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Allow me to begin this article with a joke that I sometimes tell at conference presentations and in other articles I write. I made it up myself, so be forewarned. It may not be terribly funny. But I do think it's an interesting joke:
How many clinicians does it take to do computer-mediated psychotherapy?
None. The computer can do it all by itself.
OK, so I'm not Jerry Seinfeld or Rodney Dangerfield. Why then do I think this joke is interesting? For two reasons. First, like many jokes, it points to a sensitive issue. Are we worried about computers taking over and ruining human relationships? Will really poor computer-mediated psychotherapy replace the tried and true methods of traditional psychotherapy? We could certainly make those arguments and it's something we should be on the lookout for. On the other hand, the joke suggests that big and interesting changes are coming right at us. Will computers someday actually do psychotherapy? Even if we insist that this isn't plausible, what will be possible given all this new technology? People are already doing psychotherapy in cyberspace right now. So what's next? Where is this all heading?
That's the question I'd like to address here. I'm going to take out my crystal ball in order to predict the future of online clinical work. Now, my fortune-telling skills are probably about as good as my ability to write a good joke, so maybe I should modify that statement. I'm going to talk about what I think might happen in the future, or maybe what I'd like to see happen. To a large extent I'm basing these predictions—or expectations—on issues we discuss in the Clinical Case Study Group of the International Society for