People are now checking in with their shrinks via web sessions.

The New York Times reports, since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans' health care facilities and rural clinics - all supervised sites.

Today, third-party sites like CaliforniaLiveVisit.com, have taken psychological therapy sessions to another level, that which is accessible, even preferable, to those who are always on the go or tend to shy away from office treatments.

Webcam therapy has been see on TV via "Web Therapy," the Lisa Kudrow comedy, which brings to a broad audience that virtual therapy sessions could work, if done right.

NY Times reports, a third-party online therapy site, Breakthrough.com, said it has signed up 900 psychiatrists, psychologists, counselors and coaches in just two years.

"In three years, this will take off like a rocket," said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. "Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can't replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed."

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Web psychologists who offer their services online describe a tricky aspect of the virtual set up.

 "You have to prepare vulnerable people for the possibility that just when they are saying something that's difficult, the screen can go blank," said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and New York. "So I always say, 'I will never disconnect from you online on purpose.' You make arrangements ahead of time to call each other if that happens."

While web sessions generally work, there are exceptional cases in which it may not serve well for the patient due to anonymity issues. Many people would rather hide their identity from their web therapist, who allow such set ups. The NY Times asks, what if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient?

"A lot of patients start therapy and feel worse before they feel better," noted Marlene M. Maheu, founder of the TeleMental Health Institute. "It's more complex than people imagine. A provider's Web site may say, 'I won't deal with patients who are feeling suicidal.' But it's our job to assess patients, not to ask them to self-diagnose."

According to NY Times, a number of studies have concluded that patient satisfaction with face-to-face interaction and online therapy (often preceded by in-person contact) was statistically similar. 

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