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The aim of this paper is to describe the potential role of Multiplayer Online Games (MOGs) in e-therapy. E-therapy is defined as the provision of psychological therapy and consultation over the Internet. An increasing number of MOGs are now being designed specifically for therapeutical applications, and several support groups, have been already developed in commercial MOGs such as Second Life and Entropia. From the technological viewpoint, the goal of this approach is to combine the use of Internet and Virtual Reality (VR) to create distributed virtual environments (VEs) that are used to enhance the remote communication between therapists and patients. We speculate that MOGs can convey higher feelings of presence and social presence than traditional e-therapy tools such as email or chat. Embodiment by means of avatars has the potential to facilitate the clinical communication process, to positively influence group processes and cohesiveness in group-based therapies and to create higher levels of interpersonal trust. Potential caveats related to the use of MOGs in therapy are also discussed.