The ads sport such catchy phrases as TLC (Telephone Link Counseling) and Dial-a-Shrink.
By picking up the telephone, with credit card ready, a caller can get professional psychological advice with a new degree of convenience, anonymity and cost control.
Thus are therapists in Orange County and elsewhere trying to crack a pillar of traditional therapy: the office visit.
But in doing so, they have raised a few eyebrows in the mental health professional community. This month, in fact, the ethics committee of the American Psychological Assn. in Washington will consider taking a stand on this nascent approach to therapy.
Decades ago, a psychotherapist was an authority who camped behind a desk or sat at the end of a couch, out of the sight of a reclining patient lost in free association.
Therapy took years. Deep psychoanalysis was reserved for the well-to-do who had hours every week to spend probing their psyches.
But the rigid barriers of formality softened, yielding bit by bit, until the therapist sat facing the client and became something akin to a close confidant.
"It's a natural progression of events," Caren Croxen said of telephone counseling. A licensed marriage, family and child counselor, Croxen practices in-person and telephone therapy out of her Fountain Valley home.
"We live in a world that's fast-paced, and there are a lot of demands on us. Time demands. And people are not always willing to give the time to therapy. It used to be that therapy literally meant a five-year commitment, several times a week. And nobody wants to do that today."
Croxen recently started advertising her telephone counseling, a service she said she has offered on a referral basis for about eight years.
She and other therapists-by-phone say the informality and immediacy of telephone counseling offer distinct advantages to clients.
Jeanne Nelson, who with husband Lee Hachey opened TLC, said phone counseling provides "more of a client-oriented approach to therapy."
Nelson and Hachey, both licensed marriage, family and child counselors, operate the Newport Harbor Counseling Center in Costa Mesa.
"The one-hour-a-week therapy session works very well for a lot of people," Nelson said, "but it very often can be a therapist- oriented approach that fits into the structure (in which) a therapist most conveniently works."
Added Hachey: "(A caller) can deal with the problem when it happens, not a week later," as might be the case if the caller had to arrange an office appointment.
Not for Crises
Who should call for counseling-by-phone?
People with short-term problems that are not crises, the therapists say. They cited relationship difficulties, employment anxieties, trouble dealing with children and "what should I do?" situations as appropriate.
Not the province of telephone therapy, they said, are sexual problems, crisis intervention, psychosis, physical abuse or ailments needing medical attention. The therapists said callers wanting help in those situations are referred elsewhere.
Each call begins with basic questions: your name and MasterCard, Visa or American Express card number, please? Then a caller can limit the cost by controlling the time spent in counseling, Nelson noted.
"But if they want to talk for an hour," she said, "(the cost is) comparable to what they would pay for an office visit."
Some Prefer Anonymity
Face-to-face counseling frightens some people, Croxen said, and they may associate seeking psychological help with admitting they are "crazy."
"There's something about not being seen," Croxen said. "It's like, nobody knows who you are. There's that anonymity factor that a lot of people prefer."
Also, "when people get depressed . . . they may not want to go through the process of finding a therapist and making an appointment and leaving the house to see the therapist," Croxen said.
"They need help right then, right there, without going through a big hassle. So for the depressed person, it's a big help because they don't have to get dressed, they don't have to go and find somebody, they can get immediate help without doing what's impossible when you're depressed, and that is getting motivated."
But psychologist Eugene A. Ericson, a director of the Orange County Psychological Assn., is skeptical.
Communication by Sight
"Much communicating is done by sight," Ericson said. "Body language is used constantly by everybody. A great deal of therapy that's done is accomplished through the rapport of a therapist with the patient."
Conceding that telephone counseling could be helpful "in a rather superficial way," he cautioned: "You have to assume that the patient is able to give enough information and the right kind of information" so the therapist can quickly evaluate the caller's problem.
"I hate for human problems to be treated lightly," Ericson said. "I believe therapists need all the information and data they can get" to understand and help solve a client's real problem.