Many thanks to you both for your comments!

@Sarah – I’ve only read about it from a third-person perspective, but from what I understand, it’s an entirely solution-focused approach.

@Emily – I think it’s important to distinguish between using a computer to mediate communication with a human therapist, on the one hand, and using a computer as a self-help tool (without a human directly available ‘on the other end’, so to speak), on the other. To my mind, both have an important and very useful — but distinctly different — role.

Computer software intended to be used primarily as a self-help tool (sometimes in conjunction with less frequent f2f meetings) has become pretty sophisticated, and CBT delivered by the likes of MoodGYM has done well in studies of effectiveness on depression, for example. Would you throw a person in an acute manic phase into a room with a computer-based CBT system and hope for the best? No, certainly not — but when used within the intended parameters, I think they’re actually doing pretty well.

As for computer-mediated communication, my own experience with providing online therapy services indicates that it can be effective for people presenting with a very wide range of problems — from basic personal development at the so-called ‘mild’ end all the way to those already diagnosed with one or more DSM Axis I disorders and even Axis II comorbidity. The essential point here, in my view, is that it is the therapeutic process that matters (and the ability of client and therapist to sustain that process) — not the details of the method of communication. Nobody asks, “hmmm, do you think therapy in Portuguese would be effective?” or “hey, can blind people ever have effective therapy (because after all, they can’t see their therapists)?”. For some reason, when you substitute in the word ‘internet’ or ‘computer’, it often throws the discussion into whole new directions with technology as the primary focus, rather than having the therapeutic process smack dab in the foreground.

Is it for everyone? Nope, clearly not! But then, neither is f2f therapy for everyone!

All the best,
Greg

You quote Dr. Jay Buckley saying, “The Virtual Space Station is based on proven treatment programs and is a very helpful way to work on problems in general,” but how do you think internet-based therapy compares with face-to-face therapy? I understand that for astronauts this is the only option, but projecting into the future for the general public, do you think internet therapy would be a sufficient alternative? I believe it would depend on the nature of the disorder, but it seems that milder diagnoses could highly benefit from something like this that would promote reflection and self-evaluation.

I think you offer a valid point regarding asynchronous therapy via email. While it does have the time-delay, it seems like a healthy outlet for astronauts to discuss their mental concerns to an unbiased party. The emails could act as a diary for these space-explorers to anonymously record thoughts and feelings, which alone seems therapeutic. In their situation, it may be difficult to share issues with other crew members based on a fear of judgment or a perception of weakness, but in an email they would feel empowered to know that a psychologist is listening and will provide feedback. A problem might arise if an astronaut becomes frustrated and expects a quick-fix. The mental unrest that lies within an individual must also be coped with by that person alone; a psychologist just acts as a catalyst in this process.

It also made me chuckle thinking that so many people with depression here on earth feel as if they are in outer space… this might be very appropriate!