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A Critical Analysis of Online Therapeutic Interventions for Mental Distress

Question

Task: What is the effectiveness of online therapeutic interventions for addressing mental distress, and what are the ethical considerations and intersectional issues associated with their implementation?

Answer

Introduction

The introduction of online therapy interventions has revolutionised the field of mental health treatment by providing a fresh and easily accessible method of treating a wide range of mental health issues. Focusing particularly on its use in treating mental anguish, this article seeks to critically analyse the efficacy and ethical issues of such therapies. Cognitive-behavioral therapy (CBT) delivered via mobile apps or video calls is just one example of an online therapy platform that has shown promise in recent years for people with mental health issues like depression, anxiety, PTSD, and others. These internet platforms have democratised access to treatment by increasing its availability, accessibility, and anonymity.

The evaluation of these cyber-based therapy treatments is crucial because of their potential to significantly alter the way in which mental health services are delivered. To ensure that people still get the high-quality care they deserve when they cannot participate in in-person therapy, it is crucial to understand their efficacy. In addition, it is essential to evaluate the ethical implications of online treatment since it raises certain novel ethical concerns. Careful consideration must be given to issues of confidentiality, informed permission, the maintenance of therapeutic boundaries, and the function of professional norms in this setting. In this article, we'll delve into the efficacy of online therapeutic treatments by analysing the current data and discussing the measuring techniques used in recent research. To what extent may online treatment platforms uphold ethical norms and safeguard client wellbeing will be explored. The article will also look at how internet therapy is accessible and appropriate for people of different ages, genders, cultures, and other demographics. The essay will also address intersectionality concerns that have the potential to limit internet therapy's accessibility and acceptability.

The purpose of this paper is to shed light on the evolving field of mental health treatment in the digital age by offering a thorough evaluation of the efficacy and ethics of therapeutic interventions delivered over the internet.

Online Therapeutic Interventions: An Overview

When referring to the many different approaches used to alleviate emotional distress over the web, the phrase "online therapeutic interventions" is sometimes used. These treatments may be categorised in a number of different modalities, each of which uses a unique combination of resources and approaches. Cognitive behavioural therapy (CBT) is one of the most well-known types of online treatment for depression and anxiety since it focuses on modifying negative thought and behaviour patterns. Both therapist-led and self-guided CBT may be delivered via video chats, smartphone apps, and online platforms according to Tannenbaum & Har, 2020. Eye Movement Desensitisation and Reprocessing (EMDR) is another well-known online technique used to help patients work through traumatic memories; it employs the use of guided eye movements, tactile stimulus, and audio-visual aid as per Tavor, 2022. Social media interventions harness the power of virtual friendships and helplines to connect individuals in need with like-minded people and information about local mental health resources. These therapies use social networking sites, microblogging services, and specific online forums to provide safe spaces where people in emotional distress may talk to one another and get support.

The proliferation of online therapeutic treatments may be directly attributed to the many benefits they provide according to Nam et al., 2020. The fact that people may participate in treatment without leaving their homes is a major benefit; this removes the obstacles of distance and the embarrassment of going to therapy in person. Online therapy is a practical alternative because of its flexible scheduling and asynchronous contact via text or email, which may work around busy schedules. Those with less financial means may appreciate the cost-effectiveness of online therapies since they don't have to pay for things like gas or lodging. These benefits, although significant, are not without their drawbacks. Online therapy presents unique difficulties for both the therapeutic alliance and the therapist's ability to effectively assess the client's emotional state due to the absence of physical presence and non-verbal clues. Technology issues, such sluggish internet or equipment failures during video calls, might hinder the healing process.

Effectiveness of Online Interventions

Recent research has looked at the response of anxiety, sadness, and PTSD to online treatment as explained by Fernandez et al., 2021. These studies' favorable findings imply that using internet therapy to address mental health disorders may be beneficial. Due to its effectiveness in reducing the signs and symptoms of depression and anxiety, online cognitive-behavioral therapy (CBT) has become more and more popular. Additionally, it has been shown that online exposure therapy and treatments based on virtual reality are effective in treating post-traumatic stress disorder (PTSD). These investigations often use a broad range of statistical techniques, such as self-report surveys, clinical outcomes, and psychometric assessment. According to Maul et al. (2020), the goal of these assessments is to monitor changes in symptom severity, life satisfaction, and mental health.

Researchers may use standardized tests to analyze the efficacy of online treatment, such as the Beck Inventory of Depression or the Generalized Anxiety Disorder, or GAD, 7-Item Scale. More information about the effectiveness of these therapies may be gained from clinical outcomes, such as reduced rates of clinical identification as well as symptom remission. Although these studies have flaws, they do provide some useful information. More people might perhaps benefit, there is less of a social taboo, and everything is easier and more accessible. Internet therapy may have two major limitations, namely the absence of an in-person therapeutic relationship and the difficulty in evaluating the validity of online therapies (Atwood & Friedman, 2020). The degree to which these findings may be extended to other groups and the long-term efficacy of a particular medication both need further investigation. The results of these studies are useful in providing a basic understanding of the effectiveness of online therapeutic treatments, but further research is required to address their drawbacks and maximize their impact.

Ethical Considerations in Online Therapy

It is imperative that online therapy approaches be evaluated from an ethical standpoint. Online treatment environments must maintain the confidentiality and privacy that are fundamental to the therapeutic process according to Lederman et al., 2020. Data security and privacy breaches are a growing concern, underscoring the need for encrypted platforms. Clients' understanding of the advantages and disadvantages of internet treatment should be clarified via the informed consent process. It may be difficult to establish and maintain therapeutic boundaries in an online setting, as clients lack the visual cues that are present in face-to-face sessions. There are particular moral problems that arise with online treatment platforms. While being anonymous has many benefits, it also opens the door to potentially destructive deception or action. It is more challenging for therapists to read nonverbal clues and assist in crisis situations when they are not physically there. Unqualified persons may pose as therapists on internet sites, presenting a serious risk to users as stated by Mendes-Santos, et al., 2022. The inability to provide instantaneous aid in times of crisis is a potential downside of long-distance therapy.

Online counselling is heavily influenced by the ethical rules of relevant professional organisations (C). Guidelines and standards offered by organisations like the American Psychological Association and the British Psychological Society are followed by therapists regardless of the mode of delivery. Regardless of whether therapy is provided in-person or digitally, these norms stress the significance of the client's well-being, the therapist's competence, and ethical practise. When working with clients remotely, therapists have a responsibility to be familiar with and follow these guidelines.

Accessibility and Suitability

Barriers to the availability of online therapy treatments are affected by variables such as cost, language, and availability of necessary technology according to Almathami, Win & Vlahu-Gjorgievska, 2020. The digital gap has narrowed in recent years but still needs to be addressed. It's possible that some people, particularly those living in disadvantaged areas, don't have access to the resources they need, such as cellphones or stable internet connections. Since internet treatment is not often covered by insurance, it may be out of reach for those with little financial resources. When therapeutic platforms only provide services in English, for example, they may be excluding people from other countries or with different linguistic backgrounds.

It is important to give serious thought to whether or not certain demographics may benefit from online treatment as stated by Ta et al., 2020. It's important to consider age while working with the elderly, since many of them may lack the necessary computer literacy skills. Some people may respond better to therapy if they are treated by a therapist of the same gender or from the same cultural background. These individual differences may have an effect on the therapeutic relationship and final results.

Accessibility and appropriateness have major consequences for providing fair mental health care. In order to make treatment accessible to people from all walks of life, it is crucial to remove obstacles such as a lack of resources, language skills, and technical know-how. Interventions that are both culturally competent and age-appropriate have been shown to boost participation and success. In order to offer adequate mental health care to a varied and frequently disadvantaged population, efforts are needed to broaden the reach and accessibility of online therapy.

Intersectional Issues

The success and accessibility of online therapy treatments are profoundly affected by intersectional characteristics such as disability, gender, ethnicity, culture, and sexual orientation. Disabled people, such as those with vision or hearing impairments who need adaptations, may have trouble gaining access to and making use of online treatment platforms. Some people may respond better to treatment if their therapist is of the same gender or ethnic background as them. Similarly, people from underrepresented cultures may have trouble locating therapists who value their ideas and experience (Isb??oiu, 2022). Even in virtual treatment sessions, prejudice and inequality might exist. It is possible for therapists to unintentionally display prejudices depending on a client's gender, race, or sexual orientation. It might be challenging for clients to identify a culturally competent therapist on certain platforms due to a lack of variety in the therapist offers. Because those with more privilege and resources are more likely to benefit from online treatment, inequalities in access to technology and healthcare may worsen preexisting inequities in mental health as explained by Stefan et al., 2019. In order to provide online therapy treatments in a fair and ethical manner, it is essential to address these intersecting concerns. It requires efforts to lessen prejudices and inequalities in the online treatment environment, as well as training for therapists in cultural competency.

Conclusion

Research on the efficacy of internet therapy for emotional distress shows its rising importance in the field of mental health. Virtual reality-based treatments, cognitive behavioural therapy, and other online interventions have all been demonstrated to be beneficial in reducing symptoms of mental health issues including depression, anxiety, and post-traumatic stress disorder. However, they do have certain restrictions, the most notable of which being the difficulty of establishing a therapeutic rapport without actually meeting in person.

While online treatment has the potential to improve access and convenience, it also raises some interesting ethical questions. Essential to upholding ethical norms are respect for confidentiality, informed consent, and therapeutic boundaries. Barriers to the online medium's accessibility are affected by factors such as cost, language, and technology. Inclusivity relies on a product's suitability for a wide range of people, taking into consideration their age, gender, culture, and language.

Equal access to mental health care requires a focus on C. addressing intersectional concerns. Both the efficacy and the availability of internet treatment are affected by factors such as disability, gender, ethnicity, culture, and sexual orientation. If we want mental health services to be available and useful for everyone, we need to find ways to overcome prejudice and inequality.

There is hope for the future of e-health therapeutic treatments, but obstacles still need to be overcome. The discipline is projected to develop in response to technological developments such as telemedicine platforms and artificial intelligence. Maintaining a focus on eradicating discrimination and promoting diversity in the workplace is essential. The future of the discipline hinges on finding a middle ground between accessibility and therapeutic efficacy. New developments in technology and changing mental health care paradigms are fast altering the landscape of online therapy treatments for mental distress. The possibility for providing efficient care grows with the use of telehealth systems. Treatment results might be improved with the help of artificial intelligence and machine learning by allowing for more individualised and timely treatments. Data security, client privacy, and closing the digital gap are all issues that need ongoing attention.

References

Almathami, H. K. Y., Win, K. T., & Vlahu-Gjorgievska, E. (2020). Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: systematic literature review. Journal of medical Internet research, 22(2), e16407.https://www.jmir.org/2020/2/e16407/

Atwood, M. E., & Friedman, A. (2020). A systematic review of enhanced cognitive behavioral therapy (CBT?E) for eating disorders. International Journal of Eating Disorders, 53(3), 311-330.https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23206

Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2021). Live psychotherapy by video versus in?person: A meta?analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy, 28(6), 1535-1549.https://cams-care.com/wp-content/uploads/2021/09/Teletherapy-Meta-analysis.pdf

Isb??oiu, A. B. (2022). The Effectiveness of a Cognitive-Behavioral Therapeutic Program Delivered Online in Reducing Social Anxiety Symptoms. Bulletin of the Transilvania University of Bra?ov, Series VII: Social Sciences and Law, 15(2), 119-132.https://webbut.unitbv.ro/index.php/Series_VII/article/download/3272/2601

Lederman, R., D'Alfonso, S., Rice, S., Coghlan, S., Wadley, G., & Alvarez-Jimenez, M. (2020). Ethical issues in online mental health interventions.https://scholar.archive.org/work/k6gjpgy7cras7hxzvdtooesatm/access/wayback/https://aisel.ai snet.org/cgi/viewcontent.cgi?article=1065&context=ecis2020_rp

Maul, S., Giegling, I., Fabbri, C., Corponi, F., Serretti, A., & Rujescu, D. (2020). Genetics of resilience: Implications from genome?wide association studies and candidate genes of the stress response system in posttraumatic stress disorder and depression. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 183(2), 77-94.https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ajmg.b.32763

Mendes-Santos, C., Nunes, F., Weiderpass, E., Santana, R., & Andersson, G. (2022). Understanding mental health professionals’ perspectives and practices regarding the implementation of digital mental health: qualitative study. JMIR formative research, 6(4), e32558.https://formative.jmir.org/2022/4/e32558/

Nam, G. H., Choi, Y., Kim, G. B., Kim, S., Kim, S. A., & Kim, I. S. (2020). Emerging prospects of exosomes for cancer treatment: from conventional therapy to immunotherapy. Advanced Materials, 32(51), 2002440.https://onlinelibrary.wiley.com/doi/pdf/10.1002/adma.202002440

Ta, V., Griffith, C., Boatfield, C., Wang, X., Civitello, M., Bader, H., ... & Loggarakis, A. (2020). User experiences of social support from companion chatbots in everyday contexts: thematic analysis. Journal of medical Internet research, 22(3), e16235.https://www.jmir.org/2020/3/e16235/PDF.

Tannenbaum, M., & Har, E. (2020). Beyond basic communication: The role of the mother tongue in cognitive-behavioral therapy (CBT). International Journal of Bilingualism, 24(4), 881-892.https://www.researchgate.net/profile/Michal-Tannenbaum/publication/339002960_Beyond_basic_communication_The_role_of_the_mother_tongue_in_ cognitive-behavioral_therapy_CBT/links/5e3e5732a6fdccd96590e0bb/Beyond-basic-communication-The-role-of-the-mother-tongue-in-cognitive-behavioral-therapy-CBT.pdf

Tavor, O. (2022). Coping with Social Trauma in Ancient China: The Healing Power of Meditation, Ritual, and Music. In Coping Rituals in Fearful Times: An Unexplored Resource for Healing Trauma (pp. 65-76). Cham: Springer International Publishing.https://ealc.sas.upenn.edu/sites/default/files/oritavor%40upenn.edu/Coping%20with%20Social% 20Trauma.pdf

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