One of these is clearly the loss of the dialectical process. In face to face counseling there is a continuous and immediate feedback loop between counselor and client. E-mail precludes this continuous and immediate feedback. Another disadvantage with e-mail is the complete lack of nonverbal information. Many counselors believe that nonverbals are even more important than verbals in some therapeutic situations.
Some online practitioners use text-based chat as a way of working with their clients in real time.
This is more cumbersome because appointments need to be set up and there are generally more technical details to be worked out. The next logical step would be for practitioners to use video conferencing alternatives. This would be the closest thing to actually being in the room together, and would be a great support to online counseling. However, very few sites offer video conferencing technology and the performance is largely disappointing for those that do. There are two distinct means of Internet counseling.