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How Can a Psychiatric Case How Can a Psychiatric Case Ruin Your e-BusinessRuin Your e-Business

Authors:

Milan Simic, frejzer@yahoo.com

Sonja Mrvaljevic, dzerejna@yahoo.com

Veljko Milutinovic, vm@etf.bg.ac.yu

A Synergy of Business and Medicine

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Problem ...Problem ...

What are the damages that a psycho case can create to your e-business on the Internet?

• Absence from the work• Lower productivity at the work• Physical damages to the work

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Do you really think Do you really think that they can make no real harm?that they can make no real harm?

Computer Security Institute (Poll of 2001): 25% (of respondents) detected system penetration

from the outside.

27% detected denial of service attacks.

79% detected employee abuse of Internet access privileges (e.g., downloading pornography or pirated software or inappropriate use of e-mail).

85% detected computer viruses.

273 organizations (that were able to quantify their losses) reported the total loss of $265,589,940.

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… … A SolutionA Solution

Prevent Defend Help these people If you can not win

against them,join them!

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If Still Skeptic, Read This:If Still Skeptic, Read This:

The art of war teaches us to rely not on the likelihood of the enemy’s not coming, but on our own readiness to receive him; not on the chance of his not attacking, but rather on the fact that we have made our position unassaible

Sun Zi, VI B.C.

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The InternetThe Internet

• Internet traffic doubling every three or four months• By 2004, the Internet use will grow to over 700M users• The growth chart is of S-type

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Year 2000Year 2000

Male 52,7%Female 47,3%

EducationH.S.graduated 18,8%Some collage 20,9%Bachelor’s degree 25,1%Post-graduated 16,9%

Age

0-17 19,1%18-24 11,3%25-34 19,1%35-44 23,0%45-54 17,2%55-65 6,7%65+ 3,7%

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Online Disinhibition EffectsOnline Disinhibition Effects

You don’t know me

You can’t see me

Delayed reactions

It’s all in my head

Interaction effect

loosen up

feel uninhibited

express themselves more openly

Page Number 9/87*From Stanford University

Page Number 10/87*From Stanford University

Page Number 11/87*From Stanford University

Page Number 12/87*From Stanford University

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PsychologyPsychology

A scientific approach to understanding mind and behaviors

Investigate questions about why we think and behave the way we do

Develop a distinctive set of valuable skills

– Observation,– Critical analysis,– Oral and written

communication.

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Mental Health and Mental Illness Mental Health and Mental Illness

Mental health is a state of successful performance of mental function, fulfilling relationships with other people, and the ability to adapt, to change,and to cope with adversity.

Mental illness health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof)

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Measure of DamageMeasure of DamageMeasure of damage

behavior

cluelessnewbies

employeeswith psycho problems

time stealer

hackers

stupid buthard working

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Clueless NewbiesClueless Newbies

• user entering the environment for the first time may be confused about even the most basic aspects of the site• the most common problem is blocking• the users of Internet speak different language -Tower of Babylon problem

Possible Interventions:

• clueless newbies usually don’t require disciplinary action, but rather a little help• provide some kind of assistant or help system for your e-business

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How Should Behave How Should Behave the Personal Assistant on Your Site?the Personal Assistant on Your Site?

Personal assistant

Humble Persona

Take Homes

Personalized

U.Positive Regard

ReflectionUniversal Truisms

Free Association

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Personalized (1)Personalized (1)

Make sure the program learns the client's name and addresses. A simple little thing, but very important. When spoken to by name, the client will feel more "known" and personally connected to the computerized shrink. In fact, the more information the computer recalls about the person (age, occupation, marital status, the names of significant others, presenting complaints, etc), the better.

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The program's persona admits its mistakes, doesn't take itself too seriously, is humble, and can even joke about its shortcomings. The program freely acknowledgesthat it is not human. . Maybe it even wishes it could be human, since humans are "wonderful creations." Everyone loves a wannabe-human machine like Star Trek's Data.

Humble Person (2)Humble Person (2)

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Unconditional Positive Regards (3)Unconditional Positive Regards (3)

The program always values and respects the basic human worth of the client, no matter what the client says or does. While certain behaviors or traits of the person may be unbeneficial, the person as a whole is always GOOD!

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Reflection (4)Reflection (4)

It should be able to read between the lines. For example, it should be able to remember everything the client has said about "my job" and reflect those statements back to the client. All the program has to do is remember, collate, and reflect back

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Universal Truisms (5)Universal Truisms (5)

Having a much better memory than any human, the program can have a large database of universal "truths" about life - aphorisms, sayings, stories. The trick is having the program know WHEN to intelligently present a truism to a client.Specific patterns in what the client says must trigger the presentation of the appropriate truism.

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Supporting TechnologySupporting Technology

Software agents Client side programming

• JavaScript• DHTML• CSS• Java Applets

Server side programming• JSP• ASP• PHP

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Employees with Psychiatric ProblemsEmployees with Psychiatric Problems

• This kind of persons are not easy to recognize, because they usually behave normal.• 15,4% of all ill employees suffer from some kind of mental illness• They usually ask hard or unusual questions• They can make a huge damage to the company• The roots of their behavior stems from the childhood, and it’s usually some kind of trauma

Possible Interventions:

•There are two types of solutions: technical and social.•Technical issues: -CCTV -spy software -hardware for movement control•Social issues: -observation

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Destruction of Company for DummiesDestruction of Company for DummiesCan you steel your college’s

password ?Can you make your

college go out without switching offcomputer?

Free donuts in the coffee

room!

Can you steel yourchief’s laptop?

Can you send a virus to your

company?

Get the hammer in your handsand brake everything

yes no

yes

no

yes

no

yes

no

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Time StealerTime Stealer

• Time stealers have more of free time than they need, and they spend it on the Internet by asking unnecessary questions.• That’s the way they feel wanted and noticed• They have an antisocial character• They ask for attention

Possible Interventions

• Try sending of POLITE e-mail message• Try to ignore them• Mute them using technology

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Physical vs. Cyberspace Relationships (1)Physical vs. Cyberspace Relationships (1)

noyessmelling and tasting

noyestouching

yesyesseeing

yesyeshearing

yesyestext

Cyber

Relationships

Physical

Relationships

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Physical vs. Cyberspace Relationships (2)Physical vs. Cyberspace Relationships (2)

Advantages of Cyber Relationships• the time-stretching• distance-shortening

Advantages of Physical Relationships• touch• smell• taste• the complex integration of all the five senses

The best solution is to develop our relationships in-person and in cyberspace, taking advantage of each realm

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E-mail CommunicationE-mail Communication

E-mail communication creates a psychological space in which pairs of people interact

It is the most important, most common, and the most powerful method for communicating

Other ways progress to e-mail as a way to deepen the communication

Asynchronous interaction and interactive time can be shortened or stretched, as needed.

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The Life Cycle of a Mailing ListThe Life Cycle of a Mailing List

Every list seems

to go trough the same cycle:• Initial enthusiasm• Evangelism• Growth• Community• Discomfort with

diversity• Smug complacency

and stagnation

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HackerHacker

• Someone who illegitimately brakes into the system in order to access restricted privileges or databases• Antisocial and abusive• Psychoanalytic theory would predict an underlying Oedipal striving to challenge and prove oneself better than the father • What motivates the hacker?

•A sense of accomplishment,mastery, and power from doing what others can’t• impressing other users

Possible Intervention

•The server can be programmed to disconnect hackers

•You can make database with IP address and names of hackers You can share this information with other site owners

•Pay attention on password defending

•The intervention may need to be done as quick as possible

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The Top 10 Tips For HackersThe Top 10 Tips For Hackers

BIND weaknesses

Vulnerable CGI

RPC

RDS security hole

Sendmail buffer overflow

Sadmind and mountd

File, information sharing

User IDs

IMAP and POP buffer overflow

Default SNMP community strings

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Denial-of-Services DeconstructionDenial-of-Services Deconstruction

Client

This is the machine from which a hacker coordinates attacks

host

host

host

The machines (3-4) are under the attacker's

direct control.

broadcaster

broadcaster

broadcaster

broadcaster

broadcaster

These machines running the code

that directly generates the denial of service attack.

target

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Card Stealing-Hacker Attack!Card Stealing-Hacker Attack!

In January 2000, CD Universe's server was hacked by an intruder named Maxus, who tried to extort $100,000 after copying more than 300,000 customer credit card files. The hacker then posted 25,000 of the files on the Internet (a site that has since been shut down) after the company refused to pay blackmail. The case is under investigation.

In December 2000, a hacker stole 55,000 credit card numbers from Creditcards.com, a company that serves small and midsize merchants. The hacker published the information on the Internet after an unsuccessful extortion attempt. At press time, the FBI was still investigating the case.

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Credit Card Stealing - How They Do It?Credit Card Stealing - How They Do It?

Make Your Own Credit Card Online, anyone can download credit card account generators.

Skimming Retail and restaurant employees typically use skimmers, pocket-size battery-operated devices that cost $300 to $500, to steal customers' credit card information.

Site Cloning (or Spoofing) With this tactic, the fraudsters clone an entire site or just the pages from which you place your order.

False Merchant Sites These are usually porn sites set up solely for the

purpose of capturing personal data. Triangulation A fraudulent merchant offers an item like a video camera

at a deeply discounted price.

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The 5 Top Ways To Protect Your E-BusinessThe 5 Top Ways To Protect Your E-Business

Ask for a card verification value, or CVV—the three-digit number above the signature panel on the back of a credit card.

Ask customers only for information that is crucial to complete the transaction—but always verify their billing addresses. And never store payment information in a readable form on your own servers. Once the purchase is completed, delete payment information or transfer it to an offline system.

Use transaction-risk scoring software to trace historical shopping patterns and raise red flags for unusual shopping behavior. Some good bets are systems from ClearCommerce, CrediView, CyberSource, Digital Courier Technologies, HNC Software, and Mindwave Software.

Contact organizations like the Better Business Bureau Online, TRUSTe, and WebTrust to make sure your site meets their security requirements.

Limit employee access to sensitive data and payment systems.

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Top 5 Ways To Protect YourselfTop 5 Ways To Protect Yourself

Make sure the site's security is bulletproof.

Use a separate credit card with a low limit exclusively for online shopping.

Clean out your wallet.

Order a copy of your credit report to check for fraudulent activity. If you fall victim to identity theft—or even if you're just paranoid—slap a

fraud alert on your file.

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Our TribeOur Tribe

Developing of the

on-line community

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Online Groups and CommunitiesOnline Groups and Communities

Groups ranging in size from a few people

to thousands and millions within a "community" Issues to think about:

– leadership– communication patterns– group boundaries– cohesion– alliances – sub groupings

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Making Cyber Community WorkMaking Cyber Community Work

Psychology• Virtual community can confuse a new user

Technology• Server administration• Server side programming• Web design

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Nine Design Principles for Community-BuildingNine Design Principles for Community-Building

Define the PURPOSE of the community  Create distinct, member-extensible GATHERING PLACES   Create MEMBER PROFILES that evolve over time  Promote effective LEADERSHIP  Define a clear-yet-flexible CODE OF CONDUCT  Organize and promote CYCLIC EVENTS  Provide a RANGE OF ROLES that couple power w responsibility  Facilitate member-created SUB-GROUPS   Integrate the online environment with the REAL WORLD  

Amy Jo Kim

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Purpose (1)Purpose (1) Audience

Who are the potential members? What are their needs? Are there sub-groups? 

Mission Is there a mission statement? Are there "external" and "internal" versions? 

Visual Design Does the design reinforce the purpose? Does it have a "brand personality"?  

Back Story  Does the community have a back story? How does it get communicated among members?

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Gathering place (2)Gathering place (2)

Places What are the  gathering places? 

Map Is there an index/map that shows an overview of the different social spaces? 

Building Can members earn the ability to customize and create their environment? 

Features Can members earn access to more powerful communications features? 

Gallery/Rankings Ladder Are there places for members to showcase their relevant  talents?

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Member profiles (3)Member profiles (3) Barriers to Entry

Are the benefits & requirements of membership communicated up front? How much info is collected when becoming a member? Can non-members get a flavor of the environment? 

Representation Can members create & edit their own profiles? Are members encouraged or reminded to update their profiles?  

History  Is there an explicit history of each member’s participation within the environment? Does the system update the profile automatically with info about the member's participation in the site?

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Leadership (4)Leadership (4)

Hosting Program Is there an official hosting/mentoring program? Does it have levels? Is it based on recruiting volunteers?  

UberHost Is there an experienced person to guide and manage and train new hosts? Are they empowered to resolve difficult situations? 

Hosting Manual Is there a hosting manual? Is enough flexibility built into the rules to accommodate different styles of hosting? 

Tech Support  Is it clear to members how to get technical support, and what to expect?

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Code of conductCode of conduct (5)  (5)

Constitution Is there an explicit statement of member rights and responsibilities?  

Amendments Is there a process for evolving and mutating  this document?

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Cyclic EventsCyclic Events  (6)  (6)

Celebrations Are  there any regular daily/weekly/monthly/seasonal/yearly events to celebrate?  

Newsletter Is there a newsletter to alert members to upcoming events? 

Surveys Are there surveys (or other means) that "reflect" the scale and opinions of the community back to itself?  

Contests Are there any  contests that reinforce the community's purpose?

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Range of Roles (7)Range of Roles (7)

Visitors New Member Regulars Docents Leaders Owners 

For each of these roles, answer the following questions:•Power What powers does someone within this role have within the environment?   •Access What features and content do they have access to?  •Actions What actions can someone take within this role?   •Representation Is the person explicitly "tagged" with their role? •Status How can members attain status within their role?

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Sub-groups (8)Sub-groups (8)

Publicity Are members encouraged to create subgroups? Are the groups publicized within the community?

Infrastructure Do members have access to features that can help set up and run a subgroup? 

Events Can members set up, run, and promote their own events and contests?

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Integration with Real World (9)Integration with Real World (9)

Shared Events Does the community promote and celebrate holidays and events that reinforce community identity?

Personal Events Are there ways to acknowledge and celebrate important personal events in members lives? 

Meeting IRL Are RL meetings facilitated and encouraged? (when appropriate)

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On-line Education and TherapyOn-line Education and Therapy

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Real World PsychotherapyReal World Psychotherapy Psychotherapy helps individuals

explore and resolve more enduring and deeply felt sources of conflict and dissatisfaction in their lives, so that they will gain confidence and inner wholeness

“Building an alliance of trust with the therapist leads to a reshaping of significant emotional experiences, and builds confidence and wholeness in new and enduring relationships. It provides the presence of ‘personhood,’ not just technique.”

Gary Hellman

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HistoryHistory

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Recipe for Good TherapistRecipe for Good Therapist

KnowledgeAcademic degree

TrainingSupervised ClinicalResidency

CertificationProfessional Licenseor Registration

SkillAbility to listen deeplyWithout judging

CharacterWisdom,empathy

Relationship withyou

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Communication CanalsCommunication Canals real world meetings video conferencing phone sessions one-on-one text chat multimedia chat one-on-one e-mail message board group therapy e-mail group therapy chat group therapy online support groups online self-help tools informational web sites personal web sites, online journals audio recordings and films

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Benefits of Online TherapyBenefits of Online Therapy

The major benefit of online therapy is the opportunity to reach people who are unable to visit psychotherapists due to geographical, physical, or lifestyle limitations

Because of online disinhibition effect, computer-mediated therapy also may be an important initial step in the establishment of an in-person treatment.

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Problems of Online TherapyProblems of Online Therapy The legal and political dilemmas of online clinical work

• If a therapist in Serbia is working with a client from Chile in a chat room located on a server in France, where is the therapy taking place?

Training and credentials • Online therapist must have good knowledge in

communication and technology Is it ethical to attempt psychotherapy in cyberspace?

• Valuable information - like physical appearance, body language, and tone of voice - are missing

• The therapist also may not be able to verify the identity of the client

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Some solutionsSome solutions

For gathering information about client:• Video conferences• Multimedia chat• Sending audio and video recording through the Internet

For checking of therapist’s professional license: • Distributed database of therapists• Online validation through that database

For identity checking:• Secure networks• Using encryption • User verification software

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How virtual therapy can earn How virtual therapy can earn or save your money?or save your money? Why patient should pay for virtual therapy?

• The assistance of a professional can help you identify your needs, enabling you to deal with them faster and more reliably through specialized treatment techniques

• Paying systems provide some kind of checking and security If you are patient:

• Saving your time• It’s chipper then real world therapy

If you are therapist:• Saving in maintains• Saving in space• Saving in security costs

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Computer as a TherapistComputer as a Therapist

Can computers do psychotherapy all on their own, with little or no assistance from a human?

Will computers take psychotherapy off psychotherapist hands completely?

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Advantages Advantages

Computers carry out certain tasks efficiently, precisely, reliably, and fast.

With the necessary peripheral equipment, they are capable of detecting changes in voice, body language, heart rate, skin conductance and blood pressure.

Some people may feel MORE comfortable talking with a computer.

Once developed and installed, a computer program will probably work for the less than the average psychotherapist.

Computer is more accessibly. If a computer program is placed on the internet, anyone anywhere in the world can set up an appointment at any time.

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BarriersBarriers

There are some things almost impossible for a machine to do, like noticing sarcasm in someone's voice.

Computers can be programmed to look like they have feelings, but how intuition can be simulate?

Computers are very limited in their ability to adapt to changing or new psychotherapeutic situations.

Cost for developing of a very sophisticated computerized therapist can be too large.

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What a Computer Can Do?What a Computer Can Do?

They can do very well at structured intake interviews, administering and scoring quantitative psychological tests, memorizing results, and calculating diagnostic protocols

Using multimedia stimuli, Q&A interaction with the client, and perhaps even a biofeedback interface, the computer could guide the client, step by step, through almost any conceivable relaxation program.

Computers can help clients develop new skills for managing their cognitions, emotions, and interpersonal behaviors

Using a Q&A format, a fairly simple computer program could guide a person through a series of writing experiences adapted specifically for him or her

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Study CaseStudy Case

Find-a-Therapist.com

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Introduction (1)Introduction (1)

Find a Therapist, Inc. is Web based provider of services for mental health professionals and their clients

http://www.find-a-therapist.com/ This is a big international network of Therapists,

Psychologists, Psychiatrists, Social Workers, Marriage and Family Therapists, Counselors

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Introduction (2)Introduction (2)

This site have a part for consumers and a part for therapists

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For ConsumerFor Consumer

Offers therapist profiles to allow you to choose the therapist you feel is right to address your concerns.

Offers the convenience of consulting a therapist at the time and place most convenient for you

Private online chat, phone or email sessions are available At least,traditional "face to face" counseling may be

choice of consumer

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For TherapistFor Therapist

Offers opportunity to become part of the team Offers opportunity to register himself or herself

to the database of therapists Offer the convenient, cost effective,continuing

education courses for mental health professionals.

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Study CaseStudy Case

Eliza

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Introduction of Eliza (1)Introduction of Eliza (1)

In the 1960s, researchers at MIT pioneered the development of an interactive psychotherapy program.

Weizenbaum (1976) tried to write a programme to understand natural language.

This early and unsuccessful attempt to simulate language and therapy resulted in Eliza

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Introduction to Eliza (2)Introduction to Eliza (2)

In response to the user's questions and statements, Eliza applies basic counseling techniques such as reflection, focusing, clarification, and open-ended inquiry.

There are various versions of Eliza, some more sophisticated than others and every year there is a competition to find the best.

Some of them can be found on web address:

http://www.planetary.net/robots/eliza.html

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Eliza in ActionEliza in Action

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Eliza done wrong again!Eliza done wrong again!

Eliza often made mistakes That’s why the MIT researchers didn't intend it as serious

psychotherapy, but rather as an experiment in artificial intelligence.

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Study CaseStudy Case

Native Mind:

Self-help System

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Introduction to Native Mind Introduction to Native Mind

Native Mind Self-Help Systems began in 1996 as the Internet's first interactive self-help program

http://selfhelpsystem.com/ This site provides four systems (A, B, C, D) for self-help. You have opportunity to write what troubles you and to review the

feelings that you've associated with this issue Or to see what other people write down

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Passing Through the System (1)Passing Through the System (1)

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Passing through System (2)Passing through System (2)

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Passing through System (3)Passing through System (3)

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Passing through System (4)Passing through System (4)

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Study CaseStudy Case

Virtual Realty

And

Psychotherapy

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Virtual RealityVirtual Reality

A Virtual Environment (VE) can be defined as interactive, virtual image display enhanced by special processing and by non-visual display modalities, such as auditory , to convince users that they are immersed in a synthetic space.

VR is an application that lets users navigate and interact with a three-dimensional, computer-generated environment in real time.

According to different authors the essence of VR is the inclusive relationship  between the participant and the virtual environment

VR provides a new methodology for interacting with information.

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Needed Equipment Needed Equipment

Computer

Special helmet

Special glove

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Exposure TherapyExposure Therapy

Exposure therapy involves exposing the subject to anxiety producing stimuli while allowing the anxiety to attenuate.

These stimuli are generated through a variety of modalities including imaginal (subject generates stimulus via imagination) and in vivo (subject is exposed to real situations).

For example, if the patient is afraid of heights, therapy sessions might begin by looking through a third floor window with the therapist present.

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Problems with Exposure TherapyProblems with Exposure Therapy

Exposure therapy is:

• expensive

• logistically difficult to arrange

• presents significant problems of patient confidentiality and potential embarrassment.

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Virtual Reality ExposureVirtual Reality Exposure

A team of therapists and computer scientists led by Drs. Hodges and Rothbaum conducted the first controlled study of virtual reality exposure therapy in the treatment of a psychological disorder

Virtual Reality Exposure Therapy is be very effective in reducing acrophobic subjects anxiety and avoidance of heights, and in improving attitudes toward heights.

Current work by Hodges and Rothbaum includes designing a virtual reality airplane and conducting preliminary studies on the use of virtual reality exposure in the treatment of fear of flying

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ExampleExample

This is a VR simulation used for the patient afraid of height:

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Advantages of VREAdvantages of VRE

Virtual Reality Exposure is: Patient acceptance Effective therapy

• Virtual environments have the added advantage of giving the therapist greater control over multiple stimulus parameters as well as the ability to isolate the particular parameters that are most essential in generating the phobic response

Cost effective

• Many stimuli for exposure are difficult to arrange or control. The ability to conduct exposures of virtual airplanes for flying phobic without leaving the therapists office would make better treatment available to more sufferers at a lower cost.