Sample Site. No Counseling is offered here.

SuitabilityQuiz

Before we proceed further, know that online therapy will not be appropriate for all people seeking help. Please take this quiz so we can determine what is best for you.

1. What communication methods are adequate or preferable for assessing the client?

1. Talking over the phone
2. Talking face-to-face
3. Writing a letter or email.
2. Describe your overall skills using computers and the Internet. Pick the highest number that most accurately represents your skill level. 1. I barely even know how to turn on a computer.
2. I know how to check my email
3. I know how to get to various webpages.
4. I know how to use instant messenger to chat
5. I know how to use a webcam to chat
6. I know how to program computers.
3. Are you able to easily learn new computer programs? Yes.
I have little or no trouble
I have a lot of trouble.
4. Do you have Internet access in your home? I do not have Internet access at home. I go somewhere else.
I have an Internet connection at home.
5. What type of Internet access do you have? A fast connection such as DSL or a cable modem
A dialup connection.
6. Will you be able to maintain privacy during the session? Explain.

7. Are there any known physical or mental disabilities that will limit the ability to read and write using a computer? Please explain

8. What speed is your typing? Slow
Medium.
Fast.

9. Are you currently seeing another therapist? Yes
No

9b. If yes, may we contact him/her?

Yes/No: Contact info:

9c. If yes, briefly state what you and he/she are working on.

10. Briefly describe your reasons for choosing online counseling vs. face-to-face.

11. Do you prefer the spontaneous, in-the-moment communication of chat/IM as opposed to the opportunity to compose, edit, and reflect, as in e-mail? Please Explain.

12. Please summarize your previous experiences with therapy/counseling.

Please state the reason for therapy & the outcome.

13. Are you currently taking any medications?.

14. Please describe any health problems, physical or mental.

15. What do you hope will result from online counseling with this therapist?

For an article about suitability for online counseling you may refer to:

CYBERPSYCHOLOGY & BEHAVIOR

Volume 4, Number 6, 2001

Mary Ann Liebert, Inc.

Assessing a Persons Suitability for Online Therapy: The

ISMHO Clinical Case Study Group

JOHN SULER, Ph.D.