Archive for February, 2009

John Suler’s Disinhibition Effect as summarised by Kate Anthony

 

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.

 

 

Hi everyone! Just a note to say that I will be facilitating upcoming Distance Credentialed Counselor trainings in Atlanta, GA.  The first training will be held in April and the second training will be held in July. 

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.

Kate and DeeAnna have been working feverishly on our new book and while we are completing the first draft we thought we would share with you what we received in the post today!  Sage has listed the book in the latest catalogue and it should show on Amazon soon.  The book will be hot off the press in late 2009!

I recently consulted with a therapist who resides in another country.  He offers online therapy/consult services to individuals in the United States. His referrals come from health practitioners here in the U.S. so he receives the referral, provides the requested service to the patient and sends recommendations to the health practitioner.

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

Just read an article about the $$ tagged for healthcare IT and wondering how much will trickle down to telehealth, and particularly behavioral telehealth, telepsychiatry and online therapy?  Check out the full article here: http://www.healthcareitnews.com/news/healthcare-it-slated-19b-proposed-stimulus-package Most of the money appears to be tagged for healthcare records management and not for healthcare delivery…

DeeAnna

Do you have specific information about the ethics or legalities of online therapy, telehealth, telepsychiatry or use of technology in health interventions in your state or country? If you do, please post the information to the Online Therapy Institute wiki. The wiki is free and easy to join but if you prefer you can send the information to OTI and we will post it for you!

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

Thanks!

DeeAnna

I am pleased, nay thrilled, to tell you that the British Association for Counselling and Psychotherapy (BACP) now formally accept online counselling via e-mail, forums and IRC in support of: 

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

I was asked to participate in a group discussion online.  I am a member of an organization that hosts a listserv and forums. Most recently, the idea of one big chat was suggested and all of us were invited to log on and participate.  Had all of us logged on, there would have been about 70 total individuals. 

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

Helen Glatt, a member of the Online Therapy Institute, wrote an article recently about Online Counselling.  Her article was featured on healthypages, the UKs busiest and most popular complementary health and holistic website. Read the article here! http://www.healthypages.co.uk//articles/article.php?article=186

Thanks for spreading the word Helen!

DeeAnna