Avatar Therapy: Where Technology, Symbols, Culture, and Connection Collide
The Menninger Clinic and Baylor College of Medicine, HoustonJournal of psychiatric practice 11/2012; 18(6):451-9. DOI: 10.1097/01.pra.0000422745.17990.be
The topic of "e-therapy" is of great research and clinical interest in 2012. This article presents a case study that examines several elements of psychotherapy, as administered in the "Second Life" virtual environment. In this case, psychotherapy took place primarily via text messaging between two avatars (client and therapist) who "sat" in a virtual office. The therapist resided in the United States and provided therapy to an individual from a developing nation who was currently residing in another more developed Middle Eastern country for work and to escape political atrocities being committed in his home country. This case example raises many issues that could be explored, including the ethics of providing such therapy, cultural competence, technological details, and providing therapy across national lines. However, due to the complicated and multifaceted nature of providing therapy in a virtual environment, this case presentation focuses on technical issues, such as the basics of providing therapy in Second Life. Given that the patient in this case used multiple avatars (cartoon-like representations of himself) in therapy, the topic of the avatar as the expression of internal representations and conflicts is also examined. This case report also discusses the patient's presenting problems and elements of the therapeutic alliance such as transference and countertransference. Finally, suggestions for future research are made. The author posits that mental health professionals can now reach at-risk patients (e.g., refugees residing in other countries) whom they were not previously able to treat and suggests that mental health practitioners may have an ethical duty to research and provide these kinds of services so that certain underserved populations may be treated. (Journal of Psychiatric Practice 2012;18:451-459).
Article: Technology in Practice
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ABSTRACT: A variety of new psychotherapy modalities has arisen in which the contact between patient and therapist takes place via the internet. The main objective of this systematic review is to investigate the types of online psychotherapy (OP) conducted nowadays, and to describe their main characteristics to psychodynamic psychotherapists who may wish to better understand the current scientific literature on the subject. The review used two databases, EMBASE and PsycINFO. Fifty-nine studies were retrieved and the main online psychotherapy modalities identified were self-therapy programmes using contact via email or chat; videoconference; and therapy exclusively via chat or email. The result of these studies suggests that OP is more effective than a waiting list control group. When compared with face-to-face therapies, OP showed similar effects. Most studies involved cognitive behavioural therapy; only two studies involved a form of psychodynamic psychotherapy. Different forms of communication allow patient and therapist to establish different relationships and therapeutic possibilities. OPs may be feasible treatment alternatives; however, it remains unclear, especially in relation to psychodynamic treatments, if therapeutic technique in OP, which involves changes in comparison with face-to-face therapies, would be useful in severe cases. Psychodynamic psychotherapists should adopt a posture of constant reflection on the changes taking place in the world and their impact on the minds of individuals, without, nevertheless, idealizing the ‘new’.
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