Online Counseling

Upon the death of Steve Jobs, a friend of mine* posted on Facebook, “Three apples changed the world: the one that Eve ate, the one that hit Newton on the head, and the one Steve Jobs offered us all.”  Jobs, the founder of Apple, certainly changed the way we use technology today.  It is more accessible, and constant, and personal. But how has Jobs (and his technology) impacted the world of counseling?

Well, in the trend of online counseling, he has enabled clients to literally keep their counselor in the palm of their hand.  Some counselors offer services via Skype or other live internet communication; clients can be in touch on their iphone or ipad while maintaining physical distance.  Some counselors also offer email communication (known as asynchronous communication, where the interaction does not occur in real time).  Clients also have access to lots of information about mental health, both accurate and inaccurate, through the web (Gladding & Newsome, 2010).

With email, counselors and clients can keep in touch conveniently and work with a flexible schedule, in a way that may even out the spread of power between client and counselor (each can communicate with a home court advantage).  However, email shares many risks with other internet counseling methods; namely crises in which the counselor is not present, issues of confidentiality and protecting privacy in a secure manner, as well as third-party payments (Gladding & Newsome, 2010).  In addition, there is a greater chance of miscommunication when technology is involved.  When videochatting, there is the potential for the connection to break up at a key moment.  In email, a sarcastic phrase may be taken as fact or adolescent slang may be difficult to decode.

In a recent New York Times article, one psychologist (Elaine Ducharme) discusses her long-distance practice. Ducharme uses Skype to videoconference with patients from her former practice, and is licensed to practice both in the state in which she counsels online and the one in which she lives.  She will only videoconference with a patient she has already met, and periodically returns to have face-to-face appointments.  “‘There is definitely something important about bearing witness,’ she said. ‘There is so much that happens in a room that I can’t see on Skype’” (Hoffman, 2011).  The article continues on to address the pitfalls and benefits of online counseling.

The National Board of Certified Counselors (NBCC) began putting together a task force to address technology-assisted counseling in 1995, an endeavor that tackles ethical and practical issues and led to today’s Standards for the Practice of Internet Counseling (Gladding and Newsome, 2010).  With the massive presence of the Internet in our lives, it is necessary to set these guidelines and enforce a standard in order to protect the professional integrity of counselors, both online and off.

As a beginning student, I see myself working in a more traditional face-to-face practice, as opposed to using Skype or email as a central mode of communication.  There are already so many concerns in the practice of counseling as to how to best work with a client and act in their best interest, without worrying about a dropped videocall or a crisis thousands of miles away.  I recently read what constitutes malpractice, and sat staring wide-eyed at the textbook for a good five minutes, contemplating all the ways I could screw up.  I don’t feel I need to add any additional potential for disaster to the list.  I appreciate the momentous contributions of Steve Jobs and the impact of the growth of technology on my daily and professional life, but as a starting counselor I think I may check the technology at the door.  I’ve been spending a lot of time lately learning how to be with someone, how to listen and share time and space in a therapeutic manner, and I plan to put those skills to use by counseling face to face.  As I learned in my orientation, the only real technology you need in a counseling session is a box of tissues and a clock.

Gladding, S. & Newsome, J. (2010). Clinical Mental Health Counseling in Community and Agency Settings  (3rd ed.).  Upper Saddle River, NJ: Prentice Hall.

Hoffman, J.  (2011, 23 September). When Your Therapist is Only a Click Away. New York Times, pp. ST1.

*Thanks to Michael Fleischmann for sharing this popular post.

What do we do when everyone comes?

by Joanne Larson

I have been doing some reading outside of education lately that has deeply informed my thinking about literacy in an information and communication economy. I have been working through some ideas about the consequences of what researchers are calling the most profound change in human communication since the invention of the printing press – the collaborative knowledge production made possible by internet technologies, particularly open source practices. What happens when we make the shift from a one-to-many form of communication and knowledge production to a many to many, collaborative process?

Two books I read recently have really pushed my thinking. Clay Shirky’s book, Here comes everybody: The power of organizing without organizations, looks at what happens when people can organize (or lead or educate) without needing traditional organizational (or leadership or educational) structures. Axel Bruns discusses the concept of produsage in his book, Blogs, wikipedia, second life and beyond: From production to produsage. He argues that humans are experiencing a profound shift in how culture and knowledge are produced and circulated, moving from traditional production models, to a participatory process in which we (non-professionals or pro-ams) have shifted from consumers to produsers (producing and using the knowledge that is produced). In his discussion of citizen journalism and wikipedia, he describes a process he calls casual collapse, where traditional (one to many) knowledge producers (newspapers and encyclopedias, specifically) have not fully grasped the nature and extent of the transformation humanity is going through. It made me wonder what schools may have missed and whether they are also experiencing this casual collapse.

With the shift in communication (many to many) and the transformative potential of immediate social action (flash mobs), and considering the speed and level of these practices, I am wondering whether schools have completely missed the boat? What if it’s already too late? Schools are so busy transmitting static knowledge and putting increasingly severe boundaries around what is allowed that I fear irrelevance has already set in. Publishing is global and free, social action and political change is possible without formal organizations and infrastructures, knowledge and information are generated at lightening speed by everyone, and it’s clear schools haven’t paid attention. James Paul Gee makes the point that schools are bad for everyone, white kids just get A’s for it, and he argues they will be irrelevant if they don’t account for these ontological changes.

Some of these ideas connect well with social practice theories of literacy and sociocultural-historical theories of learning, but we need more thinking about this. Bruns’s concept of equipotentiality (the assumption that while the skills and abilities of all participants are not equal, they have an equal ability to make a worthy contribution to the project) reminds me of Rogoff’s concept of community of learners, Lave and Wenger’s concept of communities of practice, and Gee’s concept of affinity spaces. Maybe we can figure this out after all?