American Psychological Association

108th Convention
Washington DC, August 4-8, 2000

[ISMHO Panel]
Photo: (Left to Right) Storm King, Yvette Colon, John Grohol, John Suler
5040 Symposium: Innovations in Practice--On-Line Therapeutic Interventions and E-Therapy

Here was the place to be for a look at how psychologists and other health professionals are utilizing the media of the Internet! Yvette Colon MSW, spoke first, about the clinical, ethical, & practical issues involved in facilitating online groups. She also highlighted how valuable these groups have been for Cancer Care participants looking for support and information, including those living in rural areas, unable to travel physically, or "trying to stay out of the hospital".

John Suler, Ph.D., presented a perspective on "the intersection of psychotherapy and cyberspace". He cited the work of ISMHO's unique Online Case Study Group, whose initial membership was comprised of 16 web-savvy therapists, from differing orientations, who met via the Internet for supportive peer supervision, co-facilitated by two licensed psychologists. Over the course of a year, it became apparent that there is a wide range of ways in which psychotherapists interact with patients online, ranging from primarily online interactions to exclusively face-to-face (f2f) sessions where emotional and behavioral aspects of Internet use play a major role. (There were also cases which incorporated the use inter-session e-mail journals, message boards, chat rooms, and the assignment of "homework"' as additional adjuncts to the treatment.) Dr. Suler described some of the issues relating to both format and process which arose in the course of the "Millennium Group" project, and outlined some of the group's current working hypotheses about online clinical practice.

Storm King, M.S., offered historical perspective and a comprehensive overview of "Internet Virtual Therapy", describing some of the unique advantages and disadvantages. He began by noting that Internet-facilitated psychotherapy (my term!) is "not a direct substitute for traditional therapy." Mr. King then underscored how it is essential for both the therapist and client to have a good understanding of "the nature of text-based relationships". He also described instances in which certain presenting situations might suggest that online treatment is not the treatment of choice (e.g, extreme psychopathology). Drawing on some of the tenets of Walther's (1996) "Hyperpersonal Model", Mr. King described various dynamics inherent in online communication, and the effects of anonymity (e.g., disinhibition, the tendency to idealize others, and selective self-presentation). Some more practical considerations such as ethical and legal concerns were also addressed. Yet despite inherent difficulties and limitations, the case was also made that in some instances, such as with social inhibition in particular, and for those with limited access to f2f mental health services, there is a great deal of promise and opportunity, amidst the controversy.

Finally, John Grohol, Psy.D., answered the question, "What is eTherapy?". He described the types of mental health services which are typically found online, including support groups and other services not generally considered to be "therapy". Dr. Grohol went on to discuss several reasons why there is a tremendous need for online mental health services (whatever one wants to call them!). One compelling reason is the large number of people with access to the Internet who simply do not seek treatment elsewhere. Dr. Grohol also emphasized how a fear of stigma often accompanies thoughts of seeking treatment, and might be minimized by offering a safe online environment which can serve as a gateway into professional treatment. He suggested, too, that an increase in the number of easily accessible services will "reduce financial barriers to treatment".

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