Internet based information and councelling services for children –

Norwegian experience

Svein ØverlandBrøset Forensic Center, St. Olavs Hospital

NorwayPsykologivirkeligheten.blogspot.no

The traditional view of the internet

The new reality

Times are a changing

• The world has changed in so many ways

• This change has had a huge impact for

banking, newspapers and medicin

• But what about psychiatry?

Cosplay and Torucon

From zombiefilms to zombiewalks

Cyber warfare

Cyber pets

Geminoids

Young people have always dreamt of a better world

Internet enables them to do something about it

Mange synes Real Life ikke virker

But before we critize, - do we do enough?

The question is not

• If internet are here to stay or not• or if this is the way it should be,• but how to adopt and develop our own

services to better meet our patients needs

Melanie Klein and Play therapy

Søren Kierkegaard• “If One Is Truly to Succeed in Leading a Person

to a Specific Place, One Must First and Foremost Take Care to Find Him Where He is and Begin There.

• This is the Secret in the True Art of Helping”.

Definition of online therapy“The use of computers as tools to enable and/or enhance the provision of therapeutic services”. Abraham Wolf, 2003

But it is so much more• Blogs; - liseliten.com and

psykologivirkeligheten.blogspot.no• Computer games; - SIMS• Robot pets and geminoids; - Paro and Henrik• Textbased nonsyncronized communication;

text messages and e-mail (as supplement or by its self)

• Telephone contact and assisted self help, as stand alone or during the waiting-list period

…and more

• Closed forums; - selvskading.net• Realtime communication; - chat• Virtual worlds and avatars; - SecondLife• Specialized Virtual vorlds for treatment; - InWorld

and VEPSY• Smart phone applications; - StopSelfHarm• Integrated portals with multiple services

the future

Waiting for the psychologist in Habbo.no

The StopSelfHarm app

Exposure therapy in virtual reality

Skills training in groups

Evidence based• Good support for ”BluePages”, ”MoodGYM”,

”Good Days Ahead” and ”Beating the blues” • There is ample evidence for the use of online

therapy for anxiety and depression• Inworld have good data on spesific population

like autistic children and social skills• NICE guidelines exist• The Norwegian Psychologist Association has

developed their own guidelines

Online and digital therapy as supplement

• The aim is not to replace standard psychotherapy, but to use it as a supplement for services that are lacking, and to enhance the effect of standard therapy

For communication with clients that has difficulties in utilizing the standard services; because of distances, shame, or need for very specialized expertice

For more effective treatment; as homework, crisis management or during waiting list

For getting inspiration to further developing more effective ways of delivering help and treatment

The development of online therapy in Norway

• A handful of entrepeneurs and clinical psychologist in private practice has developed their own web-solutions

• The growing interest has led the universities to develop their own programs

• Several studies has shown promising and cost-effective results

Some interesting projects in Norway• Blue Pages and MoodGym both for adults and

adolescent, University of Tromsø• Online therapy and diagnostics for adults and

adolescents in, University Hospital of Bergen• Integrated telepsychiatry, University of Tromsø• "The thought bank", University of Trondheim

(NTNU)• Telephone based assisted self help, several

places

The future of online therapy in Norway

• A continued development and research of the effect of online therapy in the universities, hopefully coordinated by the health authorities

• A growing interest and use by the private health care sector

• A stronger focus on confidenciality, encryption, training and guidelines

My office in SecondLife

But it is not the real thing, is it?

• Thats true. You loose most of the everpresent natural small signals of the face, the twinkle in the eyes, the signs of someone soon starting to cry, the subtle dance between souls, the smell of fear and pheromones, the tender shaking of an an eyelid, - all those precious little moments of being a vulnerable and suffering human being.

Possible pitfalls• Some clients will find it to be too strange• It can be alienating• Done unwisely it can breach confidentiality• It might be “too” cost-effective• ?• ?• ?

Virtual Reality is ”the new world”

And what is Reality?

• “Reality is merely an illusion ... It is just a very persistent one”

Albert Einstein

• "When the online services of the future is starting to develop, we have an obligation as psychologists to be proactive both in scientific and ethical ways"

The president of the norwegian psychologist association

• "The difference between online therapy and standard psychotherapy is like the difference between poetry and prose"

Eva Jacobsen – Psykologonline on LinkedIn

Vi har tre muligheter

Good luck to us all!

www.psykologivirkeligheten.blogspot.no