The New Technologies of Change - Page 3

Clients' Double Lives

VR therapy is available only in a few locations, and is a fairly costly form of treatment, but other much less expensive virtual worlds are accessible at the click of the mouse. Second Life, a website that allows users to "live without boundaries from anywhere in the world," transports users to a vast range of imaginary, interactive environments. DeeAnna Merz Nagel, an experienced online therapist who cofounded the Online Therapy Institute, explains that although the site is often categorized as a "game," the goal isn't to win or lose. In Second Life, users maneuver through avatars—animated representations of whoever or whatever they choose to be. Avatars can move, walk, fly, and engage in scenarios like dance clubs or bookstores. Big-name businesses, nonprofits, publishers, clothing stores, and more—Amazon, Coca-Cola, Toyota, and even Harvard Law School—have now opened outlets inside Second Life. Users can shop, drink a virtually ice-cold Coke, drive a new car, or do almost anything else they desire inside this extraordinary world. Second Life affords myriad possibilities for entertainment, socializing, self-discovery—and even therapy.

Four years ago, researcher Daniel Krawczyk, psychiatry professor Carol Tamminga, and Sandra Bond Chapman, director of the University of Texas at Dallas Center for BrainHealth, came across Second Life. They were interested in developing more effective treatments for clients with ailments such as autism, schizophrenia, or brain injuries that make it difficult to interact socially. This VR environment seemed like a valuable tool because it could provide a more comfortable place for their clients to practice real-world social skills. "Interactions can be intimidating for people who have autism," explains Krawczyk. "Second Life is more comfortable because there's a filter when they're an avatar within a virtual environment."

Krawczyk says that they have an "island" on the site—a separate area that has streets and commonplace locations like a school, restaurant, and coffeeshop—which only the therapists and clients can access. In this space, the clinicians and clients take on different roles to practice life skills, such as interviewing for a job or negotiating with a landlord. It's a good environment in which to role-play, Krawczyk explains, because, unlike in video games, it's clear that the avatars are controlled by humans, making social situations seem much more realistic. Clients learn how to act in specific circumstances without having to worry about penetrating the real-life complexities of facial expressions, gestures, and personal space. Because working inside Second Life makes it easy to record sessions and play them back, clients can review their behavior while the clinician offers feedback.

Although it's clearly separate from reality, Second Life offers real-world ethical dilemmas, since, along with dozens of credentialed therapists and counselors, the site includes numerous "therapists" who have no training or professional qualifications. Groups like the Online Therapy Institute have been active in educating individuals interested in practicing online about the special skills and ethics involved in this work. The institute offers workshops and training for therapists, as well as an online directory of therapists who are certified to practice on the Internet ethically and effectively.

Despite the obvious limitations and drawbacks, there are some distinct advantages to using virtual worlds therapeutically, says clinical psychologist John Suler, author of the online book The Psychology of Cyberspace. He's particularly intrigued by the creative flexibility offered by virtual sites. "If you're a psychotherapist who likes to work with dreams, fantasies, and role-plays, then Second Life is the perfect place to not just talk about such things, but to create them and work therapeutically inside them."

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Face-to-face support and communication aren't likely to become irrelevant anytime soon, but this wave of new technological adjuncts to therapy is provocative and compelling. Technology offers the prospect of reaching a broader range of people and giving therapists a multitude of options for connecting with clients who have extremely varied needs. "In the future, the therapeutic process won't necessarily look like what it looks like right now. It's not going to be as 'in-the-box' as it's been all of these years," says DeeAnna Merz Nagel. "It's not that all therapists are going to close their brick-and-mortar offices, but they'll begin to integrate technology into their practice—that's what people are going to demand."

Jordan Magaziner, a graduate of American University's School of Communication, is editorial assistant of the Psychotherapy Networker. Contact: assistant@psychnetworker.org. Tell us what you think about this article by e-mail at letters@psychnetworker.org, or at www.psychotherapynetworker.org. Log in and you'll find the comment section on every page of the online Magazine section.

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