University of Kentucky UKnowledge Theses and Dissertations--Family Sciences Family Sciences 2016 CHARACTERISTICS AND ETHICS OF E-THERAPY WEBSITES WITH MARRIAGE AND FAMILY THERAPISTS Zuzana Gassova University of Kentucky, [email protected] Digital Object Identifier: http://dx.doi.org/10.13023/ETD.2016.098 Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Gassova, Zuzana, "CHARACTERISTICS AND ETHICS OF E-THERAPY WEBSITES WITH MARRIAGE AND FAMILY THERAPISTS" (2016). Theses and Dissertations--Family Sciences. 39. https://uknowledge.uky.edu/hes_etds/39 This Master's Thesis is brought to you for free and open access by the Family Sciences at UKnowledge. It has been accepted for inclusion in Theses and Dissertations--Family Sciences by an authorized administrator of UKnowledge. For more information, please contact [email protected]. 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Zuzana Gassova, Student Dr. Ronald Werner-Wilson, Major Professor Dr. Hyungsoo Kim, Director of Graduate Studies CHARACTERISTICS AND ETHICS OF E-THERAPY WEBSITES WITH MARRIAGE AND FAMILY THERAPISTS ________________________________________ THESIS ________________________________________ A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in the College of Agriculture, Food, and Environment at the University of Kentucky By Zuzana Gassova Lexington, Kentucky Director: Ronald Werner-Wilson, PhD., Professor of Family Sciences Lexington, Kentucky 2016 Copyright© Zuzana Gassova 2016 ABSTRACT OF THESIS CHARACTERISTICS AND ETHICS OF E-THERAPY WEBSITES WITH MARRIAGE AND FAMILY THERAPISTS The current survey of 83 e-therapy websites with marriage and family therapists examined what consumers seeking online therapy or therapy over the phone might find on the Internet. The study explored how e-therapy websites characterize their services and comply with the ethical guidelines of the American Association for Marriage and Family Therapy. Furthermore, differences in compliance with ethical guidelines among the three types of the websites (individual practice websites, group practice websites, and independent contractor websites) were analyzed. Results indicated that a majority of the websites lack information regarding several major areas (e.g., crisis resources, terms of service, procedures to treatment of minors, procedures to provision of therapy across borders). In support of previous findings, compliance to ethical guidelines was low and uneven. The websites focused mostly on positive aspects of e-therapy and in some cases, used suggestive or misleading language. When the three groups were compared, the independent contractor websites demonstrated statistically significantly higher compliance than the other two groups. This study points out several disturbing patterns and calls for clear e-therapy guidelines, which are currently lacking. KEYWORDS: E-therapy Websites, Online Therapy, Phone Therapy, Ethical Guidelines, American Association for Marriage and Family Therapy, Code of Ethics Zuzana Gassova April 26, 2016 CHARACTERISTICS AND ETHICS OF E-THERAPY WEBSITES WITH MARRIAGE AND FAMILY THERAPISTS By Zuzana Gassova Ronald Werner-Wilson, Ph. D. Director of Thesis Hyungsoo Kim, Ph. D. Director of Graduate Studies April 26, 2016 TABLE OF CONTENTS List of Tables ..................................................................................................................... vi List of Figures ................................................................................................................... vii Chapter 1: Introduction ........................................................................................................1 Chapter 2: Literature Review ...............................................................................................4 Different Types of E-therapy ...........................................................................................4 Advantages of E-therapy ..................................................................................................5 Reaching out to underserved groups. ...........................................................................6 Flexibility......................................................................................................................7 Comfort .........................................................................................................................7 Time for reflection ........................................................................................................8 Healing properties of writing ........................................................................................8 Recordability and storability ........................................................................................8 Enriching interactions with clients ...............................................................................9 Power balance ...............................................................................................................9 Ease of connection with family members ...................................................................10 Text messages in situations of crisis ...........................................................................11 Disadvantages of E-therapy ...........................................................................................11 Disinhibition ...............................................................................................................12 Financial cost ..............................................................................................................12 Technical difficulties ..................................................................................................13 Limited available information ....................................................................................14 Misinterpretations .......................................................................................................15 Abrupt terminations ....................................................................................................15 Missing immediate feedback ......................................................................................16 Ethical and Legal Issues .................................................................................................16 Confidentiality and safety ...........................................................................................16 Anonymity ..................................................................................................................18 Informed consent ........................................................................................................20 E-therapy across borders ............................................................................................22 Licenses and malpractice insurance policies limitations ........................................22 Law suits .................................................................................................................23 iii Duty to warn ...........................................................................................................24 Clients' Suitability for E-therapy ....................................................................................25 E-therapy Websites ........................................................................................................27 Compliance to ethical guidelines ................................................................................28 Studies surveying e-therapists .................................................................................29 Studies surveying e-therapy websites .....................................................................29 Chapter 3: Purpose and Objectives ....................................................................................33 Chapter 4: Research Method ..............................................................................................34