Many of us grappling with emotional problems may not consider counselling as a remedy. We may be wary or sceptical, be unable to afford it, not have ready access to a professional or not know how to go about it. So how about a spot of online therapy?
There are already thousands of e-counselling websites and e-clinics in the United States, a psychology site recently came into being in the UK and a number of Irish counsellors are beginning to use e-mail as a way of keeping in touch with their clients.
Distance counselling is not entirely new. Sigmund Freud conducted some of his classic diagnosis by correspondence, for example, while organisations such as The Samaritans pioneered telephone listening almost 50 years ago.
The organisation has come up to date with jo@samaritans.org, its online service for Britain and Ireland, where trained volunteers respond via e-mail or telephone within 24 hours.
Paul O'Hare, The Samaritans' public-relations manager, says 37,000 people used the service last year, compared with 25,000 in 1999, with the genders equally divided. "People write lots," he says.
Mainstream online counselling falls into two principal categories: one-off advice and ongoing relationships.
The one-question approach can be compared to getting a personalised response from an agony aunt. Ongoing counselling, which is more like having face-to-face sessions, involves the therapist getting to know a client via e-mail.
Some of the US websites offer counselling via real-time audio-visual links, although one counsellor, Aidan Maloney, says the picture quality means you may not be able to see the tears on a client's cheek.
Apart from general counselling, a host of specialist online services deal with areas such as sexual abuse, addiction, eating disorders and gay and lesbian issues.
Many sites offer a wealth of free information, some of it very helpful, and some give the names of practitioners who offer an initial free consultation, either responding to a specific query or offering a short, online session.
So should you trust your psyche to cyberspace? At first glance, the idea seems preposterous. Counselling should be a face-to-face affair, where the practitioner can be intimately aware of the client, picking up a million subtle clues, from body language and facial expression to the general dynamic in the room.
Maloney, who combines the careers of counsellor and business consultant, has researched and reflected on the possibilities and pitfalls of such Internet encounters.
"One of the advantages of online counselling is that anonymity is a very significant factor in counselling. Most people will go to someone they don't know, so a method of therapy where you are not visible may appeal to that need in some clients.
"Also, for whatever reason, people express themselves quite freely through e-mail. It doesn't need the formality of a letter: you can put down your thoughts freely, more like a stream of consciousness. E-mailing has been likened to the client keeping a journal.
"Another advantage is immediacy and flexibility. If something happens, you can write it down and send it off, and the counsellor can open the e-mail in their own time or at the start of the real-time session."
If the advantages are about access to help, the disadvantages may be more about the quality of that help.
"The core of counselling is the therapeutic alliance, the relationship that develops between counsellor and client, allowing the work to be done," he says.
"In a face-to-face communication, a counsellor pays attention to verbal and physical language, tone, inflection and silences.
"All these are absent in a text-based environment, and it's hard to see how online counselling can compete with the loss of the visual.
"You lose the tone of voice, which can often give a double communication, as a client can say one thing while the tone of voice conveys something else. One of the tasks in counselling is just to notice those signals and either elaborate on them or bring them to the attention of the client."
In his study Silent Messages, the US psychologist Albert Mehrabian concluded that 55 per cent of our communication is non-verbal, 38 per cent is in tone of voice and 7 per cent is in content.
So a method of communication such as writing, which depends only on content, may conceal as much as it reveals.
"There is also the value of silence," says Maloney. "Some of the most valuable times in a session are when we don't say anything. This is because we can use words as a defence: we fill the silence because we find it too exposing. It's hard to stay in silence, but it can often lead people to important insights."
If an online therapist is forced to break a silence, to ask if the client is still there, it can defeat this purpose.
What happens when you log on to a therapy site?
PsychologyOnline.co.uk opened for business earlier this year, in response to a shortage of qualified psychologists to meet the huge demand for counselling.
Affiliated to the British Psychological Society, the site's 100 chartered psychologists operate under strict codes of conduct and offer treatments on everything from family problems to work stress. A disclaimer that the site is not for people with a history of mental illness inspires confidence.
"The service enables live, one-to-one communication that is simple, accessible, confidential and discreet. All you need is access to the Internet and a quiet space," it says.
"Our objective is to bring the benefits of modern psychology to more people. By using today's technology, we can now provide a better way to use valuable time and skills. Working online is both effective and convenient, location is irrelevant and travelling is unnecessary."
Fees for consultations and therapy sessions are £21 sterling for 15 minutes, £40 sterling for 35 minutes and £60 sterling for 55 minutes. It's not a hard sell. Usually, people start with a 15- or 35-minute session to briefly discuss or outline their difficulties before deciding whether to proceed.
As the 5,381st visitor to The Fellow Traveller, at www.users.globalnet.co.uk/~listen/, The Irish Times was treated to a rendition of Twinkle, Twinkle Little Star while introductions were made.
Among the services the site sells online are one-to-one e-mail counselling and group work in a chat room. The fee is £26.50 sterling per session, which is defined as an e-mail response, which may take hours to prepare, or a 60-90 minute live consultation in any electronic medium. Payment is by cheque, bank transfer or credit card.
There is a menu of free counselling information, on topics such as "changing unwanted moods". When The Irish Times tried the service, it offered a sample of two counselling sessions' worth of helpful, thought-provoking information on controlling one's feelings.
A profile some years ago of the typical Internet counsellor and client revealed that both were male, in what was probably a reflection of the male bias of Internet users.
Maloney believes the gender balance is being addressed on both sides of the therapy room, while suggesting that the Internet may suit male clients, who, anecdotally at least, are slower than women to come for counselling.
"Depression ranked high among online clients' problems, with over half the respondents reporting depression as a primary concern," he says, adding that if you don't feel like seeing people, yet need help, distance therapy could fit the bill.
When abroad on business consultancy, he gives his clients the option of keeping in touch via e-mail. "We would probably not get into new material when I'm away, but the contact does allow clients know they have been heard, which is a very important part of the counselling relationship," he says.
He quotes an apocryphal story about a US professor who wrote a program to make a computer reformulate remarks as questions or conversation. So a client might say, "I am feeling sad," to which the software would respond: "so, you are feeling sad."
To his amazement, students queued up to use the program, and even his secretary, who knew the respondent was not human but a computer algorithm, was logging on for consultations.
Martha Ainsworth runs www.metanoia.org, an independent consumer guide to online therapy in the United States. Her site asks questions to help you decide if you need counselling, then describes the types available, how to access it and what safeguards to use, as well as naming practitioners who offer a free introductory session.
The Irish Times chose a psychologist in Rochester, New York, invented a clingy girlfriend who was worrying the parents of a male family member and sent it off with the promise of a 48-hour response.
His reply, in 24 hours, suggested the person in question was "a fully sentient adult and entitled to make his own decisions and choices", which concerned parents should acknowledge while still offering him their love. "Try not to show your disappointment in him," he ended.
So what's the verdict on virtual counselling? If "caveat emptor" - let the buyer beware - applies to the purchase of most products and services these days, it may be even more important to be prudent with your problem-sharing.
Online counselling and its codes of practice are still evolving. There is a risk that clients will dip into worrying or scary issues and be left to deal with them alone. Aidan Maloney believes online help may suit a computer-literate client who enjoys expression through the written word and is unable or unwilling to have face-to-face sessions.
"What is being offered online may be therapeutic, but is it therapy?" he says. "I think problems may be solved through this method, and it may complement existing ways of keeping in contact with the client. As the sole method of communication, I don't think it can be put in the same category as the face to face meeting.
"The loss of the visual insight is a major defect in the quality of the contact, and I am not convinced that the other things it offers can compensate for that."