Online – On the Internet

Resources & References

By Ofer Zur, Ph.D.

This page provides background and resources on the new and evolving complexities of online multiple relationships dual relationships on the Internet.



Modern digital and Internet technologies have not only proliferated across the globe, but also have raised many complex clinical, ethical, and legal issues for psychotherapists, counselors, social workers, psychiatrists, administrators, and other mental health care providers, as well as for clients, patients, and other consumers of mental health services. Cyberspace provides rich and fertile ground for all sorts of multiple relationships. Most common are the social-digital multiple relationships on social networks that are created, for example, when therapists accept their clients as friends’ on Facebook or co-participate in Second Life. Similarly, LinkedIn or any social networking programs create social multiple relationships when therapists and clients knowingly or unknowingly interact. Sometimes clients may join a social network where the therapist is involved under a pseudonym, which also creates multiple relationships that the therapists may not even know exist.


Online Resources

Additional Resources

  • Barak, A., & Grohol, J. M. (2011). Current and future trends in internet-supported mental health interventions. Journal of Technology in Human Services, 29, 155–196.
  • Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008). A comprehensive review and a meta-analysis of the effectiveness of Internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2–4), 109–160.
  • Chester, A., & Glass, C. A. (2006). Online counseling: a descriptive analysis of therapy services on the internet. British Journal of Guidance and Counseling, 34, 145–160.
  • Clinton, B. K., Silverman, B., & Brendel, D. (2010). Patient-targeted Googling: the ethics of searching online for patient information. Harvard Review of Psychiatry, 18, 103–112.
  • DeGraff, J. (2014). Digital natives v. digital immigrants. Psychology Today. Retrieved from (accessed July 27, 2016).
  • DeLillo, D., & Gale, E. B. (2011). To Google or not to Google: graduate students’ use of the internet to access personal information about clients. Training and Education in Professional Psychology, 5, 160–166.
  • Fels, A. (2015). Do you Google your shrink? New York Times. Retrieved from (accessed July 27, 2016).
  • Kanani, K., & Regehr, C. (2003). Clinical, ethical, and legal issues in e-therapy. Families in Society, 84, 155–162.
  • Kaslow, F. W., Patterson, T., & Gottlieb, M. (2011). Ethical dilemmas in psychologists accessing internet data: is it justified? Professional Psychology Research and Practice, 42, 105–111.
  • Keller, A., Moore, E., Hamilton, D. Terrell, D., and Hahn, L. (2010). Facebook: Implications for Counselor Education Students, Faculty and Practitioners
  • Kolmes, K. (2017). Digital and Social Media Multiple Relationships on the Internet. In Zur, O. (Ed.) Multiple Relationships in Psychotherapy and Counseling: Unavoidable, Common and Mandatory Dual Relations in Therapy. New York: Routledge.
  • Kolmes, K. (2010, April). Private Practice Social Media Policy. Retrieved from (accessed July 27, 2016).
  • Kolmes, K., & Taube, D. O. (2011). Summary of Client–Therapist Encounters on the Web: The Client Experience. Retrieved from – client survey (accessed July 27, 2016).
  • Kolmes, K., & Taube, D. O. (2013). Seeking and finding our clients on the internet: boundary considerations in cyberspace. Professional Psychology: Research and Practice. Doi: 10.1037/a0029958.
  • Lamendola, W. (2010). Social work and social presence in an online world. Journal of Technology in the Human Services, 28, 108–119.
  • Lannin, D. G., & Scott, N. A. (2013). Social networking ethics: developing best practices for the new small world. Professional Psychology: Research and Practice, 44(3), 135–141.
  • Lehavot, K., Barnett, J., & Powers, D. (2010). Psychotherapy, professional relationships, and ethical considerations in the MySpace generation. Professional Psychology Research and Practice, 41, 160–166.
  • Menon, G. M., & Miller-Cribbs, J. (2002). Online social work practice: Issues and guidelines for the profession. Advances in Social Work, 3, 104–116.
  • Prensky, M. (2001). Digital natives, digital immigrants, Part II: Do they really think differently? Retrieved from,%20Digital%20Immigrants%20-%20Part1.pdf (accessed July 27, 2016).
  • Reamer, F. G. (2017). Multiple Relationships in a Digital World: Unprecedented Ethical and Risk- management Challenges. In Zur, O. (Ed.) Multiple Relationships in Psychotherapy and Counseling: Unavoidable, Common and Mandatory Dual Relations in Therapy. New York: Routledge.
  • Reamer, F. G. (2012b). The digital and electronic revolution in social work: rethinking the meaning of ethical practice. Ethics and Social Welfare, 7(1), 2–19.
  • Reamer, F. G. (2013). Social work in a digital age: ethical and risk management challenges. Social Work, 58(2), 163–172.
  • Skinner, A., & Zack, J. S. (2004). Counseling and the internet. American Behavioral Scientist, 48, 434–446.
  • Zur, O. (2011). I love these e-mails, or do I? The use of e-mails in psychotherapy and counseling. Retrieved from (accessed July 27, 2016).
  • Zur, O. (2012). TelePsychology or TeleMentalHealth in the digital age: the future is here. California Psychologist, 45, 13–15.
  • Zur, O., & Donner, M. B. (2009, January/February). The Google factor: therapists’ transparency in the era of Google and MySpace. The California Psychologist, 42 (1), 23–24.

Extensive Reference List on Dual and Multiple Relationships in Psychotherapy & Counseling

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