Category Archives: Online Therapy and Support

What’s this cyber speak business about then? (A Hopefully Useful guide to online communication when delivering support)

Lots of people are put of accessing or delivering support online because they feel uneasy about the language being used…it seems like everyone can speak it, except for those that don’t 🙂  It’s all too easy to feel left out in the cold but if you want to support people online you may have to bite the bullet and start LOLing with the rest of us, it’s not that hard…promise 🙂

Lets start by taking a look at some of the basics around online communication.  Some of you may be familiar with the term “cyber speak” or maybe “text speak” or possibly “net chat”, they all relate to a very particular way that people communicate online.  There are many “unwritten rules” when communicating online which I will attempt to capture for the purpose of this document.  However, given the nature and richness of online language and it’s constant evolution it would not be possible to write about all of these widely understood rules here.  So let’s get started 🙂

SHOUTY CAPS!! – If you’re typing with your caps lock on YOU’RE SHOUTING.  Generally speaking caps are reserved for extreme situations so be careful when using them.  I would suggest thinking to yourself “would I actually shout at this person if we were face to face?” before you type in caps, as most often the answer would be “No” and italics are sufficient. In some cases caps are used to emphasise a word in the absence of the italics function.

Actions – if you see any of the following in a chat room or e-mail they denote an action: ((hug)), (sigh), *wave*.  Actions are usually indicated by brackets or stars but other indicators could be forward slashes.  They’re often followed by the “at” symbol (@) to indicate who the action is being directed toward.  As with caps, we need to be careful when using an action.

Terms of Endearment – When being supported/delivering support online you will often come across others who are regularly referring to people as “Hun”, “love”  or similar. These are terms that are used much more widely online than during face to face communications.  Regardless of how frequently these terms are used online we must always remember that in some cases these terms could be be misconstrued or unwanted so if you don’t want to be referred to in that manner, please say so, and if others ask not to be referred to like this please respect their decision.

Emoticons – Symbols such as the ones you can see below are referred to as emoticons which are used to portray an emotion.  They can be added by simply clicking on one already available within the chat software you’re using or they can be typed as follows : )  ;P : ( :-O.  Most people accessing any kind of online group will be familiar with the use of emoticons and they can say a lot about a persons’ mood.  The use of emoticons to demonstrate you’re pleased to see someone or sad to hear their news can help to strengthen the online relationship and , if not used to excess, they are pretty useful!

Acronyms – acronyms are short hand methods of text based communication.  Many are so widely used that they have now made their way into mainstream offline communication.  Certain acronyms such as “lol” (laughing out loud) are very well known and most, if not all, of the people that you engage with online will know what they mean.

Online communication can be fast, fun and tricky.  There are many advantages to accessing online support due to accessibility combined with anonymity.  It does however have drawbacks as the very things that make it enjoyable can also lead us into a false sense of security.  If you’re used to online communication in your personal life you may be tempted to interact with others in a support environment in the way that you would usually communicate online ….but our interactions should always be informed by fact that a support service is not a social networking site or yahoo chat room.

So always remember:

  • Type clearly
  • Remain warm yet focussed on the reason you’re there
  • Pay attention to confrontational punctuation!!!!!!!
  • Let yourself be guided by the language used by others in groups and on forums
  • Take that extra moment to check what you’ve typed before pressing “reply”

And perhaps most importantly……

  •  If you wouldn’t do/say it offline, don’t do/say it online
Advertisements

Take a Punt on Online Support (Unedited version of article published in Therapy Today July 2014)

Working Online with Problem Gamblers

Hi, my name’s Jane Fahy and I’m the Clinical Services Manager for Gambling Therapy, a website that supports roughly sixteen thousand people around the world who either have a gambling problem or are close to someone who does. The work we do in Great Britain involves providing wrap around support for people accessing residential treatment in one of the Gordon Moody Association Residential Treatment Centres. We also educate and support their friends and families. Outside Great Britain we offer a range of services in different languages to supplement the face to face support provided by other agencies. We do this on our forums, in online groups, via e-mail or on our helpline.

The number of problem gamblers worldwide is hard to pin down for a variety of reasons that I won’t bore you with now….but generally speaking it’s accepted that between one and four percent of individuals that gamble have a gambling problem. Working with addictions is tough, ask any addiction specialist! On one hand your client wants to change, they’re desperate to, but on the other hand they are driven by a white hot desire to continue doing what they have always done. After all, it keeps them safe doesn’t it?

Some people struggle to understand how an addiction without the introduction of a foreign substance can hold an addict in its thrall in the same way as an addiction with the introduction of a substance. I mean I get it, why would you do something that cost every penny you had, destroyed your family and left you homeless unless you were high? So I suppose this leads us on to a discussion about what we mean by the term “high”, an altered state maybe….euphoria? Escape? All words I’ve encountered when working with problem gamblers.

How then is it that problem gamblers are unable to stop when they’re not actively gambling because surely the effects wear off quickly right? Wrong, the brain needs time to acclimate to working within a more “normal” range of stimulation, which can take a while! To put it in more simple terms, if you’d spent hours on a roller coaster and adjusted to such a high level of stimulation your head would spin for quite a while after you got off! So the cycle continues, the thoughts become more distorted and the gambler gambles until one day the cost is too high. That’s when I “meet” them 🙂

So how does it all work? Well, it’s kind of like a jigsaw puzzle that people coming to us for help put together themselves to form their own recovery picture. It’s a picture that changes depending on where someone is within their recovery and what they need on any given day. Accessing online services like ours means people can take a dynamic approach to their support and tailor their recovery so it’s personal to them. In practice that means that if the person accessing our site wants to talk to someone who’s “been there”, someone who’s bought the T-shirt they can do that. If people want to talk to a counsellor who can help them to explore the “whys” of their situation, they can do that too…kind of a pick and mix solution!

If we’re looking at the nuts and bolts of supporting problem gamblers online via an established website with a vibrant community, I guess we first need to look at online support in more general terms. What is it, and what is it our clients are getting from it? I view it in terms of the following categories:

  • Accessibility
  • Community
  • Anonymity
  • Flexibility

Accessibility – A client using online support can access that support at any time of the day or night irrespective of the time zone they’re in. Support can be accessed on a laptop, PC, Mac, on a tablet or even a phone. Effective and comforting assistance can be a coat pocket away!

Community – An online therapeutic community is a powerful entity. Many people who have accessed a support group talk about the feeling of acceptance that hit them like a wave when they walked into a room with others in similar situations. Now, imagine that room was a virtual room containing thousands of people from all over the world, all understanding at least part of your story, all wishing you well and offering you a hand across cyber space. Then that feeling of acceptance has the potential to turn into something altogether exceptional…maybe even overwhelming in its ability to wrap an individual up in a blanket of understanding.

Anonymity – As therapists we often hear clients talk about shame, the shame of an addiction, an experience or even a relationship. Part of the work we do is to break through that shame and allow our clients to express themselves freely through their experience of our unconditional positive regard. Understandably it can take our clients time to perceive our lack of judgement and feelings of warmth towards them which allows them to speak freely but what happens if they don’t have to look us in the eye? Kate Anthony, CEO at the Online Therapy Institute and Fellow of the BACP, refers to this as the online “disinhibition effect” a term initially coined by eminent psychologist J.Suler.  Anonymity allows clients to express themselves on a deeper level, perhaps more quickly than they would in a face to face setting and, if managed correctly by the therapist; this can lead to some very valuable work carried out over a relatively short period.

Flexibility – We all respond differently to different kinds of support and different people but sometimes it can be hard for us to be specific about what we need and what works for us. Without the need to maintain premises that can only be open at certain times, staffed by at least two people, usually more, when open for the sake of safety and often held back by physical constraints, online support is often more dynamic, lean and capable of rapid change than a land based practice. The range of services can be adjusted relatively quickly to meet the needs of those accessing them and feedback concerning what those needs are is often frank and forthcoming thanks to the aforementioned disinhibition effect. This means people accessing this form of support can choose from a wide range of help, some in real-time and some where the response is not immediate (as with forums), they can tailor to suit their personality and preference.

So we know why this kind of support works, but what specifically are the benefits and pitfalls of supporting problem gamblers in this way? Human beings are complex and problem gamblers are no exception, so when looking at how best to support them and deliver therapy we have to consider why they do what they do, what are they likely to respond to…most of all WHO ARE THEY?

I’ve come into contact with problem gamblers from all over the world who gamble on everything from poker to scratch cards…online or in a casino or betting shop…games that are legal or illegal…..alone or with others trapped in the same downward spiral. I guess the thing you need to know about problem gamblers is that there are no two the same. But what remains the same with all of them is the pain behind their actions. So, ok they’re all different but that doesn’t explain why supporting problem gamblers online works so well?

Well, let’s not beat around the bush, with addictions to substances there will be many occasions when the people accessing support won’t be in a coherent state, particularly if they’re in their home environments and early on in their recovery. Being coherent is something that’s a basic requirement when it comes to getting help online and, where no dual presentation exists; it’s something that people I’ve supported don’t generally struggle with.

Something that helps problem gamblers in recovery is the use of practical barriers. These can include handing over financial control to someone they trust, self excluding from land based venues or adding blocking software to a PC or mobile device. Many barriers involve the avoidance of triggers and one of the biggest triggers for many is walking past a bookies. For those of you reading this article from within the UK I’m sure you can imagine just how hard it would be in many of our towns and cities to plot a route somewhere that didn’t take you past a bookies? Whilst I don’t object to seeing bookies on our high streets, as I’m aware many people can, and do, enjoy gambling responsibly and recreationally, I have to feel for those that must feel they can’t escape from them. You don’t have to walk past a bookies, a casino, an arcade or a shop selling scratch cards to access help online so in a vulnerable moment the people we support relish the opportunity to connect and talk to us without taking that risk.

Of course it’s not possible to avoid all triggers, emotionally charged situations or vulnerable moments over an entire lifetime so in order to regain a sense of living a “normal” life in which avoiding triggers doesn’t play such a prominent part, problem gamblers may initially use online support as a safe and secure stepping stone back to the life they want. If we revisit the idea of the online therapeutic community that I mentioned earlier, the potential for the community as a whole to role model recovery and a return to normality is vast particularly for those who’ve completed residential treatment because leaving that bubble can be extremely daunting! The community also performs the very valuable function of acting as an ongoing safety net, always there if needed, never judging the individual in need.

Our virtual doors are open to male and female problem gamblers but something that I found surprising when I first started delivering online support was the number of women accessing the support when compared to men. I had wrongly assumed that problem gambling was a predominantly male concern…I guess I had an image of Del Trotter in my head standing outside the bookies clutching a betting slip and proclaiming “This time next year…” Needless to say, that’s not what I found and shame on me for making assumptions J Perhaps because of this common assumption women often hold off on accessing face to face counselling or group support but they seem more willing to engage with therapy online….maybe because they can choose whether or not to even disclose their gender at first. Maybe because they’re not walking into a room full of men, which they could be imaging will be the case, or maybe because they feel less judged online for being women who gamble for the reasons I’ve already mentioned. You might be surprised to learn that out of the 1868 most recent contacts, women made up roughly 46% of the people accessing the Gambling Therapy helpline or online groups.

Styles of gambling vary so much from country to country, as do attitudes towards gambling and the help available to problem gamblers. In countries such as the USA many people are used to getting support for a variety of reasons and help is readily available. However, in some other countries help might be limited and people in need of it may be being actively discouraged from seeking help outside of the family unit. Because we work in the way we do, with people from all over the world, we have to work in a truly transcultural way. We can’t know everything of cultural significance relating to every corner of the globe so we HAVE to work with the person on the other end of the screen without making any assumptions based on where they’re from. We find out everything we need to know about them, from them, and put the individual client at the centre of the process rather than being influenced, however subconsciously, by a cultural stereotype.

As with any personal development work it can be rewarding to reflect on our progress. Some use forums as a journal open for people with similar experiences to read and contribute to. Others use them to pose questions and support their peers. What is ALWAYS useful is to look back during vulnerable moments to see how far we’ve come.

So, that’s all from me, I’m sure you’ll agree that there is value in online support and see its potential particularly in terms of supporting problem gamblers. I hope you’ve enjoyed this small glimpse into our world. Thanks for reading 🙂 TTFN

 

Jane Fahy (MBACP)

jane@gamblingtherapy.org

Clinical Services Manager

Gambling Therapy, Part of the Gordon Moody Association

When Worlds Collide (First Published in TILT Magazine in May 2013)

Ok, so I’m not a techie, not really a techie, although I am married to a techie 🙂 but I do like online gaming and social networking and I have been known to frequent chat rooms in my distant past.  But all of that, well it’s just childishness really, just harmless escapism with no useful application; I wasn’t learning anything or developing any skills whilst engaging in these frivolous activities….or so I thought!

2014-04-08 17.53.26This is me 🙂

But I’m getting ahead of myself. I started my training as a counsellor about nine years ago, before that I worked in banking which is all very dull and irrelevant so I won’t bore you with that! At the time I had an eighteen month old daughter and I was working part time so I thought, well this is it, now or never, let’s do something that I really care about and my foray into counselling began.  I loved it every bit as much as I thought I would but with coursework and placements everything got a little bit stressful and I needed a way to unwind which is when my lovely (techie) husband said “Well why don’t you give World of War craft a go?”

So I did 🙂 by day I was a mild mannered (somewhat) trainee counsellor, mother and wife and by night I was a spell slinging uber mage with a penchant for turning monsters into sheep (Seriously you can’t make this stuff up). I loved the double life, the responsibilities I had for my personal and professional growth and development, for my clients and for my family were tucked away safely in the back of my mind while I romped through a fantasy world where I could be, or do anything.

But what did you learn, I hear you cry? Well my typing speed increased first and foremost! I learnt to work with large groups of people and communicate clearly with them via text.  I learnt that relationships forged online have value, my fellow players were not merely pixels on a screen they were mothers and soldiers and students, they laughed and cried and became frustrated (often with me, because in all honesty I wasn’t that great at the game!) and they were friends.  Eventually however I simply didn’t have the time to dedicate to the game and so with reluctance WoW and I parted ways.

Let’s move on a couple of years….

Having worked with compulsive gamblers for two years in a land based venue I was approached by an organisation that delivered support and therapy to problem gamblers online.  I’ll be honest here, I wasn’t convinced! How could I convey empathy, compassion and understanding via a computer screen?  How could I work with body language without a body to observe?  But that’s when it occurred to me, all of those times when I had understood others that I had only ever met online, I had shared things with those people whilst running away from goblins or trying to stop the zombie apocalypse.  Those connections had been real; those feelings had been real and those relationships had existed beyond and outside of cyberspace. So in that moment I understood that if I could recreate the strength of those connections with clients, albeit as part of a therapeutic alliance rather than a friendship, I could provide effective support and therapy.

I would like to say here that the epiphany didn’t mean that I was magically able to deliver effective online support just because I used to be a gamer.  Far from it! Certain ways of expressing things online are simply not appropriate when you are working therapeutically yet my fingers wanted to type the words anyway so I had to be very aware of that to start off with.  So I reached the decision to do things properly.  Proper training a high level of dedication and a wholehearted belief that I can really make a difference to others by delivering therapy online are what I need and whilst I have two out of three it is the first of these things that led me here.

I look forward to learning more and I know it won’t be easy but this is important to me so I’m prepared or work for it!

This article was first published in TILT Magazine (Therapeutic Innovations in Light of Technology) and I am pleased to say I have since qualified and continue to work therapeutically online.