2nd Virtual Conference on Counseling (2VCC)
September 15-18, 2010

http://sl.counseloreducation.org

The 2VCC will cover 4 days with over 40 presentations on issues related to counseling, counselor education, supervision and the use of technology (particularly Second Life) in counseling practice and training.

The conference is FREE and available to interested professionals. Reregistering for the conference on this website will assure that you will get information notecards and a program booklet emailed to you for this conference.

You can attend the conference in Second Life starting at the Counselor Education in Second Life center SLURL Marina Del Rey 102, 70, 27. The schedule of presentations will be available through this website.

You can also watch a live stream of the conference provided by http://www.onlinevents.co.uk The live stream is a great opportunity to show portions of the conference to your whole class without the burden of having to manipulate your avatar into Second Life.

2nd Virtual Conference on Counseling (2VCC)
All times are Eastern Time Zone (GMT -5)
Sessions will occur at CESL in Second Life (SLURL Marina Del Rey 102, 70, 27)
Portions of 2VCC will be web-streamed through Onlinevents.co.uk at http://onlinevents.co.uk
Attendance is free – Continuing education contact hours are free and available

9/15/2010 Wednesday

10:00 AM
1. Opening Session: Marty Jencius and Debra London

11:00 AM
2. Keynote session: Sexualized Role Play in Second Life and Beyond: Meaning and Implications. David Delmonico

12:00 PM
3. Technologically Mediated Relationship Changes, Katherine Herman and Courtney Holmes

1:00 PM
4. Counseling in GenderLand: A guide for you and your transgendered clients, Niela Miller

2:00 PM
5. Immersive Simulations in Counselor Education, David Stone and Deborha Patten

3:00 PM
6. Demonstrating Cyberculture through Film: Life 2.0 Questions and Answers, DeeAnna Merz Nagel, Kate Anthony and Jason Spingarn-Koff

4:00 PM
7. Second Life as a Pedagogical Tool: Comparing the Learning Styles and Perceptions of Counselor Education Students of Second Life, Leslie O’Ryan and Jacob Glazier

5:00 PM
8. Evaluating Student Cognitive, Affective, and Psychomotor Learning During Patient Interviewing and Diagnosis Activities, Victoria Walker and Jason Baker

6:00 PM
9. Counseling Internet and Online Issues, Paul Silverman

7:00 PM
10. The Effectiveness of Art Therapy, Nicole Brickell

8:00 PM
11. Project Pathways: Interactive Technology in the Counseling Classroom, Joseph Davis

9:00 PM
12. Training Play Therapists in a Virtual World, Julie Robinson, Jill Packman, Maria Devine Ogino

10:00 PM
Mixer / Entertainment

9/16/2010 Thursday

11:00 AM
13. Competencies in Addressing the Christian Client’s Worldview, Cheryl Durham

12:00 PM
14. Can I trust you? Can you really help me?, Brandon Browning

1:00 PM
15. CACREP Goes International with IRCEP: The International Registry of Counselor Education Programs, Carol Bobby and Rebecca Stanard

2:00 PM
16. Using Arts Processes as Psychological Tools in Second Life, Niela Miller (Note 90 minute presentation held at Niela’s SL Location)

3:00 PM
17. Developing and Implementing Online Supervision in Counselor Education: Strategies to get Started, Jonathan Lent and Paula Britton

4:00 PM
18. Teaching, Learning and Living in SL: A year in the Life of a Newbie, Chadwick Royal

5:00 PM
19. Age Cohorts: Preparing a Young Counseling Workforce for an Aging Generation, Nicki Nance

6:00 PM
20. Power and Control: When Counselors Abuse, Paul Fornell

7:00 PM
21. The Top 5 Mistakes Therapists Make in Building a Successful Therapy Practice, Laura Dessauer

8:00 PM
22. Factors Related to Severity and Prognosis in Mood Disorders, Todd Finnerty

9:00 PM
23. Counseling Stand UP Comedy Tour: Ludwig Wiigenstein and the Telling of Second-Order Truth Through Humor, Brian Mistler

10:00 PM
Mixer / Entertainment

9/17/2010 Friday

10:00 AM
24. Directives in Art Therapy, Nicole Brickell

11:00 AM
25. The Fourth Dimension: 4-D Communications with Adolescents, William Scott

12:00 PM
26. Collaborative Approach to High School to College Transition Programs, Annette Albrecht and Dennis Jones

1:00 PM
27. Facilitating Second Lives in Real Life, Tom Blume, Joel Lane, and Keolegobile Semphadie

2:00 PM
28. Service Learning with Online Graduate Students. Kylie Dotson-Blake

3:00 PM
29. Counselors-in-training Implement the ASCA National Model, Aaron Oberman

4:00 PM
30. Suicide Assessment using SIMPLE STEPS, Jason McGlothlin

5:00 PM
31. Teaching Supervision to Counselors using the Discrimination Model, Clarrice Rapisarda, Kimberly Desmond, and Jill Nelson

6:00 PM
32. Public Relations and School Counseling: Learning to Promote the Counseling Program, Kimberly Desmond, Clarrice Rapisarda, and Jill Nelson

7:00 PM
33. My Client’s Don’t Know I am LGBT Friendly: Helping School and Mental health Counselors Meet the needs of LGBT Youth, Rachel Vitale, Harry Warner, Julie Krause, and Amanda Cole

8:00 PM
34. Eating Disorder Recovery in a “War on Obesity” World, Shannon Cutts

9:00 PM
Mixer / Entertainment

9/18/2010 Saturday

10:00 AM
35. Q Methodology as a Tool for Agenda Setting. Klara Overland

11:00 AM
36. Digital Story Telling in a Multicultural Counseling Course, Diana VanWinkle, Marty Jencius

12:00 PM
37. Innovation, Avatars, and Virtual Counseling, Dick Dillon

1:00 PM
38. Publishing Your Book in Counselor Education, John Blando

39. Discovering Callings and Contributing to Community: Where Spirituality and career Development Converge, Edward Colozzi

2:00 PM
40. Artificial Neural Networks: An Introduction to Their uses in Statistical Modeling and Comparison of Predictive Power versus Multiple Regressions, Brian Mistler

3:00 PM
41. Counselor TV: Creating and Running a Streaming Television Channel, Michael Baltimore

4:00 PM
42. Closing Session

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A new  Hallmark Hall of Fame special, “When Love is Not Enough: The Lois Wilson Story, “  is the biography of Al-Anon creator and wife of AA cofounder Bill W. This movie tells the story of the beginnings of the recovery movement. Historically, the movie marks the begining of self-help, recovery and addiction programs, all of which had a great impact on how we view addictions and recovery today. Watch the movie trailer.  Winona Ryder plays Lois Wilson (cofounder of Al-Anon), Barry Pepper plays Bill Wilson (cofounder of Alcoholics Anonymous), in the Hallmark Hall of Fame presentation When Love Is Not Enough: The Lois Wilson Story, premiering Sunday, April 25, 2010 on CBS.

If you prefer books to movies, the book of the same title is also available.

If you struggle with addictions or if you love someone with an addiction, this story will speak to you. The foundation Bill and Lois laid has influenced recovery from all addictions, not just alcohol. While the 12-Steps is not helpful for everyone, the 12-Step movement has helped millions. Why don’t you tune in and share in a piece of health and wellness history?

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I had the pleasure of seeing Wishful Drinking at Studio 54 Sunday in New York. Wishful Drinking is Carrie Fisher’s life story given quite conversationally from her chair on a warm broadway stage.   I never had the opportunity to go to Studio 54 in it’s hey day as a thriving disco for celebs and those who were somehow part of the “in” crowd of the early 80’s drinking and drugging haze. Instead, I sat in what is now a lovely theatre, as a 40-something psychotherapist listening with awe and respect to the provocative life of Carrie Fisher.

The play is only running for two more weeks so if you have the opportunity, GO! Carrie Fisher gives voice to the decadent aftermath of living in the spotlight and using substances to cope. She talks of her struggle with being diagnosed with bi-polar disorder and her bouts with rehab. But what shines through is her surviving and thriving spirit. She tells her story with candid humor and grace. This is a show worth seeing!

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In Treatment is a series on HBO about psychotherapy. The show, now in season two appears to be a hit.  Gabriel Byrne received a Golden Globe award for his portrayal of Dr. Paul Weston.  It is Sunday and In Treatment airs tonight.  My colleague in the UK forwarded an article that appeared in today’s Guardian. So I thought I would round off my new obsession with a blog post!

Most of the time when I watch films or television and a therapist is portrayed, I grimace, hold my breath, and sometimes shout my dismay aloud.  How many times has a therapist had sex with the client or breached confidentiality on the screen?  Boundary violations, dual relationships and other unethical nuances usually abound when mental health practitioners are weaved into movies and television shows.

In Treatment is not much different. But what makes the experience complete is that the near ethical scrapes are brought into the forefront and interwoven into the dialogue- last season even found Dr. Weston meeting with his clinical supervisor.  His character openly discusses amorous feelings for a client and he rasply says he is burned out.  All the while, we see his therapeutic work, sometimes on the mark and sometimes not so much, as we the audience peer in on sessions and glimpse ever so briefly into his private life.

The story line is entertaining; nonetheless during certain episodes, I feel like I am viewing a day in the life of my own work.  But overall, In Treatment provides a rich snapshot into the world of a psychotherapist, and with the intensity of a 25 minute one-act play.  The show is not one that is tolerated in dribs and drabs- one episode here and there does not do it justice, so if you decide to give it a whirl, tune in for at least two or three episodes in succession before you decide if this series is for you.

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…the Myers-Briggs is indeed online and has been for years, but it is not considered a serious test of personality by experts on test design.  It is not admissible in court and the research clearly shows that it’s not much better than a horoscope.  So let me draw a distinction between serious, rigorously designed tests, and those that are not rigorously designed and thus the designers/publishers are less concerned about the issues I’m about to summarize.  That said, there ARE tests available via computer that are good, solid tests (e.g., the Strong Interest Inventory (career-aptitude test), behavioral rating tests like the CBCL and BASC-2, etc.) but these tests don’t NEED to be administered in person, and also in my experience tests are more EXPENSIVE by computer than paper.  The MMPI-2 is also available for computer administration, but not on the Internet, the client needs to be in the office with the computer.  And it’s more expensive than paper administration, again.  Companies tend to charge high fees for software, plus fees for each test “form,”  and sometimes subscription fees to maintain the service.

Anthony S. Ragusea, Psy.D.
Clinical Psychologist

P.S. Be sure to read more about online testing and assessment in our upcoming book —The Use of Technology in Mental Health: Applications, Ethics and Practice due out this fall from Charles C. Thomas Publisher, Ltd.

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Izzard plays Jack Lawson, a lawyer at a successful firm who is called upon, alongside his black colleagues, to represent a white client (Richard Thomas) accused of raping a black woman. As Mamet explains, “In my play a firm made up of three lawyers, two black and one white, is offered the chance to defend a white man charged with a crime against a black young woman. It is a play about lies…All drama is about lies. When the lie is exposed, the play is over.”

At first glance this appears to be a mystery play about a simple lie by witnesses around where the sequins are from the red dress worn by the accuser in the hotel room where the alleged attack took place. But as their planned case comes together in light of the accused’s blundering press release, issues of racism and sex come to the fore as internal assumptions around what is right and wrong between races and gender clash both within and outwith the lawyer’s office. Essentially, Mamet illustrates a world where there is nothing a white person can say to a black person without feelings of being patronized, upset or simply wrong being incurred. He also demonstrates how this happens between men and women.

So how can online therapists, in relation to not necessarily knowing the colour of their client’s skin, ensure that their internal assumptions and biases around cultures and races (born of upbringing and social environment) do not infect the therapeutic work, either by self-reflection or in Supervision? The written word with clients can often seem stark without tone-of-voice and gesture, so how easy is it to misunderstand a remark made in innocence that a person of a different culture misunderstands as being racist? If the remark is deemed as racist by the client, is this the case? Or is it the case that the therapist is telling himself or herself lies about their attitude to differences in culture, as is the case in Mamet’s play with Lawson’s self-assurance? How important is it to examine and challenge one’s own internal racism in light of not knowing the clients race?

So, Mamet’s play brings a lot of questions about society’s attitudes to difference of race and gender. As well as being very witty in parts and challenging in others, I recommend it as a thought-provoking piece of theatre, as a therapist, an theatre goer, or even as just an Izzard fan!

Kate

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We are working hard on putting together our new OTI magazine, TILT (Therapeutic Innovations in Light of Technology).

The magazine will be online and free, and launched in September 2010. It will be a blend of news, innovations, member profiles, articles, features, marketing toolboxes, news on textbooks, and advertisements of interest. We will have more news on this very soon as the first issue comes together.

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Each issue will include the following:

· Editors introduction and contents (Kate Anthony & DeeAnna Merz Nagel)
· News from the cyberstreet (tweets members, what is at OTI blog, new research news)
· New Breakthroughs column
· Online Therapist column (A Day In The Life)
· Online Supervisor column
· Ethical Dilemmas column
· Feature article 4000-6000 words
· Other article(s) – about 1500 words
· Marketing toolbox column
· Featured Verified website
· Letters/reader comments
· Book descriptions of 3 books per issue
· Advertising and conferences

If you have an article of up to 1500 words that you are burning to get out of your system on any topic related to innovative delivery of therapeutic services via technology (including coaching), please do submit it no earlier than August 1st and no later than August 20th to editor@onlinetherapymagazine.com

We’re very excited at this new development at the Online Therapy Institute and will let you know even more about the content soon!

We look forward to reading your article!

If you have other inquiries about the magazine including advertising options please email info@onlinetherapyinstitute.com

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Employee Assistance European Forum Brussels Conference 2010  See the link for the full agenda.

Best Practices for Providing EA Services via Email Exchange

Ms. Kate Anthony, Founder “The Online Therapy Institute”, President of the International Society for Mental Health Online, U.K.

 2010 EAP-MAP Conference Villanova Conference Center, PA See the link for the full agenda.

Panel Discussion – “Let your Fingers do the Talking: Adding Online Counseling to your Therapeutic Repertoire”
Jane Weiler, LCSW – Program Coordinator, NY Presbyterian Hospital Workplace Services
Mary Ellen Gornick, MA – Senior Vice President – Global Products, Workplace Options
DeeAnna Nagel, MEd, LPC, DCC – Co-Founder, The Online Therapy Institute
Cedric Speyer, MA, MAEd – Clinical Supervisor of E-Counseling, Shepell

We hope to see you there!

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The scenarios include two people, each married to someone else,  involved in a cyberaffair, complete with hook-ups in Second Life to using webcam technology for face-to-face encounters. Their love affair takes them out of cyberspace for several in-person encounters. Emotions are high and limerence, that state of intense romantic desire for another person, is clearly evident. This is an affair of great proportions~ emotional, cerebral and physical~ filled with the excitement and consequences of infidelity.

An intimate look  into the lives of several people who are brave enough to share their stories continues. Another young adult who is engaged to be married logs into Second Life and soon he has created an alter~ an 11 year-old girl who he describes is a part of himself. This story line is rich and psychodynamic offering a glimpse into the impact of virtual worlds on the lives of people who have experienced childhood trauma. The vulnerabilities of the adult male, his alter child female, his “real life” fiance and other avatars the child befriends in Second Life are all laid out across the screen in a disturbing yet expected fashion.

A woman searching for meaning in her vocation  discovers that she can merge her love of gaming with her talent for design. She also explains that she has been dealing with several health issues so working from home is a plus for her. She starts a business creating a line of clothing and accessories as well as designer homes and landscapes. She manages to turn her hobby into a profitable enterprise. As with any entrepreneur, she applies focused concentration and long hours.

It is the stuff of life that therapists have been dealing with for years, or is it?

Enter the ability to create an alternate digital reality and these life struggles become magnified. Online disinhibition means that people do and say things in cyberspace they might not be able or willing to do or say in their “real life.”  Quotations are purposeful here because the underlying message is that these cyber experiences ARE real- as real as what I had for breakfast this morning.

So what does this documentary offer those of us in the helping professions? How about a new chapter in multiculturalism? Cyberculture is rich, full, real and impactful. Our clients don’t just go to soccer games, or movies or to Paris or Walt Disney. They don’t just have clandestine affairs at work or deal with historical issues of abuse in the therapist’s consultation room. They go to Second Life, another destination rendering the thrill of decadent and clandestine meetings, corporate enterprise, vocational fulfillment and the ability to create a new beginning, reconstruct a past event or extend parts of oneself into another reality.

If you have the opportunity to view Life 2.0, don’t miss it.  Your understanding of cyberspace will grow beyond measure.

Stay tuned for more about Life 2.0. We will regularly post notes of interest to our readers.

DeeAnna

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Counselor Education in Second Life (CESL) is partnering with the Online Therapy Institute (www.onlinetherapyinstitute.com) for the 2nd Virtual Conference on Counseling (2VCC). The conference  is scheduled for September 15-18, 2010 in Second Life (an open online computer virtual world) at the CESL center. We had so much success with last years counseling conference that we are going to try to expand it this year to provide 24-hour opportunities to present and hear from other global community scholars.

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Diana has teamed up with Online Therapy Institute and several others to offer unique resources and discounts for people who purchase his book.  OTI is offering a 50% discount on our Get Verified program.

For more information on the book and corresponding offers, check out Diana’s recent blog post announcing the book launch and partners!

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What is HR Certification Institute?

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The HR Certification Institute is the credentialing affiliate of the Society for Human Resource Management (SHRM),  the world’s largest association devoted to professional human resource management. HR Certification Institute works to define and maintain the HR body of knowledge, and offers assessments and certification of this knowledge. Human Resource certification demonstrates mastery of the HR body of knowledge and is widely accepted as a symbol of professional achievement.

Introduction to Cyberspace: A Primer for the Helping Professions

Kate Anthony & DeeAnna Merz Nagel

5 clock hours of instruction.
Online and self-paced.
$69.99/£45.00

During this course, you will learn about “what is out there”, from tweeting to blogs to chatrooms to gaming to Virtual Reality environments. This course covers definitions and illustrations of the aspects of Cyberspace that you need to know about, for offering therapy services in these platforms and understanding your clients’ experience of them. The course offers examples and illustrations of the platform being talked about, and shows you how to take part in them. We will also offer a basic understanding of Internet safety. This is so that you keep your communications and behaviors safe on the Internet but also so that you have a better understanding of what your clients may experience online if they do not practice Internet safety.

• Basic Internet Functions for Therapy and Counseling

• Enhanced Internet Functions for Therapy and Counseling

• Further Enhanced Internet Functions for Therapy and Counseling

• Visual and Aural Internet Functions for Therapy and Counseling

• Web 2.0 and Implications for Therapy and Counseling

Participants will be able to browse the internet accessing email and chat applications that may enhance client and/or student relationships.

Participants will be able to browse the net accessing podcast, wiki and virtual world applications that may enhance client and/or student relationships.

Participants will be able to browse the net and apply the use of blogs, microblogs and other social networking applications to their mental health practice or counselor education setting.

Participants will be able to practice basic internet safety and understand how to educate clients and/or students about internet safety.

We have partnered with DigitalChalk to provide a user-friendly yet state-of-the art training experience.

To purchase this course, create a profile at the OTI Training Portal and visit the catalog page.

Add the course to your shopping cart and pay with a credit card.

Continuing Education for U.S. psychologists, social workers and counselors, addiction counselors and marriage and family therapists is available for an additional $25.00. Click here for details.

Are you a Human Resources Professional?

This program has been approved for 5.0 (General ) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. Please be sure to note the program ID number on your recertification application form. For more information about certification or recertification, please visit the HR Certification Institute website at www.hrci.org.

This course will give the HR professional knowledge about how to maneuver cyberspace from the perspective of wellness. Understanding where employees are spending time online is valuable and understanding the possibility that employees are spending time online engaged in gambling, cybersex, social networking or other activities that take away from work productivity is essential. Knowledge about cyberspace will aid in interventions with employees who may need additional assistance, In addition, HR professionals often make decisions about and collaborate with EAP programs for health and wellness benefits. More and more EAPs are now offering EAP services via technology, Understanding what technology platforms are available for practitioners to utilize with employee/clients is essential when determining which EAP programs would best suit the employer.

The use of this seal is not an endorsement by the HR Certification Institute of the quality of the program. It means that this program has met the HR Certification Institute’s criteria to be pre-approved for recertification credit.

If you are interested in a group training rate please email info@onlinetherapyinstitute.com.

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Marina London recently wrote an article for the Employee Assistance Report and kindly mentioned Online Therapy Institute’s Ethical Framework for the use of Technology in Mental Health. Marina, we do appreciate the mention! The pdf download is avalable to read:

Ethical & Legal Considerations of Online Counseling are Ongoing

Read more about the Employee Assitance Report publication here: http://www.impact-publications.com/category/general_info_earn

For more from Marina London, follow her on twitter @IWebU and read her blog at http://www.iwebu.blogspot.com/

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PDF download:

Using Technology to Deliver Career and School Guidance Services

Schmelter-Davis, H., Anthony, K. & Nagel, D. (2009). Using technology to deliver career and school guidance services: establishing a global and inclusive ethical framework. Student Assistance Journal. 21(3), 26-34. 

The Student Assistance Journal Magazine is published by PRP Media, Inc.

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Do you have a website that offers information, services or products related to mental health?

Online Therapy Institute verifies websites so that individuals and businesses can demonstrate to their audience that their website is in compliance with what OTI considers to be “best practice” and in accordance with OTI’s Ethical Frameworks.

Getting OTI Verified means whether you offer website development and marketing services, you are an individual practitioner in private practice or you own an e-clinic or you represent a charity or educational organization you can indicate to the public that you understand the ethical implications of delivering mental health information and services online.

Website Categories

• Client Services (therapy, counselling. counseling, coaching)
• Therapist/Coach Directory
• Social Network
• Blog
• Peer Support
• Self Help
• Practice Building/Marketing
• Supervision/Consultation
• Education/Professional Development
• Crisis Intervention

You may have a website that fits into more than one category. Or you may have two websites under the same business name. For instance, some people have a private practice website and a separate blog site. We will offer an OTI Verified Seal that you can use on all of your sites. By implementing the items on our checklist that apply to your website categories, you can Get Verified .

• Your seal will be a choice of two styles.
• Each seal carries your company name and the current date.
• The seal cannot be replicated onto another site.
• The cost is $99.99 for the first year and $49.99 renewal each year following.

Instructions

You must have Adobe Reader to Download the following files

OTI Get Verified Checklist ….. OTI Get Verified Notes

• Compare your website to our checklist to be sure your website is ready for verification.
• Read through the notes that offer clarification for items on the checklist.
• Once you are sure you meet the criteria, click Google Buy Now button below.
• Following the completion of the payment process, you will be directed to the application.
• You will be contacted within 10 business days with your OTI Verified Seal.
• Should your website not meet the OTI Verified criteria, we will make recommendations.

Get Verified!

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The photograph below shows me presenting to the room of delegates at the OCTIA conference venue, with my own laptop in front of me.  Behind me on the screen is the view from my laptop perspective into Second Life, where I was joined by colleagues from all over the world represented as avatars, who had their own chat facility with me via my laptop and the delegates in the room who were also in Second Life as avatars (hence the laptops in the audience).  The screen on the wall to my right is where I was shown live from the perspective of one of the other delegates in the room in Second Life, with the official OCTIA chatroom being scrolled to the right of the video, where I was also taking part via audio and my laptop via text.

If that description sounds confusing, the point is that I was present in five different realities simultaneously, presenting worldwide.  This groundbreaking event reached four continents – Europe, the USA/Canada, South America and Australia – bringing them together to discuss the use of virtual and mixed realities in counselling and psychotherapy experientially.  To ensure the delegates watching in the physical room and online were truly able to understand what working in mixed realities is like, I wore the same clothes that my avatar is based upon, clearer in the photograph below (with my virtual self centre-front of the screen (from my perspective, hence the back view)).

You can also view a video by John Wilson of OnlinEvents and pics of the event. Jokay, founder of Jokaydia where our OTI office and conference center is located,  took some great pics while inworld. We are ever so grateful for her design expertise and professional support.

The Islands of jokaydia is a virtual worlds community of practice facilitated by Jo Kay aka jokay Wollongong. We are exploring the use of virtual worlds and games for education, arts and social change. You can find us in Second Life, Reaction Grid and our new virtual worlds presence – the jokaydia Grid!

We hope you will visit us inworld! If you’d like to check out Online Therapy Square, and the OTI Headquarters visit: http://slurl.com/secondlife/jokaydia%20II/110/68/24.

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Ada Lovelace Day March 24th: An international day of blogging to raise awareness of the achievements of women in technology and science- I found this out today! So I thought I would add the OTI blog to the celebration!  As women co-founders of the Online Therapy Institute we are all about technology and how technology has impacted the field of mental health.

So who is Ada Lovelace? Ada Byron, Lady Lovelace, was born August Ada Byron on December 10, 1815  and is the daughter of the illustrious poet, Lord Byron.

When inspired Ada could be very focused and a mathematical taskmaster. Ada suggested writing a plan for how the engine might calculate Bernoulli numbers. This plan, is now regarded as the first “computer program.” A software language developed by the U.S. Department of Defense was named “Ada” in her honor in 1979.  Read more…

Let’s celebrate women who embrace science and technology!

Thanks for your contribution, Ada! ~ perfect timing too since it is Women’s History Month! Check out more blog posts about Ada’s influence at BlogHer.

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Kate is presenting at the Online Counselling and Therapy in Action (OCTIA) conference on the 20^th March 2010 at 4.10pm (GMT).  Kate will conduct a live tour of professional, therapeutic and educational environments in Second Life, and discuss some of the benefits and pitfalls

of conducting therapy in virtual environments.  Environments will include the offices of the Online Therapy Institute (offices, conference centre, breakout rooms and skybox for therapeutic sessions – www.onlinetherapyinstitute.com) and OnlineEvents.com 9the technical arm of OCTIA).

The location is http://slurl.com/secondlife/jokaydia%20II/147/45/24

Participation in this workshop is free.  Tickets for the main conference (online and offline) are available from http://www.octia.org.uk/OCTIA/Home.html

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Hi Everyone!

I invite you to join me and over 10 other expert speakers for a complementary Therapist Resource Telesummit. Over three days, you will have access to some incredible information on how to create an authentic and profitable therapy business, helping many more clients. I will be discussing online therapy and I am thrilled to be joining such a dynamic group of speakers!

See details here:
Therapists Resource FREE Telesummit March 12 – 14

You’ll discover:

* How to stop giving your money away to insurance companies and the biggest mistakes therapists make in building a successful fee-for-service therapy business

* How to help your potential clients TALK THEMSELVES into working with you and what you’ll need to know to attract way more clients without compromising your values

* The mindset shift and business model change you need to learn so you can easily double your current income

* How to use coaching to build a fee-for-service practice making six to seven figures a year

* The reason why you may be procrastinating in your business and the biggest gift you can offer your clients

* The marketing approach that helps your community, while growing your practice at the same time

* How to expand your practice using text-based therapy: what you need to know about using email and chat with your clients- everything from encryption, client screening, and cyber-cultural awareness

* How to create a signature presentation that leaves your potential clients asking for more

* Practical tools you can use to earn expert status and how to utilize technology and marketing strategies to engage clients, build credibility, and earn loyalty

* Specific ways social media improves your visibility online and how to use directories and google local business center to gain exposure and attract new clients

* How online networking sites and technology can bring therapists, students, and interested professional together in a global web community, maximizing your practice exposure

And so much more!

Join me!

March 12th, 13th and 14th, 2010
Register and see details here:
Therapists Resource FREE Telesummit March 12 – 14

Wishing everyone the best!

DeeAnna

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I will be there to discuss “Therapy Online [a practical guide] (Anthony and Nagel, 2010), and Dr. Stephen Goss will talk about the forthcoming title “The Use of Technology in Mental Health: Applications, Ethics and Practice” (Anthony, Nagel & Goss, 2010). We will also refer back to the original UK text on the topic “Technology in Counselling and Psychotherapy: A Practical Guide” (Goss & Anthony, 2003).

Anne Stokes and Gill Jones will consider their 2009 book “Online Counselling”, and Jane Evans will discuss “Online Counselling and Guidance Skills: A Practical Resource for Trainees and Practitioners” (2009).

Also great to welcome Jethro Adlington to talk about “Online Therapy – Reading Between The Lines – A practical NLP based guide to online counselling and therapy skills” (2009).

All these books and more are available from the OTI bookstore at http://www.onlinetherapyinstitute.com/bookstore/

Looking forward to it!

Kate

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During this course, you will learn about how the supervisory relationship works online, and the importance of secure communication between supervisor and supervisee. We will cover the use of technology historically in supervision to give you grounding in what is available to you for use in practice and to illustrate the usefulness of verbatim transcripts in particular. We will consider the ethical nuances of online supervision, the importance of contract formation, and also some of the boundary issues when being an available online supervisor in practice, particularly with regard to social networking functions of the Internet. Lessons include:

Traditional Uses of Technology
Suitability of the Supervisor
Written Communication Skills for Supervision
Ethical Considerations for the Use of Technology in Supervision
Individual and Group Case Examples
Learning Outcomes:
Participants will be knowledgeable about traditional uses of technology in supervision.

Participants will be able to apply written skills to text-based supervision via chat and email.

Participants will be informed about the ethical considerations for the use of technology in supervision .

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Now OTI is expanding inworld with a SkyBox build. The SkyBox will be located above the original office and will offer a therapy room, a small group room and a classroom.  A SkyBox location allows for more security so that others inworld cannot simply “drop in” at will. When conducting avatar therapy inworld, other measures will be utilized to ensure confidentiality such as encrypted chat and voice. Platforms like Skype can be used in conjunction with Second Life.

Jokay founded the Islands of Jokaydia where the OTI office is located. All of the residents of Jokaydia focus on education in one form or another so OTI found it to be a natural fit. Across the square from the OTI office is the office of OnlinEvents. John Wilson who owns OnlinEvents is also a therapist inworld. OTI and OnlinEvents collaborate frequently on projects and our new SkyBox will allow for even more diverse collaboration! Between the two offices will be the newly named “Therapy Square” offering resources for passersby.

Today Jokay showed Kate and DeeAnna a SkyBox space she has created for Charles Sturt School of Information Studies (also located inworld at Jokaydian Islands). This picture is at Charles Sturt’s space in Second Life.

The meet up with Jokay was great fun- it was like meeting with the builder and the decorator all at the same time! Kate and DeeAnna will keep you posted on the developments. In the meantime, visit us inworld!

The direct link is http://slurl.com/secondlife/jokaydia%20II/147/45/24.

Regards from the virtual world!

Be sure to follow all of us on twitter as well! @TherapyOnline @KateAnthony @jokay @OnlinEvents

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This embraces the importance of recognising online therapy – and indeed the function of technology in general –  as a vital component of the profession.

The new Ethical Framework states:

Variations in client needs and the diversity of settings within which counselling and psychotherapyservices are delivered have also been carefully considered. Clients vary in their requirements in order tocommunicate effectively and to gain access to services. Ethically aware services strive to meet theseneeds and to avoid excluding someone from receiving a service or lowering the quality of that servicesolely on the grounds of a client’s learning difficulty or physical disability. Services may be provided bythe independent practitioner working alone, one or more practitioners working to provide a service withinan agency or large organisation, specialists working in multidisciplinary teams, and by specialist teamsof counsellors and psychotherapists. Most work is undertaken face to face but there are also a growingnumber of telephone and online services. Some practitioners are moving between these different settingsand modes of delivery during the course of their work and are therefore required to consider whatconstitutes good practice in different settings. All practitioners encounter the challenge of responding tothe diversity of their clients and finding ways of working effectively with them. This statement thereforeresponds to the complexity of delivering counselling and psychotherapy services in contemporary societyby directing attention to significant issues that practitioners ought to consider and resolve in the specificcircumstances of their work.

The Online Therapy Institute embraces this amendment, as the work of BACP remains the basis of part of our own Ethical Framework for the Use of Technology in Mental Health (http://www.onlinetherapyinstitute.com/ethical-training/).

Kate

http://www.bacp.co.uk/ethical_framework/

Goss, S., Anthony, K., Jamieson, A. and Palmer, S. (2001) Guidelines for Online Counselling and Psychotherapy. Rugby: BACP.

Anthony, K. &  Jamieson, A. (2005) Guidelines for Online Counselling and Psychotherapy 2^nd Edition, including Guidelines for Online Supervision. Rugby: BACP.

Anthony, K. &  Goss, S. (2009) Guidelines for Online Counselling and Psychotherapy ^3rd Edition, including Guidelines for Online Supervision. Rugby: BACP.

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We will be adding new continuing education/professional development opportunities so if you would like our courses to count toward requirements in your country, please let us know and will will gladly look into it!

Our current list of courses:

.

Introduction to Cyberspace: A Primer for Helping Professionals

Relationships in Cyberspace: An Introduction for Helping Professionals

The Online Therapeutic Relationship: Theoretical Considerations

Ethical Considerations of Online Therapy

Working Therapeutically Using Asynchronous Email

Working Therapeutically Using Synchronous Chat

Continuing Education is available for U.S. psychologists, social workers, counselors, addiction specialists, marriage and family therapists, nurses and educators.

Our courses are co-sponsored by R. Cassidy Seminars.  You will take a test and receive a certificate of completion within the course module but if you are a practitioner in the U.S. and you wish to obtain accredited continuing education hours, the cost is an additional $25.00 per workshop.

Online Therapy Institute Accreditation

Co- sponsored by R. Cassidy Seminars

Satisfactory Completion

Participants must have paid course fee, submitted signed verification statement, completed evaluation, and completed post-test with passing grade of 75% in order to receive a certificate. Failure to complete and submit these materials will result in forfeiture of credit for the entire course. No exceptions will be made. Partial credit is not available.

Psychologists

R. Cassidy Seminars is approved by the American Psychological Association (APA) to offer continuing education for psychologists.  R. Cassidy Seminars maintains responsibility for this program.

Also covers LPCs, MFTs, and SWs in the District of Columbia

Social Workers

R. Cassidy Seminars, ACE provider #1082 is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) Program. Approval Period: April 15, 2009-April 15, 2012. R. Cassidy Seminars maintains responsibility for the program. Social workers should contact their regulatory board to determine course approval. Social workers will receive __#__ continuing education (clinical, social work ethics) clock hours in participating in this course.

Covers Social Workers in these states: AL, AK, AR, AZ, CT, DE, FL, GA, ID, IA, IL, IN, KS, KY, MA, MD, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NM, OK, OR, PA, RI, SC, SD, TN, TX, VA, VT, WA, WI, WY. Also covers Licensed Professional Counselors in PA

DC: See approval for Psychologists

CA: Course meets the qualifications for (#) hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences, Provider #PCE418.

OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for ( ) clock hours, #RCST110701

Counselors

R. Cassidy Seminars is recognized by the National Board for Certified Counselors to offer continuing education for certified counselors.  We adhere to NBCC continuing education guidelines.  Provider #6375.  (#) hours.

AK, AL, AR, AZ, CT, DE, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MN, MS, MT, NC, ND, NH, NJ, NM, OK, OR, RI, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY.

OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for ( ) clock hours, #RCST110701

Marriage and Family Therapists

AK, AL, AR, AZ, CT, FL, IA, ID, IN, KS, MD, ME, MT, NE, NJ, NM, OK, OR, RI, SD TN, UT, VA, WA, WY. See approval for Counselors.

DC & MS: See approval for Psychologists

CA: Course meets the qualifications for (#) hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences, Provider #PCE418

IL: Illinois Dept of Professional Regulation, Approved Continuing Education Sponsor, #168-000141.  (#) hours.

OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for ( ) clock hours, #RCST110701

TX: Approved CE Sponsor through the Texas State Board of Examiners of Marriage & Family Therapists. Provider #151

Chemical Dependency Counselors

Provider approved by NAADAC Approved Education Provider Program for (#) contact hours.  Approval #000654.

CA: Provider approved by CAADAC, Provider #4N-00-434-0210 for (#) CEHs. CAADAC is an ICRC member which has reciprocity with most ICRC member states

TX: Provider approved by the TCBAP Standards Committee, Provider No. 1749-06, (#) hours general and/or (#) hours (specific specialization), Expires 3/2009.  Complaints about provider or workshop content may be directed to the TCBAP Standards Committee, 1005 Congress Avenue, Ste. 460, Austin, Texas 78701, Fax Number (512) 476-7297.

Nurses

CA: Provider approved by the CA Board of Registered Nursing, Provider #CeP12224, for (#) contact hours.

Teachers/Educators

IL: Provider approved by the Illinois State Board of Certification #080304164719171

TX: R. Cassidy Seminars is an approved provider with the Texas Education Agency CPE# 501456. This course is (#) CE Hours.

Please Note: Licensing Boards change regulations often and while we attempt to stay abreast of their most recent changes, if you have questions or concerns about this course meeting your specific board’s approval, we recommend you contact your board directly to obtain a ruling.

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So I thought I would go to the source- at least the most accurate source I know of- to give us all  the answers.

For years I have used Hushmail email services with clients to ensure my email exchanges are encrypted. The service is easy and affordable. In fact Hushmail offers a free account too. That can be handy if a client only needs an account temporarily while working with a therapist online.  The service is HIPAA compliant and Hushmail is willing to sign a HIPAA Business Associate Agreement (required in the United States). The agreement means that any 3rd parties that may be privy to confidential client information understand their responsibility to keep the information confidential.

I emailed Hushmail support and asked if they could explain more about their service and how encryption works. I asked specifically how Hushmail differs from Gmail. I received this response and I am posting the response here with permission:

Hello DeeAnna,

Thank you for your email and we are delighted to help with this.

Hushmail has been providing web-based secure email services for over a
decade now and uses the well known and well used OpenPGP standard for
encrypting email. We are a hosted service where users create accounts
on our servers and their email/data is stored securely on our servers.

All interactions a Hushmail user has with our servers are, and always
have been done over SSL (HTTPS), which provides a secure tunnel
between the users computer and our servers. If a Hushmail user sends a
message from one Hushmail user to another the email it will be sent
securely over its entire journey over SSL. Gmail is now doing the same
as we are, and we think this is a really good thing. Hushmail however
provides additional security in that users have the ability to easily
individually PGP encrypt their messages before sending them, encrypted
messages are also stored on our servers in an encrypted state. This
means that email has greater protection not only in transit, but also
when it is being stored.

One other area where Hushmail provides additional security is in that
with Hushmail you can send an encrypted message to a non-Hushmail
user, you do this by setting a shared secret as the key to encrypting/
decrypting the message. This is different to gmail in that the message
is individually encrypted (gmail messages are not) but also, once a
message is sent to a recipient outside of your network you may not
have control over whether the email is sent securely over SSL.
Individually encrypting your message resolves this issue.

We have many customers who use our service for counselling via email
and have been doing so for a long time.

If you have any further questions please do not hesitate to contact me.

Kind regards

Ben Cutler
Hush Communications
604 685 7288

I hope you find this explanation as helpful as I did. You can follow @hushmail on twitter. Oh, and Ben says if our readers mention Online Therapy Institute, he will give a discount on hushmail services! Thanks Ben for your time, expertise and a great service!!

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Download the December 09 newsletter here!

Kate

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Learning outcomes:
By the end of the day participants will:

• be aware of the range of technological interventions available
• understand the online therapeutic relationship
• understand the basics of online etiquette and written communication
• be aware of some of the pitfalls of social networking in the counseling profession
• have considered the ethical considerations of working online
• have had experiential learning of working with online clients
• have considered how couple counselling online could be conducted.

Teaching Format
A combination of presentations, discussion, and experiential smaller group work.

Presenter:
Kate is a Fellow of the British Association of Counselling and Psychotherapy, and developed and co-authored three editions of the Guidelines for Online Counselling and Psychotherapy, including Guidelines for Online Supervision. She is co-editor of Technology in Counselling and Psychotherapy – A Practitioners Guide, The Use of Technology in Mental Health: Applications, Ethics and Practice and co-author of Therapy Online [a practical guide]. She is also Past-President and Fellow of the International Society for Mental Health Online. She trains and consults on using technology in Mental Health as CEO of www.onlinetherapyinstitute.com. Free membership of the Institutes social network is at www.onlinetherapysocialnetwork.com, where over 450 professionals meet to discuss online therapy and use the Institute’s free resources.

Please contact Alice Still or Diana Reilly for more information.
Alice.still@relationships-scotland.org.uk
Diana.reilly@relationships-scotland.org.uk
Date:
Tuesday 9th March 2010
Time:
9.45am for 10.00am – 4.00pm
Venue:
Relationships Scotland
18 York Place, Edinburgh
Cost for Members of RS Network:
£75 to include training materials, sandwich lunch and refreshments.
Cost for Non-Members:
£115 as above.
Participants:
For relationship counsellors, sex therapists, and managers of services.

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The following week I will be in Lafayette, Louisiana.

Spring months take me to Florida, North Carolina, New Jersey, Illinois and Georgia.

SAMPLING OF THE 20 COMPETENCIES COVERED:

• Determine Counselor Suitability to Distance Counseling
• Determine Client Suitability to Distance Counseling
• Learn Security and Confidentiality Strategies
• Create Individual Treatment Plans
• Discuss Ethical and Legal Issues
• Develop an Action Plan to Implement Distance Counseling in Various Work Settings
• Learn about Online Culture
• Handle Crises with Distance Counseling Clients

For full workshop details go to ReadyMinds at http://www.readyminds.com/training/dcc_event.asp.

You can also download a flyer. DCC Arizona

My full training schedule is available at http://www.deeannamerznagel.com/id5.html.

Hope to see you on my travels!

DeeAnna

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*  Code 0074T: Online evaluation & management service, per encounter, provided by a physician, using the Internet or similar electronic communications network, in response to a patient’s request, established patient.

In 2008, the CPT code 0074T was replaced. The code relating to online counseling was previously in the CPT manual under category III (emerging technologies).  As of 2008, it has been replaced by the new code numbers and is now under category I.

CPT Code 98969 is used to describe online services provided by non physician. CPT code 98966 is used to bill for phone consultation services.

Here are the billing guidelines about these two codes.  These two codes do not specify mental health-related services so the best advice is to check with the insurance carrier and advise your clients to do the same. For now it is best to assume that online counseling is not covered unless you can verify otherwise.

CPT 98969 On-Line Medical Evaluation by a Non-Physician

Online assessment and management service provided by a qualified non-physician health care professional to an established patient, guardian, or health care provider not originating from a related E/M service within the previous 7 days, using the Internet or similar electronic communications network.

Guidelines

•  Reportable services involve a personal and timely response to the patient’s inquiry, and must include permanent storage (electronic or hard copy)
• The online encounter is reported only once for the same problem/issue during a seven-day period, and includes the sum of all communication related to the online encounter (eg telephone calls, prescriptions, lab orders).
• If the online encounter relates to and occurs within 7 days of another E/M service performed and reported by the same provider for the same problem, it is not separately reportable.
• If the online encounter relates to a procedure performed by the same physician and occurs during the global post-operative period, it is not separately reportable.
• Online services should not be reported for care plan oversight or anticoagulation management when the same communication is reported using codes 99339-99340, 99374-99380, or 99363-99364.
• Online services which result in a face-to-face visit for the same problem may be reported in addition to the face-to-face visit.

Example: A patient emails her physician to request information about cancer screening after learning that there is a history of breast, colon, and prostate cancer in close family members. The physician responds and explains the implications of the family history, reviews risk factors, and offers an opinion as to what types of screening may be appropriate. The physician may also direct the patient to informational websites or attach handouts that are routinely provided to patients.

Example: The mother of a 16 year old patient with cystic acne, controlled with topical medications, emails the physician because of a recent flare-up. She is concerned about scarring and desires information about other appropriate treatment options, and the impact of diet and stress on the condition. The physician responds to her concerns, offers a short course of antibiotic therapy, provides long-term treatment options, and instructions for a follow-up visit.

Telephone Services–Non-Physician

Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment;

•  98966 5-10 minutes of medical discussion
• 98967 11-20 minutes of medical discussion
• 98968 21-30 minutes of medical discussion

Coding Guidelines

• These codes may be reported only for established patients.
• The patient or patient’s parent/guardian must initiate the contact. These codes may not be used for calls initiated by a provider.
• Codes 99441-99443 are used only for services personally performed by a physician.
• Calls resulting in a face-to-face encounter for the same problem within 24 hours (or soonest available urgent appointment) are not reportable. Instead, consider the call part of the pre-service work for the billable E/M service.
• If the call relates to and occurs within 7 days of another E/M service performed and reported by the same provider for the same problem, the call is not reportable. This also means that a telephone call related to a previous call within 7 days is not reportable, since these codes are themselves an E/M service.
• Do not report a call that is related to and takes place within the postoperative period of a procedure performed by the same physician. These calls are considered to be part of the global surgical package.
• Telephone calls should not be reported for care plan oversight or anticoagulation management when the same communication is reported using codes 99339-99340, 99374-99380, or 99363-99364.

References:

http://www.todayshospitalist.com/index.php?b=articles_read&cnt=498   

http://www.acpinternist.org/archives/2008/01/billing.htm

http://www.memo-snap.com/memo-snap/cpt.htm

http://www.memo-snap.com/memo-snap/online.htm

http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20080229cptcodes.html

http://my.counseling.org/2009/10/29/is-phone-counseling-and-online-counseling-covered-by-insurance/

http://www.google.com/#hl=en&source=hp&q=CPT+Code

.

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So what’s in store for 2010? Our authored book, Therapy Online: A Practical Guide was just released and we have another edited book, The Use of Technology in Mental Health: Applications, Ethics and Practice due out this summer. This book has 30 chapters with a total of 47 contributing authors from across the globe.

As promised, we are offering online training about online therapy. We have launched the first 6 workshops with more to come. Each workshop is the equivalent of 5 clock hours of instruction. The workshops are online and self-paced.  The cost per workshop is $119.00/70.00 £.

• Introduction to Cyberspace: A Primer for Helping Professionals
• Relationships in Cyberspace: An Introduction for Helping Professionals
• The Online Therapeutic Relationship: Theoretical Considerations
• Ethical Considerations of Online Therapy
• Working Therapeutically Using Asynchronous Email
• Working Therapeutically Using Synchronous Chat

The workshop details can be accessed at our training portal. We have partnered with DigitalChalk to bring you a user-friendly yet state-of-the-art experience. Continuing Education credits for U.S. psychologists, social workers and counselors will be available very soon.

www.onlinetherapyinstitute.digitalchalk.com.

Just create an account and peruse our catalog! Your account will remain active should you decide to return to take a course.

We are giving our website a facelift so resources are easier to navigate.

We will soon offer an Online Therapy Institute ~verified~ seal that will provide a way for online helping professionals to indicate to the public that their site meets standards of best practice.

We will be facilitating groups and workshops as well as co-sponsoring conferences online and at our Second Life location.

We are collaborating with others to add to our Ethical Framework resources.

We have created:

• Ethical Framework for the Use of Technology in Mental Health
• Ethical Framework for the Use of Technology for Career and School Guidance

Coming Soon:

• Ethical Framework for the Use of Technology in Professional Coaching
• Ethical Framework for the Use of Technology in Crisis, Disaster and Critical Incident Interventions
  

We are offering a directory listing to everyone who joins our social network at www.onlinetherapysocialnetwork.com and your listing will be posted at www.onlinetherapydirectory.net.

For OTI members who practice online, a website listing in the OTI Web Directory (online counseling category) will be added provided the following standards are met:

1. Offer encrypted services for email, chat and web conferencing.
2. List level of education, schools attended and dates graduated.
3. List certifications and licenses if applicable with verification web links.
4. List crisis information or a link on the website’s home page.
5. List therapist’s alternate contact information in addition to email.

Mostly, we will continue to encourage dialogue among our members and friends at Online Therapy Institute so that we can all learn and grow together!

Kate and DeeAnna

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You can buy the book here: http://www.australianacademicpress.com.au/Publications/Books/4-921513312.html

In the chapter, we discuss

Technology Assisted Supervision
Enhancing the Use of Video and Audio through Analytical and Research Software
Extending Direct Observation
Delivery via phone, email, listserv, chat, videoconferencing and virtual worlds
Review of the Current Standards for issues such as contracting, informed consent, legalities, confidentiality and encryption, the use (and abuse) of verbatim material
Issues of transference and countertransference
The Suitability of the Supervisor regarding technical competency, training and education

The chapter concludes with questions and activities and has an OTI hand-picked selection of resources and references.

A worthy addition to any online therapy library, and wwe hope you enjoy it!

Kate

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Others may opt to join an “E-Clinic” which is an easy way to describe a platform or portal that allows providers of services and potential clients to conduct therapy. There are some nuances across the E-Clinic menus but in a nutshell, it is a one-stop shop for the client and therapist. I have previously joined E-Clinics in the past and I am still listed on a few.  It might be interesting to note that I have been listed for several (a decade in some cases) years on some e-clinic sites and I rarely if ever receive an inquiry from a potential client. I’ll get back to that in a minute.  E-Clinics are convenient and easy. Some E-Clinics offer appointment setting, billing capability, credit card processing and an extensive listing. Conceivably, one could create a listing on such a site and use the listing as a website. Some E-Clinics offer customized or “branded” services so that you can integrate the platform into a custom website of your own.  And most E-Clinics conduct some variation of credentialing so that license and certification numbers as well as malpractice insurance information is verified.

So it sounds hassle-free. So, why not? Well, there are a few reasons why not.  One is cost. Some of these sites charge monthly fees. That’s great but if you also have a website of your own then you might be paying twice, so to speak. Remember I said previously that I rarely if ever receive client inquiries from these sites so just because they have a glossy “store front” and offer a suite of products to the therapist, it does not mean that the site is marketed well. If you want to know, do an internet search using keywords like online therapy, online counseling, online counselling, or etherapy. What comes up? Is the E-Clinic listed on the first page of results? That is but one way to find out how “popular” the service is.  The other way is to check press or media tabs on the websites. Has anyone interviewed the company? Is there any information about advertising campaigns, past, present or future?  Remember, you can create a listing anywhere on the World Wide Web. That does not mean people can find you. In the case of E-Clinics, make sure your money is working for you.

Another concern is security. Is the site encrypted? Is the information held on the company’s server? I often joke that we need to be careful about setting up our services using encrypted platforms that are hosted on Joe’s server located in Joe’s garage somewhere in an urban neighborhood across the country or the world. But seriously, the security and encryption of the site should meet very high standards. Does the E-Clinic serve via contract, any major government or insurance entities? That is one reasonable and simple way to know if the E-Clinic has “clout” so to speak. But even so, do your own security tests. Take the E-Clinic for a spin. Use their web, messaging or chat services with a colleague. When you are logged on, send the URL (which should begin with https://) via your regular email or chat (yahoo or gmail for instance). Can the person on the other end open the the URL? If so, the site is not secure. Why is this important? If you do this same test with sites like Amazon, Ebay or your bank once you have logged in, the other person will not be able to see your information and will most likely be sent to a login page for that site. The same process should occur for E-Clinic sites.

If you think you have found an E-Clinic you want to use, be sure to check out their Terms of Use, Privacy Policy and other Terms and Conditions.  You should be concerned with what you are agreeing to as the provider of services and what the consumer agrees to as the recipient of services. Does it match your legal and ethical responsibilities? Do you have the ability to upload your own informed consent documents to your clients? And if you take client referrals from these sites using their platform, what intake information do you receive? Does the site conduct any screening? Is the site set up to provide crisis intervention? If the site clearly states that online therapy is not for people in crisis, then consider whether you want to make yourself available immediately. Many of the E-Clinic sites offer instant sessions as a way to lure consumers into using the site. Some would say these E-Clinics are offering a viable service to people who are in immediate need. So I ask, is the immediate need a crisis or just needing to have a personal issue addressed right away, representing the immediacy of our culture? Be careful not to compromise standards of care. For instance, if you make yourself available immediately, what client information do you have on hand during this initial contact? Is the client allowed to remain anonymous? If so, what happens if the client is genuinely in crisis?  I recommend that if you are going to utilize the option of immediate availability that you use this option as an initial consultation- and treat that time much like you would if a client called on the phone inquiring about services.  Why? Well, consider your ethical responsibility to properly screen your client and to know the identity of your client. If you are providing crisis intervention then the site should clearly state that services are for people in crisis with the proper terms and conditions in place.  Counseling and psychotherapy services that occur within a contracted relationship are very different than crisis intervention services.

Remember that E-Clinics cater to many disciplines so be sure that you can follow your legal and ethical codes and that you remain within your scope of practice.  If you live in a geographic area that does not regulate your profession and you have no real code of ethics to fall back on for reference, then consider using best practice standards set forth by the Online Therapy Institute’s Ethical Frameworks for Mental Health Practitioners and Career and School Guidance.

Hoping this has been a helpful post~ perhaps this will generate a healthy discussion of the topic.

DeeAnna

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NEW LOW PRICE! $155.00 for the full-day session!

REGISTRATION FORM

Presented by: DeeAnna Nagel, LPC, DCC
Dallas, Texas EAPA Pre-Conference Training
Co-Founder of the Online Therapy Institute

The Employee Assistance Professionals Association (EAPA) invites you to
Register For This Full-Day Ethics Course
Ethical Implications Online: Working and Socializing in Cyberspace
Tuesday, October 20 8:00 AM – 5:00 PM; 7.5 PDH/CE contact hours

This full-day workshop will discuss best practice with regard to communicating online with potential and existing clients, business associates, friends and other therapists. With the advent of Web 2.0 and Social Media, counselors and psychotherapists now must understand the boundaries of working and socializing in cyberspace. Topics to be covered include communicating confidentially with existing clients, how to handle the email inquiry from a potential client, the basics of ethical online counseling and the slippery slope of marketing your practice on the internet via social networking sites such as Facebook, LinkedIn and Twitter.

Learn more about EAPA’s 2009 Annual World EAP conference or download the conference preview book.
PDH/CE credit hours provided by:
Employee Assistance Certification Commission (EACC)
National Association of Social Workers (NASW)
National Board for Certified Counselors (NBCC)
California Board of Behavioral Sciences
National Association of Alcohol and Drug Abuse Counselors (NAADAC)

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The Employee Assistance Professionals Association (EAPA) invites you to
Register For This Full-Day Ethics Course
Ethical Implications Online: Working and Socializing in Cyberspace
Tuesday, October 20 8:00 AM – 5:00 PM; 7.5 PDH/CE contact hours

This full-day workshop will discuss best practice with regard to communicating online with potential and existing clients, business associates, friends and other therapists. With the advent of Web 2.0 and Social Media, counselors and psychotherapists now must understand the boundaries of working and socializing in cyberspace. Topics to be covered include communicating confidentially with existing clients, how to handle the email inquiry from a potential client, the basics of ethical online counseling and the slippery slope of marketing your practice on the internet via social networking sites such as Facebook, LinkedIn and Twitter.

Special OTI Discounted Price: $295
(You Save $60!)

Add This Full-Day Business-Building Course
For Just $100 More!

Essential Sales Skills for the Non-Sales Professional
Wednesday, October 21 8:00 AM – 5:00 PM; 7.5 PDH/CE contact hours

Presented by: Shelley Plemons MS, LCDC
President/CEO, Strategic Sales Solutions

The economy is poor and the behavioral health marketplace is increasingly competitive. As a mental health professional, you may be faced with the challenge of maintaining your current work-load while becoming more involved in sales efforts. You want to increase your client base and land business, but sales is not your first profession, and feels daunting. What do you do?

First, don’t panic! Second, participate in this unique full-day training session! This is the only sales training program for non-sales professionals, written and presented by a fellow clinician, and targeted to building the sales capacity of mental health and employee assistance professionals and their programs. Shelley will introduce you to the principles and skills of consultative selling. It’s a logical, non-manipulative approach that focuses on being responsive to the needs of your prospective client and matching them to your products or services. Enhance your confidence by using your personality and skills in consultation, relationship building, and communication to build business!

Total OTI Discounted Price for Both Courses: $395
(You Save $315!)

Offer Expires September 30, 2009!

Don’t Wait ‘Til It’s Too Late!
Use This Special Form to Register Today!

Learn more about EAPA’s 2009 Annual World EAP conference or download the conference preview book.
PDH/CE credit hours provided by:
Employee Assistance Certification Commission (EACC)
National Association of Social Workers (NASW)
National Board for Certified Counselors (NBCC)
California Board of Behavioral Sciences
National Association of Alcohol and Drug Abuse Counselors (NAADAC)

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This conference is free and offers CE through NBCC.

The conference is coordinated by Dr. Marty Jencius, Assistant Professor and Counselor Educator at Kent State as well as founder and list manager for CESNET-L, a professional listserv for counselor educators and co-founding editor of The Journal of Technology in Counseling, a web-based, peer reviewed journal.

Kate Anthony and DeeAnna Merz Nagel will be co-presenting a Keynote entitled: Online Therapy in Second Life and the Online Therapy Institute.

Other colleagues are joining us with great content.

General Information:

http://sl.counseloreducation.org/Conference/conference.html

Conference Schedule:

http://sl.counseloreducation.org/vccschedule/vccschedule.html

Registration:

http://sl.counseloreducation.org/Registration/registration.php

If you do not have the Second Life platform downloaded but still want to view the conference, you may register and view the conference via John Wilson’s Online Events website. http://www.eventbrite.com/event/433929896/fbnews

Real-time conference updates and information can be read and sent through Twitter  http://twitter.com/ceinsl   hashtag #ceinsl

PDF of Progam: cesl-conference-program

Hope to see you inworld!

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What caught my eye about this article is that he points out that society is being carried away by the word “virtual”, so for instance a block of chocolate, which disappears into your mouth, becomes virtual.  More to the point, many of the things we think of as “real” – such as money or the value of a brand (Keegan cites Nike) – are in themselves virtual…. but we are used to them and so consider them real.

The full article is available here: http://www.guardian.co.uk/technology/2009/sep/09/victor-keegan-virtual-world-revolution

So – what has this to do with online therapy?

If a face-to-face session is thought of as being transient – that is, it existed in real time but no longer does apart from the memory and the learning from it (like the chocolate – I ate it and I enjoyed it and am therefore likely to do it again therefore adding to my life experience, but it is past), does that make it less virtual than online therapy sessions (where the record of the session is logged, printed, carried, re-read).  Is the reason for the suspicion of online therapy simply that we are not used to thinking of it as real, because our professional history shows that we believe face-to-face therapy as being “real”.  The face-to-face session is past and is only in our memory – the online session gives us tangible evidence of it.  It doesn’t make the fleeting face-to-face session less real… but it means the online session exists at any point we – or more to the point, the client  - want to re-experience it. 

So – does that mean the online therapy session is technically less virtual than face-to-face therapy?

Kate

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This conference is free and offers CE through NBCC.

The conference is coordinated by Dr. Marty Jencius, Assistant Professor and Counselor Educator at Kent State as well as founder and list manager for CESNET-L, a professional listserv for counselor educators and co-founding editor of The Journal of Technology in Counseling, a web-based, peer reviewed journal.

Kate Anthony and DeeAnna Merz Nagel will be co-presenting a Keynote entitled: Online Therapy in Second Life and the Online Therapy Institute.

General Information:

http://sl.counseloreducation.org/Conference/conference.html

Conference Schedule:

http://sl.counseloreducation.org/vccschedule/vccschedule.html

Registration:

http://sl.counseloreducation.org/Registration/registration.php

Hope to see you inworld!

DeeAnna

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My presentation will be on October 15th at 3PM PST. I will be speaking on the topic of Online Therapy.

The presentation will offer talking points for the therapist who is interested in offering online therapy (email, chat, webcam, VOIP) as adjunct to existing face-to-face clients and to new clients that begin the therapeutic relationship virtually. Considerations will include confidentiality. proper intake and informed consent.

I hope you can make it! There will be many great topics presented by great speakers so don’t forget to register!  Continuing Education is available. ~ DeeAnna

Online Therapy Teleseminar October 15th @ 3PM PST

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Online Counseling Crosses the Chasm

Kate and DeeAnna were interviewed for the article as well as several of our colleagues.  The Online Therapy Institute’s Ethical Framework for the Use of Technology in Mental Health is summarized as well.

Lyle, thanks for a great article! It is a wonderful contribution to the literature!

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The podcast is now available along with a very interesting accompanying article, I Am My Avatar. The podcast by the same title, I Am My Avatar is described as follows:

Kayvon Sharghi enters the virtual reality realm of Second Life to interview two “online therapists.” These specialists discuss how to treat traumas or psychological problems by working with their clients’ avatars—their online characters.

These links will take you to the article and the full list of available 2009 podcasts:

http://scicom.ucsc.edu/SciNotes/0901/pages/avatar/avatar.html

http://scicom.ucsc.edu/SciNotes/0901/pages/podcasts.html

Kayvon, thank you for your work!

Kate and DeeAnna

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I have excerpted the information from the bill below which can be found on page 379.

If you want to see the entire 1017 pages go here
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf

Happy reading!!

Subtitle F—Medicare Rural Access
9 Protections
10 SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.
11 (a) ADDITIONAL TELEHEALTH SITE.—
12 (1) IN GENERAL.—Paragraph (4)(C)(ii) of sec13
tion 1834(m) of the Social Security Act (42 U.S.C.
14 1395m(m)) is amended by adding at the end the fol15
lowing new subclause:
16 ‘‘(IX) A renal dialysis facility.’’
17 (2) EFFECTIVE DATE.—The amendment made
18 by paragraph (1) shall apply to services furnished on
19 or after January 1, 2011.
20 (b) TELEHEALTH ADVISORY COMMITTEE.—
21 (1) ESTABLISHMENT.—Section 1868 of the So22
cial Security Act (42 U.S.C. 1395ee) is amended—
23 (A) in the heading, by adding at the end
24 the following: ‘‘TELEHEALTH ADVISORY COM25
MITTEE’’; and
VerDate Nov 24 2008 00:08 Jul 15, 2009 Jkt 079200 PO 00000 Frm 00379 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS
380
•HR 3200 IH
1 (B) by adding at the end the following new
2 subsection:
3 ‘‘(c) TELEHEALTH ADVISORY COMMITTEE.—
4 ‘‘(1) IN GENERAL.—The Secretary shall appoint
5 a Telehealth Advisory Committee (in this subsection
6 referred to as the ‘Advisory Committee’) to make
7 recommendations to the Secretary on policies of the
8 Centers for Medicare & Medicaid Services regarding
9 telehealth services as established under section
10 1834(m), including the appropriate addition or dele11
tion of services (and HCPCS codes) to those speci12
fied in paragraphs (4)(F)(i) and (4)(F)(ii) of such
13 section and for authorized payment under paragraph
14 (1) of such section.
15 ‘‘(2) MEMBERSHIP; TERMS.—
16 ‘‘(A) MEMBERSHIP.—
17 ‘‘(i) IN GENERAL.—The Advisory
18 Committee shall be composed of 9 mem19
bers, to be appointed by the Secretary, of
20 whom—
21 ‘‘(I) 5 shall be practicing physi22
cians;
23 ‘‘(II) 2 shall be practicing non24
physician health care practitioners;
25 and
VerDate Nov 24 2008 00:08 Jul 15, 2009 Jkt 079200 PO 00000 Frm 00380 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS
381
•HR 3200 IH
1 ‘‘(III) 2 shall be administrators
2 of telehealth programs.
3 ‘‘(ii) REQUIREMENTS FOR APPOINT4
ING MEMBERS.—In appointing members of
5 the Advisory Committee, the Secretary
6 shall—
7 ‘‘(I) ensure that each member
8 has prior experience with the practice
9 of telemedicine or telehealth;
10 ‘‘(II) give preference to individ11
uals who are currently providing tele12
medicine or telehealth services or who
13 are involved in telemedicine or tele14
health programs;
15 ‘‘(III) ensure that the member16
ship of the Advisory Committee rep17
resents a balance of specialties and
18 geographic regions; and
19 ‘‘(IV) take into account the rec20
ommendations of stakeholders.
21 ‘‘(B) TERMS.—The members of the Advi22
sory Committee shall serve for such term as the
23 Secretary may specify.
24 ‘‘(C) CONFLICTS OF INTEREST.—An advi25
sory committee member may not participate
VerDate Nov 24 2008 00:08 Jul 15, 2009 Jkt 079200 PO 00000 Frm 00381 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS
382
•HR 3200 IH
1 with respect to a particular matter considered
2 in an advisory committee meeting if such mem3
ber (or an immediate family member of such
4 member) has a financial interest that could be
5 affected by the advice given to the Secretary
6 with respect to such matter.
7 ‘‘(3) MEETINGS.—The Advisory Committee
8 shall meet twice each calendar year and at such
9 other times as the Secretary may provide.
10 ‘‘(4) PERMANENT COMMITTEE.—Section 14 of
11 the Federal Advisory Committee Act (5 U.S.C.
12 App.) shall not apply to the Advisory Committee.’’
13 (2) FOLLOWING RECOMMENDATIONS.—Section
14 1834(m)(4)(F) of such Act (42 U.S.C.
15 1395m(m)(4)(F)) is amended by adding at the end
16 the following new clause:
17 ‘‘(iii) RECOMMENDATIONS OF THE
18 TELEHEALTH ADVISORY COMMITTEE.—In
19 making determinations under clauses (i)
20 and (ii), the Secretary shall take into ac21
count the recommendations of the Tele22
health Advisory Committee (established
23 under section 1868(c)) when adding or de24
leting services (and HCPCS codes) and in
25 establishing policies of the Centers for
VerDate Nov 24 2008 00:08 Jul 15, 2009 Jkt 079200 PO 00000 Frm 00382 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS
383
•HR 3200 IH
1 Medicare & Medicaid Services regarding
2 the delivery of telehealth services. If the
3 Secretary does not implement such a rec4
ommendation, the Secretary shall publish
5 in the Federal Register a statement re6
garding the reason such recommendation
7 was not implemented.’’
8 (3) WAIVER OF ADMINISTRATIVE LIMITA9
TION.—The Secretary of Health and Human Serv10
ices shall establish the Telehealth Advisory Com11
mittee under the amendment made by paragraph (1)
12 notwithstanding any limitation that may apply to
13 the number of advisory committees that may be es14
tablished (within the Department of Health and
15 Human Services or otherwise).
16 SEC. 1192. EXTENSION OF OUTPATIENT HOL

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Avatar Therapy is not new. The term has been discussed theoretically for nearly ten years. But now that virtualworlds have reached the mainstream and with the advent of gaming, many people understand the provocative power that exists with an avatar identity. People now live part of their lives virtually, sometimes existing in a mixed reality. Since technology and the internet have become such a part of our social fabric, separating time “online” from real world time is sometimes difficult and the lines have become blurred. Beyond standard email, people now chat and instant message, join social networks such as Facebook and MySpace and network professionally on sites such as Linkedin. People engage in consultation, business transactions, coaching and psychotherapy online via email, chat, audio and videoconferencing. The idea of engaging in therapy online within a virtual world environment is now reality. Second Life, a virtual world platform that is free to join already hosts private practitioners and mental health agencies offering psycho-education, consumer information and psychotherapy.

Three-dimensional virtual world settings offer another level of sensory experience that could enhance the therapeutic process. People can create an avatar that is a literal or metaphorical representation of self. Avatars can also represent a part of the self- perhaps the inner child or the shadow. With advances in technology and artificial intelligence, the ability to simulate various scenarios with therapy clients is not far off. Artificial intelligent avatars can be used in the therapeutic process to help a client heal from trauma, create a new ending to a dilemma, or work out unfinished business with a deceased loved one. These are but a few examples of how avatar therapy, with the aid of artificial intelligence and facilitation from a trained avatar psychotherapist can benefit people.

Properly trained avatar therapists would have a clear understanding of more traditional approaches to therapy online such as those mentioned above and understand the ethical issues related to online therapy and the delivery of mental health services through technological means. In addition, avatar therapists would have adequate knowledge of the online disinhibition effect as well as trauma related theories so that clients could be adequately prepared for avatar work. Avatar therapists would need to understand the importance of titrating emotions and properly grounding the client using containment techniques. Keeping the client emotionally safe would be paramount in a virtual environment because issues that would typically surface over several months or years could potentially surface much quicker in virtual world setting.

Avatar therapy of the future moves far beyond the therapist and client’s avatar representations engaging in an online form of traditional talk therapy. This futuristic and innovative therapy combines artificial intelligence with elements of traditional psychotherapeutic techniques used in grief work, and with trauma survivors as examples. Training therapists for this futuristic work can begin now in counseling education programs across the globe as we prepare practitioners to incorporate technology into the art of psychotherapy.

~ DeeAnna

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Well, OTI has an Ethics and Law wiki and we do our best to keep it updated as we receive information about the legal and ethical aspects of practicing online counselling across the globe.  But still, this method relies on all of us to make sure the updates are received in a timely manner and that Kate and I can upload the information that is sent to us if a person does not enter the information to the wiki him/herself.

So in this training I heard of two more states that may have implemented restrictive language into their law regarding online counseling- not allowing a licensed practitioner in that state to offer online therapy services to anyone outside the state (MA and NE).  I am hoping I can get more clarification and actually see a copy of their language.

And so on my drive back the hotel it occurred to me that one way we can effect change as professionals in our various states and countries is to become active in our professional organizations.  If you are in the states and you are member of APA, ACA, NASW, get involved. Join taskforce committees.  To have influence in your state, join a state chapter.  Volunteer to be on the board. Be part of a government relations or ethics committee.  Become the ethics chair of your state chapter.  That is how we can begin to educate our colleagues about the value of online counseling.  I do not think we should be legislating WHERE online counseling can occur.  I think we should be legislating competency.

It is obvious to me that state licensing boards are way behind the curve when it comes to understanding the global community – and global e-commerce.  Placing practice restrictions on licensed professionals does not allow consumers choice in treatment, and seems to be a rather paternalistic stance.  And clearly, state licensing boards have no clue about the online culture.  Most states require practitioners to have taken a class on multiculturalism to obtain a license to practice, yes? Yet the boards do not understand that we have an entirely new culture of people who live within a mixed reality, choosing to receive professional services online through their global community.  So if we look at the online community as a culture, then we could make the claim that in this instance, our state boards are not being very culturally sensitive, could we not?

While this issue of “crossing state lines” is rather U.S.-centric, my point in this post is to encourage professionals to become involved in their local professional organizations no matter what country, so that we can all make a difference.  We want online therapy to be a viable option within the global community!!

Have a great summer day!

DeeAnna

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Audrey Jung, Sue Whitlock, Jodi Underhill and Chris Wood are all practicing online therapists!

All members are offered a listing in the Online Therapy Institute’s Web Directory so be sure to check out their profiles!

• Audrey B. Jung, LPC NCC DAPA

  
  

• Coconut Counselling

  
  

• Jodi Underhill MH & Counseling Services

  
  

• www.e-psychotherapy.co.uk

  
  

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Kate’s contribution is “The Future of Innovation in Training Innovative Therapists” and discusses training therapists to use technologies such as SMS texting, VR, Social Networking sites, and finally Hologrammatic Therapy (you heard it here first!).

DeeAnna’s contribution is “The Future of Innovation: The Use of Avatars in Psychotherapy” introduces Innovative Avatar Therapy Simulation and discusses what Avatar Therapy looks like, how it can enhance the therapeutic process, and the importance of training in using this new method when combining AI with elements of traditional psychotherapeutic techniques.

See more on the project at : http://thefutureofinnovation.org/

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See a clip here: http://www.nhatky.in/lisa-kudrow-web-therapy-online-12338961 – enjoy!

Kate

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Great article from PsychCentral which puts DeeAnna and OTI at the forefront of Twitter for Mental Health!!

7. @therapyonline “A wide lens is cast at the Online Therapy Institute ranging from email and chat to videoconferencing and Second Life.” DeeAnna Merz Nagel maintains this popular account with a focus that’s business-to-business for professionals who offer online therapy. She manages to share lots of intriguing info while straddling a thin line between professional organization and marketer – without falling into the dark side.

See http://psychcentral.com/blog/archives/2009/06/29/top-ten-psych-tweeps/ for the other tweep pageant winners in Mental Health!

Kate

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Paul Fornell has been a clinical counselor, a professor, a career counselor, and is currently ACA’s Director of Ethics and Professional Standards

Jessica Diaz is a doctoral student at the University of Maryland and an Affiliate Professor at Loyola College.

David Kaplan is a  Past-President of the American Counseling Association and it’s current Chief Professional Officer.

DeeAnna Merz Nagel is a clinical counselor, teacher, workshop presenter, sits on the ACA Cyber Technology Taskforce, and is co-founder of the Online Therapy Institute.

I am honored that ACA has asked me to join in!  Be sure to check it out:

http://my.counseling.org/

And follow ACA on Twitter!

http://twitter.com/CounselingViews

And please, if you are so inclined, comment on the ACA blog and RT on Twitter!

Have a great summer day!

DeeAnna

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Best,

DeeAnna

METROPOLITAN  NEW  YORK  CHAPTER

NATIONAL  REHABILITATION  ASSOCIATION,  INC.

presents a training session

“TODAY’S  REHABILITATION  REALITY: 

 ETHICS  AND  EMPLOYMENT”

Thursday, June 25, 2009     8:30 AM – 5:00 PM

New York University

Wasserman Center for Career Development

140 East 14th Street (or 133 East 13^th Street)

between 3^rd and 4^th Avenues  2^nd Floor

New York, NY 10003 

4, 5, 6, L, N, Q, R, W subways to 14^th Street Union Square 

8:30  Registration, refreshments 

9:00  Welcome

            Christopher Kempski, MS, LMHC, CRC

            President, Metropolitan New York Chapter, National      Rehabilitation Association, Inc.   

9:15  Awards 

10:00 “Ethical Issues of Cyberspace:  Considerations for the     Rehabilitation Counselor”

            DeeAnna Merz Nagel, LPC, LMHC, CRC, DCC

            Psychotherapist and Consultant, Private Practice (Rumson, NJ),

            Co-Founder, Online Therapy Institute  

11:30 Break 

11:45 “Employment in Challenging Times”

            Arnold Dorin, MA

            Regional Marketing Coordinator, NYC Region,

            NYS Vocational and Educational Services for Individuals with    Disabilities (VESID) 

            Steve Towler, MA

            Director of Employment and Business Services,

            AHRC, NYC Chapter 

12:45  Lunch on your own 

2:00  “Who Takes Care of the Caretaker?  A Discussion of Ethical,    Moral, and Personal Obligations”

            Eleanor Abel, PA, MS, CRC

            Teaching Hospital Liaison, Department of Medicine,

            SUNY Upstate (Syracuse, NY) 

            Lise Mayo, MS, CRC

            Program Counselor, Mental Health Services,

            St. Joseph’s Hospital Health Center (Syracuse, NY) 

3:30   Wrap-up and Evaluations  

4:00 –  Board meeting

5:00  (one additional CRC hour if you attend)  

4.0 CRC hours (3.0 ethics hours and 1.0 standard hour) have been requested.

Discount fee for NRA members, government employees, and students. 

For more info, please contact Paula Lee, MS, CRC

(212) 998-4749   tel   paula.lee@nyu.edu 

www.nymetronra.org

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Kate and DeeAnna

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Working in partnership with some of the biggest names in music, sport and clubbing, CALM encourages young men to ‘open up’ and sort out their problems. CALM has built a strong presence through the internet, club flyers, posters, beer mats, gigs, comedy nights and in the media.

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But over the past year or so I have also assisted people with website builds.  I started out helping therapists build sites that integrated online therapy services, but lately I have been approached by others who just want a simple site to describe what they do.   And guess what?  I love the builds!  It is a creative outlet for me!  I am not a webmaster so I do not offer flash and other fancy plugins, but I can build a sturdy site for people who do not know how, don’t want to learn or just don’t want to take the time.  Once I complete the build, I can show someone how to maintain the site themselves, or I can make changes as needed.

So, if you are shopping around, check me out.  This site describes my web build services in more detail: www.therapyonlinewebsitedesign.com

Here are a few sites I have built:

DeeAnna

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The workshop went quite well and we spent the afternoon working in small groups, pondering over 10 ethical dilemnas.  Each group gave feedback on how they would handle the scenario.  Kate and I brainstormed the scenarios and intentionallly developed them ranging from obvious…to …oh, that would never happen!  The workshop attendees had great feedback, thoughts and ideas about all 10 scenarios and it was such an eye-opening experience for all of us- the workshop attendees and Kate and myself, that we are going to present the scenarios one by one over the course of several weeks here on the blog.  We hope to generate loads of comments and thought-provoking discussion. 

Stay tuned for mind-stretch ethical dilemnas! As we all navigate the waters of online therapy, cyberpsychology and boundaries in cyberspace let’s put our collective heads together and see what we can come up with!  In the meantime, check out the GSCSW article!

Thanks again Georgia social workers!  You rock!

DeeAnna

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The event was opened by Gill Jones of ACTO and Counselling Online Ltd – co-hosts of the conference.  An exciting and evolving programme emerged throughout the day, starting with a keynote from Jeannie Wright of New Zealand giving a remote presentation (pre-recorded) on “Only Connect”, covering some of the research linking expressive and reflective writing with online therapies.  A representative of BACP brought along copies of the Guidelines for purchase (see http://www.bacp.co.uk/publications/NEW%20PUBLICATIONS/onlinecounselling.php).

A change of programme meant that Dr. Stephen Goss, co-author of the recently published 3^rd Edition of the BACP Guidelines for Online Counselling and Psychotherapy, including Guidelines for Online Supervision (Anthony & Goss, 2009), stepped in at the last minute to explain the contents of the publication and the implications for the profession from a wider perspective regarding international ethical development of the field.

Due to further programme changes, the day evolved to include three workshops to run simultaneously – Anne Stokes on Online Supervision, Jane Evans on working online in HE and FE, and Gill Webb hosting a live online chat taster session.

Keynote speakers included Steph Palin covering the work of Relate with a live demonstration of how their chatroom support helps – a neat amalgamation of chat and website links within the same client screen.  Joe Ferns talked delegates through the work of the Samaritans online, with some stunning statistics and illustration of the exchanges the organisation receives through mobile texting.

The keynote in the latter part of the afternoon hosted a video interview with Audrey Jung (Pres-Elect of ISMHO) by Kate Anthony (Past-President of ISMHO) as interviewer about the state of play in the US, before going live to New Jersey to chat with DeeAnna Merz Nagel (also Past-President of ISMHO) as commentator on the interview and to answer delegate questions.

The panel of speakers, led by Anne Stokes, then answered questions from the floor for 50 minutes.

Although this was a small conference on a specialist subject, it is a great step forward for the profession in linking with people all over the world in not only observing the face-to-face presentations but also contributing from the OCTIA chatroom.  The chatroom, facilitated by the organisers, Kate Anthony and Stephen Goss – was projected onto the side wall of the conference suite so that the live chat and questions to the presenters emanating from it could be fed to the keynote speakers.  Furthermore, the conference will, with the help of OnlineEvents.co.uk, be available for download from the OCTIA website – including the pre-conference interviews with Gill Jones, Kate Anthony, and DeeAnna Merz Nagel – watch http://www.octia.org.uk.

Kate Anthony, MSc, FBACP

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ReachOut.com.au is a youth targeted website providing support and information about mental illness.   The Australian, an online newspaper, gives an interesting perspective with opinions from experts internationally, about ”Cyberspychology” and how it can help.  More here:

http://www.theaustralian.news.com.au/story/0,25197,25376388-23289,00.html

Kate

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Yesterday I presented a 90-minute workshop entitled The Impact of Technology on Mental Health.  The presentation offered an overview of the impact of technology on mental health ranging from online counseling, self-help websites, wikis, podasts and blogs, gaming, virtual worlds, social networks and other related information.  We had a lively discussion ranging from ethics to internet addiction! I offered a handout of various links that embodied the available resources and interventions online. 

Here is a sample of some of the website links I offered:

Self-Help and Information

www.psychcentral.com   www.mentalhelp.net  

www.queendom.com

Self-Help Support Groups and Peer Support

www.dailystrength.org   www.addictiontribe.com  

www.mymobileguru.co.uk

Podcasts

http://www.softconference.com/dbsa/slist.asp?C=1382  

www.thejoveinstitute.org

Wikis

www.wikipedia.org   www.onlinetherapy.wikispaces.org   

www.wikimentalhealth.co.uk

Blogs

www.mentalhealthonthewebblog.com   www.onlinetherapyinstituteblog.com  

www.graceuncensored.blogspot.org

Social Networks

www.ning.com   www.social.realmentalhealth.com  

www.onlinetherapyinstitute.ning.com

Online Therapy

www.helphorizons.com   www.deeannamerznagel.com  

www.audreyjung.com

Therapist Directories

www.psychologytoday.com   www.goodtherapy.org  

http://etherapyweb.com

Twitter

www.twitter.com   http://wefollow.com  

www.twitter.com/therapyonline     @therapyonline    @kateanthony

Delicious

www.delicious.com   www.delicious.com/onlinetherapyinstitute

Hotlines

www.befrienders.org   www.deeannamerznagel.com/id65.html

Virtual Worlds

www.secondlife.com   www.clubpenguin.com

I hope everyone is enjoying this lovely spring day!  DeeAnna

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• Advertising
• Networking
• Media Opportunities
• Case Consultation

OTI offers several ways for people to collaborate, network and gain knowledge about mental health and technology.  We have free discussion groups through Linkedin, Facebook, Second Life and our own social network.  We blog and we tweet to keep everyone up-to-date on the latest happenings in the field.  Membership is not necessary through these groups and many are satisfied with the affiliation they currently have with us.  Becoming a member however, brings additional benefits. 

When a person, business, organization, educational institution or charity joins OTI we spread the word about their cause, services, products, or training. Beginning in 2009, all members who join receive a dedicated blog post which is fed to many blog directories and social networks such as Linkedin and Twitter.  We also create a listing in our Web Directory and the new listing is then fed to Twitter and other networks.  We create another way to advertise through social media and we promote our members by assisting with research projects, networking and offering media connections.  We promote member workshops and trainings related to mental health and technology through our blog and events calendar.

For qualified clinical members, we offer a secure and encrypted forum for peer supervision and one-off case consultation regarding online and face-to-face cases.  The forum is facilitated and feedback is offered by Kate Anthony and DeeAnna Merz Nagel.

If you interested in joining, access the membership form here. Come grow with us!! And please do not hesitate to ask any questions of us. 

Annual Membership Fees

$ 50.00 USD  INDIVIDUAL Clinical and Professional

$ 75.00 USD  ORGANISATIONAL Non-profit/Charity/Educational Institution/Association

$100.00 USD ORGANISATIONAL Business/Corporate

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One simple way to support World Autism Awareness Day is to become a “fan” on Facebook!

Best to all,

DeeAnna

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We discuss various issues about using Second Life to host therapy sessions – our optimism about it as well as our concerns around security and encryption, and how we got into this field in the first place. We are so thrilled to have the opportunity to discuss this topic in such a well respected media venue.  The Metaverse Journal has long been one of our favorite picks!

Hope you enjoy it!

Kate

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The framework’s audience is global and as new technologies and ethical issues arise, the framework will be revised and updated.  Practitioners who practice according to the framework can know that they are implementing the best standard of care available to their clients.

The framework is posted on the OTI website and is also offered as a PDF download.  Members of OTI who offer therapy delivered via technology will be listed in the OTI Web Directory provided their practice follows the framework.  Anyone may join the Institute. but the directory will be reserved for practitioners and organizations who have implemented the framework into their practice.

We are excited about offering this framework to all mental health practitioners!

Best,

DeeAnna and Kate

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• Web-cam therapy is not as popular as had been expected due to the need for high speed connection and the fact that some people prefer the  perceived anonymity offered through text-based therapy.
• In theory, some officials suggest that a clinician could be liable for ethics charges of even loss of license if they see a client who resides in another state.
• The state of Ohio is looking at a new rule saying that therapy takes place whereever the client is.
• There are no legal cases yet.
• Insurers are generally not happy  with the concept of Internet services but coverage remains in place.
• The first person who gets hit (with a lawsuit) will get hit big.
• Even so, many individuals are seeking therapy online.
• Various associations offer ethical guidelines but retain attitudes ranging from indifference to hostility.
• Informed consent may need to be modified for online work.
• It is suggested that if your license is listed on your website, you come under the jurisdiction of the license regardless of what service you state you are providing (consulting, coaching or advice).

I recommend this publication to any clinician but particularly if you are in private practice.  While this particular article is, in my opinion, heaped with negativity, it does offer points that those of who practicing online should be concerned with.

To all of our non-U.S. followers- forgive this U.S.-centric post!!

DeeAnna

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Enjoy!

Kate

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MACHS

Mid-Atlantic Consortium for Human Services

2009 Annual Conference

Improving the Health and Wellness of Human Services

Recipients and Providers: Thinking Globally and Acting Locally

April 17-19, 2009

Brookdale Community College

Lincroft, NJ

Keynote: Wellness: A Model for Personal and Professional Practice.

Peggy Swarbrick, PhD., OT, CPRP 

Human service professionals are dedicated to help service recipients attain and achieve a sense of well being through access to resources, supports and skills. Service recipients encounter complex challenges to health, wellness, and longevity. This presentation will review how a wellness model can guide human service practice. Learn about the 8 dimensions of wellness, wellness principles and practical strategies to empower service recipients and fellow professionals. Participants will be challenged to apply wellness principles personally and professionally to prevent burnout and effectively deliver services that foster health, wellness, and improved quality of life.  

Sample of Workshops to be offered:  

“Mental Health and the Impact of Technology” – DeeAnna Merz Nagel, LPC

“Learned Optimism”

“The Privileges of Being in the Visible Majority”

“Introduction to Psychiatric Rehabilitation: A distinct field of human services”  

Registration Deadline: March 13th MACHS 2009 Annual Conference Registration   Name: __________________________________________ College/Organization _____________________________________________________   Email: __________________________________________ Address: ___________________________________________________________________       [] Students $75        [] Faculty/Administrator $110        [] Practitioner $110       [] Saturday attendance ONLY $45   Please Note: If you are a person with a documented disability and require special accommodations, you must contact Disability Services at 732-224-2730 or the conference coordinator (David Stout) at 732-224-2340 by the registration deadline (March 13, 2009).

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Forensic Mental Health and Technology: Risk Management Strategies for the Practitioner  is available to read online. The article is also available online as a continuing education course and applies toward necessary CE for practitioners who hold the Certified Forensic Consultant (CFC) credential. The cost is $25.00. Others may take the course and apply the 1 hour through pre or post approval methods with the various credentialing and licensing bodies.

So what are Kate and I doing writing about forensic mental health? Well, for about eight years, much of my work involved child welfare, family assessments, parental fitness, domestic violence and substance abuse evaluations for the courts. I discovered that many child protective and foster care case workers and managers, counselors, psychologists and lawyers passed client information using unsecure methods.  Kate and I combined our knowledge and wrote and article addressing these issues.

I am a member of the American College of Forensic Examiner’s American Board of Forensic Counselors and I am a Certified Forensic Consultant. While my current work does not focus as much now on forensic mental health, I am dedicated to educating mental health practitioners across disciplines about the proper use of technology.

Best,

DeeAnna

More about the Forensic Examiner:

The Forensic Examiner is the official peer-reviewed, quarterly journal of the American College of Forensic Examiners. The journal promotes the continued advancement of forensic examination and consultation across the many professional fields of our membership.

In addition to reaching forensic experts throughout the world, The Forensic Examiner is also available to a general audience through subscriptions and newsstand sales. The publication is available at Barnes and Noble, Borders, Hastings, and many other independent books sellers across the nation.

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What fun!  The graphics in SL were really bad today- Grid was apparently GRIDLOCKED but we got it done! 

woo hoo!

A more serious moment!

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Ananda emailed and stated her available SL time.  Hmmm, I thought.  I vaguely remembered SL time yet had never had a need to use it.  But with all of us in different countries, made sense. So I went inworld to see what time it was in SL currently and the time stamp said PST (Pacific Standard Time).  Huh, [scratch head] now what? I went to Second Life’s Help feature, no luck. So I googled SL Time Zone.  And the answer was revealed! http://sl.nmc.org/2007/01/02/time-zones/ - A blog post from 2007 explains it. SL time was a nifty idea conjoured up by Linden Lab but apparently it ws so confusing for most that the idea was abandoned and now everything in Second Life is on PST (California) where Linden Lab, the creator of Second Life, is located. 

Ok so that is not so hard.  I know what time zone I live in (EST) and I know what time it is in the UK – 5 hours ahead of me. Now, let’s see, Ananda lives in Brazil…

Well, we finally figured it out- 3 different time zones establishing a meeting in yet another time zone. But it felt like I was in 7th grade math class trying to solve a word problem!

See you inworld Ananda!!

(oh my, what shall I wear?)

And we will keep the rest of you posted!

DeeAnna

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You Don’t Know Me (dissociative anonymity)

The Internet offers apparent anonymity – if you wish, you can keep your identity hidden and use any name, either close to your own (e.g KatAnt) or very far away (e.g Xyz123).   For the most part, people only know what you choose to tell them about yourself.  When people have the opportunity to separate their actions from their real world and identity, they feel less vulnerable about opening up.  They also feel less need to be accountable for their actions – in fact; people might even convince themselves that those behaviors “aren’t me at all.” In psychology this is called “dissociation”.

You Can’t See Me (invisibility)

In many online environments other people cannot see you. As you browse through web sites, message boards, and even some chat rooms, people may not even know you are there at all.  In text communication such as e-mail, chat, blogs, and instant messaging, others may know a great deal about who you are. However, they still can’t see or hear you – and you can’t see or hear them. Even with everyone’s identity visible, the opportunity to be physically invisible amplifies the disinhibition effect. Invisibility gives people the courage to go places and do things that they otherwise wouldn’t, often with undesirable results.

See You Later (asynchronicity)

In e-mail and message boards, communication is asynchronous. People don’t interact with each other in real time. Others may take minutes, hours, days, or even months to reply to something you say. Not having to deal with someone’s immediate reaction can be disinhibiting.  In e-mail and message boards, where there are delays in feedback, people’s train of thought may progress more steadily and quickly towards deeper expressions of what they are thinking and feeling in comparison to instantaneous communications.  Some people may even experience asynchronous communication as “running away” after posting a message that is personal, emotional, or hostile. It feels safe putting it “out there” where it can be left behind.

It’s All In My Head (solipsistic introjection or egoistic self-absorption)

The absence of the visual and aural cues of face-to-face communication combined with text communication can have other interesting effects on people.  Reading another person’s message might be experienced as a voice within one’s head, as if that person magically has been inserted or “introjected” into one’s psyche, similar to how we hear a character when reading a book. In fact, consciously or unconsciously, we may even assign a visual image to what we think that person looks like and how that person behaves.  The online companion now becomes a character within personal mental experience of the world.  Online text communication can become the psychological tapestry in which a person’s mind weaves fantasy role-plays, usually unconsciously and with considerable disinhibition.

It’s Just A Game (dissociative imagination)

If we combine the feeling that all these conversations are going on inside our own heads with the nature of cyberspace as a means to escape real life, we get a slightly different force that magnifies disinhibition.  People may feel that the imaginary characters they “created” exist in a way that is quite separate from everyday life – a different realm altogether.  It is possible to split or “dissociate” online fiction from offline fact.  Once they turn off the computer and return to their daily routine, they believe they can leave that game and their game-identity behind. Why should they be held responsible for what happens in that make-believe play world that has nothing to do with reality?

We’re Equals (minimizing authority)

While online others may not know a person’s status in the face-to-face world and it may not have as much impact as it does in that world.  In most cases, everyone on the Internet has an equal opportunity to voice him or herself. Although one’s status in the outside world ultimately may have some impact on one’s powers in cyberspace, what mostly determines your influence on others is your skill in communicating.  People are reluctant to say what they really think as they stand before an authority figure, but online, in what feels like a peer relationship – with the appearances of “authority” minimized – it is much easier to speak out and think  “Well, what can they do to me?”  As the Internet grows, with a seemingly endless potential for creating new environments, many people see themselves as independent-minded explorers. This atmosphere and philosophy contribute to the minimizing of authority.

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Hope to see you in Atlanta!

DeeAnna

I am posting detailed information below:

The Distance Credentialed Counselor (DCC) Training prepares mental health professionals to utilize best practices in Distance Counseling via technology including telephone, e-mail, chat and video conferencing.
The DCC Credential is available to mental health professionals who currently hold the National Certified Counselor (NCC) credential and to other mental health professionals who are licensed to practice independently including professional counselors, social workers, marriage and family therapists, psychologists and psychiatrists.

The Center for Credentialing and Education (CCE) has chosen ReadyMinds to deliver the DCC training. ReadyMinds is a leader in the field of Distance Counseling and has provided services to thousands of clients and trained thousands of counselors over the last ten years.
Participants will receive 15 CE hours through NBCC
 
Two DCC Trainings are scheduled at Ridgeview Institute in Smyrna, GA for 2009.  Please find below detailed information about these workshops:

Location:Smyrna , GA (Mental Health Concentration)
Venue: Ridgeview Institute
Address: 3995 South Cobb Drive
Smyrna , GA
Date: Thursday, April 16, 2009 and
Friday, April 17, 2009
Time: Thurs: 8:30AM – 5:30PM / Fri: 8:30AM – 3:30PM
All Inclusive Training Fee:$595.00
 Includes:
two day training
all training materials
breakfast/lunch for both days

Register before:
to receive $75 DISCOUNTMarch 17, 2009
 
There will be a $25 fee collected by CCE at the time of application for the DCC Credential.
 
Last Date to Register:April 10, 2009

 
Location:Smyrna , GA (Mental Health Concentration)
Venue: Ridgeview Institute
Address: 3995 South Cobb Drive
Smyrna , GA
Date: Thursday, July 16, 2009 and
Friday, July 17, 2009
Time: Thurs: 8:30AM – 5:00PM / Fri: 8:30AM – 3:30PM
All Inclusive Training Fee:$595.00
 Includes:
two day training
all training materials
breakfast/lunch for both days

Register before:
to receive $100 DISCOUNT May 17, 2009
 
Register before:
to receive $75 DISCOUNT June 17, 2009
 
There will be a $25 fee collected by CCE at the time of application for the DCC Credential.
 
Last Date to Register:July 11, 2009

 
For more information about the training or to register online, please visit our website at www.readyminds.com/dcclocations and click on the training site ‘Ridgeview Institute’.
Discounts are available if you register early!
 
If you have any questions, please contact Lisa Miller at lisa@readyminds.com or call toll-free (888) 225-8248.

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“]”]

Therapy Online [A Practical Guide

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Recently, one steady referral source contacted him and said that he could no longer refer patients because the service was being conducted online.  I suggested the therapist write a letter/email explaining that on his end, there is no law restricting online therapy, and to his knowledge, no law exists in the health practitioner’s state either.  I suggested explaining that online therapy is not a new, untested modality but rather, another way to deliver a service. Therapy can be delivered via technology.

But this goes back to what I always say in training- even if you reside in a country or state that has no ruling about online therapy or telehealth practice, be sure to check with the country or state your potential client resides in. While various countries have no concern about practicing across borders, the U.S. does and good practice says check first. I think global telehealth will increase in the coming years and hopefully U.S. states will not legislate online therapy and telehealth into a corner that will seem obsolete and out-dated soon after a ruling is passed.

But for now, it is what it is…so check the jurisdiction in the geographical area where your potential client lives.  In the meantime, if you are aware of laws or ethics pertaining to your own geographic region, please consider joining our wiki and adding the information! 

DeeAnna

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DeeAnna

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www.onlinetherapy.wikispaces.com contact email: info@onlinetherapyinstitute.com

Thanks!

DeeAnna

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a.  the 150 hours of supervised practice post training (Criteria 4.1 and 4.2)

b.  Professional Development (Criterion 6.)

c.  Personal Development (Criterion 7)

Applicants who include on-line counselling will need to show: 

1.  that the activity was contracted counselling rather than any other activity involving the use of counselling skills.

2.  that they have undertaken some specialist training in on-line therapy and are competent to work within this specialised area.  Such training would normally take place after the applicant’s core practitioner training and would be admissible as Continuing Professional Development (Criterion 6).  It is not admissible as core practitioner training (Criterion 4).  

Online Supervision 

Online therapy is not normally recommended for novice or inexperienced practitioners or those in training without focused ongoing support and guidance from expert specialists in the field. 

The BACP counsellor / psychotherapist accreditation scheme currently accepts online supervision hours for giving and receiving supervision.  At present applicants submitting online supervision must demonstrate how they have met the 1.5-hour a month requirement.

As yet, BACP have no definitive means of calculating the time commitment, and so have invited me to consult with the Professional Standards Committee and Accreditation Assessors in May to thrash out those final details.  This will unfortunately not be in time to include those hours in the 3^rd Edition of the Guidelines, but links to updates will be included in the resource appendix.

I’ve been working towards this since the Guidelines were first published in 2001, so please join me in a big *YAY*!!

Kate

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While I was not able to make it to the meeting, I did think at the time that a group meeting that large in a chat setting would be way too much- too many people to track, etc.  Groups in general should be a manageable size if members of the group are invited to or expected to actively participate.

With regard to group therapy, I learned in graduate school that eight participants is the magic number.  Irvin Yalom’s book , The Theory and Practice of Group Psychotherapy (now in it’s 5th edition, 2005) suggests seven or eight members with a range of five to ten members.

So, what is the magic number of participants in an online therapy group?  I suggest three to six with an optimum size of four members.  Allowing for attrition, a maximum number of six participants may result in a consistent number of three to five. 

So, why the difference between sizes in face-to-face and online therapy groups?  My experience is that tracking member comments in a participatory and interactive chat is very difficult, especially with one facilitator.  While the facilitator is typing, not one, but as many members as are in the group may be responding and commenting to the therapist and others.  The therapist’s job is to facilitate and offer direction as needed so keeping the size of the group manageable is key.

Groups hosted in forums, which are asynchronous offer an opportunity for more members.  Of course, two facilitators, regardless of the delivery method is always optimal but not necessarily practical.

DeeAnna

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Thanks for spreading the word Helen!

DeeAnna

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I believe I am the same person in cyberspace as I am within what is sometimes, paradoxically, called Real Life (RL).  The fact that I exist within my writing over the Internet is what is important here, not the fact that I write.  I use writing to convey myself to others because it is the easiest form of communication that currently exists on the Internet, just as the simplest form of communication face-to-face is the spoken word.  I don’t use technology for my professional work for the sake of using technology; it is just the communication system that works best for me for that client at that time.

Would you agree that’s a fair comment and it would apply to you also?

Kate

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Two commentaries follow  my article. Neither commentary is particularly supportive or positive about what I offer.  And that is not really the point. After years of training therapists in text-based therapy, and now as my training includes therapy conducted in virtual world settings, I am quite accustomed to opposition. But I have noticed a common theme emerging.

Counselors and psychotherapists tend to discount relationships online.  As more technology infiltrates our lives, online relating becomes more and more off-putting to some.  I personally have never posited that online counseling will replace face-to-face psychotherapy.  I find that both experiences hold depth for the client and psychotherapist.  I see the benefit of delivering psychotherapy in the flesh as well as via technology.

Mental Health practitioners often do not understand how the art of psychotherapy can occur online. As with anything new, it takes a while to make the shift. And some choose not to- which is fine. But with the advent of email, chat, social networking and virtual worlds, our work becomes transformed as psychotherapy meets mixed reality.  While online relating is not enjoyable or fulfilling for some, others view their online relationships as a viable part of life and as real as any relationship that occurs face-to-face.  I find some in this profession are threatened by this notion.  But I think there are enough differences between us with our lives now full of so many choices for relating, both traditionally and through social media, that there is room for growth and expansiveness within the art of pscyhotherapy.

What do you think?

DeeAnna

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BUT the article also notes that people with this condition are notoriously inflexible – so if someone in RL uses, say, sarcasm slightly differently to how the patient learnt to recognise it in SL, the idea doesn’t work.  I’m looking forward to the results of the research and indeed the new platform they are developing which seems to be more catered towards this client group.

Kate

http://abcnews.go.com/Technology/OnCall/story?id=4133184&page=1

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Keep an eye on the updates at http://octia.eventbrite.com/ or from our Directory listings at http://www.onlinetherapydirectory.net/tag/Training.   OCTIA are currently recruiting speakers <<Kate waves>>.  What’s VERY exciting for us at OTI is that you can be there from all over the world without having to travel – let’s hope that other conferences worldwide finally take the initiative!  You can attend in person (very reasonable accomodation costs on-campus), online, and through Second Life.

Kate

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For secure and encrypted communication with other Online Therapy Institute Clinical Members, consider joining and gain access to the OTI Member Forum. Clinical Members can staff cases and engage in peer supervision in a confidential environment.

See you online!

DeeAnna

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“Our experience as online clinicians demonstrates that some individuals are more honest, more uninhibited and more expressive in writing than face-to-face,” said Speyer, who has been involved in researching, teaching and publishing in this new form of counselling for over eight years.

The full article is available here: Online Advice

Speyer is a long-time colleague and presented online counselling in a positive light.  He has helped bring etherapy into the Employee Assistance Program counselling model in Canada, the United States and across the globe.

As with most news articles of this sort, they do a fine job presenting the concept, and stressing the importance of security and encryption, as one example. But the article does point to a valid concern.  In this article, the concern is ensuring that who you reach online for services truly IS who you intend to receive services from. 

We recommend potential consumers of online therapy check out the person they are considering working with if that person is working independently and not part of a company or group that would verify credentials.  Online therapists should have enough verifiable information on their website to bolster consumer confidence. For instance, education with school name and year of graduation, license and certifications with numbers and a link to licensing boards or accrediting bodies as applicable, as well as contact information for the therapist beyond an email address are examples of extending credibility to the practitioner.

Cedric- thanks for your contributions to the field!

DeeAnna

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She is inviting participants in this voluntary study; the only requirement to participate is that you are currently delivering a therapeutic mental health service via the Internet, or have done so in the past.

The study will explore practitioners’ perceptions and experiences of the strengths and limitations of online practice. She hopes that the empirical evidence generated from this research will contribute towards policy development in this field and inform future practice.

The URL is http://www.surveymonkey.com/s.aspx?sm=rGSa26se8AlJM9h7Rj7bzA_3d_3d or you can also find her in the OTI Directory.  We’re really looking foward to the results )

Kate

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I hope you find this resource beneficial!

Happy New Year to everyone!

DeeAnna

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Lago Maggiore, Verbania-Intra, Italy

Below is a summary.  More information can be found at http://www.e-therapy.info/

Don’t forget to check the Online Therapy Institute’s Events Calendar for this and other related conferences!

The 14th Annual International CyberTherapy and CyberPsychology Conference (CT14) brings together researchers, clinicians, policy makers and funding agencies to share and discuss advancements in the growing disciplines of CyberTherapy & CyberPsychology.

The conference will seek input from a wider segment of the scientific community, and is interested in attracting experts in clinical therapy and rehabilitation, cognitive sciences, social sciences, and computer sciences interested in the meeting’s core topics: emerging applications of new media, design of new media and effects of new media.  

There is also an interest in continuing to design, evaluate and apply cutting edge technologies such as Ambient Intelligence, Augmented and Mixed Reality, Avatars, Shared Virtual Worlds, Video Game Virtual Reality (VGVR), Web 2.0 and 3.0,  3G and 4G mobile phones.

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DeeAnna

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Since the internet’s inception the use of online support forums has become a mainstay. People can find support forums for nearly every mental, emotional or physical difficulty. Websites such as DailyStrength.org offer a one-stop portal to find peer support for many issues including HIV/AIDS.

At the Online Therapy Institute, we offer a Web Directory that lists several forums and other websites that promote peer support (people with like issues coming together to suppport one another). If you are a mental health professional, consider offering information to your clients about forums and discussion boards that might be helpful. Forums can be a great adjunct to therapy, offering support and information between sessions. If you are a person seeking information about a difficult diagnosis or situation, consider utilizing a forum online.

Be sure to consider privacy issues. While there are many forums available that are free to join, they may not be encrypted. Most are password protected, but even so, if the forum offers an RSS feed, you might find your post floating in cyberspace with personal information that you had hoped only to share among a few. Be sure you understand the limits of privacy and confidentiality when using a forum or discussion board.

DeeAnna Merz Nagel

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Even when therapists “blind the record” removing all identifying information, client identity can sometimes be discovered if by simply knowing the location of the therapist through a forum or email tagline. If the therapist practices in a rural area, it may not be difficult to connect the dots. While it is enticing to enter into clinical discussions with peer professionals, counsellors and therapists should make sure discussions are completely confidential.

DeeAnna

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Read the full story at: http://www.guardian.co.uk/technology/2008/nov/15/secondlife-digitalmedia

Kate

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At least I *think* that’s what happened…

Read the full story at : http://www.guardian.co.uk/technology/2008/nov/15/secondlife-digitalmedia

Kate

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However, it’s all about “developing emotionally engaging procedural character animations. The research will be underpinned by a comparative study of psychologically derived data relating to the expression and interpretation of emotion, with film based acted and animated performances.”

All sounds very exciting!  Check it out at http://emotionalavatars.vox.com/library/post/emotional-avatars-an-art-led-research-project.html

Kate 

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Read the full story at: http://www.guardian.co.uk/education/mortarboard/2008/nov/11/highereducation-secondlife

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What particularly interests me on this story – as co-author of several editions of the UK Guidelines for Online work – is that the executive director of the Canadian Psychological Association (Karen Cohen) agrees online therapy could be beneficial.  She states that her association is drafting guidelines for online counselling as it grapples with broad questions, and I’m in contact with her as expert in the field to see if OTI can be of help )

Kate

Read the full story at :

http://canadianpress.google.com/article/ALeqM5id6Zw9EwcabyQ0iUCczof1PvjptA

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When I send someone a lengthy email (and I can be longwinded) I tend to want an answer that “works”. Granted the email may not have anything to do with psychotherapy, cyberpsychology or any other mental health issue. It may be a complaint to a major department store about my dissatisfaction with a service or a product. But what I look for in a reply is an answer.

Many online therapists tend to think that a lengthy response is the best response. I like to think in terms of giving the best answer which may be long or short. A lengthy response does not necessarily indicate a substantial response. What say all the e-therapists out there? How about those of you that have sought email therapy? What is your preference or expectation?

DeeAnna

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More and more people are seeking psychotherapy and support for mental health issues online. Comfort with technology is closing the divide as access to quality services and navigation on the web becomes easier.

It might not be so unusual for someone who is struggling with an internet addiction to reach out for help on the internet. Determining whether or not this is a suitable approach should be on a case by case basis but let’s consider the following as a point for further thought:

A person who has a history of building unstable and untrustworthy virtual relationships may have the opportunity for a positive experience through therapeutic dialogue with a therapist via the internet.

This intervention may be as adjunct to an existing face-to-face relationship and the experience may be modulated as part of an overall plan. Or a person who may not consider face-to-face therapy may reach out on the internet when his or her life has become unmanageable. Interventions may be text-based via chat and/or email, videoconferencing/webcams or by using avatars in a virtual world such as Second Life.

What do you think?

DeeAnna

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Astronauts suffering from depression, arguing with colleagues, or wrestling with their workload, will be able to receive video counselling from recordings by Mark Hegel, a psychologist at Dartmouth College in New Hampshire.

Read more at: http://www.guardian.co.uk/science/2008/oct/25/nasa-space-astronaut-houston-therapy

Top Stories

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Anne Stokes, Gill Jones and Kate

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The woman, who has been jailed on suspicion of illegally accessing a computer and manipulating electronic data, used his ID and password to log onto the popular interactive game Maple Story to carry out the virtual murder in May, a police official in the northern city of Sapporo said. He spoke on condition of anonymity because of department policy.

“I was suddenly divorced, without a word of warning. That made me so angry,” the official quoted her as telling investigators and admitting the allegations.

The woman, a piano teacher, had not plotted any revenge in the real world, the official said.

She has not yet been formally charged. If convicted, she could face up to five years in prison or a fine up to $5,000.

More at:

http://news.yahoo.com/s/ap/20081023/ap_on_re_as/as_japan_avatar_murder

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Kate and DeeAnna

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Membership in the social network is free, and while the social network does not offer all of the benefits of membership in the institute, it is another way to meet and greet.  Your profile can be viewed by everyone so the network doubles as a listing feature to market your services and products.

Please consider joining up! It is yet another place to get linked, get to know others and get known!!

OTI’s Social Networking website: www.onlinetherapyinstitute.ning.com

DeeAnna & Kate

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We will be glad to list conferences and conventions sponsored by organizations and universities so please give us a heads up at info@onlinetherapyinstitute.com. Members of OTI can list other workshops, keynotes, appearances or other events that meet the mission of OTI.   The OTI Events Calendar is accessible to the public with a search feature and an RSS feed for those who wish to subscribe.

We look forward to filling the calendar!  See you at an event soon!

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http://www.telehealthworld.com/images/TeleHealthFallEzine.pdf

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“An altruistic Google employee has come up with a system that will block -or at least make you think twice about – the kind of message you will only regret the next day. Mail Goggles, which can be set to spring into action late at night and at weekends, asks emailers to answer a series of short mathematical posers before sending their message off. The idea, according to Gmail engineer Jon Perlow, is to help people who are a little too tired and emotional to foresee the consequences of their actions.”

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Read the full article at: http://www.guardian.co.uk/technology/2008/oct/06/youtube.youngpeople

Armed with cheap video cameras and the internet, a generation of youngsters are growing up very publicly with online videos – and being failed by adults who are not paying proper attention to this new medium.
That claim is made in a research paper published today by the thinktank Demos. The study, Video Republic, examines the rise of the YouTube generation and considers how their enthusiasm and skills can be encouraged.

“It’s now as normal for teenagers to write a blog as it is to write a diary – that’s a massive shift,” said Celia Hannon, a researcher with Demos and the lead author of the report.

“Youngsters are working out their relationship to the outside world and forging an identity.”

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Anthony Cugliari shouts to Aradhna Jaswar above the raging dance beat at Birmingham University’s freshers’ fair. “Hey, we’re Facebook friends. It’s Aradhna, right?” “Yeah. Hi,” she says, eagerly extending the hand that’s not clutching her new posters and freebies.

Cugliari, 33, from Canada, and Jaswar, 18, from Wolverhampton, arrived in Birmingham less than a week ago. But they’ve been Facebook friends for three months – first spotting each other on the social networking site’s group for Birmingham University law freshers.

Both joined Facebook specifically to help themselves settle into university life. Cugliari had made 189 Facebook friends at Birmingham before he’d arrived. “I’m already going to the pub with 10 friends as a result,” he says. Jaswar says it has calmed her nerves to have had a bit of banter with students on her course before lectures start.

Charlotte Wright, 20 and about to start a maths degree at the University of Leicester, has joined two Facebook groups, one for her course and another for her hall of residence.

“I’m not so worried about being completely alone in a new city any more,” she says. “It’s been really reassuring to find out that everyone else is also suffering from that awkward mixture of nerves and excitement. Befriending people who’ve already done the first year of my course has yielded lots of useful advice.”

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Watch this space for access to it upon publication!

Kate and DeeAnna

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We have other plans as well.  2009 will bring new publications, online courses and more opportunities to network.  Stay tuned!

Kate and DeeAnna

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Phillip Hodson of the BACP states that “All you could do on a mobile download is what you can do with a leaflet, or old-fashioned agony aunting.  That could never be called therapy…. You can’t have a relationship with a mobile phone download”.

See more at www.mymobileguru.com and http://www.guardian.co.uk/lifeandstyle/2008/sep/15/healthandwellbeing.psychology – then post to the OTI forums to discuss!

Kate

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“An invitation for you to join me this Saturday 13th September 2008 at 9am BST (GMT +1) at http://www.ustream.tv/channel/therapeutic-airwaves The live webcast will feature discussion on the topic “Fit for purpose? Online work inappropriate for some? A therapist or client decision on `fit’?”
So why don’t you share your views and opinions and spend an interesting Saturday morning chatting with fellow practitioners and listeners. For further information on how to participate go to
http://therapeuticairwaves.blogspot.com/ REMEMBER you can join the discussion panel through your phone line, just forward your number and I will include you into the audio conference. Please do email me (chewalex@hotmail.com) before Saturday if you wish to be in the panel discussion so I can look out for you in Skype or ring your telephone line. I would welcome your participation.”

Sounds interesting!  Unfortunately I can’t make it, but if you can – please let us know how it went and post to the forums!

Kate

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She practices in Rumson, NJ and shares office space with Breaking the Chain Counseling and Lora Sasiela, a clinical social worker based in New York City and Rumson. With an array of specialties between them, Breaking the Chain Counseling, Lora Sasiela and DeeAnna Merz Nagel have much to offer the community. BBC helps identify patterns of unhealthy behavior and they facilitate breaking the chain, learning health ways to help individuals, couples, families and children communicate and grow. Lora assists people dealing with anxiety, depression, women’s issues and binge eating. In addition to technology and internet addiction, DeeAnna also assists survivors of abuse and people struggling with relationship issues and substance abuse.

With the added convenience of online counseling, DeeAnna is able to offer her face-to-face clients more flexibility in scheduling appointments and more availability during travel. If you are interested in working with DeeAnna, call her todayat 1.877.773.5591 for a free initial consultation.

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TeleHealth World is the new magazine serving the rapidly expanding fields of telehealth, telemedicine, and connected healthcare. It is a comprehensive news and analysis resource for healthcare providers and technology providers who are leading today’s revolution in remotely monitored and administered healthcare, medical treatment and fitness/wellness enhancement.

TeleHealthWorld began publication in April 2008 as a full-color, high-quality print magazine with a distribution of 10,000 copies in North America. Its companion internet portal and knowledge center, e-newsletter, and industry directory will begin operations at the start of 2008. Subscriptions to the print magazine will be free to qualified readers in North America.

For more information visit http://www.telehealthworld.com/index.php

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Please visit https://catalysttools.washington.edu/webq/survey/finnj/54144 to participate!

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If you want to know more about Jo Kay aka jokay Wollongong in Second Life, specializing in Virtual Worlds Design and Facilitatio