Cyber-shrink.

COMPUTER PROGRAM PROVIDES ONLINE PSYCHOTHERAPY 

Anxious? Tense? Overwhelmed?

Feel like having a little therapy but can't leave your computer because you're involved in a killer flame war on the "Star Trek" newsgroup?

Now you can turn to www.masteringstress.com, where a computer program will lead you through a simulated therapy session for a total cost of $30.

There is a hitch: No human being is at the other end. All the advice is programmed ahead of time and triggered by what you type into the computer.

The man behind the Web site is Dr. Roger Gould, former director of the neuropsychiatric outpatient department at UCLA who runs Santa Monica-based Interactive Health Systems.

He developed the "cyber-therapy" program for people who are overstressed and short on time. "We see this as a missing link between self-help books and formal therapy," he said.

But others are expressing some concern that online therapy - much as with radio call-in shows - can be a risky endeavor and even compromise patient care or confidentiality.

Sherry Mehl, executive officer of the state Board of Behavioral Sciences, believes cyber-therapy threatens to give patients a false sense that their condition is improving, ln the long ran. she said, that can hurt their progress.

"We believe therapy should be face-to-face," said Mehl, whose agency licenses counselors and social workers in California. "Right now, the capabilities of online therapy make it pretty much as effective as an advice column or call-in radio show. It doesn't do what therapy is intended to do.

Mehl pointed out that there are now no state laws governing online therapy, and that existing laws applying to psychotherapy only cover doctors licensed in California. As a result. Mehl said. there are no guarantees that patients would have legal recourse if they tried to file a complaint against a doctor in another state who counseled them online.

Gould said his program is not meant to be a miracle cure.

"We're trying to raise a person's consciousness and get them to take appropriate action that they've thought through," he said. "It may be something as easy as becoming more active and going out and seeing their friends, or resolving conflicts by making some changes at work."

Gould said the program was developed after years of testing that involved thousands of patients at hospitals and mental health centers.

He also cites a study done by two UCLA professors of psychology, Andrew Christiansen and Marion Jacobs, that suggests online therapy can work just as well as face-to-face counseling - even though computer programs or online therapists don't have the clues of body language and vocal tone to help their analysis.

The study is scheduled to be published this fall in the publication Professional Psychology.

"If you came into my office and sat down and became a patient, we would work to frame the problem you're having and discuss options to get out of the conflict," Gould said. "I would be the mediator of the internal thinking process. The computer can do the same thing."

First-time users are asked a series of basic questions (age, job, physical symptoms daily patterns). Next come more questions, delving into the underlying causes of anxiety - work, relationships, family problems and what triggers stress in the person's life.

The final step is a list of recommendations that can range from getting out more often to making more lasting lifestyle changes. The program is not designed to act in lieu of extended therapy. Gould said, but rather to address the problems that create stress in daily life.

The site is actually one of several "dot-com clinics" on the Web, targeting a range of people prone to everything from depression to eating disorders.

Gould launched masteringstress.com in February with the belief that as much as 25 percent of the population could benefit from the convenience of online self-help forums. Thus far, it has registered 1,500 hits, though he declined to offer the number of actual enrollees.

He is now working with Johnson & Johnson to market the masteringstress.com program as a subscription service to 200 major companies. Under this plan, an employer would be charged $3 per employee per year to receive an access code to use the Web site.

In addition, masteringstress.com is expanding to include advice from living, breathing professionals. In August, the Web site will add capabilities for "chat group therapy" led by professionals, along with personal development diaries so that patients can keep track of their accomplishments.

Gould also wants to expand the site to include counseling services for adolescents and therapy for couples, in which two people could sign on and answer questions at the same time.

Meanwhile, the current site even offers advice to keep you calm if your computer downloads the program too slowly.

It gently suggests you log off, prepare a cup of tea, and return to your terminal in due time. After all, it says, there is no use "getting stressed out while you're trying to manage your stress."