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Introduction
This section provides some history regarding the formation of the
Avatar Training Process group project and offers some insight into
the need for such a group for mental health professionals.
Abstract
The growing popularity of the Internet among the general public
has opened up an exciting new avenue for the delivery of mental
health services. Cybertherapy, Net Counseling, E-Therapy and a host
of other terms are being coined to describe this new direction in
mental health. Lured by the promise of a global client base, many
mental health professionals are setting up web sites and virtual
offices from which to practice. While most would agree that what
they offer is not therapy, the debate over what constitutes therapy
and the ethics of online service delivery continues. A common thread
in the code of ethical conduct between psychologists and mental
health counselors is that [practitioners] shall have training, experience
and supervision in an area and ensure competence to protect others
from harm
(American
Psychological Association, 1997;
American
Counseling Association, 1997).
Social workers have a similar call to become and remain proficient
in professional practice.
(National
Association for Social Workers California Chapter, 1997)
At the present time, no such training and supervision exists.
The Avatar Process Training Group, APT, is one of three online
training groups being developed as a means of investigating the
feasibility of providing training and supervision in online service
delivery. The other two included a small, private email group, and
a larger, listserv-based group. Both these groups were called NetPsy-EPT
and NetPsy-LPT. The idea for these groups came about as a result
of discussions held on the NetPsy listserv owned by Marlene
Maheu Ph.D. who suggested and initially organized their development
to explore online training possibilities.
The main objective of these groups is to provide a means of training
mental health professionals in the dynamics of online services delivery
by exposing them to the elements of online communication in a safe
and supervised environment. Professionals can learn first hand of
the problems that can be encountered online and gain experience
as a group member and group leader under supervision. APT uses software
that places group members in a three dimensional virtual reality
world with avatars to represent them. This software allows for a
wide range of emotional expression, movement, and realtime full
duplex voice communications.
Background
There is much debate on the professional listservs over how working
with clients online is the same or different from live face-to-face
encounters. Many cite the lack of visual and aural cues as being
a detriment to the assessment and therapeutic process. As a step
towards overcoming the missing aural component, it has been suggested
that the use of Internet Phone technology be explored. This technology
provides voice transmission through special voice compression software.
Professional (corporate) versions of conferencing software can be
quite expensive and are certainly out of practical reach of the
general public to be viable. However, many vendors offer Internet
conferencing software free of charge which provide many useful conferencing
tools. While they permit multiple simultaneous users to hold textual
chats and markup electronic white boards, they are limited to voice
communication between only two people at a time. This may be sufficient
for individual client contacts but certainly unsuitable for group
work.
There is a software product which provides both the visual and
auditory components missing from previous methods. The package named
Traveler provides access to a three dimensional, virtual reality
world. Users select an iconic representation of themselves, called
an avatar, from a list containing people, animals, objects, or fantasy
characters. Users may customize these avatars with color. To further
augment the visual aspect of this medium, the avatars are able to
display facial expressions depicting a neutral expression, happiness,
sadness, anger, or surprise. These expressions can be changed at
any time during the online conference. The graphic below is the
Onlive! Traveler window which depicts an avatar I easily customized
to closely resemble myself.
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Example of an avatar as it floats
in virtual reality space.
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The auditory component is provided with stereo effects that
allow the user to know which direction a sound is coming from.
For example, a person on a user's right will be heard from
the right speaker. In a crowded space, it can sound like a
party with many conversations going on at once. The closer
one is to the person speaking, the louder they will sound.
Unlike the other Internet voice chat software, there is no
apparent limit to the number of simultaneous speakers.
These features make the OnLive! Traveler software attractive
for doing group work and opens avenues for distance learning
for training a new breed of practitioners.
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Project
Basics
The Avatar Training Process using the Traveler software is an ongoing
project. This section presents the fundemental details of the group
and acts as the mechanism to provide informed consent to group participants.
Group
Member Requirements
The group shall be composed of mental health professionals and
graduate students. Each member must be willing to devote up to two
hours a week for the duration of the group, typically five to eight
weeks. Prior to the group's actual start, members are expected to
participate in schedule planning to decide meeting days and times,
exchange of phone numbers and make arrangements with a local mental
health professional to cover personal safety issues. Members may
be asked for written comments and/or questionaire at the halfway
point and after group termination for the purposes of evaluating
the medium's effectiveness.
Hardware
& Software Requirements
There are specific hardware and software requirements that must
be met for participation in this project. The software used, Onlive!
Traveler version 2.02, is written for use with Microsoft Windows
95/NT only, sorry, no Macs. Also, the instructions used within the
software for the voice compression will only work on PCs with a
Pentium class processors. This means that your PC must be a step
beyond a 486 processor regardless of how fast it is. Your PC must
be equipped with a 16 bit or greater sound card, speakers and a
microphone or headset. OnLive! lists the hardware
requirements.
Group
Plan and Goals
The first phase of the APT group will begin with a core of six
members and a group leader. The group leader will have supervision.
Each member will be required to download and install the Traveler
software. Group members have the option of maintaining some anonymity
as the software allows the user to select a name for the chosen
avatar and the user profile information, if any, is whatever is
entered by that user.
The APT group will be initially conducted in much the same fashion
as a personal growth, encounter, or T-Group (Yalom, 1985). The group
will meet for five weeks for 1.5 to 2 hours each weekly session.
This time includes time set aside to process the evening's session
and look at what has been learned.
The goal of this first phase is to gain experience in the conduct
of a realtime online group of this type and explore its potential
as a means of training mental health professionals in online therapeutic
methods.
Phase two will explore the group as a means of mental health service
delivery by conducting a group where members assume the role of
a person suffering from a disorder of some kind. This group format
can allow the exploration of various disorders to find which can
be effectively dealt with online.
Basic Group
Rules
The APT group follows many of the standards of traditional face
to face groups however due to the electronic nature of APT, the
standard set of rules must be expanded slightly to cover other opportunities.
The standard core rules involve the maintaining of confidentiality,
group matters stay within the group, be polite and offer constructive
criticism rather than put downs, don't interrupt. These rules must
be extended due to the remote nature of the group membership.
The software allows for private text messages to be passed between
two members. This is not allowed as it may promote subgrouping and
interfere with the cohesion of the group. Also private communication
via email or telephone during group meetings is not permitted. The
aim is to keep the discussions within the group for the benefit
of all the group members.
Other group rules and norms will be developed as the group organizes
and progresses through various stages.
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The Meeting Space
Within several virtual reality worlds available are user
spaces where individuals can create their own space. Some
of these spaces may be protected by password. The space selected
for this project is such a space to protect against intrusion
and the group members' confidentiality. In addition to the
password protection to enter the space, individual members
cannot be identified as the persons within the room are blocked
from being displayed to anyone outside the protected user
space.
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View of the "lodge" as seen
from the front
looking toward the back.
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The virtual realm selected as the meeting place depicts a
lodge in the mountains. It is a wooden structure with a vaulted
ceiling with windows high above bathing the interior space
with sunlight. Windows also line the wall on one side of the
lodge which reveals the green forest and underbrush in the
foreground, purple mountains in the distance and a blue, partly
cloudy sky. Inside this roomy space is a fireplace with triangular
flames of red, orange and yellow. The sound of the crackling
fire provides a cozy backdrop for conversation. The lodge
has three levels with each level raised a few virtual feet
above the other. A wooden railing surrounds the upper deck
and down along the steps to the lower levels.
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View of the "lodge" as seen
from the back
looking toward the front.
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Special
Considerations
A consideration is group size. The software considers the proximity
of people to one another in the determination of the volume level
for each voice. For a group to be gathered in a circle, the more
members in the group, the larger the circle. It is possible that
people on opposite sides of the circle can not hear one another
so a smaller circle is needed. An interesting feature of a 3D virtual
reality world is that various configurations can be attempted such
as members stacking themselves. Imagine a group of ten people with
five people floating above the other five in a small circle. Perhaps
a spherical pattern can be put together to make use of the space
above and below the traditional circular pattern. Is this a solution
for larger group sizes?
Time zones must be taken into consideration with any realtime gathering.
Once reaching the three hour difference between New York and Los
Angeles, some extra consideration has to be given. The New Yorker
is home from work and has finished dinner while the Californian
is at work saying "An hour till quitting time." Once the
Californian is home and finished with dinner, the New Yorker is
looking at bedtime coming up soon. It becomes a matter of who is
willing to give up what for the group, work, dinner or sleep.
The focus of this group is not to do therapy but rather to develop
personally and professionally. Even so, there may be a time when
someone goes into a situation that cannot be left unattended. Therefore
some emergency procedures will be necessary. Each member is to have
someone locally that they can call upon should the need arise also,
the group leader shall provide day and evening phone numbers.
Technology related problems are not uncommon as most Netizens can
attest to. Internet users are at the mercy of telephone companies
and Internet Service Providers and may at times have difficulty
getting online. Members need to have a procedure to follow if this
happens to them. This is especially important should the group leader
be in this situation. The group members are also at risk of suffering
hardware failures as a reason for not being able to find their way
to the group.
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Disclaimer
Members of the group must be made aware of the experimental nature
of this group and that there are many unknowns involved in the delivery
of mental health services via the Internet. Every precaution is
being taken to ensure that the safety and confidentiality of the
group members is upheld. The inherent structure of the Internet
makes it impossible to control many of the factors one may encounter
during a group session. Participants enter into this group at their
own risk and agree to hold harmless any sponsoring agency or individual.
Members are free to drop from the group at anytime.
Summaries
of Trial Runs
This section provides summary reports of the groups that have been
run as well as provide progress reports on current group activities.
The First
Attempt
The first attempt was begun in mid April, 1997. Members were solicited
from the NetPsy listserv. The group members were to create a distribution
list containing all the member's email addresses and group communications
began by e-mailing messages to the distribution. Initial group business
was conducted in this way and was to continue until the group met
at the virtual group site. That attempt was instrumental in pointing
out several areas which needed to be addressed more closely for
subsequent groups. Overall, there were two major problem areas;
overcoming the technology and building group cohesion during the
initial planning and scheduling phase of the group.
Fighting Technology
The software was easily installed however configuring it often
posed a problem for some. The virtual reality site itself turned
out to be quite troublesome as well. OnLive Technologies maintains
several sites on their servers which are very heavily used. Consequently,
connection to the servers could take several minutes to complete
giving the impression that the PC has locked up triggering the user
to initiate a reboot. Another consequence of the heavy use is the
servers would often reset throwing everyone off unexpectedly. It
must be stated here that these problems are not software problems
but simply the result of overloaded servers. The technical staff
suggested a couple of sites that could be used that were relatively
unused. Due to the need to maintain confidentiality these sites
were not suitable as they were open sites and not password protectable.
Several members reported having difficulty with establishing their
Internet connection at the appointed time.
Getting The Show On The Virtual Road
Due to the unprecedented nature of the project, it was decided
that the group should start with only a few members then as more
experience was gained more members could be added. A smaller group
could better deal with any obstacles encountered along the way.
There were many persons who requested to be a part of the group
but had to drop out for various reasons such as improper hardware
or operating system, conflicting commitments, and technically challenged
among others. Once the number of members was reached, other requests
were placed on a waiting list. Many of those on the list never responded
when they were called to replace another who dropped out.
Since this was going to be done in realtime, the group membership
had to be able to meet at a time which was convenient for all. In
this situation having members in adjacent time zones clearly creates
the least amount of conflict. The east coast/west coast time difference
became an annoyance to be dealt with pointing out the importance
of trying to stay within adjacent time zones. It was very difficult
to reach a consensus on scheduling and rules and members stopped
responding to the email so the group never actually materialized.
It was apparent that there was a lot of frustration for many of
those who participated in this attempt which no doubt led to their
subsequent departure from the project.
Group cohesion never occured as members were unable to simultaneously
meet. There was also very little e-mail traffic directed to the
group as a whole despite the initial call for the creation of a
distribution list of group members. Members did not or rarely interacted.
My thanks!
Finally, for those of you who were so brave and willing to participate
in the great unknown, I give you my most sincere thanks for your
efforts. Let's try this again soon.
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The Second
Attempt
The second attempt is currently in the planning stages. Keep watching
for further developments.
The Future
of Avatar Training
The groups being conducted using the Traveler software is just
one of many projects that will be undertaken in the months to come.
Currently, another package is being evaluated for use and trial
groups will be conducted with it as well. This will be an ongoing
process of locating and evaluating applications that can be used
to train mental health professionals to provide individual and group
services online as well as provide direct training with specific
applications.
Avatar training will help professionals to integrate their current
face-to-face skills with the virtual world. For example, avatars
have a way of making individual and group sessions more natural
than typical textual chat or email methods. Advanced packages like
the Traveler software also add the dimension of voice and facial
expression to reflect mood. The ability to move about the room provides
more clues to a person's state that might otherwise go undetected
with conventional text only communication modes. A person's choice
of a particular avatar may offer clues that can be therapeutically
used. These are all areas to be explored by professionals and topics
to be covered in future courses.
Ethical concerns must be addressed as most professional organizations
begin to seriously look at the ethics of online service delivery.
Patient/client safety and confidentiality are also matters for concern.
Avatar training will go beyond the mechanics of using technology
to provide services, ethics and competencies must play a major role
in the overall training as well.
The Goals of Avatar Training:
- To provide the mental health community with the opportunity
to get first hand experience with conducting online individual
and group sessions in a safe and supervised environment
- Provide guidance for ethical practice online
- Advance the state-of-the-art of online mental health practice
by developing online techniques and methods
- Assist in making online practice a viable adjunct to traditional
face-to-face contact
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