Good questions, Kate. I think there are pros and cons. Due to the partial anonymity online, people may be more honest about their drug problems. Then again, as you mention, it might be hard for the therapist to detect when clients are under the influence (tho I have spoken to some online therapists who say it IS sometimes possible to detect this, especially when you know how the person usually behaves online) Most therapists will agree that any kind of therapy or counseling, f2f or online, will not be very effective until the person stops using the drug. In the case of alcohol, many therapists insist the person also belong to AA in addition to being in individual therapy. If an online approach is used to help a drug addicted person, my guess is that it will be much more effective when combined with other treatments. f2f work of some kind would be an important part of that picture.
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