Internet Cognitive Behavioral Therapy (CBT) - online-therapy.com

This is my experience with online-therapy.com, which is an online Cognitive Behavioral Therapy (CBT)-based psychotherapy system. It is conducted in a workbook-style format. The program is divided into sections, much like the table of contents of a book. These sections have brief write-ups about CBT theory followed by a number of worksheets which require user input.

Where this program shines compared to the others I briefly surveyed is that there will be a therapist who provides useful feedback based on the input you give to the worksheets. The therapist’s name is Maggie Sweet (not sure if this is a real name), and based on the reviews, I see many mentions of this same therapist’s name.

Interface

When you sign up for the program, you will be provided with a list of specific problems which you may address, which include most of the commonly known problems such as depression, social anxiety, generalized anxiety, ADHD, for example. They offer three different programs which feature increasing levels of therapist contact with increase in cost. I signed up for the Basic program which was $39.95 per week, however please note that this has to be paid monthly (comes up to $159.80 per month).

The other programs provide two additional features, which are live chat sessions (instant messaging, not voice) and ability to send messages to the therapist at any time. In hindsight, I feel that I made the right choice in signing up for Basic, as I could freely communicate with the therapist through the comment system in worksheets (more on that later).

This is what the dashboard looks like:



Introduction

The program starts with an introductory worksheet where you talk about yourself, the problems you are facing, and historical information pertinent to your issues. I found this extremely useful as a refresher, and it is even better if you are in a difficult period and need to express what’s going on in your life up to now. I selected the problems which I currently face as well as ones which I did face in the past. So this section would normally set the context for the rest of the work, however it does not have to follow this predictable path as you will see.

Section 1 – CBT (Cognitive Behavioral Therapy)

As I go through this review I will try not to divulge too much information from the sections and the worksheets as I think it may detract from the value it could provide if you decide to do this. Anyway, this section gives us a theoretical basis for the work that is to come. I gained a bit of insight from the interactions between thought, behavior and emotion of which we are really no strangers to in this forum.

Section 2 – Looking into anxiety

I also just want to add that I have found it very useful to come back to fill up the worksheets as I encounter problems in life. It has given me a place to express my fears and woes in a rational manner which ends up making me feel better as a bonus. Additionally, the therapist may reply to any one of your entries, there is no set sequence or rigid following of the program. The therapy seems to work in a fluid manner with the therapist focusing on areas which she deems important.

Here, there is a brief “happiness test” as a gauge of how you feel about life in general and how anxiety affects your quality of life.

There was a productive discussion with the therapist in one of the worksheets dealing with problems related to anxiety. Here, we discussed the idea of focusing too much on problems and not looking at the reality of the situation, i.e. the facts. I gradually came to an understanding that instead of focusing on problems, it would be more productive to find creative solutions to the problems that I’m facing. The negative spiral of anxious thoughts leads to a depleted emotional state and therefore is best avoided. The therapist also suggests some practical tools (she calls them coping techniques) to use when dealing with anxiety including taking walks, breathing, body awareness, focusing on work, and more. I also asked for help regarding situations where I find myself “stuck in gear”, or when negative thinking becomes an uncontrollable loop. She suggested using “meta-questions”, such as “is there any proof that this thought is real?” or “IS the situation truly upsetting, or am I making it out to be more than I should?”. Other suggestions included more of the general coping techniques.

It's convenient to be able to use these comment histories as a resource to come back to when you feel anxious or out of sorts. It's even better to be able to implement these coping techniques consistently in my life. I still do forget about them and need reminding every now and then.

Overall, I think we covered a lot of ground in this chapter.

I recently re-did the “happiness test” and I found that I got a lower score than I did previously. I don’t know if that means that the therapy is not working or that I’ve just had a stressful day. Today I couldn’t focus and my mind wandered a lot when I started reading the news, but I’m not sure if it’s because I was malnourished and lacking important amino acids for optimal brain function. The upside is that I decided to go for a hike with a group on meetup.com and met an interesting guy too. I may have probably taken the fasting a little too far today and should have resumed eating a little sooner.


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Thank you for reading, as I am closing in to a full month on online-therapy.com, I have put in a request to pause my subscription until I finish reviewing the chapters that I have worked on.

More to follow soon...
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Well, that sounds very promising. I hope other forum members who may need to do so will take advantage of this sort of thing.

bm said:

There was a productive discussion with the therapist in one of the worksheets dealing with problems related to anxiety. Here, we discussed the idea of focusing too much on problems and not looking at the reality of the situation, i.e. the facts. I gradually came to an understanding that instead of focusing on problems, it would be more productive to find creative solutions to the problems that I’m facing. The negative spiral of anxious thoughts leads to a depleted emotional state and therefore is best avoided. The therapist also suggests some practical tools (she calls them coping techniques) to use when dealing with anxiety including taking walks, breathing, body awareness, focusing on work, and more. I also asked for help regarding situations where I find myself “stuck in gear”, or when negative thinking becomes an uncontrollable loop. She suggested using “meta-questions”, such as “is there any proof that this thought is real?” or “IS the situation truly upsetting, or am I making it out to be more than I should?”. Other suggestions included more of the general coping techniques.

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Interesting! That sounds like pretty good advice to me. It helps you to be in the present instead of in the past or in the future, and stop the internal (and draining) monologue.

I concur and many thanks for sharing!

bm said:

I recently re-did the “happiness test” and I found that I got a lower score than I did previously. I don’t know if that means that the therapy is not working or that I’ve just had a stressful day. Today I couldn’t focus and my mind wandered a lot when I started reading the news, but I’m not sure if it’s because I was malnourished and lacking important amino acids for optimal brain function. The upside is that I decided to go for a hike with a group on meetup.com and met an interesting guy too. I may have probably taken the fasting a little too far today and should have resumed eating a little sooner.

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Tests are imo always biased, because it reflects only the moment when you fill the test out and on another day you would score differently. Saying this and reading your story above you seem to do much better and that you can deal better with anxiety for example.

General that's also what I really like about cognitive therapy in general, because it is imo very practical and in the moment and helps one to deal with issues that are here and not somewhere in the past.

I'm looking forward reading more about it!

[quote author= bm]I also just want to add that I have found it very useful to come back to fill up the worksheets as I encounter problems in life. It has given me a place to express my fears and woes in a rational manner which ends up making me feel better as a bonus.[/quote]

Thank you for sharing bm, If I may I got one question:

Is there a limit at how much you can write and send to the therapist? Let's say I start now, get it on paper (word document). And keep writing till I got nothing more to write. I don't know, let’s say 10 pages? (Is that fair and reasonable?) That way I can make the most out of the month from the start. Because I fear it may take a while, Hopefully not several months …. I'm not in debt or anything, though I have to be careful with my expenses.

it sounds promising to try out, if only for one month and see how it goes.

Thanks for posting this bm, looks like it could be very useful. I assume the prices quoted are in US dollars?

Hi,

Thank you for your replies. Reading them gave me a rush of excitement and I'm feeling a little overwhelmed.

987baz said:

Thanks for posting this bm, looks like it could be very useful. I assume the prices quoted are in US dollars?

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Hi 987baz, yes, that is correct.

bjorn said:

bm]I also just want to add that I have found it very useful to come back to fill up the worksheets as I encounter problems in life. It has given me a place to express my fears and woes in a rational manner which ends up making me feel better as a bonus.[/quote] Thank you for sharing bm said:

I concur and many thanks for sharing!

bm said:

I recently re-did the “happiness test” and I found that I got a lower score than I did previously. I don’t know if that means that the therapy is not working or that I’ve just had a stressful day. Today I couldn’t focus and my mind wandered a lot when I started reading the news, but I’m not sure if it’s because I was malnourished and lacking important amino acids for optimal brain function. The upside is that I decided to go for a hike with a group on meetup.com and met an interesting guy too. I may have probably taken the fasting a little too far today and should have resumed eating a little sooner.

Click to expand...

Tests are imo always biased, because it reflects only the moment when you fill the test out and on another day you would score differently. Saying this and reading your story above you seem to do much better and that you can deal better with anxiety for example.

General that's also what I really like about cognitive therapy in general, because it is imo very practical and in the moment and helps one to deal with issues that are here and not somewhere in the past.

I'm looking forward reading more about it!

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I think you are right about that. I'm still in the program, and I don't feel like I can comment on how it works from a technical standpoint.

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Thanks for posting this bm, it looks really interesting. Look forward to updates as you progress through the therapy.

Very interesting, thanks for sharing! I'm reminded a little of what I've heard about Jordan Peterson's "Self Authoring Suite", which I have purchased and hope to start soon. Then I may try out this website or some other alternative.

Thanks for sharing this bm, it really is very interesting!

David Disalvo in his book "brain changer" recommends a book which he based some of his theory-practice method on CBT called "Change Your Thinking: Overcome Stress, Combat Anxiety and Depression, and Improve Your Life with CBT" by Sarah Edelman. It may be worth reading it considering that "Brain Changer" is such a great book

Arwenn said:

Thanks for posting this bm, it looks really interesting. Look forward to updates as you progress through the therapy.

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Thank you for reading Arwenn -- it is an interesting experience indeed! And I like the therapist, she seems really genuine, though there is a bit of copy-pasting of the stress-coping techniques here and there. It doesn't detract from the value, in fact it only adds value, but some might perceive it as being lazy and taking shortcuts. I think that would be overly judgmental.

HowToBe said:

Very interesting, thanks for sharing! I'm reminded a little of what I've heard about Jordan Peterson's "Self Authoring Suite", which I have purchased and hope to start soon. Then I may try out this website or some other alternative.

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Hey HowToBe, I'm curious about JP's work as well. It does sound very similar in that this work is all about pinpointing our deficiencies in emotional regulation and human interaction to allow us to lead more balanced and growth-filled lives. I hope the Self Authoring Suite goes well for you, and you could also let us know how it goes and whether it provided a benefit for you. I would be interested in checking it out after my work with online-therapy.com.

Yes, you could try other alternatives, but be wary of the ones without any therapist guiding you through. I for one wouldn't have been very motivated to fill up worksheets without any sort of feedback on my work. From what I've seen, most internet CBT websites don't have someone on the other end.

jhonny said:

Thanks for sharing this bm, it really is very interesting!

David Disalvo in his book "brain changer" recommends a book which he based some of his theory-practice method on CBT called "Change Your Thinking: Overcome Stress, Combat Anxiety and Depression, and Improve Your Life with CBT" by Sarah Edelman. It may be worth reading it considering that "Brain Changer" is such a great book

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Hey jhonny! Thanks for checking out my experience! I would love to read David Disalvo's work some day. I'm reading something else at the moment, so I can put this book as next in line. To tell you the truth, I haven't read Brain Changer either. It might be worthwhile for me to start with that book. I read a little bit of it on Amazon and I think it's amazing! I had to read it out aloud to kill my anxious feelings. I think my Inner Voice is affected by the wetiko virus and I need to somehow inoculate it. I like this quote from the book: "An educated inner voice speaks from a position of detachment, while an uneducated inner voice speaks from a position of reactive emotion". Words to live by.

I originally meant to leave the post here, but I feel that I need to elaborate a little more about what I meant above by the wetiko virus. I think this is the crux of the matter. This is what trips me up every time I am faced with a situation that demands a response. I have a very reactive inner voice, and my false confidence in my own thinking doesn't help one bit! I'm getting closer to where my work should be focused on... developing awareness and a truly autonomous personality -- and the enemy really masquerades as someone with the same traits, wily as can be.

Thanks again jhonny

Section 3 – Problematic Behavior

Here, the work is focused on behaviors that are driven by anxiety. CBT theory states that our problems affect our thoughts negatively, which then affect our emotions negatively. I had defined my problems in the previous section. However, I find the boundary between problems and problematic behaviors is somewhat fuzzy, making it a challenge to find things to put into the worksheets in this section. I hadn’t filled up most of the worksheets here as I wouldn’t consider myself to have avoidance behaviors. On second thought, I think I do display many behaviors that relate to avoidance, but on a more subtle level. For example, I find that I tend to get distracted at the time I plan to do the therapy worksheets. I don’t know if that’s a form of avoidance.

I had a conversation with the therapist here on avoidance. We came to a middle ground regarding avoidance, and I gained a deeper understanding on how to create a balance my relationships with others. I am still working on boundary setting with others. Anxiety tends make it difficult to set healthy boundaries with others. She recommended a meditation exercise to reduce stress, which will reduce the anxiety. This exercise was entitled Raja Yoga meditation, and involved a 10-15 minute period of meditation upon waking, followed by a simple affirmation like “I am at peace”. It was also important to acknowledge and appreciate any positive feelings that came up.

I also mentioned my issue of “putting the cart before the horse”, again a behavior that is driven by anxiety. There’s a lack of critical thinking as well as a lack in the ability to get a wider perspective on things. I realize that I rarely ever use my brain in the way that it seems to be designed – I commonly work by memorizing ideas and concepts that are useful to me. It would be wonderful to be able to think for myself and have my own feelings, thoughts and opinions. I can do this now but anxiety weakens this capacity tremendously.

Section 4 – Problematic Emotions

This section was quite an insightful one. I think CBT is quite remarkable in that it helps you sort out your emotions and keep a level head at all times. So the chapter starts with some theory about how emotions get us into a mess, and that there is a way out with awareness of what is really happening in there.

The theory starts with the question “what are emotions?” to which we don’t have a definite answer. Still, we can categorise them, label them, divide them into positive and negative, as a way to deal with them using our higher intellectual functions, or so I think. I suppose beyond just dealing with them, the awareness of emotion is what is key, as the issues I find myself in are usually due to not being aware of the underlying emotion beneath my thoughts. I would personally classify anxiety as one of those emotions that can be a little tough to be aware of. I was previously unaware of how it influenced my thinking in an entropic manner. I also think that anxiety acts as a screen which blocks awareness of other emotions. Or the focus on chaotic anxiety-fuelled thoughts tends to distract the mind from other, more important feelings and emotions, meaning lost opportunities for positive action in the world. It’s kind of like being a puppet on strings, helpless and confused.

So the first worksheet was about creating an “emotional map” which involved analyzing a situation in my life to discern what the emotion was behind the event. I looked at a situation at work, where there were some heightened emotions where I had reacted in a dysfunctional way. We (the therapist and I) had a conversation about this situation which centered around being able to handle negative emotions more effectively. I agreed with the therapist to choose an alternative, more healthy action in response to a similar event in the future.

In the second worksheet I talked about being more emotionally-centered in response to the event above. The therapist did not agree, highlighting that my response to the event showed that I was TOO emotionally centered. This came to me as a shock and I realized that it was true. I was too centered on my own emotions with no appreciation for the other, I took offense for the other’s display of emotion instead of dealing with it in a healthy and balanced manner. This is an important lesson which I’ll be applying whenever emotions run hot.

Now, I think I can stop and say that this therapist is, I think, quite competent and displayed a very flexible and adaptive approach to my needs. In the third worksheet, based on the scenario I wrote out regarding my brother, she suggested a firm approach of saying NO and meaning it rather than giving in to every demand made. This was very valuable input for me which I do constantly need to reflect upon and apply in daily life. We also reviewed the Universal Declaration of Human Rights (link: _http://www.un.org/en/universal-declaration-human-rights/), and spoke about how many people who enter therapy have no conception of basic human rights, myself included.

Also, I brought up the topic of fear of taking responsibility which I’ll just reproduce in whole here:

Also, from what I have read and from my own experience, there is a fear of taking responsibility for ones own well-being that rears its head whenever one gets closer to the issues that hinder ones own progress towards a healthier frame of mind. This is, to me, one of the major barriers that need to be acknowledged and worked through - this is one that I need to acknowledge compassionately and move through myself. Repeatedly. Every day I decide to come back here, I face this resistance that manifests as an urge to distraction. It's subtle but I am pretty sure that it is there. For example, today, instead of directly opening the e-mail notification on the new therapist message, I decided to check out facebook and meetup messages, things which are not bad in themselves, but caused a slight derailing in doing what I think I REALLY need to do to progress in my - what I like to call - work on the self.

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The therapist acknowledged this as a common issue and suggested further stress reduction techniques to reduce fear (which is usually coupled with anxiety), similar to the approach she proposed in the previous section. I do really want to get a handle on my stress coping.

So, all in all, a valuable and insightful section for me, and I hope some of this helps you as well.

The next section is on Problematic Thoughts, which is where I left off before starting this review. My therapy will resume next week.

Thank you bm to have been courageous following this therapy and reporting on it.

I declare myself at peace but one has to see his biological body and its 'dark zones' to find that it's not completely true. When I'm meditating I like to focus on my bones, it's calmer and procure the silence necessary to see what's going on on other body parts. There's also the little criteres in the body that made you hit a ceiling glass which might not be treated with this kind of therapy... ?

It seems to be really helping to have someone in front of you who gives feedbacks, and help having knowledge upon personal biases.

Could this therapy be the beginning of a profound work on the self.

Nico said:

Thank you bm to have been courageous following this therapy and reporting on it.

I declare myself at peace but one has to see his biological body and its 'dark zones' to find that it's not completely true. When I'm meditating I like to focus on my bones, it's calmer and procure the silence necessary to see what's going on on other body parts. There's also the little criteres in the body that made you hit a ceiling glass which might not be treated with this kind of therapy... ?

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Hi Nico, I did also have a slight aversion to the affirmation "I am at peace" as in many cases, it is not aligned with objective reality. In a lot of cases meditation doesn't work very well for me, because of some underlying issue at the bodily level, usually related to some misalignment in the spinal column from my own layman's diagnosis. I attend a weekly yoga class and I also perform the exercises in the morning and sometimes after work as well. It takes some dedication and consistency, but it does a lot for one's balance and sense of well-being. About the critter issue, from what I understand maybe iodine could help with that?

Nico said:

It seems to be really helping to have someone in front of you who gives feedbacks, and help having knowledge upon personal biases.

Could this therapy be the beginning of a profound work on the self.

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It would be considered work on the self, yes! It's quite remarkable to be able to work with someone on my issues with setting boundaries, dealing with emotions, and generally becoming more aware of my own mental activity and not getting swept up by it. It is easy for me to fall into complacency and self-satisfaction in thinking that I've done all the work that I need to. So it's great to have the therapy as an alarm clock or reminder. I like to go back to the worksheets and revise my understanding of the theory and the conversations I've had with the therapist. Many new understandings have popped up from just doing that. However, I find that it's counterproductive to dwell on your problems, and instead to move on when you can't find a satisfactory solution to something, or when you run out of ideas about that particular subject. Energy is better spent where productive gains can be had, as life must move on, and the universe wants you to be an active participant!

I have seen a doctor who check cellular information, it seems a lot like kinesiology, backing up his questions to my unconscious with blood pressure. He found one of my surrenal vibrating at my mother's frequency and my thyroïde at my father's frequency, moreover my anxious system was misequilibrated, he gave me some medication asking my body for the dose and the duration. There’s also a memory back in my fœtus experience that trigger blocages, it's the second kinesiologue telling me that. I will back up the results when finished.
So I know more and more how to control myself, but certain underlying misalignements slow down the process, and I 'me really interesting by yoga and spinal alignement as the information line to the universe seems to passe by it.
I want to try an atlas re-alignement that seems to relieve emotional trauma and blood pressure according to these studies :
_http://www.americanbackcenter.org/wp-content/uploads/Atlas-realignment-and-hypertension-study.pdf
_http://www.positivehealth.com/article/case-studies/case-study-atlas-re-alignment-possible-simple-approach-for-scoliosis-and-migraines

Negatives feedbacks are given too and one has to find a really good practioner.
_http://spinalalignment.com/atlasprofilax-a-potentially-dangerous-procedure/

As for iodine, the C's have said that it energizes also the bacterias and if one have a compromise catabolic /anabolic system it cannot be working properly as well. Check Keyhole comments on the methylen blue thread.

So balencing the adrenals and rectifying the atlas might be good option. I have seen an french author talking about these two treatments necessary to respond to the Big question :what does my soul have come to do on the earth here and now ?! =)