A Genie in a Bottle?

Could Online Therapy Be A Deterrent to Mass Shootings?

Could e-therapy be effective in preventing mass shootings?

How many times have we heard the gunman described as a lone wolf? One who kept to himself? Imagine being the family of one of those troubled souls and having begged, demanded, attempted to bride, and used every conceivable method in vain attempts to get them into therapy, trying to help them get help.

Given their isolation, either self-imposed or shunned by their peers, getting that withdrawn, tormented individual to sit face-to-face with a stranger and talk about their private thoughts may be fruitless effort.   Enter e-therapy, a radical new approach to the proverbial lying-on–the-chase-as-you-tell-your- troubles traditional model of one-on-one physical presence therapy.

Researchers, judiciary and legal experts, mental health professionals, and technology innovators are looking at the feasibility of online mental health services.  Some instances when it might be a viable alternative, when the likelihood of face-to-face therapy happening is nil, could include situations such as the one described above, in which a disturbed person needs a rational, calm voice in the midst of their chaos. With e-therapy, that rational, calm voice could come to them with the click of a mouse.

E-therapy is “a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these” (Manhal-Baugus, 2001).

Other applications, proponents say, include full-time caregivers, who need emotional support but have very limited free time and for convicted felons on house arrest, ordered by the court to undergo therapy. In the case of violent offenders, going into that offender’s home environment could put the therapist at risk. For college students away from home for the first time, stressed to the breaking point, and with no car on campus, e-therapy could be a sensible coping mechanism. New mothers, chronically exhausted from taking care of the baby but who don’t have a sitter or whose premature infant’s fragile immune system precludes taking the child out could likewise benefit from e-therapy as could other cases where there is illness or some other insurmountable barrier.

While proponents of the format recognize that e-therapy is not a replacement for face-to-face interaction in cases of severe mental illness in which other treatments may be needed, online therapy is flexible enough to address many difficulties which clients present to the online therapist. The use of e-therapy has been rapidly expanding since the 1990s, with growing evidence suggesting that the provision of mental health services over the Internet is both clinically efficacious and cost effective (Sucala, et al, 2012).

Some traditional therapists question whether or not the online format, in which some non-verbal cues – body language by which a therapist assesses client behavior in addition to what they say —  are lost, provides adequate connection in order that the client-therapist bond may form, without which any efforts are doomed to fail. Research results seem to indicate, though, that e-therapy is equivalent to face-to-face therapy in terms of therapeutic alliance, which is tied to outcome (Sucala, et al).

Some advantages of e-therapy may include:

  • Less expensive
  • Client may be more comfortable expressing themselves in their own environment
  • Ease of scheduling
  • No commuting necessary
  • Some see it as more confidential than traditional therapy, where clients sometimes fear being seen leaving a therapist’s office
  • For introverts, it may be a less stressful mode of interaction
  • People in abusive relationships may be able to get therapy without their partner knowing

More research is needed. And in the area of gun violence in particular, it is radically underfunded when viewed in comparison to other causes of death in the U.S. in terms of numbers (Journal of American Medical Association, CNN).


Howard, J. ( July 12, 2018). Gun violence research funding gets snub from House Appropriations Committee. CNN. Retrieved from: cnn.com/…/gun-violence-research-house-gop-bn

Manhal-Baugus M.(2001). E-therapy: practical, ethical, and legal issues. Cyberpsychol Behav. 2001 Oct;4(5):551–63. [PubMed]  https://www.ncbi.nlm.nih.gov/pubmed/11725648  

Sucala, M.; Schnur, J.; Constantino, M.; Miller, S.J.; Brackman, E. and Montgomery, G. (2012) The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review.  Journal of Medical Internet Research.  2012 Jul-Aug; 14(4): e110. Published online 2012 Aug 2 https://www.ncbi.nlm.nih.gov/pubmed/22858538


Could e-therapy be effective in preventing mass shootings?

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