How might personality type, presenting complaint, and diagnosis influence the persons suitability for online therapy?
This is a complex topic that deserves more clinical research. A separate set of guidelines could be devoted to it. One basic issue is the level of care a person may require (see Stofle’s description). People who need full or partial hospitalization with close observation and supervision may not be appropriate for online therapy. The level of care a person requires also may change over time, thereby requiring that the clinician assess the person’s history of level of functioning, and then periodically reassess the client during the therapy. As a rule of thumb, severe pathology and risky behaviors – such as lethally suicidal conditions – may not be appropriate for online work. Tendencies towards poor reality testing and strong transference reactions may become exacerbated in text communication, thereby making them difficult to manage and potentially destructive to the treatment. People with borderline personality disorders often challenge the boundaries of therapy, which can be especiall
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