Computer-mediated psychotherapy: toward patient-selection guidelines.

The greatest obstacle currently slowing the progress of research in computer-mediated psychotherapy is the fact that unless the physicians using it truly believe in its effectiveness, even the most sophisticated computer technology will fail. The more complex the tasks, the less likely are people, including mental health professionals, willing to believe that computers can successfully carry them out. Many people fear the psychotherapy experience would be dehumanized by the introduction of computer technology. But the medium must not be confused with the message; the computer is simply an extension of the therapist, permitting one therapist to treat not just a few, but thousands of desperate patients. The current state of computer-mediated psychotherapy is such that this medium appears to be best suited to individual psychotherapy of a brief or focused nature, particularly the cognitive-behavioral therapies. The introduction of computer technology into psychotherapy offers the significant advantages of flexibility, consistency, and economy that would make psychotherapy more effective and more readily available to a much broader patient population than the one presently benefiting from such treatment. The preceding discussion has been an attempt to offer some practical guidelines for patient selection for computer-mediated psychotherapy based upon available investigations. As such, it is nevertheless incomplete and open to future revision. Considerable work remains to be done before definitive recommendations can be made, but it is hoped that these suggestions may prove helpful to clinicians working at the frontier of this new and exciting therapeutic medium.