or otherwise. One might argue that those who "avoided" face-face contact, did so for this reason. Participation and communication are more than just words - typed or otherwise - there's body language, inflection, attitude, etc. - than can never fully be transmitted via email or messaging. Sorry for my cynicism, but the internet is filled with people who misrepresent who they are and what they're doing as well as those who prey on the vulnerable. Lastly, I can see the day when the insurance companies start approving online therapy as a new and first level of care.

If ONE person is helped by e-therapy then it is worthwhile. I'm getting a little tired of the venomous, self-appointed proselytizers who state "this is the way", "that is not the way", "this is the best", "I think this; I think that" or "it depends if it meets my standard". Honestly, who cares what "you" think. Nothing truly good comes from our proprium anyway. We're not talking about flavors of ice-cream here. Stating something is so or not so is like commenting about the fit of a cap without ever putting it on. If you put it on, then it's simply your experience, not "good or "bad"; it just Is. Wanting to be "right" is more dangerous than any drug will ever be. I say, easy does it. And go figure, I practice 12-step living but do not attend A/A or N/A. Judge that.

Why didn't they mention that treatment at egetgoing cost $50.00 per on-line session. What junkie is going to have that to spend.

One of the best discussions I have seen on this website. Everybody gave good suggestions, pro and con. However, I was shocked to see that they charge $50/group, more than many face-to-face tx groups in this area. Also, helping ONE person is not sufficient; what about all the others that COULD have benefited from traditional tx that chose on-line instead? This would definitely be more harm than good. Also, I can imagine insurance companies requiring this type of tx just to save money, a similar rationale they used for limiting inpatient tx to 30 days, a limitation that we now know 20 years later is woefully inadequate. Those in the field know that the main benefit of group tx is that the group holds individuals accountable, which would be lacking in "e-therapy".

how can you tell what the participants were doing while they were online?

There appears to be some serious denial among those suffering digitalisis. North America's treatment community rejected principles of the 12-step model for years; now we research how and why it works so well. Please, if you truly care about the future of our children and those soon to enter addiction, pay attention to their digital behaviors and learn to speak their digital language, especially if you think you are smart enough to treat addiction with any protocol. I mean offense to no one; I just care a whole bunch about the suffering-addict, whether online or in a snowbank. I will help them wherever they find me! Kind Regards, Kidglobal

Actually a combination of face to face and online groups sounds good. In Asia where i practise, 12 step meetings or any kind of recovery groups are pretty rare and hard to find. Those who want help can then see their therapist, and attend more groups to enhance recovery.

Easy does it! ;^) This was a study. One study. A small one where "the researchers acknowledged that the study did not investigate the long-term effectiveness of online treatment." Right on JD Anticoli, BTW. The gist of it all is -- online therapy just might help some individuals. (God forbid!). Progress, not perfection. ;^) More will be revealed, eh? I'm still going back to school for my webmaster's degree... ;^)

It say affective not perfect. We sometimes forget that the solution to this huge challenge of treatment is a combination lock not a single lock and key. Even more disappointing is that we forget that it's about the patient not our very fragile egos.

I agree with Jeanette and Mike and a few others who stated that addicts need support through relationships. Maybe on-line could get them to the place where they would be ready to work with others in support of their recovery, but I guarantee it is not going to get them over their addiction. Nor is it going to help them overcome the causes of addiction such as traumatic lives of sexual abuse, family violence and poverty and racism.

It's amazing how such a short article can lead to so much confusion! To address a few: 1. "What practitioner would want to stake the safety of patients . . . on an emailed note?" Nobody's talking about counseling via e-mail here. It's a videoconference. You can see and talk to the person. 2. "...there's body language, inflection, attitude, etc. - than can never fully be transmitted via email or messaging." Absolutely true, but again, all of that can come through in a videoconference. 3. "If abstinence is a component of this treatment, how is this measured on-line?" Good question. Note here it has been applied to a methadone program, so presumably these participants are still appearing daily at the clinic. It's just the counseling that happens online. Monitoring and drug testing can therefore still occur at the clinic. The same can be said for assessment of suicidal ideation, social skills, etc. Whether online is as effective, we can't tell from this study. I can understand and even intuitively agree with the argument that these may be more effective in person, but we have to take into account that attendance was higher online. Even if we assume that social support is better in person, there is no "in person" for those who stopped attending. Like others, I would like to see well designed outcome studies take place before drawing any conclusions, but I think we need to keep an open mind toward this until that data is in.