Recommended
Recommended
More Related Content
Similar to Narrative therapy & virtual environments ppt presentation
Similar to Narrative therapy & virtual environments ppt presentation (20)
Recently uploaded
Recently uploaded (16)
Narrative therapy & virtual environments ppt presentation
- 1. Narrative therapy & Virtual Environments Natasha Hammond – 2014 natasha.hammond@gcap.ca Graduate Centre of Applied Psychology Athabasca University
- 2. Technology & Everyday Life
- 3. Second Life
- 5. Research
- 6. Second Life & Social Anxiety Disorder
- 7. Support for Narrative Therapy in a Virtual Environment Platform for Client metaphor Offers new ways for collaboration Co-construction of preferred Client story with advantage of a visual tool Clients can witness themselves in their preferred stories New opportunity to access Narrative Therapy
- 8. Limitations & Ethical Considerations Internet addiction Value of in-person therapy Operating within boundaries of counsellor competence Limits of confidentiality and anonymity
- 9. References Allison, S. E., von Wahlde, L., Shockley, T., & Gabbard, G. O. (2006). The development of the self in the era of the internet and role-playing fantasy games. The American Journal of Psychiatry, 163(3), 381-5. Retrieved from http://0-search.proquest.com.aupac.lib.athabascau.ca/docview/220505967?accountid=8408 American Psychological Association. (2013). American Psychological Association: APA statement on services by telephone, teleconferencing, and internet: A statement by the Ethics Committee of the American Psychological Association. Retrieved from http://www.apa.org/ethics/education/telephone-statement.aspx Avination Virtual Limited. (2013). Avination: The unique virtual experience. Retrieved from https://www.avination.com/about-avination.html Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. A. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2-4), 109-160. doi:10.1080/15228830802094429 Gerardi, M., Rothbaum, B., Ressler, K., Heekin, M., & Rizzo, A. (2008). Virtual reality exposure therapy using a virtual Iraq: Case report. Journal of Traumatic Stress, 21(2), 209-213. doi:10.1002/jts.20331 Gorini, A., Gaggioli, A., Vigna, C., & Riva, G. (2008). A Second Life for eHealth: prospects for the use of 3-D virtual worlds in clinical psychology. Journal of Medical Internet Research, 10(3), e21. doi:10.2196/jmir.1029 Linden Research, Inc. (2013). Second Life: Avatar. Retrieved from http://secondlife.com/whatis/avatar/?lang=en-US Marco, J. H., Perpiñá, C., & Botella, C. (2013). Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: One year follow-up. Psychiatry Research, 209(3), 619-625. doi: 10.1016/j.psychres.2013.02.023 Murphy, L., Mitchell, D., & Hallett, R. (2011). A comparison of client characteristics in cyber and in-person counseling. Annual Review of Cybertherapy and Telemedicine: Advanced Technologies in Behavioral, Social, and Neurosciences. Retrieved from http://www.therapyonline.ca/cybercounselling/_protected/resources/Readings/Client_Characteristics_in_Cyber_and_In-Person_Counselling.pdf Murphy, L., Parnass, P., Mitchell, D. L., Hallett, R., Cayley, P., & Seagram, S. (2009). Client satisfaction and outcome comparisons of online and face-to-face counselling methods. British Journal of Social Work, 39(4), 627-640. doi:10.1093/bjsw/bcp041 Riva, G. (2011). The key to unlocking the virtual body: Virtual reality in the treatment of obesity and eating disorders. Journal of Diabetes Science and Technology, 5(2), 283-292. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125918/pdf/dst-05-0283.pdf Wallach, H. S., Safir, M. P., & Bar-Zvi, M. (2009). Virtual Reality Cognitive Behavior Therapy for Public Speaking Anxiety A Randomized Clinical Trial. Behavior modification, 33(3), 314-338. doi:10.1177/0145445509331926 White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: W.W. Norton & Company, Inc. Yuen, E. K., Herbert, J. D., Forman, E. M., Goetter, E. M., Comer, R., & Bradley, J. C. (2013). Treatment of social anxiety disorder using online virtual environments in Second Life. Behavior therapy. doi:10.1016/j.beth.2012.06.001
Editor's Notes
- Technology has become an integral part of everyday life for many people in most parts of the modern world. People connect and reconnect with other people through social networking sites, blogs, email, etc. Image reference: http://2.bp.blogspot.com/-biObSsxrn_k/Uj1fS7CoJnI/AAAAAAAAIUY/noEtkgMo8yI/s1600/share.png
- Another common environment for people to interact is through massive multiplayer online games. Current popular games are World of Warcraft and Second Life. In these games, a player creates an individualized character or avatar that can be modified to personal preferences (e.g., hip size, hair colour, wardrobe, skin tone, etc.; (Avination Virtual Limited, 2013; Linden Research, Inc., 2013). Second Life has also been used for educational training sessions using immersive 3-D technology (Gorini,Gaggioli, Vigna, & Riva, 2008). It is technological advancements like these that have created new opportunity for therapeutic engagement.Image: http://2.bp.blogspot.com/-iLVGEgfw5hQ/TzSSOnRyGCI/AAAAAAAAACc/D4elSkEKrSg/s1600/virtualWorld.jpg
- Cybercounselling has demonstrated substantial growth over the past 15 years (Barak, Hen, Boniel-Nissim, & Shapira, 2008).This includes online formats such as: email, blogs, telehealth or e-health, self-help web-based, and virtual interactive formats.Image reference: http://cultura.culturamix.com/blog/wp-content/gallery/psicologia-online-gratuita/psicologia-online-gratuita-10.jpg
- Focusing on the virtual environments, past research primarily utilizes a quantitative method of inquiry where therapeutic approaches such as Cogntive-Behavioural Therapy, including Virtual Reality Exposure Therapy were selected to address problem areas such as, anxiety (e.g., phobias and panic disorders), stress, disordered eating and body image, weight loss, and posttraumatic stress disorder (Gerardi, Rothbaum, Ressler, Heekin, & Rizzo, 2008; Marco, Perpiñá, & Botella, 2013; Riva, 2011; Wallach, Safir, & Bar-Zvi, 2009; Yuen, et al., 2013). For example, in a study to address posttraumatic stress disorder (PTSD) with Operation Iraqi Freedom (OIF) veterans, the counsellor utilized virtual reality exposure therapy (VRET; Gerardi et al., 2008). In this study, counsellors delivered and controlled the trigger stimulus while the participant, reported a subjective rating of his experienced distress in 5-minute intervals. The participant was equipped with an eMagin Z800 head-mounted display, a computer-generated view of the Iraqi environment, and a hand-held controller to manoeuvre him through the environment. To meet the need of the participant, the intensity of the triggers increased based on the feedback he provided as the session progressed. The results indicated that virtual reality environment with exposure therapy contributed to a decrease in the client’s self-reported symptoms of PTSD. In Narrative therapy people experience problems in their lives when the dominant stories they or others have created do not sufficiently represent their lived experiences (White & Epston, 1990). Therapy then becomes a matter of storying or restorying the insufficient stories.What I found interesting in this study and applicable for NT was that the participant indicated that through this process, he was able to recall other scenarios or stories regarding his war experiences, he was previously unable to remember; consequently, thickening his narrative to thereby “facilitate integration and emotional processing of the experience” (Gerardi et al., 2008, p. 211). This unique outcomes was identified by the participant and explored within the therapeutic setting to weaken the power of the problem and create space for an alternative story to strengthen. Clients within a VE are able to relive meaningful experiences - rather than simply express a verbal rendition of abstract information - while experiencing support from the counsellor in both the real and physical worlds (Gorini et al., 2008). Researchers have managed to merge a virtual reality environment with exposure therapy to assist clients in recreating their traumatic experiences while simultaneously giving feedback about this experience directly to their counsellor, an advantage that traditional exposure therapy may not afford (Gerardi et al., Rizzo, 2008; Marco et al., 2013; Wallach et al., 2009; Yuen, et al., 2013).Furthermore, in creating a virtual environment, clients are able to identify and externalize their problems. Image reference (spider): http://www.firsthand.com/creations/images/SpiderHand02_800.pngImage reference (war helicopter): http://images.sussexpublishers.netdna-cdn.com/collection-thumbnail/blogs/66313/2011/06/66493-56879.jpg
- Yuen et al. (2013) combined acceptance-based behaviour therapy (ABBT) to treat social anxiety disorder (SAD) within the Second Life environment. A therapeutic environment was constructed as a private virtual island on Second Life; a training session for the participants on how to create and manoeuvre their avatars, as well as, a psycho-educational component around information about social anxiety was also completed. Therapists and participants met for 12 individual therapy sessions in a private virtual room and communicated through headsets and typed messages. The results of this pilot study indicate that a Virtual Environment such as Second Life is an effective milieu for the treatment of social anxiety disorder using acceptance-based behaviour therapy. Although participants reported a reduction of SAD symptoms (e.g., fears in social situations), some participants and therapists reported that the lack of human components (e.g., seeing the face of the therapist and observing nonverbal communication) was an uncomfortable aspect. It is not indicated in the study whether participants were able to change their facial expressions to indicate emotions through their avatar. A lack of this kind of feature could interfere with a therapist’s ability to mirror the client to demonstrate effective listening or accurately interpreting the client’s emotional expression, resulting in a misalignment within the therapeutic relationship. That having been said, Murphy, Parnass, Mitchell, Hallett, Cayley, & Seagram (2009) compared online and in-person counselling sessions and found no significant differences in outcomes or client satisfaction. In a follow-up study using the same groups, client characteristics were found to be virtually the same in terms of gender, average age, average service hours accessed, and marital status (Murphy, Mitchell, & Hallett, 2011). The only significant difference was in terms of disclosing the referral sources; those in cybercounselling chose to not identify their referral source significantly more often (29:9).Image reference: http://farm9.staticflickr.com/8195/8084120182_f3fc56f52a_z.jpg
- In this format, the virtual environment becomes a platform for the client defined metaphor to be shared more explicitly with the counsellor than in traditional NT.A virtual environment offers new ways to build collaborative therapeutic relationships whereby clients can provide a detailed visual expression of their lived experiences for the counsellor to also visualize and gain deeper insight into the client’s dominant narratives.Through the process of co-constructing a preferred story in a VE, clients would be encouraged by the counsellor to talk about themselves and their experiences as would be done in traditional NT (White & Epston, 1990); however, they have the added advantage of a visual tool in recreating them. Furthermore, learning within a VE can provide clients an opportunity to witness themselves behaving in ways that supports their preferred discourse, thereby transforming the problem-saturated story into a self-story of success and shifting the relationship clients have with their problem (White & Epston, 1990). And, like other forms of online therapy, Narrative therapy could be offered as a preferred therapy for clients who may be unable to access this form in an in-person format for any variety of reasons.
- Limitations and Ethical Considerations:Counsellors should be mindful of the potential for internet addiction and not lose sight of the value in face-to-face interactions (Allison, von Wahlde, Shockley, & Gabbard, 2006). Not all client problems would necessarily be suitable for an online environment.To operate within the boundaries of competence, counsellors would be expected to obtain relevant training prior to implementation of a therapeutic approach involving virtual environments (American Psychological Association, 2013).Lack of guarantee of anonymity and limits to confidentiality in an online environment. Prospective clients would need to be informed of issues with confidentiality and consent obtained prior to counselling occurring (Gorini et al., 2008).