Internet PsychotherapyPros and cons of online therapy. I. Shapovalyants, PhD, Moscow, 2014 Once upon a time, a patient from a Moscow clinic with a psychosomatic disorder was referred to me. After the first face-to-face meeting, it turned out that the patient lives in another city and is not able to come for regular meetings with obvious indications for psychotherapy. This is how my online practice began. Having worked for many years in large foreign companies, I was quite accustomed to communicating via the Internet with large groups of people, as well as individual work with colleagues located in different cities and countries. However, counseling the patient was the first such experience, and the experience of professional online communication turned out to be useful in subsequent therapeutic work with clients. Considering that 80% of Internet users search for topics related to health online, as well as the significant growth in online counseling, I would like to share the main observations and conclusions based on my personal practice of working online. Perhaps someone will find this experience useful. The idea of ​​conducting psychotherapy at a distance is not new. Sigmund Freud often corresponded with his patients, believing that this would be a clinically useful technique. In the 1960s, telephone helplines were first used, and then hotlines expanded the scope of mental health counseling. Telephone psychotherapy remains extremely popular, often serving as a temporary replacement for face-to-face sessions, for crisis intervention between regular sessions, and to support the therapeutic relationship. Despite the lack of visual cues, research shows that telephone counseling and psychotherapy are quite effective and highly valued by clients. Currently, online communication is mainly used: - Email. mail - Chat - Text messages - Telepsychotherapy (Skype, Facebook, Google Plus) Electronic mail (e-mail) has disadvantages, which include, first of all, the lack of synchronization of communication, that is, the conversation does not take place in real time. This is a fast and free way of communication that almost everyone today has access to, which allows you to first arrange a meeting or change the time. Text in a chat, unlike a telephone conversation, hides vocal features, speech rhythm, irony, “double” meanings and other paralinguistic functions. At the same time, communication occurs in real time, and the client can quickly receive feedback, just like during a face-to-face session. Text messages (SMS) are more commonly used to remind, cancel, or reschedule therapy appointments and are promptly delivered at any time. Internet psychotherapy is usually carried out in private practice and uses such well-known technologies as Skype, FaceTime and Google Plus. These tools are readily available for free and are easy to set up and use. When face-to-face therapy is not possible, the alternative of conducting sessions online becomes obvious. This applies to patients who, for one reason or another, are bedridden or suffer from an infectious disease, remoteness of residence, language barriers, the need for more frequent meetings during the acute period of therapy, etc. At the same time, for some patients online therapy may not be effective enough. For example, patients with depression or agrophobia, if given a choice, would most likely choose to stay at home and conduct the session online. However, for these clients, face-to-face treatment is, at its core, a social interaction that can be therapeutic in itself or serve as good practice and training in social communication. Psychotherapy at a distance certainly loses such important details of the patient's condition as alcohol-smelling breath, auditory and visual changes (a quiet sigh or dilated pupils)..