[Dr. Michael Fenichel's CURRENT TOPICS IN PSYCHOLOGY]


Online Therapy: Context & Perspective
Moscow 2014



History

Beginnings: Are online psychotherapeutic relationships possible? Ethical? Effective?


Y2K (APA 2000) Symposium on the Nature of Online Therapy and Communication
A capsule summary of a very interesting panel on where we stand at the beginning of the 21st Century, in terms of delivering online mental health services. A discussion of the pros and cons of utilizing online communication. With John Grohol, John Suler, Storm King, and Yvette Colon. (Fenichel)

"Asynchronously Live" from APA 2001
Current Issues in Behavioral Telehealth: An illustrious panel discusses the nature of online communication and treatment, describing both the potential pitfalls and benefits of online therapy. With John Grohol, David Nickelson, Gerald Koocher, Leigh Jerome, and Patrick DeLeon. (Fenichel)

Myths and Realities of Online Clinical Work
Observations on the phenomena of online behavior, experience and therapeutic relationships
A 3rd-Year Report from ISMHO's Clinical Case Study Group: Michael Fenichel, John Suler, Azy Barak, Elizabeth Zelvin, Gill Jones, Kali Munro, Vagdevi Meunier, & Willadene Walker-Schmucker   [
.PDF) ]  [ Hypotheses ]


Practice: Training - Supervision - Ethics - Law & Licensure

Best Practice for Clinicians, Best Outcomes for Online Seekers. Theory & Technique.

Online Case Studies: Report of the ISMHO Millennium Group
A summary of 16 therapists' work across a number of modalities, all involving the Internet in some way or another. While many questions remain, a foundation is set for continuing work on developing models of training and practice. (ISMHO)

Online Psychological and Mental Health Interventions
A look at the evidence supporting the value of online interventions ranging from open forum support groups to self-guided programs, with new developments and research findings shared by a panel of experts. (Fenichel)

Online Psychotherapy: Technical Difficulties, Formulations and Processes
A discussion of some of the inherent difficulties, both practical and technological, in adopting traditional psychotherapy models for clinical online use. Questions and issues ripe for exploration in the 21st Century. (Fenichel)

Ethics in the age of the Internet (APA, 2008)
APA Ethics Director, Dr. Stephen Behnke, reflects on issues such as new definitions of 'privacy', work and personal life interaction, and clinical judgment in an age of TMI.



Applications - Asynchronous, Realtime, and Virtual


Psychological Applications on the Internet: A Discipline on the Threshold of a New Millennium [.pdf]
A scholarly explanation of the various ways in which one can seek self-help, support, or active online treatment over the Internet, and a look at some of the advantages and disadvantages to this modality.(Azy Barak, Ph.D.)

APA Presentations

2011: eHealth Odyssey
Or... The Internet as an Instrument for Change
Lee M. Ritterbrand, Ph.D.


Avatar-based Treatments
Avatar-Based Recovery Using Immersive Virtual Environments
Ivana Steigman, M.D., Ph.D., Richard Wexler, Ph.D., Albert ("Skip") Rizzo, Ph.D.


Computerized Cognitive Based Therapies (CCBT)
Computerized Cognitive Behavior Therapies - Turning on, Tuning in, and (not) Dropping Out
Kate Cavanagh, Ph.D.

Psychology, Technology, Virtual & Augmented Reality
Innovative Technologies for Psychological Intervention, Consultation and Training
Drs. "Skip" Rizzo, Hunter Hoffman, Elizabeth Carll, Timothy Lacy, & Jon Cabiria

POKE ME: How Social Networks Can Both Help and Harm Our Kids
A look at the importance of generational differences and preferences, and ways to speak the same language of connection. Larry D. Rosen, Ph.D.

Telehealth and Telehealth Licensure - Barriers and Possible Solutions
Drs. Marlene Maheu, Stephen DeMers, Dena Puskin, Joseph McMenamin, & Patrick DeLeon


Broad Concepts: Need, Efficacy, Access, and 'Fit'

Symposium on the Nature of Online Therapy and Communication
A capsule summary of a very interesting panel on where we stand at the beginning of the 21st Century, in terms of delivering online mental health services. A discussion of the pros and cons of utilizing online communication. With John Grohol, John Suler, Storm King, and Yvette Colon. (Fenichel)

Here & Now in Cyberspace
The nature of Cyberspace experience: online relationships, communication, and the therapeutic implications. (Fenichel)

Assessing a person’s suitability for online therapy
Suler, J., Barak, A., Chechele, P., Fenichel, M., Hsiung, R., Maguire, J., Meunier, V., Stofle, G., Tucker-Ladd, C., Vardell, M. & Walker-Schmucker, W. (2001). Assessing a person’s suitability for online therapy. CyberPsychology & Behavior, 4, 675-679. (see Correction, 2002, CyberPsychology & Behavior, 5, p. 93).
(PDF)

Cyberspace Travels for Psychological Researchers, Educators, & Practitioners
APA presentation at the dawn of the 21st century (Fenichel, 2002)  

Back to Basics: Context and Perspective Revisited

'What is Psychotherapy'? In what directions are research, psychology, education and advanced training headed? Neuro-science? AR/VR treatments? AI advances? Improved health care systems with access to mental health treatments matching the need? Will you read about your sessions on Facebook? What exactly makes therapy work? What are the 'Goals and Expectations', and how are results measurable? Are treatments 'evidence-based'? What is the goal of psychotherapy vs. counseling vs neuroscience?

Mental Health Professionals: For those who maintain traditional practices, you need to understand thr lifestyle of today's clients, even if you are not tech savvy or active online. Culture, language, peer group are powerful influences..What are the expectations and goals? What is the training? What are the consumer assurances and protections? What new types of disorders are being seen and felt by growing numbers? To whom might you turn, or refer a request for help? If you are just beginnning and connected is the norm, what do you need to know about the state of online mental health, globally and locally? How do you diagnose or treat Internet-based addictions?

My Answer: 'Your mileage my vary', in large part because 'context and perspective are everything.' My dissertation and focus still, is in the area of 'person-therapy fit'. On Goals. Expectations.'Chemistry'. Communication. Empathy. 'Therapeutic Alliance'

And so you have heard my perspective, and now I welcome any questions or addition to the discussion. What is important to you, in your own context? What are the mental health needs, limits, challenges and potential - from your perspective? There has been a recent explosion of laboratory and real-world research, exciting progress in applications and training and access, and there are still vast areas of research which might engage today's students and young professionals address 21st Century needs and lifestyles.

What do you think?




Q & A





[Thank You - Спасибо]

Спасибо





Bibliography

Presentation Outline

Hand-outs & Contact Info

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From Current Topics in Psychology, Online Therapy :

[Updated]Very little has changed on the landscape in the U.S., at least for licensed mental health professionals in most of our 50 states. Today, nearly two decades after the initial establishment of guidelines, training, and access platforms for online mental health activities, there is still a '50-armed Octopus' of state-by-state regulations and law in the U.S. Meanwhile, there has been over a decade of demonstrated efficacy in online therapies, including support groups, computerized cognitive therapy programs, VR treatments for trauma, and more. We've arrived, within our respective states and professions, while much of the world - with better broadband than the US - is growing in interest about 'online therapy', beyond HIPAA and state-by-state legal/licensing considerations. I continue to stress the importance of basics, like establishing a 'natural' and 'therapeutic' working relationship, with a good fit on goals and expectations.

My interest extends to psychologists' progress and challenges with things like Internet facilitated therapies and treatments, and in many situations much still can be reduced to the key 'therapeutic' ingredients such as Carl Rogers described (warmth, empathy, genuineness), well-honed online communication skills, training and supervision, and protections for, and definitions of, the relationship.

Privacy, confidentiality, identity verification, encryption, informed consent, 'good fit' on goals and methods, along with ongoing continuing education and continuing new research. These are some of the the necessary ingredients for truly effective 'online (psycho)therapy', along with the fit between the two participants and the chosen modality and technology.

Additional new and relevant references will be added regularly, along with breaking news.

APA Events (Asynchronously Live Reports)


[Disney World-Orlando-APA2012] APA Convention 2012   Asynchronously Live from Orlando 

Transmedia Storytelling
Creating Engagement and Meaning in Organizations, Education, and Practice
Drs. Keely Kolmes, Jerri Lynn Hogg, & Pamela Rutledge


Virtual Reality Goes to War
Virtual Reality Goes to War: Innovations in Military Behavioral Health Care
Albert "Skip" Rizzo, Ph.D.


 
[Capitol Building at Dusk - APA 2011] APA Convention 2011   Washington, D.C. 

2011: eHealth Odyssey
Or... The Internet as an Instrument for Change
Lee M. Ritterbrand, Ph.D.


Avatar-based Treatments
Avatar-Based Recovery Using Immersive Virtual Environments
Ivana Steigman, M.D., Ph.D., Richard Wexler, Ph.D., Albert ("Skip") Rizzo, Ph.D.


Computerized Cognitive Based Therapies (CCBT)
Computerized Cognitive Behavior Therapies - Turning on, Tuning in, and (not) Dropping Out
Kate Cavanagh, Ph.D.

Psychology, Technology, Virtual & Augmented Reality
Innovative Technologies for Psychological Intervention, Consultation and Training
Drs. "Skip" Rizzo, Hunter Hoffman, Elizabeth Carll, Timothy Lacy, & Jon Cabiria

POKE ME: How Social Networks Can Both Help and Harm Our Kids
Larry D. Rosen, Ph.D.

Telehealth and Telehealth Licensure - Barriers and Possible Solutions
Drs. Marlene Maheu, Stephen DeMers, Dena Puskin, Joseph McMenamin, & Patrick DeLeon


[San DIego] Asynchronously Live From San Diego - APA Convention 2010

Online Psychological and Mental Health Interventions
Here's a fresh look, circa 2010 (at the APA's 118th Convention) at the evidence supporting the value of online interventions ranging from open forum support groups to self-guided CBT programs, with new developments and research findings shared by a panel of experts. (Fenichel)


[Toronto] APA 2009: Asynchronously Live From Toronto

Internet: Pathway for Networking, Connecting, and Addiction

Virtual Psychology & Therapy

Future of Internet Media


Asynchronously Live from Boston: APA 2008

Boston

My Space, You Tube, Psychotherapy and Professional Relationships


Asynchronously Live from San Francisco: APA 2007

[San Francisco]
Psychology's Future / Characteristics of Social Interaction in Cyberspace: Impact of Modality


Asynchronously Live Reports - 2006
[114th Convention - New Orleans 2006]
Online Psychotherapy & Research | 21st Century Ethics | Media: Town Hall '06


Asynchronously Live Reports - 2005
[113th Convention - Washington 2005]
From the 113th American Psychological Association Convention:
Online Clinical Work


Asynchronously Live Reports - 2003
[Toronto]
From the 111th American Psychological Association Convention:
Quality of Online Health Info


APA 2002
[Chicago]
INDEX OF 2002 APA Convention Reports:
Cyber-affairs | Cyber-ethics | Cyberspace Travels for Psychologists


APA 2001
[San Francisco]
INDEX OF 2001 APA Convention Articles:
Behavioral Telehealth | E-biz of Mental Health | 2001: A Cyberspace Odyssey


APA 2000
[DC image] Asynchronously Live Reports on Psychology in the 21st Century

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General Reference - Research, Clinical Practice, Education



Assessing a Person's Suitability for Online Therapy
Online researchers and practitioners describe some challenges which have been identified in determining a person's suitability for "online therapy". Some basic issues and strategies for assessment and establishing an online therapeutic relationship are discussed. (ISMHO Clinical Case Study Group, March, 2001)

Clinical Applications of E-mail
Transcript of a live forum hosted by Behavior Online, with Craig Childress, Michael Fenichel, Robert Hsiung, Storm King, Kimberly Young, and John Suler (March 28, 1999)

Considerations for the Provision of eTherapy (SAMHSA)
(December 2009) A White Paper from the U.S. Substance Abuse and Mental Health Services Administration examining efficacy and uses of e-therapy across cultural, legal/regulatory, and professional contexts.

CSG Report: 1/2 Decade of Online Clinical Case Study
A report from ISMHO's Clinical Case Study Group, summarizing a half decade of observations and exploration, and describing some of the latest clinical issues to be addressed by the group, with case examples and links to references and prior work by the group. (Fenichel, Jones, Meunier, et al, 2005)

Cyberspace Travels for Psychological Researchers, Educators, and Practitioners
110th APA CONVENTION:
Chicago, August 24, 2002
[ Description ] [ Asynchronously live presentation - full report ]

Distance Therapy Comes of Age
A compelling review of evidence we have in support of the value of online mental health services - across a multitude of platforms, tools and devices and a variety of modalities (e.g., chat, email, video, etc.). With some discusson too of the limits of "e-therapy" we have a balanced look at the challenges and potential. Complete with a bibliography for researchers.
From Robert Epstein, Scientific American, May/June 2011. [.pdf/Adobe]

Dot.COMSense
APA's brochure provided consumers with useful guidelines for seeking online mental health services, and launched the APA into the 21st century with this new look at the intersection between technology and psychology. It is no longer available online or off. (However, there are numerous discussions, research and resources at apa.org and various educational sites.)

From Couch to Keyboard: Cyber Therapy Booms
"But Many Question Security of Unregulated E-Counseling"
(WebMD, Feb.2001)

Healthy and Pathological Internet Use
Transcript of a live online forum with Michael Fenichel, Storm King, Steven Stern, Kimberly Young, and John Suler. Topics range from "Internet Addiction" to the benefits of text-based communication. (October 24, 1999)

Here and Now in Cyberspace
Some thoughts about the nature of the here & now online, and the implications for both social and therapeutic interpersonal communication. (Fenichel, 2002)

Internet Therapy Clicks for Patients
Online therapy consumers speak about their (positive) experience, online therapists discuss practical and technical aspects of online treatment, and some of the strengths and limitations are discussed. [See also: Getting Help on the Web]
(USA Today, 5-21-2001)

Myths and Realities of Online Clinical Work
Observations on the phenomena of online behavior, experience and therapeutic relationships

A 3rd-Year Report from ISMHO's Clinical Case Study Group: Michael Fenichel, John Suler, Azy Barak, Elizabeth Zelvin, Gill Jones, Kali Munro, Vagdevi Meunier, & Willadene Walker-Schmucker (2002)

On the Nature of Online Therapy and Communication
A capsule summary of a very interesting panel on where we stand and what we know in terms of online mental health service delivery, and the pros and cons of online communication.
With John Grohol, John Suler, Storm King, and Yvette Colon. (APA Convention Symposium, 2000)

Online Case Studies: Report of the ISMHO Millennium Group
A summary of 16 therapists' work across a number of modalities, all involving the Internet in some way or another. While many questions remain, a foundation is set for continuing work on developing models of training and practice.
(ISMHO Case Study Group, 2000)

Online Psychotherapy: Technical Difficulties, Formulations and Processes
A look at some of the practical and theoretical issues inherent in online clinical practice. (Fenichel, 2000)

Psychological Applications on the Internet: A Discipline on the Threshold of a New Millennium
A scholarly explanation of the various ways in which one can seek self-help, support, or active online treatment over the Internet, and a look at some of the advantages and disadvantages to this modality.(Azy Barak, 1999)

Psychotherapy and Clinical Work in Cyberspace
"Is it possible to do psychotherapy in cyberspace?" This question is explored in depth, with a look at the technical and conceptual issues involved in online communication and psychotherapy. Many original articles and references in this chapter of The Psychology of Cyberspace. (John Suler, 2001)

Q & A on "Online Therapy"
Considerations for online counselors and therapists, in response to a November 2000 interview by a graduate student in counseling psychology. Covers some of the hot issues under discussion by professionals, including ethical, legal, and practice issues. Still valid. (Fenichel, 2000)

Surfing For Peace Of Mind
A CBS Report highlights studies demonstrating - as the new century began - how many people went online looking for health information (60 Million in 1999 according to a Harris poll) and how 4 out 10 searches on the top sites were for mental health information. (March 2000)

Telehealth Resources for Psychologists (APA)
A decade later - a recently revised/updated compendium of related research as well as an extensive bibliography of articles on theory and practice issues, from the American Psychological Association (August 2010).

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