The widespread availability of electronic mail, bulletin boards and other services available on the Internet have generated an important communications medium. It has enabled the construction of communities and intimate exchanges between people who have never physically met.
The question arises as to whether these Internet services can used to support counselling. By counselling we mean a contracted arrangement where two people meet with the intention of facilitating the emotional well-being of one of the participants. This paper explores some of the ethical considerations surrounding counselling via the Internet. In particular, it addresses the following ethical areas:
- Autonomy: Autonomy is an ethical principle which includes the right of the client to act as an autonomous agent as long as their choices do not infringe on the rights of other. However, autonomy does not necessarily imply unlimited freedom. Many codes of practice would support the breaking of confidentiality in the case where a client is threatening to kill somebody or themselves. With the isolation of an internet relationship, both client and counsellor may be separated from normal support networks and contacts. In such circumstances, how would the counsellor resolve the issue of assaulting autonomy and breaking confidentiality ? If the client and counsellor are on separate geographical or metaphoric continents who does the counsellor contact in such circumstances?
- Beneficence: acting to enhance client well-being. Is it possible to enhance a client’s well-being when the communication between the two participants is only at a textual level? It is estimated that more than 50% of communication is communicated unconsciously by paralinguistics such as tone of voice and body language. Although, methods of communicating emotions over the Internet have evolved, they are very basic and are currently no replacement for face to face contact.
- Nonmalefience: avoiding harm to clients. This may be difficult if not impossible to avoid when the client may be in another part of the world or isolated from the usual support networks. The client may also be communicating with the counsellor anonymously, using email services which hide the sender’s identity. What are the ethical considerations for providers of such anonymous email services?
keeping faith with clients. Is it possible to trust a counsellor who may be in another geographic location and when the client may not have access to any formal complaints procedures ? Is it possibe for a client to trust a counsellor who they have never met?
Counselling requires a confidential environment, within agreed limits. It is not clear that the Internet can currently offer the necessary standards for confidentiality. Can the client be certain that the counsellor is maintaining the boundaries of the contract?
Face to face counselling sessions have agreed boundaries. For instance clients may see their counsellor once a week for an hour. If the client and the counsellor are communicating via email, how often should the counsellor respond ? Clients can send electronic mail when they choose. In a more conventional setting, meetings may be limited by the service being closed. Contractural arrangements are much more difficult to agree when the communication is via the Internet.
All professional counsellor organisations require counsellors to be supervised. As has been described above there are real difficulties regarding client counsellor communications via the Internet. Similar difficulties are likely if the counsellor and supervisor are also only communicating via the Internet.