Investigating online psychotherapy in the framework of ethical codes

Abstract

The ways people communicate and interact have been changing over time as a result of the increasingly widespread developments and changes in technology. The use of the Internet, which has become an inevitable part of human life, increasingly raises the question of whether psychotherapy can be performed over the Internet. At the same time, doubts about the effectiveness of online psychotherapy; worries about not being able to establish a therapeutic alliance; the lack of technological infrastructure, privacy, and security; and ethical problems pose serious obstacles to the developments in this field. The aim of this study is to examine therapists' reactions to unexpected situations that occur in the literature within the framework of ethical codes and that are found to be the most concerning to therapists regarding online psychotherapy. This study's participants involve 43 therapists working in different provinces of Turkiye. The study examines online psychotherapy with the aim of revealing psychotherapists' perceptions with regard to hypothetical situations and analyzes the obtained data according to the qualitive analytical method of inductive thematic analysis. The findings can be grouped under five themes: (1) how to not lose control of the area of responsibility, (2) how to cope with out-of-control situations, (3) how to maintain the limits of competence, (4) how to cope with the lack of nonverbal cues, and (5) a red line not to be crossed (i.e., these participants do not prefer online therapy). When considering the findings regarding their views, they are seen to range from online therapy being considered completely unethical at one extreme and unethical not to use online therapies at the other. The study discusses these emerging themes with reference to the Code of Ethics of the Turkish Psychologists Association while also analyzing therapists' reactions to the situations and determining the needs for and resolving which items should be present in the code of ethics.