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PN: A couple of years ago, we devoted an issue to the idea that psychotherapy was one of the last bastions of the face-to-face human encounter.

ST: That may be, but I must say that I cannot believe the number of therapists who are Skyping and telephoning as a regular practice, even if they could meet with clients face to face. Of course, in an emergency, if your patient is in China, that may happen. I think they need to ask themselves, "What am I missing by not having that body in the room with me? Don't pretend to yourself that talking on Skype is the same as being face to face.

When I have office hours by Skype with students, I know the difference. When they come into my office, the room is set up to make the conversation work in the best way possible. They can sit wherever they want, they can have as much distance between me and them as they like. They tell me what's on their minds; we talk. If they don't understand how to complete their paper, we go online and look at their paper. We talk about why they can't do the paper. If I'm tired or ill and I'm truly not able to come into the office, I can say, "Let's just Skype," but I know that this will be a different experience for everyone.

I'm not saying, "Never do therapy over Skype!" I'm saying look closely at what you're losing and what you may be gaining by doing it one way or the other. So my message to therapists is that technology raises all kinds of complicated issues, both in the consulting room and outside it. And before we go much further down the road we're traveling, let's think through what those issues are and what we want to do about them.

PN: Unlike global warming, we have time to work this out?

ST: Yes, unlike global warming, we have time to figure it out. The robots aren't coming to take care of our parents unless we buy the robots. You have more than 15 minutes to make that decision. Now is the time to talk about it. But I don't think these conversations are happening as much as they should, and I hope the book makes the difference.

Mary Sykes Wylie, Ph.D., is senior editor of the Psychotherapy Networker. Contact:

Richard Simon, Ph.D., is the editor of the Psychotherapy Networker and author of One on One: Interviews With the Shapers of Family Therapy. Contact:

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