ᮢ Cedric Speyer Warren Shepell ConsultantsThe current article reviews the most recent literature addressing the definitions, ethical considerations, and potential strengths and limitations of online therapy. In addition, a framework is provided for how to conceptualize and categorize different aspects of online therapy for research purposes. Relevant studies of both online and face-to-face therapy as well as suggestions for future research are outlined.

Twenty-five volunteer clients participated in both a therapist-facilitated and a self-guided dream interpretation session; sessions were randomly ordered and separated by approximately 1 week. Observer and therapist ratings indicated that therapists adhered to the C. E. Hill (1996) model during therapist-facilitated sessions. Clients reported achieving greater depth, mastery, and insight, as well as more dream exploration-insight gains and more action-related gains, from therapist-facilitated sessions than from self-guided sessions. In addition, 88% of the clients preferred therapist-facilitated over self-guided sessions. Implications for using both types of sessions are presented.

105 volunteer clients completed single sessions of dream interpretation using the Hill (1996) model, with half randomly assigned to waking life interpretation and the other half to parts of self interpretation in the insight stage of the Hill model. No differences were found between waking life and parts of self interpretations, suggesting that therapists can use either type of dream interpretation. Volunteer clients who had positive attitudes toward dreams and presented pleasant dreams had better session outcome; in addition, volunteer clients who had pleasant dreams gained more insight into their dreams. Results suggest that therapists doing single sessions of dream interpretation need to be cautious about working with dreams when volunteer clients have negative attitudes toward dreams and present unpleasant dreams.

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The authors tested whether a focus on dreams added something specific to the therapy process beyond the structure of a 3-stage approach. Fourteen distressed clients with troubling dreams and recent loss of a loved one participated in brief structured therapy focused on dreams or loss. After therapy, clients in both conditions reported being satisfied with therapy, having lowered impact of the loss, gaining new insights about themselves, and having made changes. In addition, clients in the dream condition rated the process of therapy higher, became involved in the therapeutic process more quickly, gained more understanding of their dreams, liked the structure of therapy more, and kept fewer secrets from their therapists than clients in the loss condition. In contrast, clients in the loss condition gained more insight about the effects of the past and their loss and liked therapist guidance more than clients in the dream condition.Although dream interpretation has been practiced widely in psychoanalytic and humanistic therapies, only recently have researchers begun investigating it empirically. Most of the research on dream interpretation has investigated Hill's (1996) cognitive-experiential model. In several studies of single sessions, working with dreams using the Hill model of dream interpretation led to high levels of insight and depth (perceived quality), typically more than a standard deviation higher than those found for regular therapy (Heaton, Hill,