According to the online therapy resources, E-therapy directly addresses a major problem uncovered by the Surgeon General's Report on Mental Health (1999) which stated that, while one American in five has a diagnosable psychological problem, nearly two-thirds of them never seek treatment. For anyone suffering from severe depression, trauma, or drug or alcohol addiction, face-to-face meetings are crucial in discerning facial cues and body language. But, while seeing a therapist face-to-face sometimes preferable, in some cases it isn't always possible or necessary. Whether for financial, personal or logistical reasons, the internet can be a good source of information about general mental health questions as well as therapeutic contact.

When seeking mental health treatment, the variety of professional degrees, specific treatment competencies and licensures can be mind-boggling. Here is a truncated listing of licensure and the fields and competencies that are related. Therapists include certified counselors, advanced practice nurses, religiously trained practitioners, licensed social workers, psychologists, marriage and family counselors, substance abuse counselors, psychiatrists, doctors of medicine with advanced training in mental health specialties, and other mental health professionals. They may be licensed for individual counseling, marriage counseling, family counseling, treatment of various disorders including eating disorders, depression, anxiety, personality disorders, phobias, substance abuse and many other conditions.

In addition to this somewhat confusing array of professionals are many specialists under each category. This is both good to know, and challenging, in terms of knowing where to turn. Before beginning any therapy it is good to do some research into one's own symptoms and some accepted approaches to treatment. There are many online resources, such as the Mayo Clinic mental health listing of terms that may be helpful in defining conditions, symptoms and related issues. The National Institute of Mental Health can also provide background information.

Look for the three most important elements when choosing a therapist; academic studies, supervised clinical training and licensure and certification. Other issues to consider if going online include limited security, how payments will be made, inability of counselors to glean cues that may only be detected in person, technological issues, state boundary limitations to where counselors may practice, what insurance is accepted and other assorted issues. Once these things are settled, the service that can be provided online has the advantage of being portable, flexible and less costly for both client and provider. In addition, sessions can be tailored to the client's communication abilities and technological resources; a webcam will allow the therapist to pick up on body and facial cues almost as well as when together in an office.

Something online counseling can provide that therapy normally would not, is a verbatim record. While there is the small chance that your messages may get lost in cyberspace, when security issues are handled well, a history of messages from your online therapist can provide a good record of treatment. One thing to keep in mind is that most online counselors have their own real-world offices as well and are simply adding to their practice through online access to clients. Since therapists are legally limited to practicing in the state where they are licensed, it is feasible that an online relationship could become face-to-face should the need arise. In this way, online therapy is like having better access to a health professional than is typical in real world settings. Online therapy allows access at the discretion of the client-therapist agreement rather than being limited by organizational requirements that may allow little or no communication between visits. Email allows messages to be sent and read at any time rather than communicating within a rigid framework.