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Our Philosophy

Our Clinical Case Study Group is a peer supervision, research, and brainstorming group devoted to discussions of clinical work that involves the internet. We welcome an understanding of how different types of online clinical work may help different people. We believe in interdisciplinary efforts and the case study method as a valuable research strategy. The group's philosophy is that clinical work in cyberspace in some ways resembles traditional in-person psychotherapy, but also that the Internet has resulted in some very new clinical issues and a fascinating variety of unique intervention formats. The types of clinical work we explore include the following:

• face-to-face (f2f) therapy cases in which contact with the client via the Internet played a significant role (e.g., e-mail between sessions, the use of web sites as resources)
  
• short and long term clinical encounters with people that occurred primarily via the Internet (e.g., therapy via e-mail or chat)
  
• professional consultations that occurred via the Internet, including, for example, giving advice and/or information to people who contact an online professional and
  
• supervision via the Internet (e.g., via e-mail or message boards)
  
• f2f therapy cases in which the client's activities in cyberspace were a significant issue in the therapy
  
• online groups and communities in which the mental health professional acts as a organizer, facilitator, or consultant

In studying these and other forms of online clinical work, we uphold the importance of a professional atmosphere marked by mutual respect, support, and helpfulness.

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The Presentations

Everyone in the group is expected to present a case and participate in the discussion of other people's cases, although not everyone may have a chance to present during any given academic year (Sept through May). The facilitator for the case presentations asks members to volunteer to present and those presentations occur in the order that people volunteer. The presenter leads the group discussion for her/his case. Presentations usually last about two weeks and a maximum of two weeks is devoted to any case. If the presenter feels finished after the end of the first week, the group may end the discussion and proceed to the next case.

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The People

- Azy Barak -

My name is Azy Barak (my first name is pronounced Ahhzie: "A" like in Arnold, and not like in Amy). Barak in Hebrew means: (1) lightening; (2) shine, glitter, sparkle, glare, or gloss. I am not related to Israel's former Prime Minister (Ehud Barak).

I received my BA and MA degrees in psychology at Tel-Aviv University. I then moved to Columbus, Ohio, to study at Ohio State; there I received my Ph.D. in counseling psychology in 1976 (the era of the memorable Woody Hays' Buckeyes). I then returned to Israel and started my academic career at Tel-Aviv University, with which I was affiliated for 18 year. At Tel-Aviv I initiated the Counseling Psychology Program and served as its Chair. In 1986/7, I spent a sabbatical at The University of Western Ontario (London, Ontario, Canada). In 1993, UWO offered me a full-time appointment and a tenured position, which I accepted and held for four years. Family matters, however, prompted us to return to Israel. I obtained a position at the University of Haifa, with which I am currently affiliated, a joint appointment in the Psychology and Education Departments (a combination I enjoy). Oh, yes, I've obtained Canadian citizenship, you know.

Besides teaching and supervising students I have been actively engaged in research. Throughout my career, I have been involved in the research areas of career psychology, testing and diagnostics, counseling process and outcomes, and human sexuality (especially research related to pornography, sex education, and sexual harassment). In the last seven years, however, most of my academic/scientific conduct has to do with the Internet. You may browse my brief online bio page (at http://construct.haifa.ac.il/~azy/azy.htm) to get acquainted with my specific publications and activities in recent years. Some of my articles are published online and linked from this page. Also, for a long period of time I had a private clinic; all together I accumulated over 20 years of clinical experience. Currently, I'm involved with counseling practice too, but do this mainly online.

In 1995 - after working for some time (while in Canada) on computer-related projects - I became interested in the Internet and its relationship with psychology. I spent many hours surfing the Net and retrieving every relevant piece of professional/academic information I could find. A thorough library search produced relatively very limited information about psychology and the Internet. I was mainly interested in how the Net could be exploited to provide psychological services. Later, I became also interested in the effects of Internet use on society and individuals. I also spent time in the past to develop site-building skills. I posted my first website (or cruises!) in GeoCities and maintained it for two years with great joy.

Since then, I have been intensively involved in teaching and research in this fascinating area and intensively involved in writing articles. I'm currently undertaking several research projects on Internet-based psychological applications and planning a few new ones. Most of these projects use this or another Internet function of delivering psychological services, whether individual counseling, support groups, testing, or self-help. In addition, I participate in local online email-based discussion groups and Web forums. My main involvement in this context has been in a Web-based virtual community that I have initiated and managed, named "Person & Internet" at one of the main Israeli Web portals.

One of my greatest academic and personal experiences during the last years was teaching an online graduate course in psychology entitled, "The Psychology of the Internet," where students and me met only online (besides a single preliminary 1-hour meeting) for the whole academic year. Although this consumes many hours and makes me work very hard (6-7 times as much as a conventional course) I enjoy it tremendously. The students love it too and learn a great deal by combined didactic and experiential learning.

My greatest Internet-related activity for the last two years, however, has to do with a wonderful large-scale project I initiated. Its name is SAHAR (a Hebrew acronym for "Support and Listening on the Net") and is a fully Internet-based, free emotional support service, whose aim is to help people in severe emotional distress, particularly those contemplating suicide, and to launch a rescue operation in cases of immediate danger. Volunteer, nonprofessional helpers, who receive special training and professionally supervised, operate it. The service is provided through an information-rich website, and multiple individual and group communication channels. I presented SAHAR in detail as my case presentation in CSG3.

I'm 55 years young, married to Ilana (an I/O PhD psychologist who works for a hi tech firm), and have four daughters: mine (Orna, 31, a mother to Yuval, my sweet 3-year old grandson, soon to leave to Thailand for several years, where her husband was offered a job; and Osnat, 27, single, holds a BA degree in behavioral sciences, soon to leave to the Far East with her boyfriend, untill she starts grduate school; hers (Ornit, 27, single, holds a BA degree economics and an MBA (marketing) student; and ours (Inbal, 19 , high school graduate, soon to start her volunteering in a two-year public service program).


- Michael Fenichel -

My bio is at http://www.fenichel.com/bio.shtml
My photography is at http://www.fenfotos.com
My site map is at http://www.psychservices.com







- Ron Huxley -

Ron is a licensed child and family therapist, national speaker and columnist, web site producer, community mental health director, family advocate, and father of four!

Ron's book: "Love & Limits: Achieving a Balance in Parenting" http://www.parentingtoolbox.com/llpart1/index.html

Visit Ron's websites at http://parentingtoolbox.com and http://angertoolbox.com






- Gill Jones -

So how do I introduce myself? Well, I'm 58 in November. That seems to be very important. I am also planning to end 3-year individual therapy at around that time and that is important, too. I trained as a drama teacher in the 60s but never actually taught, preferring a short spell of professional acting, then secretarial work until the arrival of my first child in 1972 (married in 1971 and still married to Bruce some 30 years later). Then followed 15 years as a full-time Mum, raising three children, Abi (Abigail), Crispin and Izzie (Isabelle) who are all now in their 20s. By 1987 I was beginning to look for challenges outside the home and became a member of the Board of Visitors at a local prison (checking the prison conditions on behalf of the Home Secretary). My counselling training began in 1990 and my studies have taken me through an MA last year where I researched potentially destructive experiences in group supervision (my dissertation is online, zipped up in a file which can be downloaded from my website- http://www.gjcounselling.co.uk

I am very interested in online work as my secretarial skills can come back into play and last year I began to study the skills needed to offer counselling online with a group of like-minded professionals. We have since decided we can market a training course offering these skills through a virtual campus website and the students (who are all experienced counsellors and psychotherapists) meet online, roleplay online, receive supervision online and get together in small groups to discuss issues about counselling on the internet. We have just launched the course and will begin our first training group later this month. We think we may be the only people offering this type of training in this way at the moment, so we are very proud of our course and it will demand a lot of my time.

In the UK we have to be supervision if we are to work to the Code of Ethics and Practice of the largest of the UK accrediting bodies (BACP) and I am developing an online supervision arm through my website as well as offering counselling online. I am looking forward to joining in this group as I ìlurkedî in July and was very impressed by the content of the groupís exchanges.


- Susan Mankita -

I'm a licensed clinical social worker from Miami, Florida...wellllllll, not exactly FROM Miami, but have lived here for the second 22 years of my life, after spending the first 22 in New York City.  I've adjusted well to the slower pace and the warmer weather here..though I'll admit, it took quite a long time to perfect my Southern drawl... (awww, ok, truth be told...I lapse into "NewYorkese" the minute I hear someone else using it).

But...on the Internet, no one can hear my hybrid accent which brings me to the intersection of me and the work I do online...

In 1995 I developed the Social Work Forum on America Online.  It started as a small set of bulletin boards and a chat room for social work professionals, but has grown exponentially in 7 years.  We run 7 professional chats a week. (Liz does an awesome job of running our protocol chat...the one where we invite "guest experts" for a more formal educational experience.)  The Forum is supported by 18 volunteers who help me staff the chats, manage the bulletin boards, and maintain our library.  We have a monthly newsletter and weekly emailed chat notices, that include the topics for the week, a brief (hopefully insightful) topic blurb and pertinent hyperlinks.  I'm incredibly proud of the Forum.

Anyway... because of my affiliation with the SW Forum, lots of social workers began making some powerful and perhaps predictive assumptions about me. Folks assumed that, because of my role there, I had all the answers about things social work/internet.  I laugh now , because in truth, I was motivated to learn by my desire to appear competent to my professional peers.  

And learn I did.  Around the same time I was also working on my PhD at Barry U...and decided to focus my studies around social worker use of the Internet.  I say that to share that my early understanding of the psychology of the Internet comes from reasonably rigorous academic work.  I still consider myself more of a teacher than a practitioner.  

Currently, my f2f practice is largely supervision. I have about 20 supervisees, many of whom work for one child mental health agency here in Miami.  I do individual, dyad and group work with them, and really do love the mentoring/training piece.

I was also hired by a new Internet start-up to assist them in developing the clinical aspects of their program, ie: how to practice safely and ethically, recruiting therapists and ultimately training them.  I have done this kind of work before; the first time I did, it was as a consultant for the now defunct eTherapy.com.  I developed a training guide for them, even made a CD and did chat room trainings for new therapists.  It was great fun and an unbelievable learning experience...particularly finding out what therapists wanted and needed in order to feel comfortable doing this work.  

I've been lucky to have been invited to give lots of professional presentations on Online Therapy around the U.S. and I often focus on helping therapists to begin thinking about transfering their f2f clinical skills to an online environment.

Although I've never taken money for providing online therapy, I have worked with several people clinically via the Internet, and have run a support group for social workers.  My interests lie in online groupwork...particularly clinical supervision...but I'm open and ready to learn as much as I can ( and offer as much as I can too )

If you want even MORE of me...I do have a little vanity web page I created for my AOL SW Forum Identity. It's at  http://hometown.aol.com/susanmankitalcsw/index.html


- Vagdevi Meunier -


- Kali Munro -

My undergraduate degree is in sociology and so I'm a big fan of sociology too. I guess I'll continue introducing myself...I did most of but never completed a MSW - I was young, and couldn't handle the conservatism, etc etc. I later did my M.Ed. in adult education and counselling. I've worked as a therapist, group facilitator, and Clinical Director at a number of social services in Toronto. At my last place of employment I was the Clinical Director of a women's feminist counselling, legal and cultural interpretation centre for women who had been abused - child sexual abuse, adult sexual assault and abused spouses. For the last six years I've been in private practice - the BEST job I've ever had! I do some contracts for an EAP agency and now I'm doing some online work for them as well, with Cedric for those of you who know him from the ISMHO list. I sometimes contract out and do groups for other agencies usually about sexuality, body image and sexual abuse for women and men.

I work predominately with lesbians, although some gay men, and heterosexual women and men. I've offered a variety of groups in my private practice - lesbian support groups, male sexual abuse survivor groups (mostly gay/bi men), body image groups for women, and sexual abuse survivor groups for women. I really like doing group work.

I'm eclectic - I incorporate body awareness (encouraging awareness of sensations and feelings in the body, being aware of what the body is "saying" etc), cognitive, gestalt, psychodynamic, good old Rogerian empathic approaches, visualization, guided imagery, relaxation, coping strategies/skills development, EMDR, and my intuitive good sense! I avoid pathologizing human problems and concerns - oh I'm humanist and feminist and have a history with anti-psychiatry community development (Thomas Szaz and Peter Breggin type thinking).

I've just turned 40 which has been very significant - good! - and says something about me :)

I have been supporting some of my f2f clients online for a number of years. Very recently started online work, mostly emails but some instant messenging. I've shifted with some clients from online to f2f, from f2f to email, from email to phone and I've quite liked mixing the different mediums. I started as a skeptic about therapeutic services that were exclusively online, but after being asked for help online by people who read my online articles, I discovered how much it can do for people. But, I originally put up a website to promote my f2f work and to offer free resources to a larger audience.

www.KaliMunro.com


- Willadene (Billie) Walker-Schmucker -

First let me tell you a little about myself, I am an ARNP which translates into an Advanced Registered Nurse Practitioner. That means in the State of Florida I am authorized by the State of Florida to diagnosis, treat, and prescribe medications for the patient population in which I have certification. I am certified in both adult and adolescent/child mental health. I also have specialized training Crisis Intervention. I have Masters degrees in education and psychology in addition to nursing. I have a private practice in Sarasota and I see clients in most age ranges. Most insurance accepted and sliding scale available. The name of my practice "The Alternative" denotes my personal preference to look at alternative approaches to treatment. I am interested in discovering the match between the individual's needs and the available treatments. I am open to both in person treatment and long distance treatment, either e-mail or chat communication in addition to phone contact.




- John Suler -

I'm never quite sure what to write for these introductions. Let me start at the beginning.... I was born on a sunny, cold day in January.... no, wait, maybe that's going a little TOO far back ...... (fast forwarding) ........ and when I brought home, say, a 98 on a spelling test, my Mom would say "So how come you didn't get a 100?" ........ (fast forwarding)....... my dissertation advisor, Ed Katkin, and his right-hand-man graduate student Steve Goldband (a genuine computer genius) would chuckle at my panic when the computer program I wrote for my dissertation experiment kept crashing ...... (fast forwarding) ....... the job market was terrible when I graduated, but I did get a faculty position at Rider University, where I began churning out articles on psychotherapy, mental imagery, and eastern philosophy, did a truckload of teaching, therapy and supervision in the counseling center, started a private practice, and joined a weekly clinical supervision group led by the psychoanalyst Nancy McWilliams, where I spent 12 years ........ (fast forwarding) ......... and I thought life was busy! I ain't seen nuthin until Asia and Kira were born!........ (fast forwarding)....... so spending all that time at home being a MomDad, what should I do when the kids were playing, napping (which they did rarely) or watching the Elephant Show? We bought a computer, I discovered the internet, and began exploring cyberspace while keeping an eye on the kids. It was all downhill from there. I cut my teeth on the mysteries of online living as a resident of the Palace "avatar" community, wrote an article about being addicted to Palace, which turned into a collection of articles about Palace, which gradually expanded into an online book about the psychology of cyberspace. Along the way, I also built a number of other web sites, including Teaching Clinical Psychology, Zen Stories to Tell Your Neighbors (a very popular one), and recently a site for CenterPoint, the clinical practice that my wife Debra and I are building. Because psychotherapy and group dynamics (especially peer supervision groups) are my areas of expertise, I'm focussing mostly on that in my current cyberpsychology work.... which leaves my story off right here, in this group!


- Liz Zelvin -

I'm Liz Zelvin, I'm a social worker in New York City, worked in addictions programs for 15 years, as program director for 10 of those, and had a general psychotherapy office practice for most of that time, but then I fell in love with online practice and am in the process of building up my client base on my own website at www.LZcybershrink.com and as part of the online therapy network at Find-a-Therapist.com. I'm also part of the startup of a promising new online clinic site that's not yet launched and currently writing and editing a series of interactive e-books for it. I keep my hand in the addictions field by serving as special topics editor of the Journal of Social Work Practice in the Addictions, masterminding email-generated debates on controversial topics in addictions from a social work perspective. I also do teaching and training in the addictions field as well as on online practice. If you take a look at my website, you'll see that I'm also a poet and singer/songwriter. My latest book of poems is Gifts and Secrets: Poems of the Therapeutic Relationship. My songs are about everything from being a therapist, alcoholism, and September 11 to online relationships and dissipated teddy bears, and if you know of any appropriate venues, including professional conferences, I have guitar, will travel: most recently to Manila, Hawaii, and Berkeley where I gave a concert for a bunch of old campus radicals from the Sixties.


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Ethical Guidelines

Our prime directive is to protect the confidentiality and welfare of the clients that we discuss. According to many professional organizations, there are two basic principles that apply to case study presentations in any educational or training format:

(a) Do not disclose confidential, personally identifiable information regarding patients, individuals or organizations obtained during the course of one's work, unless the person or organization has consented in writing or unless there is other ethical or legal authorization for doing so.

(b) In professional presentations, disguise confidential information concerning patients, individuals, or organizations so that they are not identifiable to others and so that discussions do not cause harm to people who might identify themselves.

Our group also created and continues to discuss its own list of queries that encourages members to consider these general ethical issues, as well as issues that are unique to an online peer supervision group. Although all of these queries may not be relevant to every case that is presented, they are always important to consider:

1. Are you protecting the confidentiality of the person or group by disguising and/or deleting information that could directly or indirectly reveal the person's offline or online identity, or the group's identity and location?

2. Does anyone on this list have direct or indirect contact with the person/s you will discuss, and could this jeopardize the person's confidentiality or in anyway harm those person/s?

3. Has the person or group given permission for their case to be discussed?

4. What precautions have you taken to safeguard the security of messages from our case discussion (i.e., how have you restricted access to your computer and these e-mail messages)?

5. Are you requesting explicit permission from the appropriate individual and/or the whole group to use quotes or specific material for your presentation?

6. During your discussions with people outside of this list (professional or otherwise), how will you protect the confidentiality of the list and the cases presented here?

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Participation Guidelines

Pacing Styles: Remember that people use e-mail at different paces and that servers on the internet may deliver some mail late. Expect some delays in people responding and messages that arrive out of order.

Be Responsive: Although chronic lurking is accepted in many online groups, it is not appropriate here. Reply to people, especially people presenting a case, even if it's just a simple one-liner or an "I agree." On big lists with lots of traffic, some people get annoyed by such short messages, but it's good for our purposes. When people post to a list and don't get any reply, they tend to be reluctant about posting again. No one likes to be ignored.

Repetition is OK: If you are short on time during a particular case presentation, read the initial message presented for the case and respond to that. Don't worry about possibly repeating feedback that someone else might have offered in a message you didn't get a chance to read. Independent thinking that yields different ideas or external validation is valuable.

Be Concise: Avoid very long, scrolling messages. Get to the point clearly, efficiently, while showing thoughtfulness and concern. It will take more effort for you, but the net result for everyone will be a more focused, less overwhelming batch of messages. Mark Twain said "Sorry I wrote such a long letter. I didn't have time to write a short one."

Precise Quoting: Avoid long quotes of previous messages. Quote the specific sections you are responding to.

Announce Absences: Let us know when you're going to be away from your computer. That way we will know why you seem to be "quiet." If you get disconnected from the internet for an extended period due to technical problems, try to let someone in the group know so they can forward a message to the group for you.

Watch for Ambiguity: Because there are no face-to-face cues (voice, body language), it's easy to misread the tone and therefore the meaning of someone's message. So when in doubt, ask for clarification. Remember the motto, "Assume good will."

Professionalism: Be helpful to the presenter, not critical. We will expect respectful, professional behavior on this list. Persistent disrespectful behavior will result in your being removed from the group.

Back channel talk: It's good to connect with other group members through other channels, like e-mail, chat, or even better, face-to-face. If there's something that you discuss about the group in these encounters, consider bringing those ideas to the group. It could be very valuable to us!

Format and Process: Use the "format and process" thread to comment on what you see happening in how we are going about discussing cases. This could be very useful to us. You can report technical problems in this thread too. Abbreviate "format and process" in your message title if you'd like to add a subtitle, for example, "F&P: Fast-paced"

Questions/Suggestions? If you have any questions, ideas, or suggestions - please bring it up for discussion, perhaps in the format and process thread. Other people may be thinking the same thing.