Ethical issues in online therapy: Assessing compliance with best practice in Ireland and the United Kingdom

Online therapy has been an accepted treatment option for mental health professionals and their clients for almost 20 years and offers many advantages. Despite evidence of its efficacy, the adoption rate for online therapy remains very low. One explanation is the perceived level of risk associated with the delivery of online therapy. Risk management is addressed in most countries by professional bodies’ codes of conduct. It is not clear, however, to what extent therapists and their clients are aware of the risks and the mechanisms designed to mitigate them. Previous studies in the United States and Australia examined evidence of compliance with codes of conduct on therapist’s websites. In each of the previous studies, the research has shown that levels of compliance are very low. This study replicates these studies and is the first to do so in an Irish and United Kingdom (UK) setting. Therapist websites were selected from the directories published by the Irish Association for Counselling and Psychotherapy (IACP) and the British Association for Counselling and Psychotherapy (BACP) and were then reviewed against a ten-item ethical compliance checklist. An additional survey of therapists was included to assess if there was a gap between what therapists do in practice and what they say on their websites. The result of the website review showed similar very low levels of compliance; however, the results of the therapist survey demonstrated higher levels of compliance with ethical codes. The professional bodies have a critical role to play in increasing adoption and compliance but this will require a significant investment in training and communication.