Within social media therapy, synchronous or asynchronous dialogue occurs through exchanges of audio, text or visual information.
[1] Time spent online via email, websites, instant messaging and social media has increased: since 1999, more than 2,554 million people have become internet users.
[3] People are influenced by data sharing, social marketing, and technological tools.
Criticism of providing therapy through online methods comes from concerns over the lack of physical contact.
Patricia R. Recupero and Samara E. Rainey stated in their article "Informed Consent to E-Therapy" of American Journal of Psychotherapy that the lack of face-to-face interaction increased the risk of misdiagnosis and misunderstanding between the E-therapist and patient, thereby increasing the risk of uncertainty for the clinician.