Confidentiality
Unrecorded, face-to-face psychotherapy offers a fairly secure space for discussing sensitive personal issues. And there was a time when utilizing insurance coverage had little or no impact on a client's privacy. But not today. Today, managed care policies typically require therapists to submit regular reports that include sensitive personal information.
The insurance administrators who review your case are free to request additional information... ostensibly to determine if your treatment is "medically necessary" and appropriate for your problem. From that point on, God only knows what data-base your private information will find its way into.
Given today's realities, your personal information may be more secure in online therapy. Since insurance typically does not finance online therapy, it's irrelevant to your online privacy. Not surprisingly, online therapy has its own distinctive source of privacy concerns. Are you sure you're emailing a professional, someone who will respect your personal information and keep it private? Are your transmissions sufficiently secure? Just as phone conversations can be tapped, email can be filtered for key words. Perhaps neither event is very likely, but they are possible. Particularly if you are emailing via an intranet at work: a situation I strongly recommend you avoid because of the frequent email monitoring in that environment. If you are using your home computer and a private access account, there is little chance that your email will be intercepted. In addition, there are a number of strategies, such as email encryption, that almost guarantee the confidentiality of email in transit. Your greatest security risk is most likely to arise from emails you store on your computer. Anyone with access to your computer can potentially read any information you keep there, including your email.
How might you protect the confidentiality of email therapy information on your computer? The surest way is not to have any. Shred, not delete, all emails once you have read them. Emails? What emails? One obvious drawback to that strategy? You won't have access to your past emails, either. Next best is to combine a number of safeguards, such as: have a secret password for access to your computer; encrypt, and password protect, any email records on your computer; periodically sweep your computer for key-logging programs, etc. Of course, you would never leave an email open on your desktop while you run to the store for a soda, right? If confidentiality matters to you, please do take steps to protect your information. Which steps are appropriate for you will depend on how important confidentiality is to you and the risks you face. I wholeheartedly encourage you to familiarize yourself with online risks to privacy and the steps you can take to minimize them.