online consultation and therapy - the norwegian experience
DESCRIPTION
This is a presentation I did in Estonia in may 2013 for several NGOs and invited by the Norwegian Institute of Public Health and their Estonian partnersTRANSCRIPT
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Internet based information and councelling services for children –
Norwegian experience
Svein ØverlandBrøset Forensic Center, St. Olavs Hospital
NorwayPsykologivirkeligheten.blogspot.no
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The traditional view of the internet
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The new reality
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Times are a changing
• The world has changed in so many ways
• This change has had a huge impact for
banking, newspapers and medicin
• But what about psychiatry?
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Cosplay and Torucon
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From zombiefilms to zombiewalks
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Cyber warfare
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Cyber pets
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Geminoids
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Young people have always dreamt of a better world
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Internet enables them to do something about it
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Mange synes Real Life ikke virker
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But before we critize, - do we do enough?
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The question is not
• If internet are here to stay or not• or if this is the way it should be,• but how to adopt and develop our own
services to better meet our patients needs
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Melanie Klein and Play therapy
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Søren Kierkegaard• “If One Is Truly to Succeed in Leading a Person
to a Specific Place, One Must First and Foremost Take Care to Find Him Where He is and Begin There.
• This is the Secret in the True Art of Helping”.
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Definition of online therapy“The use of computers as tools to enable and/or enhance the provision of therapeutic services”. Abraham Wolf, 2003
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But it is so much more• Blogs; - liseliten.com and
psykologivirkeligheten.blogspot.no• Computer games; - SIMS• Robot pets and geminoids; - Paro and Henrik• Textbased nonsyncronized communication;
text messages and e-mail (as supplement or by its self)
• Telephone contact and assisted self help, as stand alone or during the waiting-list period
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…and more
• Closed forums; - selvskading.net• Realtime communication; - chat• Virtual worlds and avatars; - SecondLife• Specialized Virtual vorlds for treatment; - InWorld
and VEPSY• Smart phone applications; - StopSelfHarm• Integrated portals with multiple services
the future
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Waiting for the psychologist in Habbo.no
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The StopSelfHarm app
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Exposure therapy in virtual reality
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Skills training in groups
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Evidence based• Good support for ”BluePages”, ”MoodGYM”,
”Good Days Ahead” and ”Beating the blues” • There is ample evidence for the use of online
therapy for anxiety and depression• Inworld have good data on spesific population
like autistic children and social skills• NICE guidelines exist• The Norwegian Psychologist Association has
developed their own guidelines
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Online and digital therapy as supplement
• The aim is not to replace standard psychotherapy, but to use it as a supplement for services that are lacking, and to enhance the effect of standard therapy
For communication with clients that has difficulties in utilizing the standard services; because of distances, shame, or need for very specialized expertice
For more effective treatment; as homework, crisis management or during waiting list
For getting inspiration to further developing more effective ways of delivering help and treatment
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The development of online therapy in Norway
• A handful of entrepeneurs and clinical psychologist in private practice has developed their own web-solutions
• The growing interest has led the universities to develop their own programs
• Several studies has shown promising and cost-effective results
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Some interesting projects in Norway• Blue Pages and MoodGym both for adults and
adolescent, University of Tromsø• Online therapy and diagnostics for adults and
adolescents in, University Hospital of Bergen• Integrated telepsychiatry, University of Tromsø• "The thought bank", University of Trondheim
(NTNU)• Telephone based assisted self help, several
places
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The future of online therapy in Norway
• A continued development and research of the effect of online therapy in the universities, hopefully coordinated by the health authorities
• A growing interest and use by the private health care sector
• A stronger focus on confidenciality, encryption, training and guidelines
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My office in SecondLife
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But it is not the real thing, is it?
• Thats true. You loose most of the everpresent natural small signals of the face, the twinkle in the eyes, the signs of someone soon starting to cry, the subtle dance between souls, the smell of fear and pheromones, the tender shaking of an an eyelid, - all those precious little moments of being a vulnerable and suffering human being.
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Possible pitfalls• Some clients will find it to be too strange• It can be alienating• Done unwisely it can breach confidentiality• It might be “too” cost-effective• ?• ?• ?
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Virtual Reality is ”the new world”
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And what is Reality?
• “Reality is merely an illusion ... It is just a very persistent one”
Albert Einstein
• "When the online services of the future is starting to develop, we have an obligation as psychologists to be proactive both in scientific and ethical ways"
The president of the norwegian psychologist association
• "The difference between online therapy and standard psychotherapy is like the difference between poetry and prose"
Eva Jacobsen – Psykologonline on LinkedIn
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Vi har tre muligheter
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Good luck to us all!
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www.psykologivirkeligheten.blogspot.no