Harnessing Technology
Feature Articles - Research/Scientific
Thursday, 31 January 2002

Editor’s note: Counselor, The Magazine for Addiction Professionals does not endorse the web sites referenced in this article. These sites have been chosen by the author simply as helpful references for the counselor.

Many counselors are overwhelmed and avoidant of the wonderful opportunities the Internet and technology present. This article is designed to assist you in learning the basics so that you will no longer be “cyber phobic,” and will be able to develop a “cyber practice,” utilizing Internet technology to enhance traditional practice and services lines. This includes the integration of e-mail, listservs, web pages, chatroom technology, search engines, and other interactive web-based technologies that will enable you to:

1. communicate with colleagues, patients, and clients,
2. gather and disseminate information related to practice issues,
3. engage in social, political, and professional advocacy,
4. facilitate research,
5. market your practice and services,
6. develop and enhance your professional community,
7. enhance your professional competency through online distance education,
8. and develop your networking capacity.

Let’s begin with the basics.

E-mail
Many practitioners, agencies, and nonprofit organizations are using e-mail to communicate both “in house” and with external stakeholders (customers and clients). If you are working in an agency your computer system is probably “networked,” meaning that your e-mail system is designed to communicate with others within the agency. Many networked agency systems either do not allow you to send e-mail to individuals outside the networked system, or may not allow Internet web browsing. If your networked system does allow these other features all the better! Check with the MIS (management information systems) person in your agency if you are not sure. If you have external e-mail capabilities, or if you are a private practitioner, you can have free e-mail services. Some of the most popular e-mail services are Hotmail at http://www.hotmail.com, Yahoo at http://www.yahoo.com, and Juno at http://www.juno.com.

Listservs
Listservs are an excellent way of communicating with groups of people at one time. Listservs require individuals to “join the list” as members. Once you have joined the specific listserv you will be able to send and receive e-mails to and from the list. A note of caution (from experience): when you are responding to an e-mail message “from the list” you are sending your response to all of the members of the listserv at one time. Listservs are not used for individual responses to individual members, only to all listserv members at once. A listserv “thread” is a series of listserv e-mails concerning a specific topic. Usually the topic heading is listed in the e-mail message as the subject. Most of the national professional organizations have a listserv for members. Note than some listservs will say “announce only” when you join. This means the organization or listserv moderator does not allow return comments from you to the listserv messages. This type of listserv is generally used by the administration of the organization to send organizational announcements, legislative alerts, etc., to members. If you want to explore listservs further go to Yahoo Groups at http://www.yahoogroups.com. These are free listserv management programs on the Internet. You can even start your own listserv. I manage twelve listservs, and am a member of two more. It’s a great way to develop a sense of community.

Chatrooms
Chatrooms can be fun as well as educational, and a great way to communicate with colleagues and clients. There are two methods of communication in chatrooms, depending on the chatroom software program: Synchronous (in real time) and Asynchronous (delayed time usually of a few seconds). A chatroom is a designated place in “cyberspace” where individuals gather to communicate around a specific topic, not unlike a room full of people anywhere. Some chatrooms are limited to members of a specific group and some are open chats available to anyone. I am the chat host, affectionately (sometimes) known as Host WPLC EDSW, of the national clinical social work chat provided by the Social Work Forum on America Online on Tuesday evenings from 9-10 p.m. The AOL social work forum is a community of social workers with a membership of over 1,000 at any given time. Unfortunately, only AOL members have access to the chatrooms. If you are an AOL member, you can get to the Social Work Forum by typing in the keyword: social work. If you are not an AOL member, don’t despair! There are a number of Internet chats available to you for free. Here are a list of some chatrooms available to those interested in mental health: Behavior Online Chat Events at http://behavior.net/chatevents/index.html; The Counseling Zone at http://www.counselingzone.com; The Child Welfare Chatroom at http://hadm.sph.sc.edu/Students/KBelew/chatroom.htm; and Virtual Meetings at http://hometown.aol.com/behavioralscicon/virtualmeeting.html. You can also create your own chatroom for free and invite your colleagues or clients, by going to Beseen at http://www.beseen.com and downloading the chat software.

Search engines
The Internet has millions of web sites and it would be impossible to find what you’re looking for without some direction. Search engines provide that direction for you. There are general search engines such as: Yahoo at http://www.yahoo.com or Infoseek at http://infoseek.go.com. There also are specific search engines on mental health topics such as: Dr. Grohol’s Psych Central at http://psychcentral.com/resources, Grassroots Social Science Search at http://www.andrews.edu/SOWK/grassroots.htm, and Socialwork research at http://www.socialworksearch.com. When using a search engine be specific! You can usually type a phrase within quotation marks such as “mental health,” or single topics such as psychopathology. You can also usually broaden or narrow your search by using “and, or.” For example, “mental health” and psychopathology, or mental health or psychopathology.

Online counseling
This is one of the hottest debates in the mental health field at present time. The development and practice of online or WebCounseling is happening at this very moment. There are a number of clinicians from a variety of mental health disciplines providing online counseling through a variety of Internet technologies. The issues at the heart of this debate are confidentiality, licensure, insurance reimbursement, and ethical practice. Let’s begin by looking at ethical practice standards. The National Board of Certified Counselors (NBCC) has developed the most thorough standards concerning ethical web-based counseling. These standards can be viewed on: NBCC at http://www.nbcc.org/ethics/wcstandards.htm. The American Psychological Association has also developed ethical guidelines for the use of the telephone, teleconferencing, and the Internet. This information can be found at http://www.apa.org/ethics/stmnt01.html.

Some Internet mental health and health practitioner organizations have emerged that have developed their own code of ethics concerning Internet-based services. These can be found at: The Health on the Net Foundation on http://www.hon.ch/HONcode/Conduct. html and The International Society for Mental Health Online at http://www.ismho.org. Some ethical guidelines and discussion concerning web counseling can also be found on: Metanoia at http://www.metanoia.org/imhs/isittx.htm. As the debates and discussion continue, many clinicians are practicing web counseling. The following sites are representative of this practice. I do not personally endorse these sites or practitioners. Most of these practitioners use either e-mail, or a combination of e-mail and chatrooms to provide services. These sites are simply used as examples: Online Clinics on http://www.onlineclinics.com, Headworks at http://www.headworks.com/mail1.htm, and Behavioral Science Associates at http://hometown.aol.com/egeratylsw/BSA.html. There is even a Who’s Who listing of Internet therapists that can be found at: Who’s Who in Mental Health on the Web at http://idealist.com/wwmhw/profiles/view.html. I provide online counseling to clients whom I have seen in person at least once and who do not exhibit suicidality or other seriously self-destructive behaviors. Primarily I use this means of counseling for individuals who are housebound due to medical illness, or who are away temporarily at college, work assignments, etc. These services are not reimbursable at this time. My online services can include e-mail and the creation of a private chatroom on America Online for AOL members. It is possible for non-AOL members to download AOL Instant Messenger at http://www.aol.com/aim/about.html for free and then the individual is able to chat online in an Instant Message with me.

Online consulting
Online consulting, or online coaching, is a simple procedure in that the client or client organization communicates with the consultant either through e-mail or in a chatroom (previously described). I have found this method to be extremely effective when working with organizations out-of-state, or with executives who are too busy to leave their workplace and come to my consulting office. It is quite easy to e-mail documents in Word format, edit, and revise written plans, etc. Furthermore, there is always a written and printable dialogue if you save your e-mails and Word documents. I frequently use my conference room on my Behavioral Science Consultants web site, or an AOL private chatroom, to have “real time” meetings with clients. You can view my chatroom, Behavioral Science Consultants at http://beseen3.looksmart.com/chat/rooms/j/11070. Another option is to create a web-based virtual office (an Intranet) using a free service like Intranets at http://www.intranets.com. This site can also be used for associations. Here you are able to upload and download documents for all to share.

Associations
Professional mental health and health practitioners usually belong to their respective professional associations and sometimes we may feel separate from our professional organizations. The Internet is a great way to feel connected again. All of the mental health professional associations are represented on the Internet, and most of the association web sites are quite interactive; including professional news, listservs, chats, e-mail addresses, and links of interest. You can view some of those sites: The National Association of Alcoholism and Drug Abuse Counselors at http://www.naadac.org, The Clinical Social Work Federation at http://www.cswf.org, The National Association of Social Workers at http://www.naswdc.org, The International Employee Assistance Professionals Association at http://eap-association.org, The American Psychological Association at http://www.apa.org, The National Board for Certified Counselors at http://www.nbcc.org, The American Association of Marriage and Family Therapy at http://www.aamft.org, The American Counseling Association at http://%20www.counseling.org/, The American Psychiatric Association at http://www.psych.org/main.html, and The American Psychiatric Nurses Association at http://www.apna.org.

Advocacy
My favorite Internet activity is online political and social advocacy. As is the case in the “real time” world, there is a web site for just about every political, religious, professional, and social “special interest” group. It is interesting to note that recent demographic research has indicated that most of the “powers that be” are more responsive to e-mails and online petitions than they might be to “snail mail” (letters) and telephone calls. This makes sense in that most individuals with Internet access are upper-middle class, educated, and politically active. These demographics unfortunately reveal that the poor and disenfranchised do not yet have this service available. All the more reason to advocate on the Internet for them! A simple search on your Internet browser concerning your interest area will usually reveal numerous sites to explore. Here are some that I use frequently: The Family Preservation and Child Welfare Network at http://www.familypreservation.com, The Volunteer E-Advocacy Page at http://www.serviceleader.org/vv/activist.html, and The Interactive Town Hall, E-The People at http://www.e-thepeople.com. Homelessness advocates can advocate on the National Coalition for the Homeless at http://nch.ari.net. You can create online polls on Netvote at http://www.netvotes.com. In addition, most of the professional organizations listed earlier have an online advocacy section.

Research
Depending on your research topic, you may be able to simply type the topic in your Internet browser and be linked to hundreds of web sites related to information on your topic. In addition, the search engines mentioned earlier will lead you to many sources. Most state, local, and university libraries have some type of online search capabilities. Some specific research sites are: Because-Mental Health Matters at http://www.mental-health-matters.com and The National Institute of Mental Health Online Research Reports at http://www.nimh.nih.gov/research/reportmenu.cfm.

Marketing
The Internet provides you the opportunity to market your services to virtually millions of people. But first you must create a “web presence.” As with most communities, it is necessary to let others know you exist, and to participate in the community in which you work or reside. The Internet community is no different. If you say you live in Madison, Wisconsin but you had no house or apartment there, no mailing address, no telephone number, and no one ever saw you there, would anyone believe you lived in Madison, Wisconsin? To dwell in cyberspace you must establish a residence. A web site is that dwelling, the presence that lets others in the Internet community know you reside and participate there. Also, just like renting or buying a house in your “real time” community, the type of “residence” in which you reside in your Internet community depends on what size “dwelling” you can afford. Building your web site can be cheap or expensive. Again, it depends on what kind of presence you want to create on the Net. Just like building a house, you can either build it yourself or contract with a builder who does this for a living (web site developer). It can be a simple “dwelling” or a complex one. To build your own web site you must have (or gain) some degree of building experience. This takes time and money. You can certainly gain that experience through the numerous web design courses offered locally or nationally. I have learned web design myself using the AOL Press web-building program on America Online. Your local computer store can provide you with web site development software such as FrontPage Express. Many people find it less time consuming to simply hire a web site builder, particularly if you want a complex site. Most web site builders have both a great deal of education and experience in this process. In addition to designing your site the web site builder can maintain your site for you, submit your site to search engines, and increase the size of your site as your web presence grows. Once your web site is “on the Web” you will need to determine if you want your site to be simply informational (less complex) or interactive (more complex). Some ways to indirectly market the services offered on your web site is to create a listserv and/or chatroom and add it to your web site. As I mentioned earlier, on my web site I have added a chatroom and also have a listserv for those interested in organizational development issues. You can view this listserv by going to http://groups.yahoo.com/group/OrganizDev, which is attached as a link under organizational development resources on the BSC web site. Obviously you also need to have your e-mail address on your web site so individuals will know how to contact you about the services you offer. To provide a more interactive environment you can attach a chatroom to your web site as I mentioned earlier. The benefits of a chatroom on your site are that you can communicate more directly with those viewing your site, and you have the opportunity to create an ongoing community of “chatters” who visit your site regularly. The potential drawback of a chatroom on your site is that you need to be online regularly and facilitate the chat. You would need to decide the amount of time that you are able to commit to being online regularly at specific times. You can also develop an online newsletter and attach it to your web site. You can view an example of Intersector, the online newsletter of BSC, at http://hometown.aol.com/BehavioralsciCon/Page5.html. You can also provide free web exposure to individuals as a community service on your web site, or offer free information, assessments, etc. Your web site needs to be sent to search engines in order for people to find you on the Web, unless you have given your web address to those specific people. If you want a lot of “hits” (Internet surfers viewing your site) you will need search engine assistance. (See the previous section on search engines.)

More direct marketing strategies include: buying advertising space on search engines and other web pages, asking other web sites to provide a reciprocal link from their site to yours after you have provided a link to their page on your site, purchasing a listing on pages designed to advertise your specific type of service, and paying for e-mail mass marketing services. E-mail mass marketing services can reach millions of individuals in a matter of seconds. However, like direct mail bulk advertising, many people find it offensive to receive information that they have not requested in their online mailbox, and generally delete it immediately and angrily without reading it. If all of this sounds too difficult to do yourself, you can join one of the free online mental health office sites like ISyke at http://www.isyke.com.

Distance education
Another issue that brings up quite a bit of debate in professional mental health services is the validity and efficacy of Internet-based distance education. Distance education can be subdivided into three categories:

1. distance education leading to graduate and postgraduate degrees,
2. continuing professional education,
3. and in-service/staff education and training within organizations. Let’s briefly review each of these:

Degree education
Colleges and universities (both accredited and non-accredited) are increasingly offering all levels of education, either partially or completely, over the Internet. Some examples of accredited graduate degree programs offering courses over the Internet are: The Fielding Institute PhD in Clinical Psychology at http://www.fielding.edu/psy/index.htm, The Athabasca University Graduate Program in Nursing at http://www.athabascau.ca/htm/programs/grad/agd_nurs.htm, and The Indiana University School of Education Masters in Counseling at http://www.indiana.edu/~educ/disted.html. You can also view a more complete listing of graduate schools (both accredited and non-accredited) on Distance Learning Graduate School Programs, at http://distance.gradschools.com.

Continuing professional education
There are many online continuing education programs. The major issue is whether or not your respective state examiners board will accept the particular continuing education course. Always be sure to check with your state board concerning any online course. Some examples are CE City at http://www.cecity.com, and CME on the Web at http://www.cmeweb.com. Two CE courses created for social workers through the Maryland chapter of the National Association of Social Workers are Counseling Clients with AIDS at http://www.blackboard.com/courses/SW102, and A Review of the NASW Code of Ethics at http://www.blackboard.com/courses/SW103. Since it can be rather difficult to find continuing education online, I have created on online continuing education clearinghouse web site called CE-Online at http://hometown.aol.com/egeratylsw/CE-ONLINE.html.

Staff training/in-service education
Many agencies and organizations find it is more cost/time effective to provide staff training and development courses “in-house” using Internet education programs. These courses are designed for the individual organization based on staff education needs. Organizations can put their policies, personnel manuals, and employee handbooks online and have their staff complete the training and take a competency test to determine mastery of the content.
To learn more about distance education course development go to http://hometown.aol.com/egeratylsw/Internet.html. Some additional resources you may find helpful are the Free Nonprofit Management Library at http://www.mapnp.org/library/index.html, Professional Ethics resource page at http://hometown.aol.com/egeratylsw/ethics.html, DELTA-T temporary mental health staffing jobs at http://delta-tgroup.com/main.htm, and Human Services jobs at http://www.hspeople.com. For those of you interested in risk management issues check out At Health.com’s risk management page at http://www.athealth.com/Practitioner/Newsletter/FPN_4_33.html, and spend some time cyber networking at Shrinks Online at http://www.shrinksonline.com. The mental health profession is just beginning to harness the power of the Internet, and with new Internet applications being developed daily we have only begun to realize the advantages of an enhanced practice through the integration of Internet technology and mental health practice. Now that you have the basics down, I will see you in Cyber Space. Feel free to e-mail me at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

Ed Geraty, LCSW-C, CCDC, is a licensed clinical social worker and Maryland certified chemical dependency counselor with a private clinical practice and organizational development consulting practice in Baltimore, Maryland. He has presented internationally on topics related to the integration of Internet-mediated communications technology and mental health practice. He is the chat host of the national clinical social work chat on America Online, and provides Internet consulting and distance education course development for associations and organizations.
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