Many ethical and practical questions have been asked in relation to the delivery of therapy via e-mail including: is therapy delivered via e-mail acceptable to clients? Are people recruited into treatment via an e-mailed advertisement similar to a clinical sample? Is such therapy effective? Is there a therapeutic relationship which involves expression of emotion, therapist empathy, and other features of the face-to-face therapeutic interaction? Is such therapy safe? This paper attempts to answer these questions based on findings from ongoing studies on the use of cognitive behavioural treatment (CBT) delivered via e-mail to individuals with bulimic disorders. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association.