In Brief

The OnlineClinics Web site has a simple short-term goal: attract clients and privately communicate with clients who have mental health concerns via the Internet and telephone. Its long-term goal? To invite "virtual" clients who need to visit the psychologists' real offices for professional face-to-face services.

The site, www.OnlineClinics.com, connects clients with licensed practitioners, who begin the therapeutic relationship by providing instant, direct and secure services online. OnlineClinics expect that once clients feel comfortable receiving these online services and establish initial trust, they will warm up to office visits.

"People who up to now hesitated to seek a psychologist's services, were shy or found it hard to openly seek professional help, may find the distance of online consultation a friendly beginning," says psychologist Ron Kraus, PhD, OnlineClinic's president and founder.

Here's how it works: When clients visit the site they search for psychologists and social workers who are licensed in their state, and they can freely view the providers' photograph, resume, specialty, location and fees. Most clinicians charge between $50 and $100 for a 50-minute session online. Clients can directly schedule appointments with a professional of their choice through the site. The site ensures that conversations between patients and providers are kept confidential by using sophisticated encryption software that requires clients to have a user name and password.

About 400 licensed psychologists and social workers have already registered to provide consultation services to clients through the site. OnlineClinics insists on screening all interested providers and requires them to show a current license and proof of valid liability insurance, says Kraus. The company also uses HSP Verified, a nationally recognized verification service, to check the credentials of its providers. The site currently accepts no advertising and is managed by clinicians.

Kraus asked George Stricker, PhD, and Judy Hall, PhD, both former chairs of APA's Ethics Committee, for their suggestions on making the site professional, legal and ethical. Both serve on OnlineClinic's board and Hall is the president of HSP Verified and executive officer of the National Register of Health Service Providers in Psychology.

Because online therapy is still an emerging medium, there is some degree of ethical uncertainty and legal issues regarding its use. For instance, it's unclear whether a psychologist licensed in one state can legally treat a client in another state by telephone or over the Internet. Unlike similar services, OnlineClinics eliminates this concern by requesting that providers treat only clients who live in their state, says Stricker, a distinguished research professor at Adelphi University.

Kraus also paid close attention to patient confidentiality when he designed the site. In addition to using encryption software and passwords, he made sure that conversations and instant and interactive e-mail transmissions between patients and providers aren't recorded on the site's secured host computer. And, unlike many Web sites, OnlineClinics doesn't share its clients' private information with third parties, says Kraus.

"We wanted to make the online resource center look, appear and function exactly like a real clinic with the extra ease of allowing clients to use their computer to get educated, to ask a question, to see how we maintain confidentiality online and to find a qualified provider of their choice," says Kraus.

--L. RABASCA