Page 1

volume 2, Issue four Spring 2012

Cyberspace as Culture

A New Paradigm for Therapists and Coaches PAGE 24

Advancing Lives Through the Science Virtual Reality PAGE 11

The Social Media Coach PAGE 45


Legal Briefs, Cybersupervision, Marketing Toolbox and much, much more...

TILT - Therapeutic Innovations in Light of Technology TILT is the magazine of the Online Therapy Institute, a free publication published four times a year online at ISSN 2156-5619 Volume 2, Issue 4, SPring 2012 TILT Magazine Staff Managing Editors Kate Anthony & DeeAnna Merz Nagel Magazine Distribution Coordinator Sophia Zollman Magazine Design and Layout Delaine Ulmer Associate Editor for Research Stephen Goss Associate Editor for Innovations Samantha Murphy Associate Editor for Supervision Anne Stokes Associate Editor for Marketing and Practice Building Susan Giurleo Associate Editor for Film and Culture Jean-Anne Sutherland Associate Editor for Coaching Lyle Labardee Advertising Policy The views expressed in TILT do not necessarily reflect those of the Online Therapy Institute, nor does TILT endorse any specific technology, company or device unless Verified by the Online Therapy Institute. If you are interested in advertising in TILT please, review our advertising specs and fees at Writer’s Guidelines If you have information or an idea for one of our regular columns, please email with the name of the column in the subject line (e.g. Reel Culture). If you are interested in submitting an article for publication please visit our writer’s guidelines at

TILT is about envisioning therapeutic interventions in a new way. While Kate was visiting DeeAnna on the Jersey Shore, they took a late afternoon boat ride and a display of sail boats tilting against the sunset came within view. It reminded them how, as helping professionals, we should always be willing to tilt our heads a bit to be able to envision which innovations – however seemingly unconventional – may fit our clients’ needs. Our clients are experiencing issues in new ways in light of the presence of technology in their lives. As helping professionals, so are we. TILT and the Online Therapy Institute is about embracing the changes technology brings to the profession, keeping you informed and aware of those developments, and entertaining you along the way.

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Features 11 Advancing Lives Through the Science of Virtual Reality

24 Cyberspace as Culture A New Paradigm for Therapists and Coaches

45 The Social Media Coach

Issue in every


News from the CyberStreet

16 Research Review 20 What Would You Do?! 22 Wired to Worry 36 Reel Culture 38 Legal Briefs 40 Technology Enhanced Coaching 52 A Day in the Life: Therapist 55 A Day in the Life: Coach 58 CyberSupervision 62 New Innovations 64 Marketing Toolbox

66 For the Love of Books 68 Advertiser’s CyberMarket

A Note from the Managing Editors… Welcome, or welcome back, to TILT – Therapeutic Innovations in Light of Technology. We are pleased to offer you a discussion piece about the concept of Cyberspace being a culture in and of itself, written transatlantically via GoogleChat/emails passing back and forth between us as we brainstormed the concept of what would be different in our lives and professional work if we let go of Cyberspace as a “communications channel” and started treating it as a culture in its own right. It is a concept both of us have touched on before – in kate anthony & deeanna merz nagel with the blogs, articles, books and media – but it takes time (and online therapy institute in second life teamwork together and with our colleagues worldwide!) for the seeds of our thoughts to come together as a definitive argument. We welcome all thoughts and opinions about what the article means to you, and how recognizing the invisibly diverse – those who are different from you because of their use of Cyberspace means having a different culture – is going to affect the profession in the future. Always looking for new and innovative ways to fuel our brains, we leant on the art world for this creative thinking, with the Institute supporting an art project about online connectivity, and we are pleased that the artist herself – Gretta Louw – has been so generous in allowing us to reproduce some of the illustration from the project for our readers. We are also pleased to share the essential results of Lynn Wernham’s recent research “to investigate the extent to which social media tools and materials are currently being used by internal or external coaches to support face-to-face coaching in a public, private or voluntary organisational context.” This important study opens up the real state-of-play regarding what is actually happening out there in Cyberspace for the Coach community, and helps formulate recommendations for ways in which social media tools and materials could be used to support face-to-face coaching. She addresses both the possible positive and negative aspects of taking this route within coaching clients. Tandra Allen discusses her important work with the Center for BrainHealth in Texas, and of research aimed at developing an intervention with experiential practice of real life scenarios utilizing a Virtual Reality environment designed to influence and facilitate social change in individuals, particularly those on the Autistic spectrum. Not only did participants improve their social skills within the virtual environment, the researchers found that “follow-up results after treatment indicated the participants personally felt improved in how they interacted with others, which suggests the VR social training positively impacted their daily lives”. We look forward to seeing how this work can be taken forward to further treat Autism and the wider field of those clients looking to improve social expertise. Our aim continues, issue by issue, to keep you up-to-date with developments in innovations in service delivery. In this issue, you may see a few changes - as we grow and mature as a learning institute, we are shifting our News from the Cyberstreet column to reflect news about new courses and opportunities from Online Coach Institute and Online Therapy Institute. Our news will be about what is new and noteworthy at the Institutes as well as with our Verified Members and Certificate Trainees. All our other regular columnists are here, with useful and entertaining comment on coaching; research; marketing; legalities; film culture; innovations; and CyberSupervision. There’s a new Ethical Dilemma for you to consider and to post responses at our social network forums for publication in the fifth issue of Volume 2 (Issue 11). Our featured “Day in Life” therapist and coach are Tandra Allen and Lyn Kelley respectively – we hope you find it as interesting to hear about their work as we do. And of course there is a good dose of humour from our resident cartoonist, Christine Korol. We hope you enjoy this issue, whatever professional world you inhabit. J

Managing Editors

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NEWS CyberStreet

TILT – Therapeutic Innovations in Light of Technology

from the


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Through partnerships with and, we now offer a Field Placement course for Therapists and Coaches! See these two courses that will give you the field experience you need and a marketing strategy that works!

INSTITUTE NEWS! Look who has become verified!

Giving Back- The Ethics of Pro Bono and Sliding Scale Services for Online Therapists and Coaches Field Placement for Online Therapists and Coaches

Just One Small Step

We have two new book courses available! Read the book and receive Continuing Education credit!

Cognitive Behavioural Coaching Works!

Therapy Online: A Practical Guide


Use of Technology in Mental Health: Applications, Ethics & Practice

Grow Training Institute ILT Solutions Institute for Life Coach Training Mootu Thomas A. Merz Behavioral Health Innovation Click here for more information about becoming Verified

News from the Training Room! We have 2 new exciting add-ons to all our training courses! 99 All trainees receive a free subscription to our encrypted Consultation and Business Forum! 99 All OTI trainees receive a free copy of Online Therapy Institute’s Quick Start Guide! (Online Coach Institute’s Quick Start Guide coming soon!)

Are you interested in becoming a Certified Coach? Two new BCC training providers are in your midst! Online Coach Institute in partnership with Grow Institute now offers the Certified Professional Coach (CPC) credential! If you are interested in becoming a coach, consider the CPC credential! OCI is working to promote the CPC outside of the US to the benefit of our international trainees! And since OCI and GROW are also Board Certified Coach (BCC) Course Providers through the Center for Credentialing and Education (CCE) your CPC credential automatically qualifies you for the BCC! GROW and OCI share faculty and that means you have a choice about your course delivery AND your coach certification! The following courses can be delivered to you

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TILT – Therapeutic Innovations in Light of Technology

through GROW via home study or through OCI via online learning! • How to Become a Personal/Life Coach Utilizing “Success Motivation Coaching”™ • Ethical Issues for Therapist-Coaches • Promote Your Practice Exclusively to a WellPay, Fee-for-Service Clientele: Ethical and Professional Methods of Promoting Your Practice and Improving Client Services within your Local Community

Kate Anthony is facilitating a workshop in London on May 23rd through the Association for Coaching: “Online Coaching: Applications, Ethics and Practice” For details check out http:// association-for-coaching-presents-dr-kateanthony-online-coaching

• How to Become a Corporate/Business Coach

DeeAnna is facilitating a Distance Credentialed Counselor training in Oregon on June 22/23rd through ReadyMinds. For details check out http:// or email

• How to Become a Virtual Coach: Coach by Phone or Internet

Coming soon: Avatar Therapy Certificate

Contact Online Coach Institute 877.773.5591 OR GROW Training Institute 888.700.4769

In other training news... Kate and DeeAnna of Online Coach Institute are teaching their Introduction to Online Coaching course at the Institute for Life Coach Training (ILCT). ILCT is a Verified member of Online Coach Institute and a Board Certified Coach (BCC) Provider. For details check out http://onlinetherapyinstitute. tion-to - online coaching For more information contact Ellen at 8

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OPEN OFFICE HOURS Join us each month for our Open Office Hour and ask your questions about online therapy and online coaching! Upcoming Open Office Hour Dates! Time is 2pm EST/7pm GMT 24th May 14th June 5th July 16th Aug 20th Sep

Sign up here: http://

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MedForward Offers HIPAA-Secure Online Form Submission to the Medical and Mental Health Professions To see previous Press Releases see http://www.

Recent Graduates Congratulations to Eve Russell, who recently gained the Online Therapy Institute's Specialist Certificate in the Therapeutic Use of Technology!

Media News Kate Anthony and DeeAnna Nagel wrote an article for the inaugural issue of Coaching Today – Brave New World. Online Therapy Institute and DeeAnna Nagel were featured in the March issue of the APA Monitor and the issue had three articles related to mental health and technology: monitor/2012/03/index.aspx Online Therapy Institute was featured in the May issue of Women’s Health Magazine. Kate and DeeAnna were interviewed for the newsletter of the IAC, VOICE, regarding their experience of the IAC Masteries process, and we invite all IAC members to join us at our Discussion Forum!

SOCIAL MEDIA We have many social media outlets for you to find out the latest news! You can join our Linkedin Groups Online Therapy Institute Online Coach Institute Like us on Facebook Online Therapy Institute Online Coach Institute Follow us on Twitter @TherapyOnline @KateAnthony @onlinecoachtech @TILTmag

Press Releases Offers a Virtual Platform for Mental Health Professionals Who Seek to Manage Their Practices and Deliver Counseling Online

Join our own social network where membership is free!

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TILT – Therapeutic Innovations in Light of Technology


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s e v i L g n i c n a Adv f o e c n e i c S e h t through

l a u Virt y t i l Rea BY TANDRA ALLEN

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TILT – Therapeutic Innovations in Light of Technology

FIGURE 1. Therapist and Participant Avatars in SecondLife

Imagine walking into a room paralyzed with fear to talk with someone. For Stacey, a young woman on the autism spectrum, that is a fear she faces every day. As a college student, Stacey attends her classes and returns home right after – never talking with anyone or making friends. She is too afraid to try and does not know what to say to start a conversation. For years, she has tried various social training groups, but still has never felt comfortable in social situations. Frustrated, anxious and alone, Stacey cannot make a connection with anyone.

enjoy being in social situations with others. It’s so hard for me to interact in a group of people – I just don’t understand what they’re thinking.” Those on the autism spectrum also have difficulty understanding social relationships, creating a social and emotional stall as teens enter youngadulthood and are forced to attempt independent living. As a result of their social struggles, most young adults with autism want to belong, but feel isolated limiting their contributions to society. Also concerning is the economic burden to the individual and society, which is becoming an ever present reality. Those on the autism spectrum often need to rely on others for financial support and have difficulty finding meaningful and lasting employment (Hendricks & Wehman, 2009).

The considerable fear and anxiety that those with autism experience in starting conversations is not the only core social cognition deficit. As John, a young man with autism, stated, “I wish I could

New evidence indicates that interpersonal skills such as learning how to read and convey emotions may be improved with explicit training in a motivating and visually stimulating way. Science has


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shown that social brain networks can change given appropriate and meaningful intensive training. To capitalize on the brain’s inherent plasticity, its ability to grow and change throughout our lifetime, researchers at the Center for BrainHealth in Dallas, TX have been on the forefront of research aimed at developing an intervention with experiential practice of real life scenarios utilizing a Virtual Reality (VR) environment designed to influence and facilitate social change in individuals. Young adults like John and Stacey are using this VR tool and learning, for the first time, how to attempt social situations that they would otherwise turn away from. The VR social training, unlike a traditional therapy approach that uses one-on-one social training or social skills groups, allows participants to use a flexible VR training environment aimed at improving their daily social interactions. In the Center’s recent research, Virtual Reality Social Cognition Training for Young Adults with High-Functioning Autism (Kandalaft et al., in press), therapists and participants utilize the online program SecondLife™ (Linden, 2003) to assume the role of an avatar and engage in social practice ¬(Figure 1) The study evaluated the VR platform on its ability to improve social skills, social cognition (the brain networks involved in social decision making) and daily functioning in autism. The integral difference of the VR social training at the Center is that the training capitalizes on how the brain learns new information. The brain benefits best from short and intensive practices that are purposeful and meaningful. In the recent study, the entire training consists of 10 one-hour sessions over a 5-week period, a relatively short amount of time compared to traditional therapies. The young adults, aged 18-26 diagnosed with highfunctioning autism, practice online conversations that target true-to-life social interactions such as starting a conversation, building friendships, interviewing for a job, negotiating, dealing with confrontation, and even dating. In each session,

participants, through the help of their own avatar, engage in non-scripted conversations with a confederate therapist to simulate a real-life situation (Figures 2,3,4). The social training also maximizes the strengths of VR technology including its ability to immerse the participants in a practice that allows them to feel the same emotions they would in a real conversation. It also exposes the participants to everyday situations in a number of flexible environments by transforming daily living struggles into a safe and effective practice that can decrease anxiety and increase confidence. As Stacey explained after one of her training sessions, “At first, I was so overwhelmed because I didn’t know what to say, but then I realized it’s okay to mess up in practice. I could remember what I learned in the virtual world and it became easy to try to talk to people at school.” With a big smile on her face she described how she now gets excited to meet her two new friends for a day of shopping – something that she never would have done before. For John, he never considered the science behind starting a conversation. He just knew he didn’t understand what people where thinking. Even though he had a part-time job at a retail store, he just kept to himself as a stocking clerk and tried not to interact with too many people, especially the customers. As a participant in the research study, John practiced interacting in real-world situations, like those at work, and attempted to “read” what someone else is thinking. After training, researchers could test if his understanding of others had really changed. In fact, practicing in this flexible environment did result in an improvement of underlying social cognitive skills for John and other participants in the study. In other words, the brain’s understanding of others in social situations was shown to improve after training in the VR environment. Social cognitive skills are essential to understanding what someone else is truly thinking or feeling. For T I L T M A G A Z I N E SP R I N G 2 0 1 2


TILT – Therapeutic Innovations in Light of Technology

FIGURE 2.Coffee Shop Setting

instance, it affects the way the brain interprets what someone is intending when they make a sarcastic statement, “Yeah, I’m great” but shows an incongruent disgust on their face. Knowing what someone is thinking or feeling allows us to make social judgments about how we respond. The researchers at the Center also investigated the change in real-life functioning after the VR training and found that social behaviors and conversational skills had improved. More importantly, follow-up results after treatment indicated the participants personally felt improved in how they interacted with others, which suggests the VR social training positively impacted their daily lives. Even John’s parents described the difference in their son after training. They noticed a distinct improvement in how John presented himself with self-assurance and made direct eye contact with others. The participant’s personal stories, like those from John and Stacey, described similar benefits from the VR training that gave them the assurance to meet new people and make new friends. Shortly after the sessions, John was happy to report he had been given a promotion from a behind the scenes stocking clerk to an upfront sales position. He described how providing customer service 14

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was something he now enjoys doing because he can anticipate what his customers want by their reactions. He stated, “I see for the first time what people are really saying just by picking up on cues I didn’t notice before.” Being able to learn through the VR social training how to interact with his customers gave him even further confidence to put his newly trained social adeptness to practice by pursuing a law degree. The key to the success of the VR social training is that it makes use of the benefits of science and technology. The sessions target practice of meaningful events in a low stakes environment. It affords the ability to mess-up and begin again, given guidance from a therapist. The VR platform yields the capacity to seamlessly change social situations and conversational partners while building the social networks of the brain. The VR also maximizes treatment over a relatively short amount of time. As John stated, “four or five sessions of virtual training is worth about two or three years of real world training.” Although there is need to further validate the effectiveness of VR social treatment, the early gains look quite promising to illustrate how technology can advance training the social networks of the

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FIGURE 3. Apartment Setting

brain. The potential impact of this virtual training has both social and economic implications. This type of intensive and dynamic social training provides hope for social success to hundreds of individuals with autism who typically do not have access to treatment. It also provides low-cost intervention to these young adults and gives them practical skills needed to connect to others as they so long to do. Additionally, the economic burden of on-going costly treatment or job-training services could be reduced through fast and efficient virtual training. Beyond the scope of autism, this type of virtual training method could be beneficial to a wide array of individuals looking to gain social expertise. From the executive looking to improve his social networking skills to the soldier returning home after deployment and looking to reengage into

FIGURE 4. Office Building Setting

civilian life, the combination of science and virtual technology training offers a new range of possibilities. For someone with autism, VR represents a door to their future, and for the first time they have to tools to approach with confidence instead of fear.


Tandra Allen is project coordinator at The Center for BrainHealth at the University of Texas at Dallas. Her work at the Center focuses on evaluating and treating social cognitive disorders in children and adults. She has over 9 years clinical experience as a speech-language pathologist working and residing within Dallas, Texas. Her work with the social cognition research study is featured on The Center for BrainHealth website:

REFERENCES Hendricks, D. R., Wehman, P., (2009). Transition from School to Adulthood for Youth With Autism Spectrum Disorders. Focus on Autism and Other Developmental Disabilities. 24(2): 77-88. Kandalaft, M.R, Didehbani, N., Krawczyk, D.C., Allen, T.T., Chapman, S.B., (in press). Virtual Reality Social Cognition Training for Young Adults with High-Functioning Autism. Journal of Autism and Developmental Disorders. Linden_Lab (2003). Second Life. [Software].

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TILT – Therapeutic Innovations in Light of Technology

Research Review

Good &

in Onlin

Does technology improve our lives or did the luddites get it right? Kairouz et al (2012) compared 8,456 people who

gamble offline with a representative sample of 111 people who indicated that they indulge in online gambling. Apart from being more often male, young and students, the online gamblers showed a greater tendency towards ‘excessive’ gambling, which co-varied with increased risky behaviours of other kinds – such as abuse of alcohol and cannabis. A tentative conclusion might be that, “those who gamble online appear to be more at risk for gambling-related problems” (p.175) but whether this represents high-risk gamblers choosing to do it online or that online gambling is itself inherently more risky is more difficult to say and further research is clearly warranted, as the authors note. Guillory and Hancock (2012) compared online and offline deception in résumés. 119 subjects were asked to create résumés in the traditional, offline way or online through LinkedIn in both public and private formats. Intriguingly, the overall levels of deception did not change, suggesting we are just


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as willing to lie no matter what the environment, or how public it may be. What did change, however, was what was lied about. The more public the résumé – that is, if it was publicly available through the LinkedIn system – the more it was likely to be accurate about the things a prospective employer is probably going to be most concerned about – like the person’s work history. That good news for employers was balanced, though, by an increased willingness to lie about things like social activities and hobbies. As the authors note, “the results stand in contrast to assumptions that Internet-based communication is more deceptive than traditional formats” (p. 135), suggesting instead that, for some purposes at least, an online presence may be a better indicator of a person than an offline one. Computer gaming, quite apart from gambling, seems to be only rarely problematic despite the well-known seemingly ‘addictive’ nature of some games. If even the British Prime Minister, David Cameron, has completed all the levels of “Angry Birds”, are we all in danger of being sucked in? It seems not, according to a study of a representative sample of over 900 people in The Netherlands, by Haagsma et al (2012). Only 1.3% of respondents showed identifiable problematic gaming behaviours, although that did rise to 3.3% among

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S t e p h e n G o ss

& Bad

ne Life adolescents and young adults, particularly young men. Meanwhile, virtual realities have long been a subject for psychological research with some encouraging findings (see previous editions of this column for examples). More reason to be optimistic about their potential in the mental health arena comes from a preliminary study by Hoch et al (2012), which found that traditional mind-body relaxation training methods can transfer well to virtual platforms such as Second Life, with every reason to expect that the concomitant improvements in well-being and the progress of chronic conditions, both mental and physical, known in offline application of the same intervention would accrue. Participants followed an in-world version of an existing 8 week course in relaxation and despite the small numbers involved in the study, showed significant improvements in global mental health and perceived stress levels. So the good and bad both exist, of course, and it is the use that counts perhaps more than the technology. Awareness of the positive opportunities balancing the awareness of potential negative impacts in the lives of our clients is a crucial must-have for therapists and coaches in the modern world, as even these few examples reveal. n

ABOUT THE AUTHOR Stephen Goss, Ph.D. is Principal Lecturer at the Metanoia Institute, and also an Independent Consultant in counselling, psychotherapy, research and therapeutic technology based in Scotland, UK (http://

REFERENCES Guillory, J. and Hancock, J.T. (2012) Cyberpsychology, Behavior, and Social Networking. March 2012, 15(3): 135-140. Haagsma, M.C., Pieterse, M.E. and Peters, O. (2012) Cyberpsychology, Behavior, and Social Networking. March 2012, 15(3): 162-168. Hoch, D.B., Watson, A.J., Linton, D.A., Bello, H.E., Senelly, M., Milik, M.T., Baim, M.A., Jethwani, K., Fricchione, G.L., Benson, H. and Kvedar, J.C. (2012) The Feasibility and Impact of Delivering a Mind-Body Intervention in a Virtual World. PLoS ONE. 7(3): e33843. Kairouz, S., Paradis, C. and Nadeau, L (2012) Cyberpsychology, Behavior, and Social Networking. March 2012, 15(3): 175-180.

Please send reports of research studies, planned, in progress or completed, to the TILT Editor at Subject line: Research Review.

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TILT – Therapeutic Innovations in Light of Technology

Research Call Katerina Terzi is a final year D.Psych in Counselling Psychology student at the University of Strathclyde/Glasgow Caledonian University and is conducting a research on the therapeutic relationship in online therapy. She is looking for therapists who have experience in providing online therapy and who would be willing to conduct a 30 minutes interview via skype or telephone.

Keeley Kolmes is looking for participants in a brief survey about what you — as a consumer — would be interested in finding on an online review website for mental health professionals. This survey will take just a few minutes to complete and will help her understand what people really want to see on such sites.

If you are interested in participating and want to learn more about the research and the questions you would, please, follow the link below or contact Katerina directly. CONTACT INFORMATION SHEET

SURVEY LINK therapistreviews CONTACT

The University of Iowa, Department of Rehabilitation and Counselor Education is conducting a research study on online peer group supervision. Participants in this study will complete a pre and post survey about the use of online groups in school counselor supervision and will be randomly assigned to one of the two study groups CONTACT Yi-Chun (Jean) Lin, primary investigator 319-400-033&


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Moira McLaughlin is currently researching telephone coaching as part of her MA in Coaching and Mentoring at Oxford Brookes University and is looking to interview executive coaches who use this medium for contracted coaching sessions. She is interested in gathering accounts of both successful and unsuccessful outcomes. The study will involve a 60 - 90 minute semi-structured interview and a 30-60 minute follow up to share her findings. Ideally, she is looking for participants based in London, UK or the South East of England as she is hoping to conduct at least the initial interviews in person, but further afield is not necessarily a problem. The timescale for the initial interviews is post Easter - middle of May. If you'd like to know more, or have any questions, please contact her directly at the link below. CONTACT

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TILT – Therapeutic Innovations in Light of Technology


You are a coach or therapist and you have been engaged with a client using indiv chat and support group discussion forum. This client was referred to you throu wellness center in your local community and your sessions have not utilized an aud video component.

Your client has requested an in-person session at your office. What concerns migh have about making this transition? What would do you?


e Perkin

Larry F. Saidman responds: " that the client The main concern is the "shock crepancy between might experience from the dis ked and sounded what he or she thought I loo the appointment like...and the reality. Before ht-hearted' way.... I'd address this in a fairly 'lig share what s/he maybe by asking the client to envision I look like, expects (i.e. what does s/he g some information talk like, etc.), or, by disclosin the client to disclose about myself. I'd also invite le with about what anything s/he feels comfortab that could reduce I might experience, as I think some anxiety. suggest one session Another option could be to ponent, if available. using an audio or video com valuable to invite In the group forum it may be k about their other group members to tal ebody 'in person' experiences with meeting som ly an on-line presence. after having experienced on


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s respon

ds: My thou ghts are that dis expecta cussing tio with the gain fro ns of a f2f mee cli t m it wo uld be a ing and what t ent, thei any tran h help ey are h sit op technic ion in delivery. ful first step in al platfo approac I would rm that hi do this to a face usin we h -to-face meeting ad been using g the sam their ex , before perienc . I would eo agr discuss to-face things s contact f the service cu uch a , wh rrently, longer-t their ho erm and ether the trans pes for ition is t whethe transitio o r we are n. both co be tempora mfortab I would le maki als informa o be taking int o consid tio eration permiss n relating to sa any bac fety con ion to h kground a cerns an ve a dis about th c d perha u e clients ssion w ps gaini it approp felt ove riatenes h the referring rly conc worker s for inerned. person Essentia contact lly, I wo if I uld con session tract for would b the tr eu in-perso n meetin sed for and ma ansition and w hat the ke sure g my offic I felt saf e before especially if th e with an ere are agreein minors g to the attendin change g .

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vidual ugh a dio or

In each issue of TILT we shall be presenting an ethical dilemma about a Web 2.0 experience and other ethical topics related to mental health and technology, and inviting readers to comment at the Online Therapy Institute’s social network. In the following issue of TILT, we shall publish a selection of comments about what YOU would do when faced with the dilemma.

ht you

ir ping to ing me reeing as r faceary or ing a

d ing

NEXT Month's dilemma You are an online therapist or coach and you have been asked to be interviewed for a webinar series. You will be discussing your area of expertise- for example, motivation, career, anxiety, depression. The webinar is free to members of the hosting organization and others can pay a small fee to join the webinar. The platform offers a chat room for questions and at the end of the interview the host will open the audio lines for live questions from the audience. You have seen a few negative comments in the chat room but did not recognize the person's name because their chat username was Joh123. When the audio lines open Joh123 begins making the same derogatory remarks verbally that he was previously writing in the chat room and he is addressing you and your area of expertise. You realize Joh123 is a current client of yours. What would you do?

What would you do?! Weigh in at the OTI/OCI Social Network’s Discussion Forum!

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Searching for help in all the wrong places

by Christine Korol 22

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The days of feeling like you are the only one suffering with a particular problem are long gone. There are many great online communities that help people feel less isolated and alone by connecting them to others with similar concerns. The value of being able to talk to someone who has been there before is immeasurable and you can find terrific advice if you know where to look. The downside of some online forums is the participants

who are not coping well and scare newcomers with their horror stories. I remind my clients that you rarely hear about the people who get better because they move on and stop visiting the group. This explanation is usually met with a big sigh of relief. While it’s great to know that you’re not alone, it’s even better to hang out with the crowd that has figured it out. More disheartening are businesses that capitalize on the fears of a particular group. My practice focuses

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on treating anxiety and OCD and many of my clients have spent huge sums of money on online programs that don’t deliver what they promise (one program in particular is extremely outdated and ridiculously expensive). My intention for creating the free online anxiety classes on www. has not only been to help people but to provide an alternative community of support and good information. I want to contribute to a continuing discussion of how good life

can be once you figure a way out of worry. I would love to see more therapists find their cause, start speaking out and building (or supporting) healthy communities for the people we serve. The only way to fight some of the darkness that you find online is to be a light. My own experiments in online community building have been fun and rewarding in more ways than I can count. If you have something important to share, I would

encourage you to take that first step and see where it leads you. Your future tribe is ready and waiting for you to show up!

ABOUT THE AUTHOR/ ILLUSTRATOR: Christine Korol, Ph.D. is a cartoonist, psychologist in private practice in Calgary, Canada and the host/producer of a podcast on that provides free online anxiety and stress reduction education videos.

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Cyberspace as Culture A New Paradigm for Therapists and Coaches by DeeAnna Merz Nagel and Kate Anthony, with Gretta Louw T I L T M A G A Z I N E SP R I N G 2 0 1 2


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What is it about being connected in a virtual world that some people don’t “get”? I am not a gamer. But I understand how one can become connected in a virtual world like Second Life, and even become absorbed to the point of neglecting one’s responsibilities and relationships in one's real life or “first life” (as Second Lifers refer). But that’s not really the story that needs to be told. Connections are taking place. New relationships are being built. Students are learning. Co-workers are listening. And yet there are many people who don’t understand any of it. In one’s role as a coach or therapist, a person’s life journey is heard from many different

perspectives. People tell their stories in different ways. Coaches and therapists may even give the client tools to discover different ways to tell their story -vision boards, sand play, gestalt, art, music and other expressive therapies are considered a quite proper adjunct to the work. So how would most of us react (at least the unseen reaction) to someone telling their story through an avatar in a virtual world? Would you be open or would your biases be immediately obvious? Would the fear of the technology itself keep you from joining with your client to hear possibilities? Or would you embrace the opportunity as a sacred invite from someone who has chosen you to accompany them to the next guidepost? Cyberspace transcends culture while being its own culture. I have touched on this before through various blog posts, presentations, book chapters and articles. Kate has joined me in teaching cyberspace from a cultural perspective. For most of us therapist


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types, a requirement of our schooling is a class in multiculturalism or Multicultural Awareness. I still remember my text bookI can see the old cover - A Handbook for Developing Multicultural Awareness by Paul Pederson (now in its third edition). Several new multicultural textbooks are available today but I am not aware that any of these courses include a section on cyberspace, gaming or virtual worlds. Lago (2011) briefly addresses online counseling and distance training as a route to better understanding of transcultural work, but defines the speed, volume and breadth of social networking, mobile phone and computer technology as anxiety-inducing and causing the “sense of overload or threat” that subsequently causes inter-relational problems, rather than it being a question of learning a new culture as we are arguing here. Such talk is usually set aside for discussion within the overview of cyberpsychology. But unless that is one’s particular area of study, most therapists and coaches miss the opportunity to learn about the very culture that they depend on in some way either for work, leisure or relationship building. Certainly, our clients and potential clients participate in cyberspace in ways that extend well beyond Facebook, Twitter, Pinterest and all the rest. And while cyberpsychology offers us an understanding of how people behave in cyberspace, it does not address the more central issues assigned to culture such as shared attitudes, values, goals, and practices. Kate and I had the recent fortune of being a part of a project that goes beyond our basic

RC: [Our discussions] could be in Second Life (SL) too. Gretta Louw: I think the learning curve would be a little steep to set that up so quickly, so if it’s possible to [have the conversations in] Skype that would be better. RC: I could make the learning curve simple for you, if you just took my avatar, one of my avatars... You just have to feel it. Just a couple of hours, I’ll show you around, then I think it’ll all be a lot clearer.

understanding of cyberspace. I was asked to write a short essay about Internet Addiction to be included in a book about cyberspace and relationships. The book, Controlling_ Connectivity: Art, Psychology, and the Internet is a summary of an art project by Gretta Louw. Gretta made herself available 24 hours a day for 10 days for discussions, emails, comments and interviews from any internet user from anywhere in the world. The performance uses the pervasiveness of internet-based social networking as well as the obligation and opportunity for constant connection with these platforms as a paradigm for a severe and systematic disruption of normal, socially accepted patterns of life and interpersonal interaction during a selfdocumented performance. The subsequent exhibition at the Art Laboratory Berlin not only documented the performance but analysed the phenomena of

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total connectivity. When I received my copy of the book I was quite bowled over with how succinctly Gretta captured the various cultural innuendos of cyberspace from Twitter to Google+ hangouts and Second Life. Not only did she capture cyberspace as culture, but she captured the transculturalism of Cyberspace! As I read her interviews with people sharing their Second Life experiences, I immediately asked for her permission to use her material. At the Online Therapy Institute we have been busy preparing the curriculum for our Avatar Therapy Certificate Programme as part of our Specialist Certificate Programme Series. As counselor and coach educators, we incorporate the concept of cyberspace as culture. We feel it is critical to understand

the culture of cyberspace in order to be able to deliver the best coaching and therapy services via technology. Consequently, there is much emphasis on the culture of virtual worlds in the Avatar Therapy curriculum. We have included video clips, required movie viewings, opportunities to participate in virtual world environments and other experiential assignments. Try as we might to capture that 3-D virtual world environment through various show and tell avenues, what captured it best- right at its essence were the written words in Gretta’s book. She included excerpts from interviews she had conducted with people in Second Life and the verbatim transcripts of those interviews made me think, “If people read this, they will get it.” I passed along the reading to Kate and she agreed. We dismissed our original idea

GL: How would you explain your lifestyle choices to someone who doesn’t use the internet [regularly]? RC: When you go into a virtual world... at first it’s just like a video game. But you start to realise very soon that the people you’re talking to are just like you, they’re real, behind these pretty avatars there’s a real human being. It’s not like you’re shooting at monsters, you know? What seems to happen is some people get that and they start to really live in SL as a real person. Some don’t, some just play - serious people try to stay away from [them], because they are very hurtful. Once you... start to see that this IS real, it’s very exciting, and that SL can either supplement, or even take the place of Real... It can just take you away. 
Now that’s good and bad; a lot of people talk about SL addiction. Most of the people here are addicted. GL: How would you define SL addiction? RC: I would say that it’s on a continuum. The extreme would be when you’re on SL all the time, you neglect your Real to the detriment of your physical and financial stability. I have tried to quit unsuccessfully and successfully at different times... I have pulled away... when I have found “Real” - the woman that I want to be with in Real - when I move in with somebody or whatever, I pretty much turn SL off. GL: Do you see the two things [SL and real life partner] as competing? RC: Yes, I think they do, they compete for your time.


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to open the course with a video and opted instead to use the written word. Why? The written word is foundational to the concept of transculturalism in cyberspace. The use of written language is embedded across cultures and is familiar. Images of words on a page are not new or startling. So perhaps describing an unknown culture with words on a page is more palatable somehow. To immerse oneself in a new culture, we usually start with educating ourselves through the written word, whether through travel books, textbooks or even googling a location. This

RC: I really want you to experience SL, and I’d like you to let me guide you through it... I have a female avatar, I can just give you the name and just guide you through. RC: It’s so beautiful, it’s so interesting. It’s so real! It’s sort of like living a soap opera instead of watching it. But, the people are real and the pain is real. GL: I think I would find it really difficult to be unaware of... my context. RC: If you spent any time in SL it would just be a couple of days before you would be able to feel this immersion. It’s true, there are some people who come in and say ‘I don’t want this, this is scary’, but not usually. GL: What about people who come in and say ‘I don’t want this, I find it boring’. RC: If they find it boring, it’s because they can’t see. They can’t see the depth of it... Anything that’s in the real world, you will find a counterpart in SL.


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new culture of cyberspace began with written language via emails, chatrooms, bulletin boards and the like. What are the implications for the profession in treating Cyberspace as a cultural phenomenon rather than just a new communication tool? Many of us remember a time without the Internet or mobile devices – our culture was different back then. Ten years ago we struggled as a profession to embrace the new way of living and working (and many of us still do). Yet clients and the professionals joining the profession today have been brought up in a different culture, wherever they physically live. They have grown up in the culture of Cyberspace. Uphoff (2011) defines the invisibly diverse – those from different cultures that are not immediately identifiable by their accent or physical appearance. When considering Cyberspace, we can see the parallels with being invisibly diverse when accents and physical appearance are removed altogether, and this has been hailed as what makes the internet a power-leveler for all (after all, on the internet no-one knows you’re a dog). So what are we left with? If Cyberspace allows transcultural communication, is the perception of cultural barriers being broken down? Kate and I argue differently – it is time to embrace the new culture of Cyberspace and address the issues for the profession in light of that (including the invisibly diverse as they exist within it). We have little historical reference points to use – traditionally, online therapy and coaching have been a game of catch-up – writing ethical guidelines as the

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issues become apparent rather than preempting them; writing anecdotal evidence for its success rather than pre-and post-therapy RCTs. By treating Cyberspace as a cultural phenomenon, we can do better than that for the future of the profession. We can learn from previous transcultural examination and apply it to how society is changing in light of the new technologies. Your son or daughter may live in the same culture as you offline. But they are invisibly diverse. We believe that it is only once we accept the online generation as being diverse in

their own right will the profession be able to work effectively with that client group. We can do this by immersing ourselves in what we already know about the culture of Cyberspace, through experiential training and a shift of how we look at those different to ourselves. For too long, we have been struggling with the concept that relationships held online are somehow “not real” or “less real” because they are not conducted face-toface. If we look at face-to-face work as being a different cultural phenomenon – one that will always have its place but that also belongs to a different culture – we are free to examine T I L T M A G A Z I N E SP R I N G 2 0 1 2


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(Interview with members of a SL ‘Vampire Clan’ and RC) V1: I have been on SL for almost 2 years now... I’ve tried lots of other things and it’s... all sexual stuff... I just wanna have fun and enjoy friends and I’ve met a lot of great friends... I followed Mom to this new clan. Mom: I am Mom. V1: Yeah, that’s Mom. She’s my Mom. RC: Mom’s the Queen [of the Vampire Clan]. V1: My story is that 3 years ago my Mom in real life (RL) got cancer... In May my Mom passed away from cancer, and I almost gave up SL. I didn’t want to do anything, and this mother here and my family have kept me going. They are my family, they are my friends. I mean everyone thinks it’s just a virtual world, that it’s just a game, but I have made actual friends - and if it wasn’t for them, I probably would have laid down and gave up. GL: Something that I’m interested in... is this idea of a dichotomy between the virtual world and the real world; could you tell me a little bit about how you see that. V1: People will go on Facebook, it seems like Facebook has hit it off real good. But really and truly Facebook is no different to what SL is... You go on there, and you have people and you become friends with them and stuff, and that’s the same as what this is, except that we can do a whole lot more... Facebook seems to be acceptable to everybody, but really and truly SL is no different than Facebook. GL: Most people that are using Facebook are adding people that they’ve met, that they know in real life. V1: That’s the theory but... like on Farmville, you have to have so many neighbours to even get anywhere in the game... It’s really not just your friends because then your friends will recommend people for you to add so you can play these games. RC: But without the whole sense of having a body, I think I’d like it much, much less. Mom: It’s not nearly as animated as a virtual world. And over here you can go sky-diving, hot air ballooning... V1: You can go anywhere, we went to Paris one time and climbed up the Eiffel Tower and hot air ballooned off of it. GL: Would you want to see the Eiffel Tower in ‘real life’ more or less [than in SL]? V1: I would love to see the Eiffel Tower in RL, but I know I’m never going to. So, this is just like being there. GL: So SL is a chance for you to do things you don’t think you’ll be able to do in ‘real life’? V1: I feel like I’ve actually been there. How can I explain it?... I mean, I can change my hair 15 times a day,


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I can change my clothes 15 times a day - I can’t do that in RL. Mom: And everyone is beautiful. V1: It makes you wonder why we don’t get along in RL. In SL everyone fits in, everyone is family. RC: Well, I wouldn’t say everyone gets along in SL! V1: I’m not gonna say that everybody on SL has real life problems, but there are some that just don’t fit in in RL. And when they come to SL, they fit in. They have the family, they have the friends... RL can be really, really cruel. They look at you, or they see what you do, or they see that you don’t have the fancy car. And on SL we don’t care about any of that. Mom: Not only that, in RL how many people can you reach? Right now our family is 150+. We’ve had deaths in the family, we’ve had attempted suicides, break-ups in RL - and they all come together here. Whereas in RL, how many people can you reach at one time when you need them the most? ... I’m kinda like a social worker, as the Mom. People come to me as the leader, and I help them... I did 27 years of law enforcement, I’m retired. V1: It’s almost like in RL, even if you think they’re your friends, you have to put on an air. They expect you to be a certain way. GL: [How do you think] internet-related technologies might be changing society? V1: I’m hoping it changes everybody’s outlook on RL because if we can get along on here and we can all be family... how come we cannot do it in RL. Mom: [On SL] you have power of selection... You can select who you want to be friends with. If there’s someone who’s being very negative... you mute them. GL: How many hours do you think that each of you spend online each day? V1: Oh my goodness! (laughs) Sometimes I’m only on for an hour a night, but sometimes... we can be on for hours, and hours, and hours. GL: Would you say that you were addicted? V1: I could stop at any time, I just don’t want to. I wouldn’t say it’s an addiction, it’s more of a choice. This is my family, these are my friends. Mom: We need to be there for our loved ones... And we can dance all night long and in the morning my feet don’t hurt! And I never have a bad hair day! GL: If you could take 10 or 20 of your favourite clan members and move them into your town, would you still spend as much time online, or seeing them in real life? Mom: I think I would do both. We would get online and go to Italy, to Spain. And it would be fun because everyone would be there.

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RC: How did coming in [to SL] change your perception of the world? GL: Well there are some very interesting visual effects... RC: It’s gorgeous! It still has that edge of cartoonishness, but every year it gets more and more real looking. GL: Well, I wouldn’t say that it looks real at all, but it has a very particular aesthetic, which is amazing when you think about how many people are building it. That’s an interesting aspect, this shared aesthetic across hundreds if not thousands of builders.

but rather, we learn the historical value and integrate the knowledge into current practices even as methods of connectivity continually evolve. By the very nature of Cyberspace demanding – for the most part – a lack of physical presence, we will all be invisibly diverse. The implications of this and how we (and our clients) define ourselves within it will become, we believe, a central tenet of how mental health treatment is defined in the future.


what we call “innovative” ways of working but which are actually just parts of a new culture that we are just getting used to. There will come a point when the new culture of living online will have become so ingrained, we will be back to studying the sub-cultures of Cyberspace rather than the sub-cultures of a continent or country. We find we teach these sub-cultures in our trainings as related to online therapy and coaching. Regarding each type of online communication as a sub-culture – videoconferencing, social media, virtual worldswe continuously focus on the use of textual language. It is the original online culture to which everything else has evolved, therefore the teachings as related to online therapy must be taught. This is akin to learning the theoretical underpinnings of psychotherapy and psychoanalysis or learning the basis for motivation when becoming a therapist or a coach. We do not abandon early teachings,


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Anthony, K. & Nagel, D (2012). A Brave New World: Coaching Online. Coaching Today. BACP Publications, Lutterworth. PP33-37, Issue 1. Lago, C. (2011). (ed) The Handbook of Transcultural Counselling & Psychotherapy. Maidenhead, Open University Press/McGraw Hill Nagel, D.M. (2012). Internet Addiction, Really?? In G. Louw Controlling_Connectivity: Art, Psychology and the Internet. Limited Edition Artist’s Book: Berlin. Pedersen, P. (2000). A handbook for developing multicultural awareness (3rd ed.). Alexandria, VA: American Counseling Association. Uphill, A. (2011). The effects of a European heritage: Between two chairs. In Lago, C. (2011). The Handbook of Transcultural Counselling & Psychotherapy. Maidenhead, Open University Press/McGraw Hill.

ABOUT THE AUTHORS DeeAnna Merz Nagel and Kate Anthony cofounders of the Online Therapy Institute and the Online Coach Institute. Gretta Louw is a multidisciplinary artist working with a variety of mediums, exploring the potential of art as a means of investigating individual, cultural and psychological phenomena.

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(Skype talk with RC during whilst in SL) RC: Do not do anything. I have to get you dressed first. GL: Yikes. RC: So what do you think about the way you look? GL: I can see [the avatar’s] butt! RC: (laughs) I know, well I guess that’s my choice of things, sorry about that. That’s one of my favourite outfits... I think you look great. GL: I thought you didn’t look at the avatar - that’s what you said to me before. RC: Well, I lied (laughs)... Let me show you a few things. We’re going to dance. You click on the pink ball and allow it to animate your avatar... (avatars dance) RC: I think you look lovely... I’m just gonna go through a couple of the other dances so you can... RC: So what kind of music do you like? Do you like jazz? What I’m going to do is take you to a jazz bar. I’m going to teleport you now. Did you accept it? GL: Yes, I’m there now. RC: Click on the pink ball in front of me... Ok, excellent. Now we are dancing. GL: So basically people are going on here mostly to meet other people, right? RC: Yes, it is a social place, a social medium. Some people call it a game, but serious people here shun that word. GL: Do people get upset if someone just comes here to play? RC: Not if they’re just exploring, but... You know like married men come on here and date all these women, and say they’re single and lie to them and stuff. GL: Would you classify this [SL] as a dating program? RC: No. You’re getting that impression because that’s how I use it. GL: So I can also dance a single dance by myself? RC: Yes. Did I make you uncomfortable? GL: No I just want to try out other things. RC: I’m going to put on a couple of other things that I like now... Ok here’s something you might wear if you want to be a little more intimate... This is my tarzan look. Do you see my body now?

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Jean-Anne Sutherland

Our Interdependent World Tiffany Shlain's "Connected"

Tiffany Shlain’s new film Connected begins with a familiar scene: she’s enjoying dinner with an old friend and, while the company is good, the topics of conversation plentiful, she caves to her desires, sneaks into the women’s room, pulls out her cell and succumbs to texting and emailing. She asks, “What have I become?” Indeed, what WE have become is the central concern fueling “Connected.” Shlain asks, “When did things begin moving so quickly?” What has the historical surge of technology meant for human beings? How has the increased interconnectedness of the world impacted us physically, socially and, globally? As her father, the author and surgeon Leonard Shlain once advised; when you want to know about something, go to the past and look for patterns. That’s what Tiffany Shlain does in this documentary exploring the internet, the synthesis of left and right brain hemispheres and, our increasingly interdependent world. Woven throughout this documentary is the very personal account of Shlain’s father; his work, his life, and his eventual death to cancer while she was simultaneously experiencing a high-risk pregnancy and working to complete this film. Shlain relies on the writings of her father as she probes the modern era (check out his work here). Zipping across the time line, 36

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past the dinosaurs, after the earliest of humans with their fancy opposable thumbs, literacy was invented as a way to accumulate knowledge. It was right about here, Shlain argues, that a balance of power shifted. As we cruised into the age of enlightenment, science and reason stimulated the left hemisphere of our brains, leaving our right hemisphere, the one prone towards beauty and empathy, to play a less vital role in modernity (make sure you check out hers and her father’s interesting argument that patriarchy was born out of this brain hemisphere split). The micro and macro elements of modernity collide in this film. Shlain juxtaposes her personal encounter with science (her pregnancy and her father’s brain cancer) with the macro repercussions of technological achievement. While we can appreciate the “pros” of modern manufacturing, global work forces, the internet, cell phones, hand-held computers and the like, we must also take note of the less glamorous consequences including increased pollution, the superfluity of sweat shops involving vulnerable communities, global warming and, a curious decline in honey bees which trigger a loss of food. Moreover, on the meso-level, as Shlain explains via the story of her cell phone craving, our social lives are deeply changed due technology and, in particular, our increased connectivity. Shlain advances an interesting argument regarding the internet’s ability to synthesize the left/right brain split described above. As we peruse the internet, she asserts, clicking on massive amounts of text information, we are stimulating our left brain which

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craves logic and reason. At the same time, the images and videos we access satisfy our right brains. In sum, the internet, a product of scientific thinking -- the same approach to knowledge which led us to value left brain over right brain thinking – has the ability to synthesize our formally “split” brains. The internet can, quite literally, change the way we think. We can create a global village with increased empathy, collaboration and collectivity. While I like the overall tone of Shlain’s argument that everything is attached to everything else and we are part of something larger than ourselves (this is, after all, good news for we sociologists and job security!), I am left with an underlying concern. For instance, as we celebrate the connectedness that allows us

to glimpse into other cultures (potentially inciting cultural compassion and relativity), we might be inclined to assume that the plethora of images we consume via the internet are implicitly “true.” As we know, even as the internet allows us to reach across the world, often times we grab considerably more fried Twinkees before our hands come to rest on something a bit healthier. Facebook, as we’ve witnessed, can serve as a vital tool in the organization of social movements. Simultaneously, it can suck up a significant portion of our day as we scroll along, riveted by the news of our “friends’” choice (and photo) of a lunch entrée. Shlain, let me add, does not suggest such naiveté concerning the paradoxes of technology. Watching the conclusion of the film, I felt my sociological hairs rising on my neck (the impulse that makes many folk avoid us for fear that we suck the fun out of everything) reminding me that indeed, the internet CAN give rise to global empathy. Unfortunately, it can also be utilized as a tool to further drive a wedge between the haves and the have-nots. While other films have considered modernity and technology, in Connected Shlain explores the topic by weaving the personal, the political and, the biological. While at times it feels like she has two distinct films, one personal the other more historical, the significance of her observations come through. We ARE an increasingly interdependent world. Ideas do have the potential to cross-pollinate. The connectedness that the internet provides does mean that we are a changed people. Regarding what these changes might mean, Shlain gives us plenty to chew on. n

Jean-Anne Sutherland, Ph.D. is assistant professor of sociology at University of North Carolina Wilmington, USA with one of her research focuses being sociology through film.

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Three P's of Digital

Privacy, Protection, and

Social networking has sparked many questions for counselors, such as, “Is it ethical to utilize a search engine such as Google to look up a client?” and “Should I accept a client’s friend request on Facebook?” You can protect your career, your reputation, and your license by following three P’s of digital ethics: privacy, protection, and policy. Privacy You are responsible for keeping client information confidential, whether it’s in speech, in print, or online. Adhere to the Health Insurance Portability and Accountability Act (HIPAA) privacy rules and professional standards such as the Code of Ethics from the American Counseling Association.

Because encryption of e-mails isn’t universally available, don’t include anything you wouldn’t feel comfortable posting in public for all to read. Consider including a signature line in your e-mail that reminds clients the information exchange isn’t secure. The need for privacy extends to social networking venues such as Facebook, Twitter, and blogs. Don’t post information related to a client even if you think it can’t be linked back to him or her—you may end up in court. In June 2010, for example, Tri-City Medical Center in Oceanside, Calif., fired five nurses for allegedly discussing patient cases on Facebook, even though apparently no names were disclosed. Using a pseudonym isn’t enough. There may be enough information elsewhere online for someone to put the pieces of the puzzle together. If you want to post information about a case for educational purposes, obtain consent from the client but still omit names and key identifying information. Keep in mind that your lecture at a professional meeting may end up online on YouTube. Protection Protection includes both clients and counselors. Experts differ on whether it’s ethical to “Google” clients before accepting them or to


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l Ethics:

d Policy

verify information. Ofer Zur, Ph.D., a psychologist who speaks on social media issues and offers continuing education courses on the topic, says that professional counselors with home offices may want to prescreen new clients by conducting an online search. Zur adds that it’s important to have a “well-articulated reason” before conducting online searches of clients. You may want to obtain permission from the client beforehand. Zur also suggests you periodically search online for your own name. You may find that clients have commented or rated you on sites such as Yelp. com. Many experts recommend you don’t become “friends” with clients on Facebook, LinkedIn, MySpace, or other social sites because it crosses the boundary of the therapeutic relationship. Remember to set your privacy settings on your personal page. Policy Establishing policies helps clients understand the ground rules. For instance, include social media information in new-client packets. Tell them not to contact you via your personal Facebook page and that even though you have a Twitter account, you will not “follow” clients. Clients who want to follow you on Twitter or a blog but want to maintain privacy might consider

using an RSS feed to protect their identity. A sample social media information page for clients can be found at You can find examples of organizational social media policies at Another ground rule might be not texting or phoning during a session. Be aware that younger clients see nothing wrong in multitasking— they’ve likely been doing it for most of their lives. However, it’s certainly reasonable to ask a client not to use smartphones during a session. What is acceptable? Agreement on correct behavior for online client-related communication is far from universal. It’s best to err on the side of caution when making decisions in this area and to keep current on new developments.

Reprinted with permission from Healthcare Providers Service Organization (HPSO); 159 E. County Line Road, Hatboro,PA 19040 1-800-9829491 HPSO Risk Advisor 2011-2012.

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"B" Your Best Seven years ago, self proclaimed “tech geek” Ran Zilca was working at IBM’s research division, developing the next voice biometrics technology. Little did he know at that time that he would soon start a chain reaction in his life starting with recruiting an all-star team of social scientists, founding the first company to release positive psychology and coaching apps, becoming a social scientist, going on a 6,000 mile solo motorcycle trip, and eventually completing coach training at the Institute for Life Coach Training and earning his Board Certified Coach credential. Today, as Chief Scientist of bLife, Inc, Ran has the opportunity to be a part of the team that formed bLife - the first iPad coaching app, utilizing his research knowledge, his personal transformation, and his coaching experience. In this edition of “Technology Enhanced Coaching” we’re looking at this unique app that Ran describes as a mixture of three interlocking components: Evidence-based behavioral science; a finely tuned user interface which incorporates algorithms replicating the natural coaching process; and a third element Ran refers to as “heart” - that which makes the sum total of all of the parts in some way personable and likeable. I find myself immediately


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thinking of what makes Jobs’ iPhone and other Apple creations so insanely likeable for so many people. Users know it when they see it, but they can’t quite say exactly what makes it that way. Considering his professional background, we might expect such a three-part, formulaic description from Zilca. After all, he holds a Masters of Science in Electrical Engineering from Tel Aviv University and a Bachelors of Science from Ben-Gurion University. He served six years in the Israeli Army specializing in the research and development of statistical and signal processing algorithms, followed by further work at IBM in New York where he worked in the area of biometrics and for the first time got interested in social science when researching the idea of a “mind print”. Yes, a “mind print”, like hand scanning or a fingerprint only, well, a tad more complex …. I’m thinking we’ll be hearing more about this in the upcoming editions of Wired Magazine. Yet it wasn’t only deep, objective scientific rigor that led Ran to become a coach and focus on coaching technology. The rigor is certainly there, but it was his zest for life, that desire to “head out on the highway” and experience the fullness of a coast to coast adventure atop that beloved, two

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D COACHING Lyle Labardee

wheeled thing of beauty that gives every rider a roaring sense of freedom. As Ran tells it, his desire to travel across the country on a motorcycle started out innocently enough, as it might for any of us reflecting on a mid-life passage. He just, literally, pushed a few buttons in one of the company’s earlier apps; more specifically the buttons having to do with setting goals; buttons that, by the way happen to be wired to algorithmic equations incorporating motivational psychology. Ran was about to discover the power and effectiveness of that science. Before long, he found himself actually following through on each and every goal he set, going from having a remote dream right up to straddling that seat, firing it up, rolling off the kickstand and, well, heading out on the highway. That was just the beginning. The idea turned into a personal video project and blog, called “Ride Of Your Life”. Along the way Ran met with his partners

and collaborators, to have a deep discussion into the philosophy of happiness and inner peace: authors like Deepak Chopra, Byron Katie, Dr. Sonja Lyubomirsky and Dr. Barbara Fredrickson. Like all personal life adventures, Ran’s experience brought more than miles traveled and remarkable meetings, it brought awareness of a deeper sense of calling and purpose, to more fully and completely “be”. To not only support the work of those involved in effecting positive change in the lives of others but to personally experience the dynamic growth and change that comes with living a full-on, fully-alive, on-purpose life; ultimately he decided to become a life coach. The bLife app is a product of the company’s years of experience in the field and it delivers. Though its iPad-only functionality and interaction with Facebook might be a little intimidating for those not quite familiar with similar apps, or who otherwise spend more time on their laptop or iPhone than their iPad (like me), it quickly becomes comfortable. Once I started the program I found myself simultaneously engaged and energized. It’s a place I found myself wanting to be. Ah, there’s that “be” word again. Perhaps it’s the soothing colors, the light and airy music that links each part of the program together for us like a secure guide rope that gently slips through our fingers as we travel along from one step to the next, or maybe it’s the authentic and inspiring voice of program guide and motivational psychologist, Dr. Heidi Grant Halvorson. Then again, maybe it’s the way T I L T M A G A Z I N E SP R I N G 2 0 1 2


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TECHNOLOGY ENHANCED COACHING the information is served up; in bite size pieces that lead us easily from one interactive exercise to the next. More than likely it’s all of these elements and more. Overall, bLife provides the user with a systematic, step-wise approach to developing life goals that are well-defined and derived through the application of motivational science: Thus the goals one finally arrives at are goals that are much more likely to promote authentic happiness and actually be achieved. Upon logging in for the first time the user is introduced to the objective of bLife: to assist the user in creating goals consistent with their personal vision. The easy to use, drag and drop interface enables users to select and slide major life areas from the main part of the screen to the column on the left. Once a major life area is selected the user is then invited to start developing goals by writing words that help define what the user hopes to achieve relative to the major life area selected.

As the user builds their vision and related goals, they receive instruction along the way from Dr. Heidi Grant Halvorson. Dr. Halvorson delivers the science of motivation and goal setting in a brief and engaging way, and makes it easy for the user to grasp and apply the concept in the exercises that follow. In “Setting the Right Goals”, Dr. Halvorson instructs users on the importance of being specific, and challenging themselves with


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continued goals that go beyond what they might at first imagine to be possible to achieve. Now that the user is beginning to think about big and specific goals, Dr. Halvorson uses the section entitled “Set Your Goals” to provide additional insights into the qualitative aspects of goals. For example users learn that they are much more likely to achieve goals born out of intrinsic desires, than goals that are purely, externally, reward based.

Once pictures and messages have been uploaded the user is presented with a personalized visual representation of their goal and strategy for achieving success.

In “Mindset for Success”, Dr. Halvorson helps users develop a mental way of approaching goal pursuit that leads to success. Here she points out that it is persistence, motivation and adaptability in the face of obstacles that enables one to overcome and ultimately achieve success. The interactive exercise that follows presents users with the opportunity to build a vision for their goal by uploading meaningful pictures and words. Pictures capture the vision of the goal and related obstacles, and text boxes provide a place to write strategies for overcoming obstacles.

The specific, well developed goal is then reinforced in the “If/Then Plans” section. Here Dr. Halvorson provides guidance on how users can create and use if/then thinking to increase self control and stay on track in reaching their goals. Lastly, in T I L T M A G A Z I N E SP R I N G 2 0 1 2


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TECHNOLOGY ENHANCED COACHING “Stay on Track”, Dr. Halvorson leaves the new goal setter with a final word about the importance of remembering the reason the goal was set in the first place. Here she reinforces the value and importance of goals based on intrinsic rewards as these are the ones that are most attainable and will ultimately contribute to one’s sense of authentic happiness. Having completed the initial goal development phase of the bLife app, users are then presented with their personalized dashboard where they can see and update their vision, set goals, and visualize their goals in new ways. Users are also provided with a glimpse of what lies ahead on the bLife roadmap, specifically, the ability to make contact with a qualified coach and, or trusted team members for support and encouragement.

for success, and training users in how to develop and apply mental strategies reinforcing goal attainment. To the extent the goal of the bLife team was to build an app that brings together evidence-based behavioral science, a finely-tuned user interface, and the essence of the interactive coaching process, it appears as though they’ve been pretty successful. I think users will find bLife extremely helpful in its delivery of the science around effective goal setting and a pleasure to interact with. This is an app with heart. n

To learn more about the bLife app go to: To learn more about Ran and his personal coaching practice go to www. Also, watch for Ran’s E-Series course on “Meaningful Goal Pursuit” slated for release at the Institute for Life Coach Training in the summer of 2012.

Overall, bLife does a great job of systematically guiding users through the development of personal goals that incorporate the ingredients


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Lyle Labardee, LPC, BCC, DCC, is a Licensed Professional Counselor and Board Certified Coach who is credentialed in distance counseling. He serves as CEO of the Institute for Life Coach Training and its parent, LifeOptions Group, Inc.. He is based in Michigan, USA and may be reached via

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by Lynn Wernham

Individuals and organisations throughout the world are actively involved in the use of social media to support learning yet its potential use within the field of coaching in organisations has presently not been empirically investigated. T I L T M A G A Z I N E SP R I N G 2 0 1 2


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The aim of my research was to investigate the extent to which social media tools and materials are currently being used by internal or external coaches to support face-to-face coaching in a public, private or voluntary organisational context. The outcomes from the research provide the coaching community with information that they can use to consider whether social media could be of value in their coaching practice (or not). 117 coaches who work in an organisational context completed a questionnaire and the findings show that over a quarter use social media to support coaching and that there is scope and benefit to using social media tools and materials to support both individual and group coaching in organisations. However

over 50% of coaches indicated that there are a number of disadvantages and barriers that can prevent the use of social media. Key Issues raised by coaches were organisational security concerns, client confidentiality and ensuring that all parties have the necessary technology skills.

Research Objectives The objectives of this research within the context of the organisation were to: • Identify whether social media tools and materials are being used by coaches to support face-to-face coaching • Explore which social media tools and materials are being used by coaches and how they are being used to support face-to-face coaching • Investigate perceived benefits and disadvantages of using social media tools and materials to support face-to-face coaching • Investigate the barriers to using social media tools and materials to support face-toface coaching


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• Formulate recommendations for ways in which social media tools and materials could be used to support face-to-face coaching

Research Findings Which Social Media Tools and Materials are Being Used by Coahces and How Are They Being Used to Support Faceto-Face Coaching Only 28% of participating coaches use social media to support coaching and 72% don't, despite the fact that more than 95% of all participating coaches use social media outside of the coaching process. The most widely used tool by both groups outside of the coaching process is online communities. When using social media to support coaching, online communities are also the most widely used tool with 63.6% of participating coaches using it to support coaching. 39.4% of coaches use document creation and sharing tools and 30.3% use micro-blogging tools and multimedia tools to support coaching. When asked how social media tools were used to support coaching (see table 1), 78.1% of participating coaches use

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social media to encourage coachees to network and collaborate with others and 56.3% of coaches use social media to encourage reflection. 46.9% use social media to gather materials for use in a coaching session and 43.8% use it to support team or group coaching. One coach commented "Since these tools are SOCIAL tools and lend themselves much better to group interactions - we should be thinking more about their use in terms of GROUP coaching”. Some Practical Examples of Ways in Which Social Media is Being Used to Support Coaching included: • Encouraging the coachee to expand their learning network via Twitter or groups to explore and gather ideas and new perspectives on relevant issues • Encouraging the coachee to seek out and follow ‘experts’ who could offer a new perspective to an issue and have dealt with similar issues or situations that the coachee is facing • Setting up a closed community to support team


or group coaching • Signposting coachees to online resources, tools and techniques via your blog, twitter or groups • Introducing Linkedin to clients to support them in building a professional network • Using You Tube clips to support coaching sessions • Introducing private wikis in team or group coaching to share knowledge creation • Encouraging the coachee to use a private wiki or blog to record reflections and learning

The Benefits of Using Social Media Tools and Materials to Support Coaching Those coaches who do use social media to support coaching were asked about the benefits they had experienced through their use of social media. 41% of coaches mentioned the benefit of being able to collaborate and share information with both groups and individual clients. One coach stated that "It allows me to share information, articles and blog comments which may be relevant to my clients, as individuals and as groups".

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41% highlighted the flexibility of social media tools which can enable "Anytime, anywhere learning."

perspectives which encourage reflection, develop coachee thinking, offer new ideas and spark new thinking.

38% have experienced increased networking opportunities with others; both for themselves and by encouraging their coachees to network with others. One coach stated that "For the coachee, the huge benefit is a whole world of networks, resources and learning."

21% have signposted coachees "to different resources/tools which they can explore and use to help them achieve their goals."

34% have found that social media offers learning opportunities and additional



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Coaches who don't use social media to support coaching at present were asked their opinion on the potential benefits of using social media to support coaching (see table 2). Networking and collaboration with others was both the most

frequently perceived benefit (80.8%) and the most frequent way (78.1%) that social media is being used to support coaching. The Disadvantages of Using Social Media Tools and Materials to Support Coaching Coaches who use social media to support coaching were asked about their experience of the disadvantages of using social media to support coaching. 48% of coaches have found no

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TABLE 3 Barriers to using social media to support coaching

Do use social media to support face to face coaching

Individual clients don't use social media tools Lack of skills or experience in using technology Client organisations don't allow the use of social media tools at work Organisational security concerns The technology needed is not available There are no barriers

disadvantages to using social media to support coaching. However, 28% have found that client confidentiality and security can be compromised and that materials shared via social media can be unreliable. Two coaches stated that "Privacy settings and confidentiality need to be carefully monitored" and "I only use some tools where I can create private groups for such interactions rather than use public social media - although I do use these for more open conversations/ discussions with others". 16% have found that using social media to support faceto-face coaching can cause confusion in the coaching

Don't use social media to support face to face coaching













relationship if it was not agreed and included in the contracting process. 8% of coaches have found that the possibilities of social media can be overwhelming and highlighted the need for social media training both for the coach and the coachee in order that potential problems could be avoided. The Barriers to Using Social Media Tools and Materials to Support Coaching Table 3 shows that both coaches who do (55.2%) and don't (49.3%) use social media to support coaching identified that the lack of skills or experience in using technology

was a barrier to using social media to support coaching. The most common barrier for coaches who do use social media to support coaching is that individual clients don't use social media tools. One coach stated that "Everybody knows about LinkedIn or Twitter, but few are able to register and start using it". It appears from the additional comments from coaches who don't use social media to support coaching that the lack of skills in using the technology lies with both the coach and the coachee. Two coaches stated that "I'm not sure how I would use this media to assist with a coaching intervention" and "Delegates misunderstand and underestimate the power of social media for learning and supporting learning/working." Both groups, in similar proportions have found that organisational security concerns and blocks on using social media tools to be a barrier to using these tools to support coaching. One coach stated that "organisations block access to third party tools and don't see how they can be used�. Some of those who have come across these blocks have

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used private secure spaces rather than blocked public tools to support coaching. How Could Social Media Be Used to Support Coaching in the Future? Responses to this question have been themed in table 4 as follows: The most common finding related to how social media could be used in the future to support coaching by both groups was to enable the coachee to network, share ideas and build relationships with others. This is consistent with previous findings. There appeared to be a certain degree of inevitability about its increasing future use in coaching in the context of the rapid evolution of information technology. One coach stated that "As realities become more virtual, social media will increasingly become the norm of conversational learning". Additional future uses identified by between 1-5% of coaches were: marketing of coaching services, supporting supervision, using iPad apps, using You Tube videos and coaching using Second Life.


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Additional Issues Raised This question raised a number of other issues that link to disadvantages and barriers as follows: • Social media spaces often have a sales focus and discrimination is needed when using them. • Social media can blur the coaching relationship and its use needs to be agreed with the coachee. • When using social media to support coaching, the coach needs to be clear about what they are doing and why they are doing it


• A new skillset is required. One coach stated that "A coach using social media may need to develop a different skillset compared to that of face-to-face coaching”. • Culture change is needed if social media is to be valued and used to support coaching. One coach stated that "I think there would need to be a culture change in my own organisation and another stated "Making collaboration effective requires a massive culture change and we are only just scratching the surface of this change."

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Recommendations Both literature in related fields and the findings from this research suggest that there is scope and significant benefits to using social media tools and materials to support both individual and group coaching in organisations. Online communities can be used to support coaching by enabling the coachee to network and collaborate with others. Social media can also offer additional perspectives to the coachee which can provide new ideas and spark new thinking. However there are a number of disadvantages and barriers that can prevent its use or suggest that it is inappropriate to use. Client confidentiality and security need to be addressed and assured. If social media potentially compromises this confidentiality then social media should not be used to support coaching. To avoid confusion, the way in which social media was to be used to support coaching would need to be agreed as part of the coaching contracting process. Both coach and coachee need both knowledge and appropriate technology skills regarding social media use in

order that it can be used to support coaching. Ideally both need to be actively using social media at the point when it is agreed that it will be used to support face-to-face coaching. The barriers of organisational security concerns and blocks would need to be addressed and removed if social media was to become more widely used to support coaching in this context. This may require significant culture change. Although there are significant disadvantages and barriers in place the research findings and literature in related areas suggest that there is a certain inevitability about the future use of social media which indicates that it will be used

more frequently in the future to support coaching. Issues such as organisational security concerns, client confidentiality and ensuring that all parties have the necessary technology skills need to be addressed when considering whether social media could be used to support coaching.

Related Reading Ethical Framework for the Use of Technology in Coaching (Labardee, Nagel & Anthony, 2010) Ethical Framework for the Use of Social Media by Mental Health Professionals (Kolmes, Nagel & Anthony, 2010)

About the Author Lynn Wernham is an independent business change & learning professional with 20+ years’ experience in the design of L&D solutions and frameworks, blended learning, performance improvement, coaching, facilitation, and partnership working. Lynn has recently completed her MA dissertation exploring the extent to which social media is used to support face-to-face coaching in organisations. More about Lynn can be found at http://2coach. and A full copy of the findings and discussion can be found here:

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an Online Therapist

A Day in the Life of

Each day, when I arrive at work, I set out to plan a therapy session that will impact and influence the lives of my patients.



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As a project coordinator of a research study, there are countless tools at my disposal and each one provides an opportunity to facilitate and measure change. It’s up to me to choose the method that I believe provides the best outcome. For me, my tool of choice is a unique online virtual reality program, which provides social training to individuals with autism spectrum disorders. Using this technology I act as part therapist, part research scientist, part community liaison, and part member of a digital development team. Having this virtual tool allows me to seamlessly take on each role with dedicated purpose to help my patients recognize their own social roles that can connect them to their daily life. As I begin each day, thinking about my patients as a therapist, each one has their own unique circumstances and situation in life. One may be in college looking to make a friend, one may be graduating high-school and worried about their next steps in life, and one may be struggling to interview for a job. My role is to take each person’s story and create a social practice session that is meaningful to them. The training must come alive through the unscripted conversation of an avatar and must be standardized enough to follow the research study guidelines. Using the online tool enhances the social practice and eliminates extra effort on my part to help the participants “feel” the realism of a conversation. They become immersed in practice allowing me to step back and simply guide their improvement by giving feedback of how they are progressing. As I begin each virtual training session logging in as my avatar online, I switch roles and become

a research scientist. I critically evaluate what I see during the session and how the participants respond. I listen to their comments when they tell me that the session was hard for them at the beginning of the practice but became easier when they could finally “get the hang of it.” For the first time, they are making small-talk with a friend or inviting someone to go on a date. I feel success with them, because I know they have the tools to take with them to go and connect to someone in their own social world. As a scientist I can ask how they get better and actually measure their progress. When I get back to my desk, I switch roles again as soon as the phone starts to ring. A parent needs help finding resources for their adolescent son. Their autistic son is about to graduate from highschool and they are terrified about his next steps because he struggles with his social skills. They are concerned how their son will go to college or find a job. As a community liaison, I listen to their worries and share the latest research on young adults with autism so that they can have tools to implement in their own family. Each individual calling with concerns and questions can benefit from learning more information about what help is available to them. As my outlook calendar reminder pops up, I am reminded to go to my next meeting. I change roles again as I walk to the computer lab. One of the most interesting roles I take on each day is as a member of a digital development team. I share with the team how the participants did that day using the newly developed virtual environment. We discuss the current boundaries of our program, and think creatively on how best to use it and adapt it for the purpose of social intervention. Working T I L T M A G A Z I N E SP R I N G 2 0 1 2


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on a creative technology team, we collectively trouble shoot the use of the virtual reality tool and decide what is currently working and what can be improved for the benefit of the participant. As I return back to my office, I glance at my therapist license proudly displayed on my wall. The importance of having a “bag of therapy tools” was one of the first lessons I learned when training to be a speech-language-pathologist. I never imagined that a computer and on-line game would be one of those tools that would become invaluable to me. Being able to make a lesson come alive to the patient is paramount in helping transfer learning to everyday life. Daily, I encounter new ways to utilize and transform a lesson or training objective into a meaningful exchange of conversation through a virtual online


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platform. One of the advantages of being able to use technology is the flexibility to reach my clients where they are – even if that means transforming myself into an avatar to talk with them.

about the author Tandra Allen is project coordinator at The Center for BrainHealth at the University of Texas at Dallas. Her work at the Center focuses on evaluating and treating social cognitive disorders in children and adults. She has over 9 years clinical experience as a speech-language pathologist working and residing within Dallas, Texas. Her work with the social cognition research study is featured on The Center for BrainHealth website:

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an Online Coach A Day in the Life of

I awake at 6am at the sound of my alarm clock. I’ve set my alarm sound for church bells because it inspires me to get out of bed. The church bells tell me I have important work to do today. I have a calling. I have a ministry. I am an Online Coach.

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BY Lyn Kelley I say a few words of gratitude, brush my teeth, comb my hair, get my coffee and sit outside on my patio with my day planner. I spend my first half hour making my list of all the things I need to do today. Then I look at my short-term and long-term goals, just to make sure I’m on track. I spend some time contemplating and prioritizing. I write in my Gratitude Journal – giving thanks for all that I have now, and all that I will soon receive. I recite my favorite Wayne Dyer quote, “Nothing bad happens…everything happens for my highest good. It’s all good.” I love what I do – it’s my passion -- well, at least the coaching part. But before I can do it, I have to get through the mundane chores. It’s Monday, my busiest day. I stay in my pajamas until I’m finished checking my emails and voice mails, which takes about an hour or two. Then I get dressed and ready for my day – usually wearing exercise clothes -- as I am fortunate to be able to work mostly from my home office. Still, I make sure I look


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presentable, because I usually see people – my assistant, the mail carrier, the UPS guy, the Fedex guy, and various other visitors who stop by to chat because they think I don’t really work since I work from home (NOT!). My assistant comes in around 9am at which time I start my telephone calls. I have to return several calls, and then a half hour consultation here or there throughout the morning. Between calls I work with my assistant on various marketing projects. I give her a list of things to do, bills to pay, website edits, etc. The best thing about my assistant is that she also acts as a business coach for me. I tell her my goals and she helps me implement them, always holding me accountable. She keeps me organized and on task. It’s something we both do for each other and I love the teamwork! I didn’t always have an assistant, and found that I often floundered without one. It’s difficult to motivate yourself when you work alone. Having my assistant/coach is one of the best investments I’ve ever made! This morning I spent a half hour coaching a therapist on

building her therapy practice, a half hour coaching a therapist on building his coaching practice, and half hour relationship coaching with a young woman who just broke up with her boyfriend. While I’m coaching, I often look at a poster on my wall to remind me: Coaches are not teachers, but they teach. Coaches are not counselors, but they counsel. Coaches are not your boss, but they make you work. Mainly, they observe, ask, listen and guide. A good coach never tells you what to do. Instead, he suggests to you, in an extraordinarily inarticulate fashion, what you want to do yourself. A good coach motivates you to go where you’ve always wanted to go. This is my favorite part of my day! I love the feeling of coaching – helping others achieve their goals. The fact that they trust me to assist them in the first place is a humbling thing. Then the fact that they tell me I’ve helped them in some way is exhilarating! I’m starting to feel hungry so I make myself a fruit smoothie and take my vitamins. This is

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about the time I start feeling very grateful for being able to do what I love and do it from the comfort of my home! Now I go for my run or go to the gym for an hour. Afterward, I run my errands – today I need to get gas in my car, go to the grocery store, the bank, and office supply store. I come home around 2pm, take a shower, start preparing dinner, and make myself a small snack. Then I’m back in my office on my computer. When you work as a Virtual Coach, you do most of your marketing online. I check my emails again, and do some social media postings. I try to

post something on Facebook, LinkedIn and Twitter every day – not just about my services and books, but also informative and “just fun” stuff. I want my followers to see me as a human being as well as a coach. I am always working on getting more followers. One of the best ways to do this is writing monthly newsletters, so I write 3 different newsletters a month, for 3 different types of followers. I spend a few hours a day just writing. I spend about a half hour a day on my newsletter writing, about a half hour a day on updating one of my 26 current books, and/or writing a new one, and about a half hour a day on my social

media sites and my website. It’s time to put my work away and spend some time with family and friends. I find seeing them for dinner is the best way to spend quality time together. Before or after dinner I do dishes, laundry, and general home management. I crawl into bed around 8pm to watch one of my favorite TV reality shows that I’ve recorded on my DVR. Tonight it’s Housewives of Orange County – oh the drama!! It helps me unwind and get my mind off my work, and especially makes me grateful that my life works for me! A little more gratitude and I’m off to sleep…

ABOUT THE AUTHOR Lyn Kelley runs www., which offers educational programs for Mental Health Professionals, Coaches and Medical/Healthcare Providers. She can be contacted at lyn@

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Cyber Supervision Anne Stokes

No academic solution Is satisfactory It has to be a lived posture (From Miller Mair in ‘No academic solution’)

For me, these four short lines embody the essence of supervision. While theory and academic knowledge are useful as an underpinning, we miss the person, both the client and the supervisee, if supervision is not a ‘lived posture’. What I would like to suggest in this short article is that using our creativity helps us to move towards that integration –


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that living posture. It can cut through the layers of ‘shoulds, oughts, musts and mustn’ts’ and help us discover what may be happening in the counselling relationship and how we can then be alongside our clients as they journey. Humans are creative beings, though through education and life experiences, many people believe that they are not. Creativity is wrongly equated to being ‘artistic’, rather than being concerned with using our ability to harness our right brain. Using our creativity with our online clients and supervisees may help them to break through to meanings and understandings that they are struggling with. Because it often by-passes conscious

thought, it can be very powerful. However, counsellors and supervisors may be loath to engage in this area of work because they have not had the opportunity to try it out for themselves. I think this is especially true with online work, as we panic, thinking we don’t have the tools to hand in the same way as in our f2f practice – no stones, no paper, no felt tips! But remember – creativity is a way of being! Therefore in the moment in online supervision, decide what might ‘fit’ in being useful to shine a light on the process. Does the client (or the supervisee) use visual or auditory words? Do they use metaphor and images? Go with this as it suggests they may

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Using Creativity in Online Supervision be receptive to working in a particular way. Photographs, drawings, and collages can be shared, either directly or through scanning them. This can be done whether you are working synchronously or asynchronously, particularly once you are both used to working this way. You can use a whiteboard together and create images or drawings, or show the supervisee’s understanding of a particular dynamic (different sized and coloured circles can be the equivalent of the stones in f2f work!). I have found that supervisees (and their clients) often refer to a scene from a film, or a piece of music. These can be accessed comparatively easily

online, though possibly not as instantaneously as we would like. Using these can bring hidden feelings, thoughts and awareness into the online room. Simply working with words can be so creative. Poems and stories are written and shared – in the moment or by email as part of supervision by email, or before a session in realtime. Indeed, I have experienced supervisees writing poems or short stories in the online session which have powerfully brought about a new understanding or insight. If you are a Second Life resident, you might well take your supervisee (or your supervisor!) into your office and work there in the fantasy world. This would be a very good way

of undertaking a ‘supervision journey’ with the avatar client. One of the important aspects of working with our creativity in supervision concerns how to translate this back into the work with our clients. Sometimes our new understanding of a particular aspect of the process is enough – it will transform our work simply through that awareness. However, it is sometimes essential to put time aside in online supervision to ask ‘What does this mean in my practice with client Y? Do I need to “do or be” any different?’ In a synchronous session, the supervisor can ensure that time is set aside for this. In asynchronous work, it may be that the supervisor asks the question in an email exchange,

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TILT – Therapeutic Innovations in Light of Technology

and leaves the supervisee to reflect on this themselves. There could, of course, be a further exchange of emails to consolidate and integrate this aspect. As an appendix to this article, there are some suggestions of ways of working. You may or may not want to try them out. A final word of warning though – if we become slaves to creative techniques, rather than being creative in our ways of living our online supervision, then we are in danger of changing the opening lines above to ‘No creative technique is satisfactory’.

‘What do I want to learn Or come to know In the psychotherapeutic situation? …………………. What it is to reach for The spirit of man (From Miller Mair in ‘What do I want to know?’)

REFERENCE Mair, M. (1989) Between Psychology and Psychotherapy: a poetics of experience. London Routledge

Some t Blocks to Creativity • Using the whiteboard, make a circle of aspects of your creativity (you could also draw this offline, scan and send it to your supervisor. Another way would be to use clip art rather than drawings) • Place ‘yourself’ in the middle • Then put in representations of what might block you using your creativity in your work • With your online supervisor, consider what you need to help you remove the blocks

The Fish Exercise ABOUT THE AUTHOR Anne Stokes is based in Hampshire, UK, and is a wellknown online therapist, supervisor and trainer and Director of Online Training ltd.


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(yes – this favourite f2f exercise can be done online too!)

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things to try! • Think of a client • Draw that person as a fish

• You could do the same thing with films.

• Now add yourself in • Look at your drawing and notice what you see • Ask your supervisor to notice what s/he sees

Writing a Poem Think about the online supervision of this client: • What has come to you?

Here are two ways of using stories . • The first is access which story (great literature, fairy tale, best seller) comes to mind when you think of them. This will often reveal aspects of their life or your relationship with them • The second is to ‘write’ their story with your supervisor as a witness. It could be done in a live session, or by email. It can highlight how you view the client, and /or things about them you haven’t noticed.

• What have you learned about yourself, your client or your work? • What do you want to leave behind or take away?

supervisor the drawing you have done offline. • Look at that picture with your supervisor and see what new meaning can be drawn from it. Now create your own ideas and share them with your supervisor – they will be better than anything from outside! Experiment and believe in your own creative spirit.

• Do you want to send this poem to your online supervisor? Thinking about Systems • Use a system your client is in, and draw that system as a room/sweet shop/ house. You could use a whiteboard in a live session, or send your

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Considering the Between Twitter Samantha Murphy In the past year or so, I’ve given in and am finally on Twitter because I’m currently working as a psychotech journalist and it’s proven itself to be a great way to find stories, monitor chatter between sources, and network with fellow reporters. But for professionals like us, and especially clinicians, it’s much more complicated than it seems, and blurring the lines can happen in a single tweet. But the deeper you get into the “Twitterverse”, you’ll find that not only does it come with its own language, but also its own set of norms. It always amazes me; despite the massive volume of civilized people dwelling within its pages,


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things are drastically different from the real world.

part of the Twitterati. In real life, you’re a gossip.

So here is a quick guide to the rules I’ve discovered:

On Twitter, when you add celebrities, politicians, and interact with them, you’re using the platform appropriately. In real life, you’re a #1 fan!! (And, on security’s “watch list”.)

On Twitter, when someone “follows” you, it’s good. It means they want to read what you write. In real life, it’s creepy. It means they might plan to kill you. On Twitter, when you “follow” someone else, they’ll often thank you for the compliment. In real life, when you follow someone else, they’ll probably call the police. On Twitter, when you read and comment on everything you see and just want more, you’re

On Twitter, preaching regularly about your deep thoughts or observations makes you an active user and desirable to follow. In real life, sharing these things so persistently would get you labeled with delusions of grandeur or at the very least, annoying. How do we remedy these two worlds? I mean, even I get

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Cultural Differences and Offline Life confused. I’ve had thoughts all week that I’ve been fighting off sharing with people. Twitter teaches me that everyone’s interested, so I came really close to telling people today that I notice that unless I’m sitting upright, I am always clenching my buttocks. Is that interesting? I don’t even know anymore. Twitter has blurred my lines of tact and common sense. An otherwise sane person, I now interact with Charlie Sheen and giggle with delight when he responds. I “retweet” crude messages by comedians. I hawkishly monitor the Real Housewives of every city for any signs of drama, and I read

everything posted by game designers and science mags and am left still wanting more. Nothing is ever enough. I don’t know which world is right or why. But I’m happy to be a functioning member of both societies. The real concern, however, is when they merge… When the most popular people are the ones with the most stalkers and entertain them with witty quips at regular intervals to keep them comin’. When I casually inform my grandmother about the discovery of my new favorite sexual position during Wimbledon. When students announce their crushes in the

Samantha Murphy is a former psychotherapist turned freelance psychotech writer based in "Silicon Pastures", aka, Lancaster, Pennsylvania. She discusses all things psychology, technology, and bacon-related at @smanthamurphy.

middle of the cafeteria- ZOMG. Until such time, I appreciate having an outlet for documenting my every experience, thought and observation. Moreover, I like that others are doing the same. I can appreciate a window into someone’s mind as much as the next therapist. But most of all, I’m glad that when in person, we all pretend it never happened.

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TILT – Therapeutic Innovations in Light of Technology

Marketing Toolbox

Susan Giurleo

All real estate agents know that building their business is about location, location, location. The same can be true for your online practice. Marketing, whether done online or off, is all about people getting to know, like and trust you and your services. Often the process of getting to know people can be easier in your community than online. Think about this: if you see face-to-face clients they already know, like and trust you. They may be the first (and best) candidates for your online work. Maybe they are ready to step down from intense office-based work, but could use an occasional check in by video or email. Maybe you work with parents who find it difficult to come to the office weekly due to child care issues, but would be happy to meet via video. Or maybe you have an online psychoeducational program that will benefit current (or former) clients to improve their treatment outcome or maintain their progress.


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Other community resources Often our patients have connections with other professionals who might benefit from knowing of your expertise. While we never ask patients to do our marketing for us, it is perfectly acceptable connect with other providers to coordinate care (with a signed release of informed consent, of course) or inform about your practice offerings. Online therapy and psychoeducation is unique and convenient. It is often something interesting to talk about at networking or professional events. Colleagues, who have client referrals that they cannot accommodate, may refer to your online practice due to its convenience or unique characteristics that may be a better treatment option for certain people. Online therapy can certainly be marketed online, but don’t overlook the many marketing opportunities right in your back yard. Online therapy doesn’t always need to be distance therapy. It can be a treatment option for those looking for convenience and/or as a better modality due to presenting concerns for people in your immediate community.

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Marketing Your Online Practice Close to Home

Considering taking our course that compliments the ideas expressed by Susan!

ABOUT THE AUTHOR Dr. Susan Giurleo is a psychologist who blogs about health care, small business and social media marketing at You can connect with her on Twitter at @SusanGiurleo

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TILT – Therapeutic Innovations in Light of Technology

“I suggest that the only books that influence us are those for which we are ready, and which have gone a little farther down our particular path than we have yet got ourselves.” ~E.M. Forster

Love For the

Books of


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Controlling_Connectivity: Art, Psychology, and the Internet Gretta Louw There are many who argue that participation in the elaborate communication networks that now underlie social interaction is no longer a matter of choice, since failure to participate is akin to social withdrawal and even ostracisation. It is argued that with the opportunity for connectivity and limitless access to information, comes the obligation to be increasingly available to receive and transmit; to be perpetually connected. The consequent erosion of true leisure time, the blurring of the traditional professional / personal, public / private dichotomies, and an information overload are creating hitherto unknown levels of psychological pressure.


Controlling_Connectivity uses the pervasiveness of internet-based social networking, and our ability to (and ever increasing obligation to) constantly be connected with these platforms as a paradigm for a severe and systematic disruption of normal, socially accepted patterns of time within daily life during a self-documented performance.

Alone Together: Why We Expect More from Technology and Less from Each Other SHelly Turkle Consider Facebook—it's human contact, only easier to engage with and easier to avoid. Developing technology promises closeness. Sometimes it delivers, but much of our modern life leaves us less connected with people and more connected to simulations of them. In Alone Together, MIT technology and society professor Sherry Turkle explores the power of our new tools and toys to dramatically alter our social lives. It's a nuanced exploration of what we are looking for—and sacrificing—in a world of electronic companions and social networking tools, and an argument that, despite the hand-waving of today's self-described prophets of the future, it will be the next generation who will chart the path between isolation and connectivity.


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TILT Magazine (Issue 10)  

Therapeutic Innovations in Light of Technology is about envisioning therapeutic interventions in a new way. TILT magazine is published bi-mo...

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