Few satisfactions are as sublime as alleviating another’s pain. Consequently, few professions are more rewarding than online mental health therapy.  But it isn’t free.

Below are the three greatest challenges of online mental health counseling.

Ethical Issues Confronting Online Mental Health Therapy

Online Mental Health Therapy can brush up against genuine ethical issues and engender discomfort and dilemma in the relationship. Some of the more common challenges  are:

Values:  It is imperative that the therapist’s cultural and religious values and beliefs stay out of the therapy. If the clinician is to be of help, then he/she must strive to understand the client’s religious and cultural orientation in a professional manner free and clear of discrimination. If the therapist feels there is a conflict, then the client must be referred to another therapist.

Confidentiality: Short of written permission otherwise, the client’s information must remain strictly confidential as counseling depends upon trust. Even when family or friends request information, this confidence must be maintained despite the protests otherwise. Alternatively, a court order may require the therapist to divulge private information.

Boundaries: Many mental health therapists feel their most challenging ethical issues is maintaining professional boundaries with their clients. Sometimes the professional role of clinician will be in direct conflict with another relationship with the client be it friend, business or otherwise. This dual relationship will often compromise if not completely undermine the benefit of the therapy.

Changing Patterns

Often a client is “stuck” in a detrimental situation or relationship due to patterns that developed and were reinforced through decades of repetition. Helping clients detach themselves from these destructive and deeply entrenched patterns can present a daunting challenge.

It can seem impossible to generate movement beyond these deeply held beliefs and thoughts that have been clung to dearly often since childhood.

What complicates this further is that the client can’t just drop cold turkey. A happy medium is required to on the one hand allow the client to continue these unhealthy patterns (when necessary) while simultaneously pushing for substantive change. Finding this happy medium in online mental health therapy requires a great degree of sensitivity, understanding, and finesse.

Emotional Drain and Burnout

But perhaps the most difficult challenge for many a therapist is enduring their client’s pain as the client works through the issues.  Effective therapy by definition often demands to navigate emotionally painful territory. Experienced therapists know that “baring one’s heart” doesn’t always make it feel better.  In fact sometimes, it makes it feel worse.  But they also know that this courage is often the key to success.

Dredging up painful experiences and memories, to say the least, can be upsetting and sometimes overwhelming. Effective counseling, while rewarding, is often a difficult and at times painful process.  There may be many bumps in the road.  For a compassionate and sympathetic therapist, this journey is not easy to witness – not to mention being part of it.

It is critical that the person involved in online mental health therapy acknowledges his/her emotional drain. If a therapist wants to remain helpful and avoid “burnout”, the taxing of these emotions must be addressed.  Clinicians have found various strategies that have been helpful.

Some therapists work shorter days which helps keep energy levels up. Others get ready for sessions through deep breathing and visualization techniques that help prepare for clients. Still others empathize and feel with their clients during sessions, but to also leave it all in my office when they go home. They don’t let the emotional experiences “stick”.

As one therapist was told, “You are very good at being empathic and breathing people’s stuff in. You need to remember to breathe it out.”