Psychiatric Care in Second Life

I am always thrilled to find new and exciting ways Second Life can be used as a platform for much needed professional services. While pondering the legal services offered by Jake Reitveld (who has also offered invaluable RL legal advice here in the forums) I wondered what other professional services could be brought into Second Life.

If RL lawyers are successful in rendering legal services in SL, do you guys feel there is a place in our economy for RL mental health professionals? The idea of internet-based therapy is not new, in fact it’s starting to blossom as a hot (albeit controversial) trend in therapy. Here are a few links:

http://www.asktheinternettherapist.com/
http://www.usatoday.com/news/health/2001-05-22-internet-therapy.htm

I can see some immediate advantages to SL-based therapy.

1. Users in need of Psychiatric care may sometimes be too intimidated or overwhelmed to seek the RL services they need. Talking to an SL therapist could be a healthy “baby step” in the right direction.
   
   
   
2. Users who spend a great deal of time in Second Life may find the comfortable and familiar setting more conducive for “opening up.”
   
   
   
3. Instant access to emergency psychiatric services could be more readily available in SL. For example, users dealing with the loss of a family member or contemplating suicide could be an IM away from a professional ready to help.
   
   
   
4. The anonymous, transformative nature of Second Life may attract people with specific kinds of mental conditions. This would make the platform an ideal place for specialists in certain psychiatric fields.
   

What do you folks think? Are liability and trust issues too daunting to make these kinds of services work in SL?

Do we even NEED psychiatric services in SL?

Discuss!

virtual reality based therapy is pretty common already, for example, helping people overcome a fear of heights, spiders, clowns, etc.

The first step to getting over these phobias is encountering your fears and getting comfortable with them in a virtual setting. It's supposedly quite effective, however IANAT.

But, yeah, actually, I think it would be an ideal usage of SecondLife.

Now, if only people would get over their fear of computers!

Privacy Concerns?

A meeting with a therapist is generally confidential, sort of like a Doctor's appointment. Then there is the issue of that therapist's credentials. For instance, lets say a person seeks out SL therapy because that person is suicidal, it is pretty important that it's not just some random guy with no experience or credentials who serves as their therapist. Then there is the expectation of privacy within a virtual world that has almost no privacy in it.

The privacy thing can probably be overcome now that I think about it.
A Locked down Virtual Island with an 'allow' list. And the only people on the allow list are those scheduled for appointments and staff. Not everything would be able to be within SL though. There are a lot of tests (Beck's Depression Index, etc...) that could be emailed to the client, the client fills them out and sends them back in via email so they can be scored.

Now that I think about it, yes, it could work. But the therapists providing the services shouldn't be like mentors or volunteers or anything. They should be licensed counselors.

Jessica

Absolutely!

Blaze, also great points I hadn't thought of. Model jetliners could be constructed with "takeoff and landing" scenarios scripted to help people with fear of flight. I am thinking all realistic sound effect, etc.

I was also thinking about how SL already seems to be a theraputic tool for gender dysphoria. It would be great to have a therapists go hand in hand with the user experience.

Actually, a few people tried this. Not sure how successful they were.


But.

When it comes to subjects like this, I think the key is for both parties keep an open mind. Discussing law is very different than diagnosing a person.


That said, there's also a problem of honesty. While I personally dislike Psychiatrics, actually discussing the matter face-to-face is a big thing. Over the internet, there's a higher chance someone is just screwing with your head.


So. Legal matters in the virtual environment, sure. Medical concerns, on the other hand, should be extremely cautious in such a medium.




Edit: On the subject of extending a person's abilities, however, I agree. There are quite a few (famous) people in Second Life with autism that seem to be coping well using the world as their canvas.

Well. Care to comment, Torley? I know you're watching.

As a mental health proffessional in RL, i think this is a bad idea.
We rely on several ques to work with people... verbal, total, body language in RL, all missing in SL

So, in my proffessional opinion only quacks are going to offer psychiatric care in SL.

Here's another one. Don't you get tired of this Aimee? Are we going to have one of these every day? These are all about/inspired by the same individual, folks.

coco

There is no doubt about it... for those in need of therapy NOTHING compares to face-to-face, long term (years) commitment to treatment.

I guess I am wondering if Second Life can be used as:

A. an alternative to those who need psychiatric care who will never ever bring themselves into RL therapy.
B. Preliminary treatment ("OK, I believe these are the issues you need to overcome, and here is a therapist I would recommend in your area"
C. Emergency care, much like suicide hotlines.

I am also not ready to dismiss Blaze's suggestion that SL could be used to create settings that will allow patients to overcome phobias.

Nice assumption cocoa, but probably wrong in this case. Aren't you an alt? Oh yeah, we don't like negative assumptions do we?

What about phone consultations? These occur very frequently in a therapist setting. In fact, there are therapists that only deal with patients over the phone. Your missing all of the non verbal components of communication over the telephone, but these services do work to help clients.

While there is probably nothing better than a face-to-face meeting with a therapist, it is certainly a viable alternative. It is a commonly recognized problem within the counseling field that many people who need therapy *will not* go to a face-to-face meeting. Generally telephone-based therapists can provide an intermediate step between doing nothing about a problem and a face-to-face meeting with a therapist.

I can see an SL-based therapist as being the equivalent.

Maybe psychological counselling. Psychiatric care, I don't know, that sounds like a bad idea to me.

I think the opportunities for anonyminity that you can't have in the RW would make privacy concerns less of an issue in SL rather than more.

No one is going to see you come in / out of a doctor's office either.

Come on, Forsetti. I follow things, and I know you do, too. This makes three threads in a row exploring thoughts Aimee has had regarding a particular individual.

The first one was two days ago, and was about enemies. Now that was kinda iffy, admittedly, though one could make a few educated guesses.

The second was yesterday, and was about public figures. No question there.

Today's is about people supposedly needing psychiatric help.

I know what all this is about, and I really don't care that you - and six or seven others - expect me to go along with the game and pretend it's not, and discuss this individual while pretending not to discuss this individual.

I don't like it, and that is my opinion, which I get to say here.

I say, if someone has a problem with a particular individual, they should take it to that person's blog or to their own blog, where they can discuss it. Straight-forwardly. Even if it means putting back comments limited only to accepted people on that blog.

Disagree with my opinion all you want, AR me all you want, but there it is. I don't like these little games. At all.

coco

Edited to add: I may have my Forseti's mixed up.

You know, I'm getting more and more convinced every day that Amy Weebler is actually our good friend Prok.

I think it was missworded.

I think the original intent was for therapy / counseling services.

Psychiatric care can't be done online. It involves hospitals, drugs, needles and things.

My real life partner is a psychologist, with over 24 years working with the chronically mentally ill for our state department of health and welfare. So, i do know a little about the pitfalls of trying to provide therapy if you are not imminently qualified and have a controlled setting.
Now, for "counselling", friendship, helping with the fluff stuff, sure it could work. but serious mental illness is nothing to take or treat lightly...and shouldn't be attempted by anyone who is not both licensed in the state they reside in, (and the patient resides in) and willing to take the risks involved, "professional liability" insurance comes to mind. I work in insurance, and i know our company wouldnt touch the exposure presented by this sort of endeavor.

Just my own 2 cents worth.

You guys are all nuts.

Given that e-mail sessions and IM's with therapist have been considered by scientific studies to be "as good as the real thing" I thing therapy in SL is overdue and yes should be practiced by licenced people only.

With that said, a lot of RL info should be exchanged as the therapist-client relation should NOT be anonymous.

Other things that could be made available is subject matter to be read.

As far as suicide, there are two areas to protect... the lives of those who are suicidal, and the doctors right to forgo responsibility. (and possible a third area of LL)

I really don't think they should sue Blizzard when a kid plays EQ then commits suicide... I do belive the bowling alley got no repremand when the colubine kids went nuts.

Mind you, I'm speaking as a person who has been suicidal from time to time. Commiting suicide isn't anything someone "makes" you do (well save for the hale-bob kids but I digress).

If you feel suicidal, you call 911.. period. Feeling suicidal is not a time for therapy, it's a time to cope how you can and call the hospital if you can't. Therapy can increase your ability to cope (so can reducing the real stessors in your life but hey I'm not a therapist).

Anyone who is going to offer therapy, it is usually (and should) be done under the disclaimer of "if you feel like killing yourself don't come to me, call the hospital". A message like that is on most therapists answering machines or help lines.

This isn't to be confused with "reverse suicidal tendencies" which is when you wish everyone ELSE would just kill themselves. (only happens to me in the WA)

I'd hate to see people killing themselves though due to improper monitoring of a patient, and I'd hate to see doctors or LL sued over a rightious suicidal case who feels they want to "make everyone pay".

I have my own personal therapy where I just yell "STOP IT" at people.... but again I'm not licensed.

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A good start would be maybe very private group counseling.

So from some of the more serious posts, I am getting the feeling that SL could be used in two ways:

1. Counseling for milder issues, and perhaps preliminary counseling before real psychiatric care is sought.

2. As an immersive 3D environment that could be used hand-in-hand with RL therapy.

I would imagine that a person with a phobia, sitting at a computer alongside a therapist, might be able to overcome certain fears. I think SL could be a tool a therapist might use, perhaps - but probably not one therapists would use for patients not actually in the room with them.

Yes, a telephone consultation, can operate as a stop gap, but as viable long term therapy, it is a lame duck. On the phone though, a therapist can hear tone, pick up on thinngs in the voice, as well as what is being said.... SL is one step further removed, and therefore less use in gauging a clients situation, and frame of mind..... also, communication between all health care proffesionals in a multidisciplinary approach is vital, for conistency, and continuity of care.

So sorry as far as im concerned as an area for real psychiatric work, Second Life is not viable.

Of course if a friend had a problem they wished to discuss, i WOULD offer advice, but not without talking in voice on another chat client, and also explicitly stating 1) the advice is entirely unnoficial, and 2) they should seek the help of health and/or mental health proffessionals face to face in RL

As someone who is metally ill I disagree (can hear the "I knew it!"'s now). SL now provides more and more subtle feedback and truely commiting (pun intended) patients can help communicate as much as they can.

I've been stuck at home with agoraphobia and having access to a therapist via just IM or phone is not available due to the fear that "I might go wacko and they are too far to help me".

No I'm going to go wacko cause I can't get any help. Mental services is a freaking joke 10 times worse than the failing Medical industry.

Get your services every place you can and not just where you deem best. Do physchiatrists and phycologists have to take they hypocratic oath?

Get people to sign and hardcore 'you can't sue if you kill yourself, nor can your family' and get some help to those who need it. If not in SL, voluteer somewhere in RL.

Blueman, im not saying people cant get support through SL, youre agoraphibic, and SL provides you with a chance for social interaction, the same as for many individuals isolated socially for various reasons, however this thread isnt about the support friends online can give you, its about people acting as counsellors within SL, an entirely different matter.
In no way am i saying SL (or any medium which promotes social interaction) doesnt have potential psychological benefits, but as far formal counselling goes (no doubt with attendant fees) its not a viable arena, sorry.

I wouldn't say 'Milder Issues'

Psychiatrists are the actual guys that push psychiatric drugs, work on the psych wards at hospitals, work in mental insitutions, that sort of thing. They deal with Severe Schizophrenia, Unregulated Multiple Personality Disorder, Violent Psychotic Episodes, the really, really severe cases that require hospital time, supervision, and prescription medication.

Counseling and Therapists deal with mental issues that are not so... life threatening? severe? I wouldn't go so far as to say, 'milder' though.

I can see that virtual counseling would be missing a lot of the tools that you can use in RL with a more complete human connection, but hey, if it helps people open up and solve their problems, I'm all for it.


[p.s. cocoa, don't want to derail this further. I can understand why you have the impression you have, but I truly think you are off-base here. There is a valid discussion to be had here. And I'm not going to AR you, silly.]