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Egyptians seek psychological support online

In light of exacerbating social and economic pressure, Egyptians are seeking psychotherapy online, but what are the pros and cons of this online service?

CAIRO — Doua (a pseudonym) was not expecting ads for psychological support websites to flood her social media accounts after visiting some of these websites while seeking support from a specialist to help her cope with a personal issue. She eventually gave up the idea of seeking support online because a large number of these ads annoyed her.

Specialized websites offer psychological support online, some at no cost and others for a fee. Support is usually given in articles or letters exchanged online between the therapist and the patient. Some websites even use direct communication through videoconferencing. 

Like many other websites, these support sites are promoted by ads posted on social media, as well as on main search engines such as Google.

Doua told Al-Monitor she is now avoiding these websites because of the ads that keep popping up. “Sometimes the wording of the ads made me feel threatened. They warn me that I should continue my online treatment to stay safe. When you register on one of these websites, you will receive emails urging you to continue the treatment and warning about the risks of stopping therapy. This is exactly what happened with my colleague," she said.

“The need for psychotherapy in the Arab world has changed," said Ahmad Abdullah, a professor of psychology at Zagazig University and the co-founder of a website offering psychological support. "People no longer resort to us when they suffer from a severe obsessive disorder or schizophrenia, but we are consulted about personal and family problems caused by daily stress."

Psychotherapist Ali Yahya told Al-Monitor that advertisements should refrain from intimidation and harassment. He said, “The issue is the wording of ads. If a patient who suffers from schizophrenia, depression, a phobia or any other disorder is exposed to such ads and sees them as intimidating or coming on too aggressively, this patient would exhibit other symptoms and may relapse. Psychological treatment must never take place by coercion or intimidation. However, if the patient's family informs the treating physician that the patient attempted suicide, the latter may be forced into treatment or may be detained.”

Abdullah believes these ads should not be described as unethical or blamed for the deteriorating condition of some patients. “What good can come from labeling advertising policies in general as unethical? Ads will continue popping up and no one will be able to control this. The problem will be resolved only when the targeted segments become more aware and learn to filter out the bad ads,” he told Al-Monitor.

Mustafa (a pseudonym), who used some of these websites, told Al-Monitor, “I was looking for psychological support sites and saw a website called Maganin [Arabic for "crazy persons"] that offered free written psychological counseling. I found the name of the website itself to be repulsive. Let’s say the community is not well-informed and sees psychological patients as insane and crazy, but why would psychotherapists use this name for their website, which is supposed to serve as a refuge for these patients?”

Ahmad Abdullah, the co-founder of Maganin, told Al-Monitor the site was initially dedicated to poetry and literature. He said, “More than 80 physicians provided psychosocial support through, but this website was closed and Maganin offered these physicians the chance to keep providing their services through it.”

“After a while we thought about setting up another website with a different name, but we ended up sticking to the name Maganin since it was so catchy,” he added.

Seeking psychological support is no longer stigmatizing according to Abdullah. He said, “Most people feel comfortable about seeing a psychotherapist and feel no shame about this. The issue now is how to follow up on the cases of our website visitors. Most cases are not about chronic obsession or depression, but we sometimes find ourselves interfering with family problems and trying to remedy the effects of psychological problems on social relations.”

He explained the meaning of the word “magnoun” (singular form of maganin and Arabic for "crazy person") from his point of view, saying, “Magnoun in Arabic does not refer to a person with a psychological disorder but rather to a genius or to a person who is different from others. The website offers services that are not provided by any other website and are free of charge. We provide useful content; the name is just for attracting users.”

On the other hand, Ali Yahya, also a psychotherapist, asserted that hospitals specialized in psychological and neurological disorders are no longer using the word "magnoun” to describe a person with a psychological disorder because this stigmatizes and offends a segment of society.

Mustafa did not only visit Maganin but also several other sites before finding a support website that offered a paid service and that made him feel comfortable.

He said, “The ad for one of these websites said it offers free psychotherapy, but when I tried to open an account the website requested detailed personal information. I had to answer more than 200 questions and I got bored and tired and decided not to go through with it. This large number of questions that would certainly not be asked by a psychotherapist during a session raised my suspicions. Why would answering these questions be a condition for registering on this website?”

The relationship between the therapist and the patient is one governed by many controls and protocols, as Yahya explained. “We study in medical schools the vocabulary of this relationship. There are many complex controls in psychotherapy, and invasion of privacy, stigmatization and intimidation contradict these controls,” he said.

Yahya noted that the patient is given a form similar to those given at a physician’s clinic and the patient must fill this out in order for the psychotherapist to assess the situation and give a proper diagnosis.

“These forms may be given to patients to fill out at home. This should not happen online, as privacy is not guaranteed and questions should be personalized based on the patient’s case,” Yahya said, pointing out that sometimes the psychotherapist would be treating a patient that he has not seen and he cannot ensure that he is telling the truth. “A psychotherapist is supposed to focus on personal interaction with a patient and accurately read his or her body language.”

The National Council for Mental Health affiliated with the Ministry of Health is the authority entrusted to grant licenses to psychological treatment facilities in Egypt. Head of the council’s technical secretariat Amjad al-Ajroudi told Al-Monitor, “There is no law regulating the activities of these websites that offer psychotherapy services, so there is nothing we can do to prevent them from doing so.”

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