Avatar Therapy

Okay folks, my summer sabbatical is over. Let’s talk Avatar Therapy.  I teased you about this concept back in blog one, now it’s time to deliver.  Here’s the deal:  a therapist can join the virtual online community called Second Life www.secondlife.com, chose an Avatar with which he or she can navigate through Second Life and communicate with other Second Life members.  The therapist can then purchase land in Second Life and create a virtual office space where “real” clients can visit for “virtual“ therapy sessions and pay real dollars (or Second Life currency, called "Linden" dollars, after the creator of Second Life)

No joke.

D. Craig Kerley, Psy.D., a psychologist in the state of Georgia, has an Avatar Therapy practice in Second Life.  Check him out.  http://www.drkerley.com/avatartherapy.html. 

Here is my initial take.  I want to have an open mind, but the concept of Avatar Therapy really gets my ethical spider sense tingling.  Creating a fantasy environment as the setting for a therapeutic relationship seems wrong.  The most powerful benefits of therapy come from the quality of the therapeutic relationship itself.   What are the ramifications of that relationship being formed in a fantasy world?  How does the learning translate to the real world?  

Feel free to challenge me on this one.  I can see some useful applications of Avatar Therapy: as a step in the exposure therapy model of treating specific phobias, as a way of initially engaging an agoraphobic client or a troubled and alienated adolescent.  But, if we are going down this road, please let’s keep the work brief and focused on getting the real person into a real office. 

Let’s help people get better in their First Life. 

MOOD 24/7

You meet with your clients for fifty minutes a week.  During that time you use your training and skill to assess their mood states. But, what about the rest of the week?  Sure we ask our clients to report on their symptoms.  “So, Mr. E, how have you been feeling since our last session?”  Mr. E gives us a summary of his weeks ups and downs.  Maybe he has excellent recall and we get a full and accurate report.  More often he “forgets” some important details, like that horrible fight he had with his wife where he called her horrible names.   So, we only get a partial view of Mr. E’s week.  Maybe we assign Mr. E a mood log to fill out during the week.  Maybe he does his homework; more often, he doesn’t. If you receive a crisis call between sessions from Mr. E you will have another opportunity re-assess his mood state, but we don’t want that, do we?  What is a tech savvy therapist to do?  

Dr. Adam Kaplin of Johns Hopkins University in collaboration with HealthCentral - a clinical resource and support provider - have developed a simple and elegant solution to help track client mood states outside of the therapy office.  It is called Mood 24/7 -- a secure web application that sends the following text message to the registered user:  “On a scale of 1 to 10 what was your average mood today?” The user responds with a number and an optional comment of up to 160 characters.  The data is transmitted back to the Mood 24/7 secure website, loaded to a secure data repository and used to create a report displaying the users mood patterns over time. 

So, on Mr. E’s next appointment you can sit with him and say, “What happened on Wednesday Mr. E?  Your mood was a 2.”  Now, maybe Mr. E goes on to tell you about that terrible fight with his wife, maybe he doesn’t.   This app will not enhance a client’s motivation to be more honest with you, but it will provide us with more real time data about a client’s emotional well being. 

The rest is up to us.

A Memorial Day message.

On this Memorial Day I thought it fitting to focus my attention on our brave men and women in the military.  Our soldiers are a special group of individuals who experience extraordinary stress in their lives.  Many are in need of behavioral healthcare, but face significant internal and external barriers to treatment.  Soldiers devote their lives to protect and serve us.  They do not readily seek services for themselves.  


I am pleased to read that the Veterans Health Administration of the Veterans Affairs Department have increased efforts to use digital technology for reaching out to soldiers with PSTD and/or Traumatic Brain Injury. http://www.af.mil/news/story.asp?id=123210510  I am also encouraged  to read that The Senate Armed Services Committee is seeking to "improve the delivery of mental health care to combat veterans".  http://www.defensesystems.com/Articles/2010/06/24/BRAIN-INJURY-TECH.aspx


Both organizations have identified Skype as a useful tool in increasing the effectiveness of  treatment engagement.  Military personnel are more likely to open up to a clinician through Skype.  I do not suggest that Skype therapy should replace traditional therapy, but if the safety and accessibility of distance therapy helps us reach more soldiers in need, I support this approach one hundred percent.  It is the least we can do for them.

A brave new mobile world in Behavioral Healthcare

After a ten year hiatus I have returned to clinical practice.  During my time away I ventured first into the world of behavioral healthcare clinical management and then (...wait for it...) Software Development.  I am told being a Therapist and a Software Developer is an odd pairing.  I suppose, that's true.  But, what I am sure of is that many of you therapists understand and embrace the power of technology.  You may not be able to write your own Android App in Java, or build a marketing solution in SQL Server, or create an e-commerce website with PHP/MySQL, but I bet you have a fancy-pants mobile phone, and you know how to use it (most of the time, anyway). 

Personally, I own an Android:  the Samsung Fascinate, distributed by Verizon.   I am not a rabid consumer of technology.  I do not need to have the latest and greatest device on the market. (My wife and I don't even own a television).  But, I go nowhere without my Fascinate.  I check the status of my world:  my wife's day, my writer's digest critique group, the score of the Red Sox game, and of course, Facebook.   I read my Amazon Kindle books on my brilliant WVGA Super AMOLED screen.  I write my Word documents on my ThinkFreeOnline app, and  upload them to my free storage on www.thinkfree.com. My Fascinate has taken over my day to day operations.

Now, tell me this: How many of your clients walk into session with a mobile phone in hand? Hold on, that's the wrong question.  How many of your clients DON'T walk into session with a mobile phone in hand?  Yeah, that's what I thought.  We live in a mobile device dominated world, brothers and sisters.  These little guys have burrowed their way into our lives.  They are not going away. 

So, here I am: back in practice.  This Tech Savvy Therapist has put the old empathy hat back on his head, and is braving the 50 minute hour once again.  How might I use my knowledge of technology to better help the souls who enter my office? This question is the reason I have entered  the Blogosphere.  So, come along with me, won't you?  I'll do some research, and report back each week.  There are some interesting and controversial topics to explore.  How does technology affect the client-therapist relationship? Does it de-humanize the process? What about email-therapy? Skype therapy? Avatar Therapy (...Yes, Avatar Therapy...I'll get back to you on that one.  I promise...).   Lots to discuss. But, for now let me end with this belief of mine: we as helping professionals can use technology to be more effective helpers.  Simple.  Are you with me?