In the late 1990’s, large online clinics such as “eTherapy.com”, “Here2Listen.com” and “HelpHorizons.com” appeared, and for a time they were profiled in mainstream media sources (including CBS and Psychology Today magazine). I remember, as an undergraduate psychology student, visiting these websites and being intrigued at the idea of providing therapy over the Internet. But then something happened; or should I say, then nothing happened. As I finished my undergraduate studies and spent the years following in graduate school, I expected Online Counseling to be everywhere, to be discussed in my classes, and to be the “new wave” of the field—but it wasn’t. In fact, I heard nothing about it. Unable to sleep one night, I began an online search with the question, “What happened to Online Counseling?”
What I found was a hodgepodge of the large online clinics’ elaborate, though defunct, websites, and smaller clinics’ active, terrible sites, scattered across the Web. I joined a group called the International Society for Mental Health Online (ISMHO), an organization founded in 1997 to promote the understanding, use and development of online communication, information, and technology for the international mental health community. And as soon I gained access to the member discussion board, I set out to harass every active member. My first and most pressing question was simply “What happened?” Dr. Jason Zack, the once clinical director of the now defunct eTherapy.com—and past-president of the ISMHO—explained to me the downfall of the early eClinics.
Note: the following is a combination of testimony from numerous experts in the field, what has been previously written on the subject, and what I have been able to piece together from defunct websites present in the Internet archives.
The Rise and Fall
The two most impressive online clinics of the late 1990s were “eTherapy.com” and “Here2Listen.com.”22 Perhaps the best funded, eTherapy.com had millions in capital and, boasting the slogan “Setting New Standards in Online Care”23, hired attorneys who were involved in writing the APA ethics code. eTherapy.com also set out to survey every U.S. state in search of any laws that would interfere with online counseling provision.24Not to be outdone, Here2Listen.com gained immediate legitimacy by acquiring an advisory board of respected professionals including APA President Philip Zimbardo (he conducted the famous “Stanford County Prison Experiment”).25The future looked bright for these young companies, but today they are both defunct. Why? Several reasons have been suggested.26
Spending and Revenue. With the expectation that they would become huge enterprises, Internet start-ups in the late 1990’s spent liberally on high salaries, expensive office suites, and other lavish accoutrements. eTherapy.com was no exception. Then, in late 2000 the infamous dot.com stock market crash, affectionately referred to as the ‘dot.BOMB’ occurred. After that, investors became scarce and financial problems plagues hundreds of Internet companies.
Moreover, it has been said that Here2Listen.com’s profits were anticipated but never came. One writer explains, “it had been discussed in mail-list groups that the market for online services had been overestimated, and some sites had closed because their large investments were not producing a profit.”27 Even though eTherapy.com had hundreds of registered professionals, such did not equate success because profits were contingent on taking a portion of the counselors’ fees for services. What this meant is that if therapists didn’t treat clients, eTherapy.com didn’t make any money. In fact, eTherapy.com accrued a considerable administrative expense every time a new therapist registered to be an online provider, and the company was never able to recoup those sums.
Management and Technology
eTherapy.com was owned and operated by non-clinicians who knew little about managing a counseling practice (one owner allegedly had a successful online business selling watches)28.Hence, eTherapy.com failed to implement practical counseling technologies, such as the telephone. Instead, at a time when the vast majority was still using dial-up Internet connections, they encouraged therapists to provide a greeting on VHS that they would convert into Web video!29A good idea, but it was about a decade early.
Eventually, eTherapy.com closed their doors, leaving hundreds of registered therapists in the dark, not knowing the status of their online practice.30 Similarly, without notice to clients or therapists (and allegedly with many outstanding debts) Here2listen.com shut down. Rumor has it the proprietors of Here2listen.com fled the US to avoid creditors.31 Their website domain name, possibly their last asset, has been for sale at buydomains.com for several years without purchase.32
When I began researching Online Counseling, I wanted to know the most I could about every operating and defunct online clinic. At the same time, I was very concerned about the possibility of waking a sleeping giant that would rise again the way it had in the late 1990’s—making building Online Counseling.com more impossible than it already seemed.
But the more I asked questions. The more volumes I read about the topic. The more nights I spent rifling through the Internet archives and paying experts (with student loan money) for interviews, the more it seemed the Online Counseling industry was in a state of disrepair. If it was a house, it was not a livable residence. The wiring—the way counseling technologies were put to use—needed updating. The roof—the quality of services provided—needed to be raised. The foundation—a mission and vision for Online Counseling services—was built on sandy ground, and over 20 years time it had shifted, and the structure above had caved under the weight of overzealous investors and multi-million dollar corporations; as well as well-intentioned practitioners. The corporate giants had long abandoned this place. Or they were on the ground floor when it all came falling in. ETherapy.com and Here2Listen.com were not sleeping giants. They were dead.
22 Personal communication with Dr. Jason Zack, past Clinical Director of eTherapy.com, 2004).
23 Viewable at Archive.org
24 Zack, Personal Communication, (2004).
25 Kraus, R. (2004). Ethical and legal considerations for providers of mental health services online, In R. Kraus, J. Zack, G. Strickler (Eds.). Online counseling: A handbook for mental health professionals, USA: Elsevier Academic Press.
26 Zack, Personal Communication, 2004
27 Slavich, S. (2003). The status of online mental health services. Unpublished doctoral dissertation, Wichita State University. Wichita, p. 8.
28 Zack, Personal Communication, (2004).
29 Video solicitation from a webpage that has since been removed
30 Zack, Personal Communication, (2004); Suler, J. (2004)
31 Zack, Personal Communication, (2004)
32 Grohol, J. (2003), October 23. International society for mental health online business and eCounseling
technical aspects of online counseling forum. Message posted to http://forums.ismho.org/viewtopic.php?t=92, Grohol, J. (2004). A historical perspective, In R. Kraus, J. Zack, G. Strickler (Eds.). Online counseling: A handbook for mental health professionals, USA: Elsevier Academic Press.; see www.buydomains.com