Sitting on the proverbial couch in a therapist's office is being redefined by the Internet. Now, you can sit on your own couch in your own home and speak to a therapist through online therapy. With a com puter and Internet access, the grow ing alternative to traditional face-toface therapy is only a click away.

One local therapist dabbling in the idea is Dr. Peter Patch, a clini cal psychologist from Attleboro with an online coaching Web site, www.thehabitdoctor.com.

Patch uses an Internet phone or chat sessions through Instant Mes saging to alter his clients' patterns, habits and lifestyles by developing strategies to help them change an undesired behavior, such as overeat ing.

`` Many people are not receiving help because they're embarrassed about walking into a therapist's office,'' he said. `` The Internet has a huge potential to reach those peo ple.''

Patch isn't ready to jump into online therapy head-first, however. `` My personal opinion is that the technology isn't there,'' he said, cit ing as his main concern the lack of visual cues in online therapy.

`` There's a variety of issues to bear in mind,'' Patch said. `` Are you using a (web) camera or not? Are you using live chat? You really have to take into account the media that is being used.''

Marian Bacon, a mental health advocate at the Tennessee Mental Health Consumer Association, overcame her fear of talking to people through online therapy. After a year, she has seen a lot of improvement in herself.

`` I'm learning a lot. (My therapist) was helping me grow more in my ability to talk to people,'' said the Memphis native, who's inability to communicate with people scared her away from traditional therapy.

`` It was an easier way to open up,'' she said, while also noting, `` There were a couple of times I clammed up and didn't say something I should have, but not all of the time.''

While non-verbal communication is important, Dr. John Grohol, a psychologist from Boston specializing in online mental health services, said people often feel more comfortable opening up to someone they don't have to face.

`` With non-verbal cues, the longer the time spent online, the less of an issue it becomes. People get used to expressing themselves,'' said Grohol.

Patch also raised concerns that online therapy could cause people to close themselves off from the world.

`` There's a danger and risk that the field will accidentally enable those who are avoiding human contact to do so even more,'' he said.

But Grohol said online therapy can lead people to seek traditional therapy. `` It's often a doorway to face-to-face therapy,'' said Grohol. `` It's a way for people to test the water. It gives people a taste for it.''

Bacon began traditional therapy six weeks ago in Memphis while also continuing online therapy. She said she's in no hurry to end her online sessions.

Along with anonymity, online therapy offers other conveniences such as lower costs than traditional therapy and more flexible scheduling. E-mails can be written anywhere, anytime, with access to the Internet and people may be able to form their thoughts more coherently than they would in a traditional therapy setting.

People are also no longer restricted to their area and can choose therapists from all over the country.

`` Americans are all about having a great amount of choices available to them,'' said Grohol. `` (With traditional therapy) you're not sure what you're getting until you sit down. With online therapy they give information, specialization, degrees. You can find someone who is a specialist in a specific area.''

Bacon tried several therapists through chat rooms and e-mails before settling on one from Hawaii.

Grohol recommends searching for therapists through online clinics like www.helphorizons.com and www.find-a-therapist.com, where therapists have undergone background checks and are members of the clinics. Online clinics also provide security measures such as encrypted e-mails to ensure confidentiality.

Online therapy isn't recommended for people with severe depression or anyone who is suicidal. Grohol recommends it for individuals needing guidance in life, relationships, careers, or gaining better insights on issues. He added, though, that he has seen online therapy help some people with chronic depression or anxiety.

`` It's an alternative to the traditional way of approaching therapy. It's not necessarily better. It's another option when face to face isn't enough,'' said Grohol.

While Patch is hesitant to offer online therapy, he's not completely ruling it out. As streaming technology and web cameras continue to progress, Patch hopes online therapy will be able to include the visual cues it lacks thus far.

`` It's something I would, and am, considering for the future,'' he said. `` I'm waiting for technology to catch up.''

STACEY M. PERLMAN is an intern at The Sun Chronicle. You can contact her at perlman.s(at)(at)neu.edu.