This document summarizes theories and research on computer-assisted therapy. It discusses the history of computer programs designed to simulate counseling conversations. Early programs included ELIZA and PLATO. More recent advances allow for solution-focused and cognitive-behavioral approaches. The document also examines the advantages and limitations of computer-assisted therapy, such as increased accessibility but inability to assess nonverbal cues.

1. Theories of Counseling:Computer Assisted Therapy PowerPoint produced by Melinda Haley, M.S., New Mexico State University. “This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of an image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program.” “Copyright © Allyn & Bacon 2004”

2. Computer-Assisted TherapyCybercounseling History It is hypothesized that in the 21st century, computers will be used as therapeutic assistants and possibly as the primary therapeutic agent. ELIZA: A computer that was programmed to give Rogerian responses to clients. PLATO: A system that generates strategies to deal with dilemmas and gives clients feedback as to their solutions. The prevalence of cognitive theories are adaptable for some computer programming. “Copyright © Allyn & Bacon 2004”

3. Computer-Assisted TherapyCybercounseling History (continued) Solution Focused Brief Therapy: Gingerich and de Shazer have developed a computer program to aid counselors called Briefer I and Briefer II. Computer advances that have facilitated using computers for counseling: Increased memory to sustain complex programs, use of the Internet and virtual reality. “Copyright © Allyn & Bacon 2004”

4. Computer-Assisted TherapyCybercounseling Theory of Personality Counseling computers do not have theories of counseling. However, cognitive-behavioral theories seem to work best in computer programming whereas psychoanalytic works least well. “Copyright © Allyn & Bacon 2004”

5. Computer-Assisted TherapyCybercounseling Nature of Maladjustment Computers are limited in their ability to deal with: relationship exploration, adjustment problems, and situational, cognitive based problems such as phobias or depression. Virtual reality has some usefulness in these areas but is still limited in its scope. “Copyright © Allyn & Bacon 2004”

7. Materialist Theory: The mind is just a physical process.

8. The Dualist Theory: The mind is separate from the body.“Copyright © Allyn & Bacon 2004”

9. Computer-Assisted TherapyCybercounseling The Counseling Process Computer therapy can help people who live to far away from counseling services or those who can not afford traditional therapy. Online and computer counseling is available 24-hours per day. Computers can be programmed to “do no harm” and make referrals when needed. “Copyright © Allyn & Bacon 2004”

10. Computer-Assisted TherapyCybercounseling The Counseling Process (continued) There are specific ethical codes that govern computer use, written by the American Psychological Association and the American Counseling Association. The computer counselor cannot FEEL but people can project their own feeling onto it. The computer counselor is perpetually patient and can guide the client to practice new skills and behaviors without tiring. “Copyright © Allyn & Bacon 2004”

11. Computer-Assisted TherapyCybercounseling The Counseling Process (continued) The computer does not participate in countertransference. The computer counselor is an expert. Therapeutic responses, as well as treatment plans, can be programmed into it. The computer can be individually tailored to the client’s needs. “Copyright © Allyn & Bacon 2004”

12. Computer-Assisted TherapyCybercounseling The Counseling Process (continued) Computer counseling is infinitely less expensive then human counseling and therefore more accessible to more people. The computer counselor is never sick or on vacation. The computer cannot pick up on nonverbal communication or subtlety but this may changed with future technological advances. “Copyright © Allyn & Bacon 2004”

13. Computer-Assisted TherapyCybercounseling The Counseling Process (continued) Emotional Bracketing: Used in cybercounseling or computer counseling to display underlying emotion. “Okay, I get it now [Relieved].” “Good, you had me going there for a minute [Worried].” Descriptive Immediacy: This is a description of what is going on physically, emotionally and cognitively with the client and uses language that simulates a face-to-face encounter. “Great! You did it! If I could smile at you right now I would.” “Copyright © Allyn & Bacon 2004”

15. Emoticons: Keyboard symbols that when turned sideways look like facial expressions e.g. ; ) or : ) and some computers will take the last one and turn it into  .One benefit of the Internet is the abundance of chat room support groups available on just about any condition, issue or disorder. “Copyright © Allyn & Bacon 2004”

16. Computer-Assisted TherapyCybercounseling The Counseling Process (continued) Currently, computer counseling can only achieve what has been written into the computer code. Some people may be put off by computer counseling while others will thrive on it. Usually, it is a generational phenomenon. Older people dislike it and younger people love it. “Copyright © Allyn & Bacon 2004”

17. Computer-Assisted TherapyCybercounseling Advantages of Computer-Assisted Therapy or Cybercounseling Relieves the human therapist of many tedious tasks such as taking a history, diagnosis, and case management or follow-up. It can help the human therapist confirm his or her diagnosis. The computer can handle many clients at the same time. The computer could free up valuable time for the human therapist. “Copyright © Allyn & Bacon 2004”

18. Computer-Assisted TherapyCybercounseling Advantages of Computer-Assisted Therapy or Cybercounseling (continued) The computer could field crisis calls and alert a human therapist or 911. It can be a simulator to train new therapists. Using virtual reality has real benefit in working with client’s with phobias. “Copyright © Allyn & Bacon 2004”

19. Computer-Assisted TherapyCybercounseling Disadvantages of Computer-Assisted Therapy or Cybercounseling There is still a debate regarding ethical problems associated with using computers in counseling. Confidentiality is harder to ensure online or on hard drives. There has not been enough research done on computer counseling or counseling programs to ascertain validity of such programs. There is no way to ascertain the credentials of the online therapist. “Copyright © Allyn & Bacon 2004”

20. Computer-Assisted TherapyCybercounseling of Computer-Assisted Therapy or Cybercounseling (continued) It has not yet been determined in what ways liability and malpractice will be extended to Internet or cybercounseling. Computer programs and computer counseling has not advanced far enough to view people phenomenologically. Human touch cannot be given by a computer. “Copyright © Allyn & Bacon 2004” Disadvantages

21. Computer-Assisted TherapyCybercounseling Computer-Assisted Therapy or Cybercounseling with Diverse Populations. Cybercounseling or computer assisted counseling has tremendous advantages for people living in remote areas, for those who cannot afford traditional therapy or have physical disabilities that make it hard to travel. It may make counseling easier for shy people, for people who feel their problem is socially unacceptable because the computer is nonjudgmental and nonthreatening. It may not be as readily available in all cultures. Anglo-Americans are more likely than any other culture to own a computer. “Copyright © Allyn & Bacon 2004”

22. Resources Ivey, A. E., D’Andrea, M., Ivey, M. B. and Morgan, L. S. (2002). Theories of counseling and psychotherapy: A multicultural perspective, 5th ed. Boston, MA.: Allyn & Bacon. James, R. K. & Gilliland, B. E. (2003). Theories and strategies in counseling and psychotherapy, 5th ed. Boston, MA: Allyn & Bacon. Kottler, J. A. (2002). Theories in counseling and therapy: An experiential approach. Boston, MA: Allyn & Bacon. “Copyright © Allyn & Bacon 2004”