The Lived Experiences of Online Therapists Maintaining Ethical Boundaries

The provision of counselling and psychotherapy using technology, also referred to as telecounselling or e-therapy, is a burgeoning area of mental health care that has garnered much enthusiasm. Many professional health organizations have developed ethical guidelines to specifically address this unique style of treatment. Skepticism remains in the area of applying standards into practice. Ethical guidelines are meant to be broad principles that can be applied to a range of unique practice experiences. The problems is that these principles have been developed over a century of practice-based experiences and designed to address situations that the clinician faces when their client is being treated in the same room. There is a gap in knowledge that has yet to describe what unique practice-based ethical challenges arise when the client is being treated remotely or even asynchronously through an electronic ‘office space.’ This qualitative hermeneutic phenomenological study explored the lived experiences of practitioners with online practice and the ethical usage of electronic treatment platforms. The sample consisted of 10 practitioners licensed in Ontario who have been using online forums for at least 1 year. The study unveiled themes of shifting power dynamics and new ideas in boundary crossing electronically. Online therapeutic interventions present new challenges in how mental health professionals present themselves as ethical clinicians; therefore, the theory of professional identity was a fitting theoretical framework to guide this inquiry. The social change implications of this research are directly related to the implementation of ethical guidelines and empowering practitioners to have a voice in their evolution