User login
Web logs: ‘Blogging’ into the future
Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.
If you have any questions about blogs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Related Resources
- Dvorak JC. The blog phenomenon. PC Magazine Feb. 5, 2002. Available at: http://www.pcmag.com/article2/0,4149,81500,00.asp. Accessed Dec. 16, 2002.
- NetHistory.com. Media coverage of blogs. Available at: http://nethistory.urldir.com/blogs.php. Accessed Jan. 2, 2003.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
1. Alex Chernavsky’s Blog. Available at: http://www.astrocyte-design.com/blog/. Accessed Dec. 12, 2002.
2. Cohn M. Blogged down at the workplace. Internet World Dec. 1, 2002. Available at: http://www.internetworld.com/magazine.php?inc=120102/12.01.02upscope.html. Accessed Dec. 16, 2002.
3. Traction Software. Available at: http://www.tractionsoftware.com. Accessed Dec. 16, 2002.
4. Xanga Blogrings. Available at: http://www.xanga.com/blogrings/. Accessed Dec. 16, 2002.
Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.
If you have any questions about blogs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Related Resources
- Dvorak JC. The blog phenomenon. PC Magazine Feb. 5, 2002. Available at: http://www.pcmag.com/article2/0,4149,81500,00.asp. Accessed Dec. 16, 2002.
- NetHistory.com. Media coverage of blogs. Available at: http://nethistory.urldir.com/blogs.php. Accessed Jan. 2, 2003.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.
If you have any questions about blogs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Related Resources
- Dvorak JC. The blog phenomenon. PC Magazine Feb. 5, 2002. Available at: http://www.pcmag.com/article2/0,4149,81500,00.asp. Accessed Dec. 16, 2002.
- NetHistory.com. Media coverage of blogs. Available at: http://nethistory.urldir.com/blogs.php. Accessed Jan. 2, 2003.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
1. Alex Chernavsky’s Blog. Available at: http://www.astrocyte-design.com/blog/. Accessed Dec. 12, 2002.
2. Cohn M. Blogged down at the workplace. Internet World Dec. 1, 2002. Available at: http://www.internetworld.com/magazine.php?inc=120102/12.01.02upscope.html. Accessed Dec. 16, 2002.
3. Traction Software. Available at: http://www.tractionsoftware.com. Accessed Dec. 16, 2002.
4. Xanga Blogrings. Available at: http://www.xanga.com/blogrings/. Accessed Dec. 16, 2002.
1. Alex Chernavsky’s Blog. Available at: http://www.astrocyte-design.com/blog/. Accessed Dec. 12, 2002.
2. Cohn M. Blogged down at the workplace. Internet World Dec. 1, 2002. Available at: http://www.internetworld.com/magazine.php?inc=120102/12.01.02upscope.html. Accessed Dec. 16, 2002.
3. Traction Software. Available at: http://www.tractionsoftware.com. Accessed Dec. 16, 2002.
4. Xanga Blogrings. Available at: http://www.xanga.com/blogrings/. Accessed Dec. 16, 2002.
Web logs: ‘Blogging’ into the future
Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.
If you have any questions about blogs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Related Resources
- Dvorak JC. The blog phenomenon. PC Magazine Feb. 5, 2002. Available at: http://www.pcmag.com/article2/0,4149,81500,00.asp. Accessed Dec. 16, 2002.
- NetHistory.com. Media coverage of blogs. Available at: http://nethistory.urldir.com/blogs.php. Accessed Jan. 2, 2003.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
1. Alex Chernavsky’s Blog. Available at: http://www.astrocyte-design.com/blog/. Accessed Dec. 12, 2002.
2. Cohn M. Blogged down at the workplace. Internet World Dec. 1, 2002. Available at: http://www.internetworld.com/magazine.php?inc=120102/12.01.02upscope.html. Accessed Dec. 16, 2002.
3. Traction Software. Available at: http://www.tractionsoftware.com. Accessed Dec. 16, 2002.
4. Xanga Blogrings. Available at: http://www.xanga.com/blogrings/. Accessed Dec. 16, 2002.
Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.
If you have any questions about blogs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Related Resources
- Dvorak JC. The blog phenomenon. PC Magazine Feb. 5, 2002. Available at: http://www.pcmag.com/article2/0,4149,81500,00.asp. Accessed Dec. 16, 2002.
- NetHistory.com. Media coverage of blogs. Available at: http://nethistory.urldir.com/blogs.php. Accessed Jan. 2, 2003.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.
If you have any questions about blogs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Related Resources
- Dvorak JC. The blog phenomenon. PC Magazine Feb. 5, 2002. Available at: http://www.pcmag.com/article2/0,4149,81500,00.asp. Accessed Dec. 16, 2002.
- NetHistory.com. Media coverage of blogs. Available at: http://nethistory.urldir.com/blogs.php. Accessed Jan. 2, 2003.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
1. Alex Chernavsky’s Blog. Available at: http://www.astrocyte-design.com/blog/. Accessed Dec. 12, 2002.
2. Cohn M. Blogged down at the workplace. Internet World Dec. 1, 2002. Available at: http://www.internetworld.com/magazine.php?inc=120102/12.01.02upscope.html. Accessed Dec. 16, 2002.
3. Traction Software. Available at: http://www.tractionsoftware.com. Accessed Dec. 16, 2002.
4. Xanga Blogrings. Available at: http://www.xanga.com/blogrings/. Accessed Dec. 16, 2002.
1. Alex Chernavsky’s Blog. Available at: http://www.astrocyte-design.com/blog/. Accessed Dec. 12, 2002.
2. Cohn M. Blogged down at the workplace. Internet World Dec. 1, 2002. Available at: http://www.internetworld.com/magazine.php?inc=120102/12.01.02upscope.html. Accessed Dec. 16, 2002.
3. Traction Software. Available at: http://www.tractionsoftware.com. Accessed Dec. 16, 2002.
4. Xanga Blogrings. Available at: http://www.xanga.com/blogrings/. Accessed Dec. 16, 2002.
Personal digital assistants: Which one is right for your practice?
Personal digital assistants (PDAs) are becoming more commonplace in practice because they immediately provide critical information at the point of care.
If you’re in the market for a handheld computer, chances are you’re fazed by the multitude of available models, upgrades, and extras. Choosing a PDA is not that difficult, however, if you take the time to assess your needs and do a little homework. Start by answering these four questions:
1. Why do I need a PDA? Look at your work patterns and see how a PDA would fit in. Do you frequently look up DSM-IV criteria and other reference information? Are you constantly writing prescriptions, giving presentations, or assessing drug-drug interactions? Do you find yourself regularly checking your schedule?
Also try to envision:
- where you would carry the device
- where, when, and how you would charge it when needed
- what connections to computers for data exchange are available
- with whom you would share data
- and from whom you could get technical support.
You may have trouble thinking that far ahead, but doing so will help you narrow your PDA choices.
2. Which operating system should I use? A PDA operates on one of four main operating systems:
- Palm OS, the most popular world wide
- EPOC OS, which is more popular in Europe
- Pocket PC, which is rapidly gaining popularity
- and Linux OS, which recently entered the PDA market.
Choosing a PDA platform is much like deciding between Macintosh and Windows. The differences between PDAs based on Pocket PC or Palm OS have been diminishing in the last year. All PDAs have similar basic personal information manager functions, but available software, hardware features, and accessories set them apart. Pocket PC-based PDAs generally have much more memory and more diverse multimedia capabilities-but also lower battery life (1 day with average use) and compatibility with fewer software titles-than do Palm OS devices.
Because of their higher memory capacity, Pocket PC PDAs may generally be better suited to:
- large groups or organizations
- and users who rely heavily on multimedia, large data sets, or interface with Microsoft Office documents.
However, newer PDAs that are based on Palm OS 5 and employ the StrongARM processor (as do Pocket PC devices) offer greatly improved function in these areas. Compared with Pocket PC PDAs, Palm OS devices are much more intuitive and easier to use, offer longer battery life (1 week or more for average use), and are compatible with more medical software titles. More physicians use Palm OS PDAs because of their simplicity and reliability.
Consider either a Palm or Pocket PC PDA. EPOC PDAs are good devices, but Psion, a major manufacturer, has ceased development of EPOC devices to focus on specific markets. Linux PDAs are only recommended to users who are familiar with Linux or UNIX and are capable of writing their own software.
3. Where should I purchase my PDA? Visit any major computer, office supply, or electronics or chain retailer and check out the different models and manufacturers. Consider your priorities on features such as size, screen resolution, color, weight, memory, wireless capability, and accessory options. Consider purchasing there or online.
The level of support you need should dictate your point of purchase. Online retailers usually charge less for PDAs, but devices may be back-ordered and support often is offered only through the manufacturer. Beginners are probably wise to purchase locally and obtain support through the store.
4. How can I avoid purchasing a soon-to-be-obsolete model? Because PDA technology is improving so rapidly, new devices are frequently reaching the market. This can be frustrating to someone who has just purchased what he or she thought was the latest model.
If you are a beginner, plan to keep your PDA device for at least 1 year while you gradually learn to use it to its full potential. Consider spending about $200 for a device, then upgrade only when newer devices provide more features that you can use. Avid users may upgrade more frequently and spend $500 or more for a device.
Palm vs. Pocket PC: Finer points
Palm OS PDAs. If you are new to PDAs, start with a Palm OS-based PDA from Palm, Sony, or Handspring. The Sony models make more sense if you have or plan to purchase other Sony products (e.g., digital cameras, digital camcorders, computers) because the PDA’s external memory stick can be shared among the products.
Handspring offers models integrated with a cellular phone if you prefer a combined device. The Palm Tungsten T has built-in Bluetooth wireless mobile capability and offers portable keyboards that fold out to full size.
Pocket PC PDAs. Not long ago, Pocket PC PDAs were only compatible with software specific to the device’s processor. Today, the StrongARM processor is standard in any device running on Pocket PC 2002. Therefore, stick with Pocket PC 2002 devices only, as many of the earlier devices cannot be upgraded.
Because Pocket PC devices offer such a short battery life, consider a device with interchangeable lithium batteries or purchase a portable charger. If you choose a Pocket PC with integrated wireless connectivity, be aware that your battery life will be about 2 to 3 hours. Avoid the Jornada line of handhelds, as these will be phased out in the merger of Compaq and Hewlett Packard.
To learn more about PDAs
The Internet has a wealth of information on these devices. PDABuzz, Handango, and PDAGeek offer reviews, user opinions, and useful links. Two excellent magazines, Handheld Computing Magazine (www.hhcmag.com) and Pocket PC Magazine (www.pocketpcmag.com), are devoted to PDA/handheld computers. Manufacturers also post extensive information about their PDA devices on their Web sites (Box).
If you have any questions about PDAs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Palm OS
Manufacturer URL
Palm www.palm.com
Handspring www.handspring.com
HandEra www.handera.com
Sony http://www.sonystyle.com/
Acer global.acer.com/products/pda/index.htm
Pocket PC OS
Audiovox www.audiovox.com/pda
Casio www.casio.com
Toshiba pda.toshiba.com
HP www.compaq.com/products/handhelds/pocketpc/index.html
NEC www.neccomp.com/v2/products/MobilePro/P300/
Zayo (Asus) usa.asus.com/PDA/a600/overview.htm
ViewSonic www.viewsonic.com/products/pocket_pc_pocketpcv35.htm
URThere www.urthere.com
Related Resources
Carlson J. Palm organizers: visual quick start guide (2nd ed). Berkeley, CA: Peachpit Press, 2001.
Chan C, Luo J, Kennedy R. Concise guide to computers in clinical psychiatry (1st ed). Washington, DC: American Psychiatric Press, 2002.
Dyzsel B. Palm for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Underdahl B. Pocket PCs for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Personal digital assistants (PDAs) are becoming more commonplace in practice because they immediately provide critical information at the point of care.
If you’re in the market for a handheld computer, chances are you’re fazed by the multitude of available models, upgrades, and extras. Choosing a PDA is not that difficult, however, if you take the time to assess your needs and do a little homework. Start by answering these four questions:
1. Why do I need a PDA? Look at your work patterns and see how a PDA would fit in. Do you frequently look up DSM-IV criteria and other reference information? Are you constantly writing prescriptions, giving presentations, or assessing drug-drug interactions? Do you find yourself regularly checking your schedule?
Also try to envision:
- where you would carry the device
- where, when, and how you would charge it when needed
- what connections to computers for data exchange are available
- with whom you would share data
- and from whom you could get technical support.
You may have trouble thinking that far ahead, but doing so will help you narrow your PDA choices.
2. Which operating system should I use? A PDA operates on one of four main operating systems:
- Palm OS, the most popular world wide
- EPOC OS, which is more popular in Europe
- Pocket PC, which is rapidly gaining popularity
- and Linux OS, which recently entered the PDA market.
Choosing a PDA platform is much like deciding between Macintosh and Windows. The differences between PDAs based on Pocket PC or Palm OS have been diminishing in the last year. All PDAs have similar basic personal information manager functions, but available software, hardware features, and accessories set them apart. Pocket PC-based PDAs generally have much more memory and more diverse multimedia capabilities-but also lower battery life (1 day with average use) and compatibility with fewer software titles-than do Palm OS devices.
Because of their higher memory capacity, Pocket PC PDAs may generally be better suited to:
- large groups or organizations
- and users who rely heavily on multimedia, large data sets, or interface with Microsoft Office documents.
However, newer PDAs that are based on Palm OS 5 and employ the StrongARM processor (as do Pocket PC devices) offer greatly improved function in these areas. Compared with Pocket PC PDAs, Palm OS devices are much more intuitive and easier to use, offer longer battery life (1 week or more for average use), and are compatible with more medical software titles. More physicians use Palm OS PDAs because of their simplicity and reliability.
Consider either a Palm or Pocket PC PDA. EPOC PDAs are good devices, but Psion, a major manufacturer, has ceased development of EPOC devices to focus on specific markets. Linux PDAs are only recommended to users who are familiar with Linux or UNIX and are capable of writing their own software.
3. Where should I purchase my PDA? Visit any major computer, office supply, or electronics or chain retailer and check out the different models and manufacturers. Consider your priorities on features such as size, screen resolution, color, weight, memory, wireless capability, and accessory options. Consider purchasing there or online.
The level of support you need should dictate your point of purchase. Online retailers usually charge less for PDAs, but devices may be back-ordered and support often is offered only through the manufacturer. Beginners are probably wise to purchase locally and obtain support through the store.
4. How can I avoid purchasing a soon-to-be-obsolete model? Because PDA technology is improving so rapidly, new devices are frequently reaching the market. This can be frustrating to someone who has just purchased what he or she thought was the latest model.
If you are a beginner, plan to keep your PDA device for at least 1 year while you gradually learn to use it to its full potential. Consider spending about $200 for a device, then upgrade only when newer devices provide more features that you can use. Avid users may upgrade more frequently and spend $500 or more for a device.
Palm vs. Pocket PC: Finer points
Palm OS PDAs. If you are new to PDAs, start with a Palm OS-based PDA from Palm, Sony, or Handspring. The Sony models make more sense if you have or plan to purchase other Sony products (e.g., digital cameras, digital camcorders, computers) because the PDA’s external memory stick can be shared among the products.
Handspring offers models integrated with a cellular phone if you prefer a combined device. The Palm Tungsten T has built-in Bluetooth wireless mobile capability and offers portable keyboards that fold out to full size.
Pocket PC PDAs. Not long ago, Pocket PC PDAs were only compatible with software specific to the device’s processor. Today, the StrongARM processor is standard in any device running on Pocket PC 2002. Therefore, stick with Pocket PC 2002 devices only, as many of the earlier devices cannot be upgraded.
Because Pocket PC devices offer such a short battery life, consider a device with interchangeable lithium batteries or purchase a portable charger. If you choose a Pocket PC with integrated wireless connectivity, be aware that your battery life will be about 2 to 3 hours. Avoid the Jornada line of handhelds, as these will be phased out in the merger of Compaq and Hewlett Packard.
To learn more about PDAs
The Internet has a wealth of information on these devices. PDABuzz, Handango, and PDAGeek offer reviews, user opinions, and useful links. Two excellent magazines, Handheld Computing Magazine (www.hhcmag.com) and Pocket PC Magazine (www.pocketpcmag.com), are devoted to PDA/handheld computers. Manufacturers also post extensive information about their PDA devices on their Web sites (Box).
If you have any questions about PDAs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Palm OS
Manufacturer URL
Palm www.palm.com
Handspring www.handspring.com
HandEra www.handera.com
Sony http://www.sonystyle.com/
Acer global.acer.com/products/pda/index.htm
Pocket PC OS
Audiovox www.audiovox.com/pda
Casio www.casio.com
Toshiba pda.toshiba.com
HP www.compaq.com/products/handhelds/pocketpc/index.html
NEC www.neccomp.com/v2/products/MobilePro/P300/
Zayo (Asus) usa.asus.com/PDA/a600/overview.htm
ViewSonic www.viewsonic.com/products/pocket_pc_pocketpcv35.htm
URThere www.urthere.com
Related Resources
Carlson J. Palm organizers: visual quick start guide (2nd ed). Berkeley, CA: Peachpit Press, 2001.
Chan C, Luo J, Kennedy R. Concise guide to computers in clinical psychiatry (1st ed). Washington, DC: American Psychiatric Press, 2002.
Dyzsel B. Palm for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Underdahl B. Pocket PCs for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Personal digital assistants (PDAs) are becoming more commonplace in practice because they immediately provide critical information at the point of care.
If you’re in the market for a handheld computer, chances are you’re fazed by the multitude of available models, upgrades, and extras. Choosing a PDA is not that difficult, however, if you take the time to assess your needs and do a little homework. Start by answering these four questions:
1. Why do I need a PDA? Look at your work patterns and see how a PDA would fit in. Do you frequently look up DSM-IV criteria and other reference information? Are you constantly writing prescriptions, giving presentations, or assessing drug-drug interactions? Do you find yourself regularly checking your schedule?
Also try to envision:
- where you would carry the device
- where, when, and how you would charge it when needed
- what connections to computers for data exchange are available
- with whom you would share data
- and from whom you could get technical support.
You may have trouble thinking that far ahead, but doing so will help you narrow your PDA choices.
2. Which operating system should I use? A PDA operates on one of four main operating systems:
- Palm OS, the most popular world wide
- EPOC OS, which is more popular in Europe
- Pocket PC, which is rapidly gaining popularity
- and Linux OS, which recently entered the PDA market.
Choosing a PDA platform is much like deciding between Macintosh and Windows. The differences between PDAs based on Pocket PC or Palm OS have been diminishing in the last year. All PDAs have similar basic personal information manager functions, but available software, hardware features, and accessories set them apart. Pocket PC-based PDAs generally have much more memory and more diverse multimedia capabilities-but also lower battery life (1 day with average use) and compatibility with fewer software titles-than do Palm OS devices.
Because of their higher memory capacity, Pocket PC PDAs may generally be better suited to:
- large groups or organizations
- and users who rely heavily on multimedia, large data sets, or interface with Microsoft Office documents.
However, newer PDAs that are based on Palm OS 5 and employ the StrongARM processor (as do Pocket PC devices) offer greatly improved function in these areas. Compared with Pocket PC PDAs, Palm OS devices are much more intuitive and easier to use, offer longer battery life (1 week or more for average use), and are compatible with more medical software titles. More physicians use Palm OS PDAs because of their simplicity and reliability.
Consider either a Palm or Pocket PC PDA. EPOC PDAs are good devices, but Psion, a major manufacturer, has ceased development of EPOC devices to focus on specific markets. Linux PDAs are only recommended to users who are familiar with Linux or UNIX and are capable of writing their own software.
3. Where should I purchase my PDA? Visit any major computer, office supply, or electronics or chain retailer and check out the different models and manufacturers. Consider your priorities on features such as size, screen resolution, color, weight, memory, wireless capability, and accessory options. Consider purchasing there or online.
The level of support you need should dictate your point of purchase. Online retailers usually charge less for PDAs, but devices may be back-ordered and support often is offered only through the manufacturer. Beginners are probably wise to purchase locally and obtain support through the store.
4. How can I avoid purchasing a soon-to-be-obsolete model? Because PDA technology is improving so rapidly, new devices are frequently reaching the market. This can be frustrating to someone who has just purchased what he or she thought was the latest model.
If you are a beginner, plan to keep your PDA device for at least 1 year while you gradually learn to use it to its full potential. Consider spending about $200 for a device, then upgrade only when newer devices provide more features that you can use. Avid users may upgrade more frequently and spend $500 or more for a device.
Palm vs. Pocket PC: Finer points
Palm OS PDAs. If you are new to PDAs, start with a Palm OS-based PDA from Palm, Sony, or Handspring. The Sony models make more sense if you have or plan to purchase other Sony products (e.g., digital cameras, digital camcorders, computers) because the PDA’s external memory stick can be shared among the products.
Handspring offers models integrated with a cellular phone if you prefer a combined device. The Palm Tungsten T has built-in Bluetooth wireless mobile capability and offers portable keyboards that fold out to full size.
Pocket PC PDAs. Not long ago, Pocket PC PDAs were only compatible with software specific to the device’s processor. Today, the StrongARM processor is standard in any device running on Pocket PC 2002. Therefore, stick with Pocket PC 2002 devices only, as many of the earlier devices cannot be upgraded.
Because Pocket PC devices offer such a short battery life, consider a device with interchangeable lithium batteries or purchase a portable charger. If you choose a Pocket PC with integrated wireless connectivity, be aware that your battery life will be about 2 to 3 hours. Avoid the Jornada line of handhelds, as these will be phased out in the merger of Compaq and Hewlett Packard.
To learn more about PDAs
The Internet has a wealth of information on these devices. PDABuzz, Handango, and PDAGeek offer reviews, user opinions, and useful links. Two excellent magazines, Handheld Computing Magazine (www.hhcmag.com) and Pocket PC Magazine (www.pocketpcmag.com), are devoted to PDA/handheld computers. Manufacturers also post extensive information about their PDA devices on their Web sites (Box).
If you have any questions about PDAs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Palm OS
Manufacturer URL
Palm www.palm.com
Handspring www.handspring.com
HandEra www.handera.com
Sony http://www.sonystyle.com/
Acer global.acer.com/products/pda/index.htm
Pocket PC OS
Audiovox www.audiovox.com/pda
Casio www.casio.com
Toshiba pda.toshiba.com
HP www.compaq.com/products/handhelds/pocketpc/index.html
NEC www.neccomp.com/v2/products/MobilePro/P300/
Zayo (Asus) usa.asus.com/PDA/a600/overview.htm
ViewSonic www.viewsonic.com/products/pocket_pc_pocketpcv35.htm
URThere www.urthere.com
Related Resources
Carlson J. Palm organizers: visual quick start guide (2nd ed). Berkeley, CA: Peachpit Press, 2001.
Chan C, Luo J, Kennedy R. Concise guide to computers in clinical psychiatry (1st ed). Washington, DC: American Psychiatric Press, 2002.
Dyzsel B. Palm for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Underdahl B. Pocket PCs for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Personal digital assistants: Which one is right for your practice?
Personal digital assistants (PDAs) are becoming more commonplace in practice because they immediately provide critical information at the point of care.
If you’re in the market for a handheld computer, chances are you’re fazed by the multitude of available models, upgrades, and extras. Choosing a PDA is not that difficult, however, if you take the time to assess your needs and do a little homework. Start by answering these four questions:
1. Why do I need a PDA? Look at your work patterns and see how a PDA would fit in. Do you frequently look up DSM-IV criteria and other reference information? Are you constantly writing prescriptions, giving presentations, or assessing drug-drug interactions? Do you find yourself regularly checking your schedule?
Also try to envision:
- where you would carry the device
- where, when, and how you would charge it when needed
- what connections to computers for data exchange are available
- with whom you would share data
- and from whom you could get technical support.
You may have trouble thinking that far ahead, but doing so will help you narrow your PDA choices.
2. Which operating system should I use? A PDA operates on one of four main operating systems:
- Palm OS, the most popular world wide
- EPOC OS, which is more popular in Europe
- Pocket PC, which is rapidly gaining popularity
- and Linux OS, which recently entered the PDA market.
Choosing a PDA platform is much like deciding between Macintosh and Windows. The differences between PDAs based on Pocket PC or Palm OS have been diminishing in the last year. All PDAs have similar basic personal information manager functions, but available software, hardware features, and accessories set them apart. Pocket PC-based PDAs generally have much more memory and more diverse multimedia capabilities-but also lower battery life (1 day with average use) and compatibility with fewer software titles-than do Palm OS devices.
Because of their higher memory capacity, Pocket PC PDAs may generally be better suited to:
- large groups or organizations
- and users who rely heavily on multimedia, large data sets, or interface with Microsoft Office documents.
However, newer PDAs that are based on Palm OS 5 and employ the StrongARM processor (as do Pocket PC devices) offer greatly improved function in these areas. Compared with Pocket PC PDAs, Palm OS devices are much more intuitive and easier to use, offer longer battery life (1 week or more for average use), and are compatible with more medical software titles. More physicians use Palm OS PDAs because of their simplicity and reliability.
Consider either a Palm or Pocket PC PDA. EPOC PDAs are good devices, but Psion, a major manufacturer, has ceased development of EPOC devices to focus on specific markets. Linux PDAs are only recommended to users who are familiar with Linux or UNIX and are capable of writing their own software.
3. Where should I purchase my PDA? Visit any major computer, office supply, or electronics or chain retailer and check out the different models and manufacturers. Consider your priorities on features such as size, screen resolution, color, weight, memory, wireless capability, and accessory options. Consider purchasing there or online.
The level of support you need should dictate your point of purchase. Online retailers usually charge less for PDAs, but devices may be back-ordered and support often is offered only through the manufacturer. Beginners are probably wise to purchase locally and obtain support through the store.
4. How can I avoid purchasing a soon-to-be-obsolete model? Because PDA technology is improving so rapidly, new devices are frequently reaching the market. This can be frustrating to someone who has just purchased what he or she thought was the latest model.
If you are a beginner, plan to keep your PDA device for at least 1 year while you gradually learn to use it to its full potential. Consider spending about $200 for a device, then upgrade only when newer devices provide more features that you can use. Avid users may upgrade more frequently and spend $500 or more for a device.
Palm vs. Pocket PC: Finer points
Palm OS PDAs. If you are new to PDAs, start with a Palm OS-based PDA from Palm, Sony, or Handspring. The Sony models make more sense if you have or plan to purchase other Sony products (e.g., digital cameras, digital camcorders, computers) because the PDA’s external memory stick can be shared among the products.
Handspring offers models integrated with a cellular phone if you prefer a combined device. The Palm Tungsten T has built-in Bluetooth wireless mobile capability and offers portable keyboards that fold out to full size.
Pocket PC PDAs. Not long ago, Pocket PC PDAs were only compatible with software specific to the device’s processor. Today, the StrongARM processor is standard in any device running on Pocket PC 2002. Therefore, stick with Pocket PC 2002 devices only, as many of the earlier devices cannot be upgraded.
Because Pocket PC devices offer such a short battery life, consider a device with interchangeable lithium batteries or purchase a portable charger. If you choose a Pocket PC with integrated wireless connectivity, be aware that your battery life will be about 2 to 3 hours. Avoid the Jornada line of handhelds, as these will be phased out in the merger of Compaq and Hewlett Packard.
To learn more about PDAs
The Internet has a wealth of information on these devices. PDABuzz, Handango, and PDAGeek offer reviews, user opinions, and useful links. Two excellent magazines, Handheld Computing Magazine (www.hhcmag.com) and Pocket PC Magazine (www.pocketpcmag.com), are devoted to PDA/handheld computers. Manufacturers also post extensive information about their PDA devices on their Web sites (Box).
If you have any questions about PDAs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Palm OS
Manufacturer URL
Palm www.palm.com
Handspring www.handspring.com
HandEra www.handera.com
Sony http://www.sonystyle.com/
Acer global.acer.com/products/pda/index.htm
Pocket PC OS
Audiovox www.audiovox.com/pda
Casio www.casio.com
Toshiba pda.toshiba.com
HP www.compaq.com/products/handhelds/pocketpc/index.html
NEC www.neccomp.com/v2/products/MobilePro/P300/
Zayo (Asus) usa.asus.com/PDA/a600/overview.htm
ViewSonic www.viewsonic.com/products/pocket_pc_pocketpcv35.htm
URThere www.urthere.com
Related Resources
Carlson J. Palm organizers: visual quick start guide (2nd ed). Berkeley, CA: Peachpit Press, 2001.
Chan C, Luo J, Kennedy R. Concise guide to computers in clinical psychiatry (1st ed). Washington, DC: American Psychiatric Press, 2002.
Dyzsel B. Palm for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Underdahl B. Pocket PCs for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Personal digital assistants (PDAs) are becoming more commonplace in practice because they immediately provide critical information at the point of care.
If you’re in the market for a handheld computer, chances are you’re fazed by the multitude of available models, upgrades, and extras. Choosing a PDA is not that difficult, however, if you take the time to assess your needs and do a little homework. Start by answering these four questions:
1. Why do I need a PDA? Look at your work patterns and see how a PDA would fit in. Do you frequently look up DSM-IV criteria and other reference information? Are you constantly writing prescriptions, giving presentations, or assessing drug-drug interactions? Do you find yourself regularly checking your schedule?
Also try to envision:
- where you would carry the device
- where, when, and how you would charge it when needed
- what connections to computers for data exchange are available
- with whom you would share data
- and from whom you could get technical support.
You may have trouble thinking that far ahead, but doing so will help you narrow your PDA choices.
2. Which operating system should I use? A PDA operates on one of four main operating systems:
- Palm OS, the most popular world wide
- EPOC OS, which is more popular in Europe
- Pocket PC, which is rapidly gaining popularity
- and Linux OS, which recently entered the PDA market.
Choosing a PDA platform is much like deciding between Macintosh and Windows. The differences between PDAs based on Pocket PC or Palm OS have been diminishing in the last year. All PDAs have similar basic personal information manager functions, but available software, hardware features, and accessories set them apart. Pocket PC-based PDAs generally have much more memory and more diverse multimedia capabilities-but also lower battery life (1 day with average use) and compatibility with fewer software titles-than do Palm OS devices.
Because of their higher memory capacity, Pocket PC PDAs may generally be better suited to:
- large groups or organizations
- and users who rely heavily on multimedia, large data sets, or interface with Microsoft Office documents.
However, newer PDAs that are based on Palm OS 5 and employ the StrongARM processor (as do Pocket PC devices) offer greatly improved function in these areas. Compared with Pocket PC PDAs, Palm OS devices are much more intuitive and easier to use, offer longer battery life (1 week or more for average use), and are compatible with more medical software titles. More physicians use Palm OS PDAs because of their simplicity and reliability.
Consider either a Palm or Pocket PC PDA. EPOC PDAs are good devices, but Psion, a major manufacturer, has ceased development of EPOC devices to focus on specific markets. Linux PDAs are only recommended to users who are familiar with Linux or UNIX and are capable of writing their own software.
3. Where should I purchase my PDA? Visit any major computer, office supply, or electronics or chain retailer and check out the different models and manufacturers. Consider your priorities on features such as size, screen resolution, color, weight, memory, wireless capability, and accessory options. Consider purchasing there or online.
The level of support you need should dictate your point of purchase. Online retailers usually charge less for PDAs, but devices may be back-ordered and support often is offered only through the manufacturer. Beginners are probably wise to purchase locally and obtain support through the store.
4. How can I avoid purchasing a soon-to-be-obsolete model? Because PDA technology is improving so rapidly, new devices are frequently reaching the market. This can be frustrating to someone who has just purchased what he or she thought was the latest model.
If you are a beginner, plan to keep your PDA device for at least 1 year while you gradually learn to use it to its full potential. Consider spending about $200 for a device, then upgrade only when newer devices provide more features that you can use. Avid users may upgrade more frequently and spend $500 or more for a device.
Palm vs. Pocket PC: Finer points
Palm OS PDAs. If you are new to PDAs, start with a Palm OS-based PDA from Palm, Sony, or Handspring. The Sony models make more sense if you have or plan to purchase other Sony products (e.g., digital cameras, digital camcorders, computers) because the PDA’s external memory stick can be shared among the products.
Handspring offers models integrated with a cellular phone if you prefer a combined device. The Palm Tungsten T has built-in Bluetooth wireless mobile capability and offers portable keyboards that fold out to full size.
Pocket PC PDAs. Not long ago, Pocket PC PDAs were only compatible with software specific to the device’s processor. Today, the StrongARM processor is standard in any device running on Pocket PC 2002. Therefore, stick with Pocket PC 2002 devices only, as many of the earlier devices cannot be upgraded.
Because Pocket PC devices offer such a short battery life, consider a device with interchangeable lithium batteries or purchase a portable charger. If you choose a Pocket PC with integrated wireless connectivity, be aware that your battery life will be about 2 to 3 hours. Avoid the Jornada line of handhelds, as these will be phased out in the merger of Compaq and Hewlett Packard.
To learn more about PDAs
The Internet has a wealth of information on these devices. PDABuzz, Handango, and PDAGeek offer reviews, user opinions, and useful links. Two excellent magazines, Handheld Computing Magazine (www.hhcmag.com) and Pocket PC Magazine (www.pocketpcmag.com), are devoted to PDA/handheld computers. Manufacturers also post extensive information about their PDA devices on their Web sites (Box).
If you have any questions about PDAs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Palm OS
Manufacturer URL
Palm www.palm.com
Handspring www.handspring.com
HandEra www.handera.com
Sony http://www.sonystyle.com/
Acer global.acer.com/products/pda/index.htm
Pocket PC OS
Audiovox www.audiovox.com/pda
Casio www.casio.com
Toshiba pda.toshiba.com
HP www.compaq.com/products/handhelds/pocketpc/index.html
NEC www.neccomp.com/v2/products/MobilePro/P300/
Zayo (Asus) usa.asus.com/PDA/a600/overview.htm
ViewSonic www.viewsonic.com/products/pocket_pc_pocketpcv35.htm
URThere www.urthere.com
Related Resources
Carlson J. Palm organizers: visual quick start guide (2nd ed). Berkeley, CA: Peachpit Press, 2001.
Chan C, Luo J, Kennedy R. Concise guide to computers in clinical psychiatry (1st ed). Washington, DC: American Psychiatric Press, 2002.
Dyzsel B. Palm for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Underdahl B. Pocket PCs for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
Personal digital assistants (PDAs) are becoming more commonplace in practice because they immediately provide critical information at the point of care.
If you’re in the market for a handheld computer, chances are you’re fazed by the multitude of available models, upgrades, and extras. Choosing a PDA is not that difficult, however, if you take the time to assess your needs and do a little homework. Start by answering these four questions:
1. Why do I need a PDA? Look at your work patterns and see how a PDA would fit in. Do you frequently look up DSM-IV criteria and other reference information? Are you constantly writing prescriptions, giving presentations, or assessing drug-drug interactions? Do you find yourself regularly checking your schedule?
Also try to envision:
- where you would carry the device
- where, when, and how you would charge it when needed
- what connections to computers for data exchange are available
- with whom you would share data
- and from whom you could get technical support.
You may have trouble thinking that far ahead, but doing so will help you narrow your PDA choices.
2. Which operating system should I use? A PDA operates on one of four main operating systems:
- Palm OS, the most popular world wide
- EPOC OS, which is more popular in Europe
- Pocket PC, which is rapidly gaining popularity
- and Linux OS, which recently entered the PDA market.
Choosing a PDA platform is much like deciding between Macintosh and Windows. The differences between PDAs based on Pocket PC or Palm OS have been diminishing in the last year. All PDAs have similar basic personal information manager functions, but available software, hardware features, and accessories set them apart. Pocket PC-based PDAs generally have much more memory and more diverse multimedia capabilities-but also lower battery life (1 day with average use) and compatibility with fewer software titles-than do Palm OS devices.
Because of their higher memory capacity, Pocket PC PDAs may generally be better suited to:
- large groups or organizations
- and users who rely heavily on multimedia, large data sets, or interface with Microsoft Office documents.
However, newer PDAs that are based on Palm OS 5 and employ the StrongARM processor (as do Pocket PC devices) offer greatly improved function in these areas. Compared with Pocket PC PDAs, Palm OS devices are much more intuitive and easier to use, offer longer battery life (1 week or more for average use), and are compatible with more medical software titles. More physicians use Palm OS PDAs because of their simplicity and reliability.
Consider either a Palm or Pocket PC PDA. EPOC PDAs are good devices, but Psion, a major manufacturer, has ceased development of EPOC devices to focus on specific markets. Linux PDAs are only recommended to users who are familiar with Linux or UNIX and are capable of writing their own software.
3. Where should I purchase my PDA? Visit any major computer, office supply, or electronics or chain retailer and check out the different models and manufacturers. Consider your priorities on features such as size, screen resolution, color, weight, memory, wireless capability, and accessory options. Consider purchasing there or online.
The level of support you need should dictate your point of purchase. Online retailers usually charge less for PDAs, but devices may be back-ordered and support often is offered only through the manufacturer. Beginners are probably wise to purchase locally and obtain support through the store.
4. How can I avoid purchasing a soon-to-be-obsolete model? Because PDA technology is improving so rapidly, new devices are frequently reaching the market. This can be frustrating to someone who has just purchased what he or she thought was the latest model.
If you are a beginner, plan to keep your PDA device for at least 1 year while you gradually learn to use it to its full potential. Consider spending about $200 for a device, then upgrade only when newer devices provide more features that you can use. Avid users may upgrade more frequently and spend $500 or more for a device.
Palm vs. Pocket PC: Finer points
Palm OS PDAs. If you are new to PDAs, start with a Palm OS-based PDA from Palm, Sony, or Handspring. The Sony models make more sense if you have or plan to purchase other Sony products (e.g., digital cameras, digital camcorders, computers) because the PDA’s external memory stick can be shared among the products.
Handspring offers models integrated with a cellular phone if you prefer a combined device. The Palm Tungsten T has built-in Bluetooth wireless mobile capability and offers portable keyboards that fold out to full size.
Pocket PC PDAs. Not long ago, Pocket PC PDAs were only compatible with software specific to the device’s processor. Today, the StrongARM processor is standard in any device running on Pocket PC 2002. Therefore, stick with Pocket PC 2002 devices only, as many of the earlier devices cannot be upgraded.
Because Pocket PC devices offer such a short battery life, consider a device with interchangeable lithium batteries or purchase a portable charger. If you choose a Pocket PC with integrated wireless connectivity, be aware that your battery life will be about 2 to 3 hours. Avoid the Jornada line of handhelds, as these will be phased out in the merger of Compaq and Hewlett Packard.
To learn more about PDAs
The Internet has a wealth of information on these devices. PDABuzz, Handango, and PDAGeek offer reviews, user opinions, and useful links. Two excellent magazines, Handheld Computing Magazine (www.hhcmag.com) and Pocket PC Magazine (www.pocketpcmag.com), are devoted to PDA/handheld computers. Manufacturers also post extensive information about their PDA devices on their Web sites (Box).
If you have any questions about PDAs or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to [email protected].
Palm OS
Manufacturer URL
Palm www.palm.com
Handspring www.handspring.com
HandEra www.handera.com
Sony http://www.sonystyle.com/
Acer global.acer.com/products/pda/index.htm
Pocket PC OS
Audiovox www.audiovox.com/pda
Casio www.casio.com
Toshiba pda.toshiba.com
HP www.compaq.com/products/handhelds/pocketpc/index.html
NEC www.neccomp.com/v2/products/MobilePro/P300/
Zayo (Asus) usa.asus.com/PDA/a600/overview.htm
ViewSonic www.viewsonic.com/products/pocket_pc_pocketpcv35.htm
URThere www.urthere.com
Related Resources
Carlson J. Palm organizers: visual quick start guide (2nd ed). Berkeley, CA: Peachpit Press, 2001.
Chan C, Luo J, Kennedy R. Concise guide to computers in clinical psychiatry (1st ed). Washington, DC: American Psychiatric Press, 2002.
Dyzsel B. Palm for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Underdahl B. Pocket PCs for dummies (2nd ed). Hoboken, NJ: Wiley Publishing, 2002.
Disclosure:
Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.
E-therapy: Alerting patients to the benefits, risks
E-mail is fast becoming a key medium for addressing interpersonal and other therapeutic needs. E-therapy delivered via e-mail and other media offers convenience and a sense of privacy that can break down barriers to treatment for persons grappling with the stigma of mental illness or an emotional problem.
E-therapy is not a substitute for psychotherapy or psychological counseling, nor should it be confused with those modalities. By helping the patient resolve life and relationship issues under the guidance of a qualified professional, however, e-therapy can be a worthwhile adjunct to psychiatric treatment. E-therapy is best for significant but not critical issues that result in adjustment disorders, such as frustration over not receiving a promotion or job offer.
In additional to counseling via e-mail, e-therapy also takes the form of telemedicine; “ask-the-expert” Web sites; office-based therapy supplemented with e-mail, instant messaging or private chat programs; and online group treatment.
Benefits and drawbacks
Convenience is a major advantage of e-therapy. For people with limited mobility or who are leery of entering a mental health facility, e-therapy provides access to psychological services that would otherwise be unavailable. For patients with anxiety disorders such as social phobia, e-therapy abolishes the initial barrier to treatment.
When asynchronous communication such as e-mail is employed, e-therapy provides time for reflection on issues raised in the previous message. While traditional therapy offers a more free-form process, e-therapy allows the user to organize and carefully examine his or her thoughts and feelings.
Since the need for social interaction and nonverbal cues is eliminated, the salient issues may be addressed quickly and without distraction. Also, links to educational material can easily be embedded within messages, providing immediate access to information not available in traditional face-to-face therapy.
Depending on which e-mail program is used, e-therapy is also potentially more confidential and can be performed more anonymously than traditional therapy.1 For example, a patient can use a Hushmail (www.hushmail.com) account, which provides secure e-mail messaging.
But many of these benefits double as major drawbacks. For one, most e-mail programs/services are not secure, subjecting patients to possible breach of confidentiality as evidenced by Carnivore, a program that enables the FBI to intercept electronic communications without detection.2 Use of a virtual private network allows users to establish a two-way encrypted channel of communication and reduce the chances of intrusion.
The asynchronous nature of text-based communication can also be detrimental. A miscommunication cannot be immediately clarified and can leave the patient feeling more rejected or isolated than before.
Also, the social and nonverbal cues that may facilitate the communication’s context are not available. Without these cues, emergencies such as suicidal ideation may go undetected. For that reason, patients who are suicidal should be advised against e-therapy. Also, since the therapist is not “present,” e-therapy should not be used to address issues that raise intense feelings.
More research needed
Information on the efficacy of e-therapy is limited. According to preliminary data on Metanoia-an online mental health consumer guide (www.metanoia.org)-60% of 450 patients who have tried e-therapy found it very helpful, 32% found it somewhat helpful, and 8% found it not helpful.3
Stephen Biggs, MA, a doctoral candidate in clinical psychology at York University in Toronto, is conducting a more formal assessment of the consumer’s experience with online mental health services.4
Helping patients choose an e-therapist
E-therapists-mostly psychologists, marriage and family therapists, and licensed clinical social workers-are fairly easy to find on the Web. Interestingly, a recent Web search using the term “e-therapy” turned up only one psychiatrist from among 30 names, although more MDs may offer online therapy as the modality gains acceptance.
Because most state laws governing licensing do not address e-therapy, a patient dissatisfied with his or her e-therapist has no legal recourse. Therefore, advise patients to proceed carefully. John Grohol, Psy.D, founding president of the International Society for Mental Health Online (ISMHO), recommends that patients sign or consent to a counseling agreement and a privacy statement, which clearly delineate responsibilities and operating procedures.5
Online resources such as Metanoia and ISMHO (www.ismho.org) offer advice on choosing a qualified e-therapist. Metanoia, for example, offers a directory of e-therapists6 and explains what to look for-and avoid-in a therapist. Site creator Martha Ainsworth notes that Metanoia only lists therapists who have credentials, a degree, and/or a license to provide therapy. ISMHO’s Suggested Principles for the Online Provision of Mental Health Services7 also spells out what services patients should expect from an e-therapist.
Finally, although cyberspace has a global reach, advise patients to choose an e-therapist who lives within driving distance if possible. That way, the patient can consult the therapist in person if a crisis arises.
Related resources
- Hsiung RC (ed). E-therapy: case studies, guiding principles, and the clinical potential of the Internet. New York: W.W. Norton & Co., 2002.
- Fink J. How to use computers and cyberspace in the clinical practice of psychotherapy. Northvale, NJ: Jason Aronson Inc., 1999.
Disclosure
The author reports no affiliation or financial relationship with any of the companies whose products are mentioned in this article.
1. Grohol JM. Best practices in e-therapy: clarifying the definition. Available at: http://psychcentral.com/best/best5.htm. Accessed Oct. 30. 2002.
2. FBI Programs and Initiatives-Carnivore: Diagnostic Tool. Available at: http://www.fbi.gov/hq/lab/carnivore/carnivore2.htm. Accessed Nov. 4, 2002.
3. Metanoia Internet Therapy Survey Results. Available at: http://www.metanoia.org/imhs/results.htm. Accessed Oct. 30, 2002.
4. Biggs S. E-therapy Study. Available at: http://www.yorku.ca/sbiggs/. Accessed Oct. 30, 2002.
5. Grohol JM. Best practices in e-therapy: legal and licensing issues. Available at: http://psychcentral.com/best/best4.htm.
6. Metanoia Directory of Internet Psychotherapists. Available at: http://www.metanoia.org/imhs/directry.htm Accessed Oct. 29, 2002.
7. International Society for Mental Health Online. Suggested principles for the online provision of mental health services. Available at: http://www.ismho.org/suggestions.html. Accessed Oct. 30, 2002.
E-mail is fast becoming a key medium for addressing interpersonal and other therapeutic needs. E-therapy delivered via e-mail and other media offers convenience and a sense of privacy that can break down barriers to treatment for persons grappling with the stigma of mental illness or an emotional problem.
E-therapy is not a substitute for psychotherapy or psychological counseling, nor should it be confused with those modalities. By helping the patient resolve life and relationship issues under the guidance of a qualified professional, however, e-therapy can be a worthwhile adjunct to psychiatric treatment. E-therapy is best for significant but not critical issues that result in adjustment disorders, such as frustration over not receiving a promotion or job offer.
In additional to counseling via e-mail, e-therapy also takes the form of telemedicine; “ask-the-expert” Web sites; office-based therapy supplemented with e-mail, instant messaging or private chat programs; and online group treatment.
Benefits and drawbacks
Convenience is a major advantage of e-therapy. For people with limited mobility or who are leery of entering a mental health facility, e-therapy provides access to psychological services that would otherwise be unavailable. For patients with anxiety disorders such as social phobia, e-therapy abolishes the initial barrier to treatment.
When asynchronous communication such as e-mail is employed, e-therapy provides time for reflection on issues raised in the previous message. While traditional therapy offers a more free-form process, e-therapy allows the user to organize and carefully examine his or her thoughts and feelings.
Since the need for social interaction and nonverbal cues is eliminated, the salient issues may be addressed quickly and without distraction. Also, links to educational material can easily be embedded within messages, providing immediate access to information not available in traditional face-to-face therapy.
Depending on which e-mail program is used, e-therapy is also potentially more confidential and can be performed more anonymously than traditional therapy.1 For example, a patient can use a Hushmail (www.hushmail.com) account, which provides secure e-mail messaging.
But many of these benefits double as major drawbacks. For one, most e-mail programs/services are not secure, subjecting patients to possible breach of confidentiality as evidenced by Carnivore, a program that enables the FBI to intercept electronic communications without detection.2 Use of a virtual private network allows users to establish a two-way encrypted channel of communication and reduce the chances of intrusion.
The asynchronous nature of text-based communication can also be detrimental. A miscommunication cannot be immediately clarified and can leave the patient feeling more rejected or isolated than before.
Also, the social and nonverbal cues that may facilitate the communication’s context are not available. Without these cues, emergencies such as suicidal ideation may go undetected. For that reason, patients who are suicidal should be advised against e-therapy. Also, since the therapist is not “present,” e-therapy should not be used to address issues that raise intense feelings.
More research needed
Information on the efficacy of e-therapy is limited. According to preliminary data on Metanoia-an online mental health consumer guide (www.metanoia.org)-60% of 450 patients who have tried e-therapy found it very helpful, 32% found it somewhat helpful, and 8% found it not helpful.3
Stephen Biggs, MA, a doctoral candidate in clinical psychology at York University in Toronto, is conducting a more formal assessment of the consumer’s experience with online mental health services.4
Helping patients choose an e-therapist
E-therapists-mostly psychologists, marriage and family therapists, and licensed clinical social workers-are fairly easy to find on the Web. Interestingly, a recent Web search using the term “e-therapy” turned up only one psychiatrist from among 30 names, although more MDs may offer online therapy as the modality gains acceptance.
Because most state laws governing licensing do not address e-therapy, a patient dissatisfied with his or her e-therapist has no legal recourse. Therefore, advise patients to proceed carefully. John Grohol, Psy.D, founding president of the International Society for Mental Health Online (ISMHO), recommends that patients sign or consent to a counseling agreement and a privacy statement, which clearly delineate responsibilities and operating procedures.5
Online resources such as Metanoia and ISMHO (www.ismho.org) offer advice on choosing a qualified e-therapist. Metanoia, for example, offers a directory of e-therapists6 and explains what to look for-and avoid-in a therapist. Site creator Martha Ainsworth notes that Metanoia only lists therapists who have credentials, a degree, and/or a license to provide therapy. ISMHO’s Suggested Principles for the Online Provision of Mental Health Services7 also spells out what services patients should expect from an e-therapist.
Finally, although cyberspace has a global reach, advise patients to choose an e-therapist who lives within driving distance if possible. That way, the patient can consult the therapist in person if a crisis arises.
Related resources
- Hsiung RC (ed). E-therapy: case studies, guiding principles, and the clinical potential of the Internet. New York: W.W. Norton & Co., 2002.
- Fink J. How to use computers and cyberspace in the clinical practice of psychotherapy. Northvale, NJ: Jason Aronson Inc., 1999.
Disclosure
The author reports no affiliation or financial relationship with any of the companies whose products are mentioned in this article.
E-mail is fast becoming a key medium for addressing interpersonal and other therapeutic needs. E-therapy delivered via e-mail and other media offers convenience and a sense of privacy that can break down barriers to treatment for persons grappling with the stigma of mental illness or an emotional problem.
E-therapy is not a substitute for psychotherapy or psychological counseling, nor should it be confused with those modalities. By helping the patient resolve life and relationship issues under the guidance of a qualified professional, however, e-therapy can be a worthwhile adjunct to psychiatric treatment. E-therapy is best for significant but not critical issues that result in adjustment disorders, such as frustration over not receiving a promotion or job offer.
In additional to counseling via e-mail, e-therapy also takes the form of telemedicine; “ask-the-expert” Web sites; office-based therapy supplemented with e-mail, instant messaging or private chat programs; and online group treatment.
Benefits and drawbacks
Convenience is a major advantage of e-therapy. For people with limited mobility or who are leery of entering a mental health facility, e-therapy provides access to psychological services that would otherwise be unavailable. For patients with anxiety disorders such as social phobia, e-therapy abolishes the initial barrier to treatment.
When asynchronous communication such as e-mail is employed, e-therapy provides time for reflection on issues raised in the previous message. While traditional therapy offers a more free-form process, e-therapy allows the user to organize and carefully examine his or her thoughts and feelings.
Since the need for social interaction and nonverbal cues is eliminated, the salient issues may be addressed quickly and without distraction. Also, links to educational material can easily be embedded within messages, providing immediate access to information not available in traditional face-to-face therapy.
Depending on which e-mail program is used, e-therapy is also potentially more confidential and can be performed more anonymously than traditional therapy.1 For example, a patient can use a Hushmail (www.hushmail.com) account, which provides secure e-mail messaging.
But many of these benefits double as major drawbacks. For one, most e-mail programs/services are not secure, subjecting patients to possible breach of confidentiality as evidenced by Carnivore, a program that enables the FBI to intercept electronic communications without detection.2 Use of a virtual private network allows users to establish a two-way encrypted channel of communication and reduce the chances of intrusion.
The asynchronous nature of text-based communication can also be detrimental. A miscommunication cannot be immediately clarified and can leave the patient feeling more rejected or isolated than before.
Also, the social and nonverbal cues that may facilitate the communication’s context are not available. Without these cues, emergencies such as suicidal ideation may go undetected. For that reason, patients who are suicidal should be advised against e-therapy. Also, since the therapist is not “present,” e-therapy should not be used to address issues that raise intense feelings.
More research needed
Information on the efficacy of e-therapy is limited. According to preliminary data on Metanoia-an online mental health consumer guide (www.metanoia.org)-60% of 450 patients who have tried e-therapy found it very helpful, 32% found it somewhat helpful, and 8% found it not helpful.3
Stephen Biggs, MA, a doctoral candidate in clinical psychology at York University in Toronto, is conducting a more formal assessment of the consumer’s experience with online mental health services.4
Helping patients choose an e-therapist
E-therapists-mostly psychologists, marriage and family therapists, and licensed clinical social workers-are fairly easy to find on the Web. Interestingly, a recent Web search using the term “e-therapy” turned up only one psychiatrist from among 30 names, although more MDs may offer online therapy as the modality gains acceptance.
Because most state laws governing licensing do not address e-therapy, a patient dissatisfied with his or her e-therapist has no legal recourse. Therefore, advise patients to proceed carefully. John Grohol, Psy.D, founding president of the International Society for Mental Health Online (ISMHO), recommends that patients sign or consent to a counseling agreement and a privacy statement, which clearly delineate responsibilities and operating procedures.5
Online resources such as Metanoia and ISMHO (www.ismho.org) offer advice on choosing a qualified e-therapist. Metanoia, for example, offers a directory of e-therapists6 and explains what to look for-and avoid-in a therapist. Site creator Martha Ainsworth notes that Metanoia only lists therapists who have credentials, a degree, and/or a license to provide therapy. ISMHO’s Suggested Principles for the Online Provision of Mental Health Services7 also spells out what services patients should expect from an e-therapist.
Finally, although cyberspace has a global reach, advise patients to choose an e-therapist who lives within driving distance if possible. That way, the patient can consult the therapist in person if a crisis arises.
Related resources
- Hsiung RC (ed). E-therapy: case studies, guiding principles, and the clinical potential of the Internet. New York: W.W. Norton & Co., 2002.
- Fink J. How to use computers and cyberspace in the clinical practice of psychotherapy. Northvale, NJ: Jason Aronson Inc., 1999.
Disclosure
The author reports no affiliation or financial relationship with any of the companies whose products are mentioned in this article.
1. Grohol JM. Best practices in e-therapy: clarifying the definition. Available at: http://psychcentral.com/best/best5.htm. Accessed Oct. 30. 2002.
2. FBI Programs and Initiatives-Carnivore: Diagnostic Tool. Available at: http://www.fbi.gov/hq/lab/carnivore/carnivore2.htm. Accessed Nov. 4, 2002.
3. Metanoia Internet Therapy Survey Results. Available at: http://www.metanoia.org/imhs/results.htm. Accessed Oct. 30, 2002.
4. Biggs S. E-therapy Study. Available at: http://www.yorku.ca/sbiggs/. Accessed Oct. 30, 2002.
5. Grohol JM. Best practices in e-therapy: legal and licensing issues. Available at: http://psychcentral.com/best/best4.htm.
6. Metanoia Directory of Internet Psychotherapists. Available at: http://www.metanoia.org/imhs/directry.htm Accessed Oct. 29, 2002.
7. International Society for Mental Health Online. Suggested principles for the online provision of mental health services. Available at: http://www.ismho.org/suggestions.html. Accessed Oct. 30, 2002.
1. Grohol JM. Best practices in e-therapy: clarifying the definition. Available at: http://psychcentral.com/best/best5.htm. Accessed Oct. 30. 2002.
2. FBI Programs and Initiatives-Carnivore: Diagnostic Tool. Available at: http://www.fbi.gov/hq/lab/carnivore/carnivore2.htm. Accessed Nov. 4, 2002.
3. Metanoia Internet Therapy Survey Results. Available at: http://www.metanoia.org/imhs/results.htm. Accessed Oct. 30, 2002.
4. Biggs S. E-therapy Study. Available at: http://www.yorku.ca/sbiggs/. Accessed Oct. 30, 2002.
5. Grohol JM. Best practices in e-therapy: legal and licensing issues. Available at: http://psychcentral.com/best/best4.htm.
6. Metanoia Directory of Internet Psychotherapists. Available at: http://www.metanoia.org/imhs/directry.htm Accessed Oct. 29, 2002.
7. International Society for Mental Health Online. Suggested principles for the online provision of mental health services. Available at: http://www.ismho.org/suggestions.html. Accessed Oct. 30, 2002.
A valuable audio-visual tool in your pocket
The days of lugging a portable projector and a laptop to your clinical or other presentations may soon fade to black.
Many psychiatrists use personal digital assistants (PDAs, or handheld computers) to organize their schedules, access medical texts, and check for drug-drug interactions. These pocket-size devices are also quite adept at editing and displaying PowerPoint presentations. For an investment anywhere between $100 and $250, you can turn your PDA into a valuable audio-visual tool.
To display and edit your presentation, you will need:
- software that converts PowerPoint slides into a PDA-compatible format
- hardware that connects the PDA to the LCD projector.
I have used the Margi Presenter-to-Go (www.margi.com) for the Handspring Visor Edge PDA (Palm operating system), which comes with both the software and hardware adapter (Table 1). For the Pocket PC operating system, I have used a Toshiba e740 device with the Toshiba expansion module (hardware), which works with IA Presenter software (included).
Using Palm
The conversion software for Margi Presenter-to-Go must be installed onto your desktop computer from the CD-ROM-just click on the “install” icon when the CD-ROM starts.
The software is also easy to use: simply choose the Presenter-to-Go “Virtual Printer” on your computer, then “print” your presentation to the Presenter-to-Go conversion program. This action initiates the conversion process and takes several minutes. To load the converted presentation onto the PDA requires only a “HotSync” (synchronization of information from desktop to handheld); this should take 5 to 10 minutes depending on the size of your presentation.
If you wish to include Web pages and Microsoft Word documents in your presentation, Margi Presenter-to-Go can convert them as well.
As you prepare to speak, you will need an extra power outlet near the LCD projector in order to power the Margi presentation module. Connect the LCD projector to the module’s VGA cable and point the PDA infrared port towards you. Using the infrared remote that is included with the presentation module, you can move through the slides from about 6 feet away.
You can reorganize your slides on the PDA and hide or show selected slides. The PDA can store more than one presentation, and multiple users can load a presentation onto their devices. The slides are also quite sharp at 1,024 by 768 pixels and 8-bit color depth.
The capacity of Presenter-to-Go slides, however, is limited by the PDA’s main memory, usually between 8 and 16 mb for Palm OS PDAs. Presentations on the desktop computer typically will be compressed when converted for the PDA, but presentations with many embedded images will be about the same size when on the PDA. I suggest using QuickPoint software and Pitch presentation module to minimize the size limitation. Still, with any Palm OS product you will lose all available “movement,” such as animation and slide transitions.
Using Pocket PC
While solutions for Palm OS are less expensive, hardware and software options for Pocket PC offer more power and variety (Table 2). Converting PowerPoint presentations for Pocket PC also are a minute or two faster than conversion for Palm OS because less processing is needed. For example, after installing IA Presenter from the Toshiba CD-ROM, simply “drag and drop” your presentation into the “Pocket PC My Documents” folder on your desktop. Connect the expansion module to the handheld and the LCD panel, and you’re in business.
The resolution in Pocket PC is also good at 1,024 by 768 pixels and 16-bit color depth. Standard features include speaker notes, ability to hide slides, slide sorting, and presentation beaming. You also can maintain slide transitions and progressive display sequencing of individual bulleted items, graphics, photo shapes, and objects.
Because current Pocket PC devices offer more main memory than current Palm OS devices (32 or 64 mb for Pocket PC versus 8 to 16 mb for Palm), PowerPoint presentation size is less limited. The presentations also can be stored in external memory such as compact flash cards. The main drawback to the Pocket PC solution is its significantly shorter battery life (several hours with intense use). I strongly recommend using an AC adapter with your Pocket PC to avoid a potential blackout-even if your presentation is only an hour long.
THIS MONTH’S WEB PICKS
Medical hardware accessories for your PDA
- ActiveECG (www.activecenter.com)
- Snap (www.viasyshealthcare.com/products/snap/snap.asp)
- Pocketview ECG (www.micromed.com.au/08_products/20_pocketview/)
- Magic Marker (www.eeg-persyst.com/web/MagicMarker-Look.html) EEG remote monitor for Pocket
The days of lugging a portable projector and a laptop to your clinical or other presentations may soon fade to black.
Many psychiatrists use personal digital assistants (PDAs, or handheld computers) to organize their schedules, access medical texts, and check for drug-drug interactions. These pocket-size devices are also quite adept at editing and displaying PowerPoint presentations. For an investment anywhere between $100 and $250, you can turn your PDA into a valuable audio-visual tool.
To display and edit your presentation, you will need:
- software that converts PowerPoint slides into a PDA-compatible format
- hardware that connects the PDA to the LCD projector.
I have used the Margi Presenter-to-Go (www.margi.com) for the Handspring Visor Edge PDA (Palm operating system), which comes with both the software and hardware adapter (Table 1). For the Pocket PC operating system, I have used a Toshiba e740 device with the Toshiba expansion module (hardware), which works with IA Presenter software (included).
Using Palm
The conversion software for Margi Presenter-to-Go must be installed onto your desktop computer from the CD-ROM-just click on the “install” icon when the CD-ROM starts.
The software is also easy to use: simply choose the Presenter-to-Go “Virtual Printer” on your computer, then “print” your presentation to the Presenter-to-Go conversion program. This action initiates the conversion process and takes several minutes. To load the converted presentation onto the PDA requires only a “HotSync” (synchronization of information from desktop to handheld); this should take 5 to 10 minutes depending on the size of your presentation.
If you wish to include Web pages and Microsoft Word documents in your presentation, Margi Presenter-to-Go can convert them as well.
As you prepare to speak, you will need an extra power outlet near the LCD projector in order to power the Margi presentation module. Connect the LCD projector to the module’s VGA cable and point the PDA infrared port towards you. Using the infrared remote that is included with the presentation module, you can move through the slides from about 6 feet away.
You can reorganize your slides on the PDA and hide or show selected slides. The PDA can store more than one presentation, and multiple users can load a presentation onto their devices. The slides are also quite sharp at 1,024 by 768 pixels and 8-bit color depth.
The capacity of Presenter-to-Go slides, however, is limited by the PDA’s main memory, usually between 8 and 16 mb for Palm OS PDAs. Presentations on the desktop computer typically will be compressed when converted for the PDA, but presentations with many embedded images will be about the same size when on the PDA. I suggest using QuickPoint software and Pitch presentation module to minimize the size limitation. Still, with any Palm OS product you will lose all available “movement,” such as animation and slide transitions.
Using Pocket PC
While solutions for Palm OS are less expensive, hardware and software options for Pocket PC offer more power and variety (Table 2). Converting PowerPoint presentations for Pocket PC also are a minute or two faster than conversion for Palm OS because less processing is needed. For example, after installing IA Presenter from the Toshiba CD-ROM, simply “drag and drop” your presentation into the “Pocket PC My Documents” folder on your desktop. Connect the expansion module to the handheld and the LCD panel, and you’re in business.
The resolution in Pocket PC is also good at 1,024 by 768 pixels and 16-bit color depth. Standard features include speaker notes, ability to hide slides, slide sorting, and presentation beaming. You also can maintain slide transitions and progressive display sequencing of individual bulleted items, graphics, photo shapes, and objects.
Because current Pocket PC devices offer more main memory than current Palm OS devices (32 or 64 mb for Pocket PC versus 8 to 16 mb for Palm), PowerPoint presentation size is less limited. The presentations also can be stored in external memory such as compact flash cards. The main drawback to the Pocket PC solution is its significantly shorter battery life (several hours with intense use). I strongly recommend using an AC adapter with your Pocket PC to avoid a potential blackout-even if your presentation is only an hour long.
THIS MONTH’S WEB PICKS
Medical hardware accessories for your PDA
- ActiveECG (www.activecenter.com)
- Snap (www.viasyshealthcare.com/products/snap/snap.asp)
- Pocketview ECG (www.micromed.com.au/08_products/20_pocketview/)
- Magic Marker (www.eeg-persyst.com/web/MagicMarker-Look.html) EEG remote monitor for Pocket
The days of lugging a portable projector and a laptop to your clinical or other presentations may soon fade to black.
Many psychiatrists use personal digital assistants (PDAs, or handheld computers) to organize their schedules, access medical texts, and check for drug-drug interactions. These pocket-size devices are also quite adept at editing and displaying PowerPoint presentations. For an investment anywhere between $100 and $250, you can turn your PDA into a valuable audio-visual tool.
To display and edit your presentation, you will need:
- software that converts PowerPoint slides into a PDA-compatible format
- hardware that connects the PDA to the LCD projector.
I have used the Margi Presenter-to-Go (www.margi.com) for the Handspring Visor Edge PDA (Palm operating system), which comes with both the software and hardware adapter (Table 1). For the Pocket PC operating system, I have used a Toshiba e740 device with the Toshiba expansion module (hardware), which works with IA Presenter software (included).
Using Palm
The conversion software for Margi Presenter-to-Go must be installed onto your desktop computer from the CD-ROM-just click on the “install” icon when the CD-ROM starts.
The software is also easy to use: simply choose the Presenter-to-Go “Virtual Printer” on your computer, then “print” your presentation to the Presenter-to-Go conversion program. This action initiates the conversion process and takes several minutes. To load the converted presentation onto the PDA requires only a “HotSync” (synchronization of information from desktop to handheld); this should take 5 to 10 minutes depending on the size of your presentation.
If you wish to include Web pages and Microsoft Word documents in your presentation, Margi Presenter-to-Go can convert them as well.
As you prepare to speak, you will need an extra power outlet near the LCD projector in order to power the Margi presentation module. Connect the LCD projector to the module’s VGA cable and point the PDA infrared port towards you. Using the infrared remote that is included with the presentation module, you can move through the slides from about 6 feet away.
You can reorganize your slides on the PDA and hide or show selected slides. The PDA can store more than one presentation, and multiple users can load a presentation onto their devices. The slides are also quite sharp at 1,024 by 768 pixels and 8-bit color depth.
The capacity of Presenter-to-Go slides, however, is limited by the PDA’s main memory, usually between 8 and 16 mb for Palm OS PDAs. Presentations on the desktop computer typically will be compressed when converted for the PDA, but presentations with many embedded images will be about the same size when on the PDA. I suggest using QuickPoint software and Pitch presentation module to minimize the size limitation. Still, with any Palm OS product you will lose all available “movement,” such as animation and slide transitions.
Using Pocket PC
While solutions for Palm OS are less expensive, hardware and software options for Pocket PC offer more power and variety (Table 2). Converting PowerPoint presentations for Pocket PC also are a minute or two faster than conversion for Palm OS because less processing is needed. For example, after installing IA Presenter from the Toshiba CD-ROM, simply “drag and drop” your presentation into the “Pocket PC My Documents” folder on your desktop. Connect the expansion module to the handheld and the LCD panel, and you’re in business.
The resolution in Pocket PC is also good at 1,024 by 768 pixels and 16-bit color depth. Standard features include speaker notes, ability to hide slides, slide sorting, and presentation beaming. You also can maintain slide transitions and progressive display sequencing of individual bulleted items, graphics, photo shapes, and objects.
Because current Pocket PC devices offer more main memory than current Palm OS devices (32 or 64 mb for Pocket PC versus 8 to 16 mb for Palm), PowerPoint presentation size is less limited. The presentations also can be stored in external memory such as compact flash cards. The main drawback to the Pocket PC solution is its significantly shorter battery life (several hours with intense use). I strongly recommend using an AC adapter with your Pocket PC to avoid a potential blackout-even if your presentation is only an hour long.
THIS MONTH’S WEB PICKS
Medical hardware accessories for your PDA
- ActiveECG (www.activecenter.com)
- Snap (www.viasyshealthcare.com/products/snap/snap.asp)
- Pocketview ECG (www.micromed.com.au/08_products/20_pocketview/)
- Magic Marker (www.eeg-persyst.com/web/MagicMarker-Look.html) EEG remote monitor for Pocket
In a virtual world, games can be therapeutic
Many of us—and our patients—enjoy computer games, and at first glance computer gaming and psychiatry appear to have little in common. Yet computer gaming has spurred the growth of cyber technology by demanding high-level capabilities in computer hardware and software. Games initially were developed and played in two dimensions, but—with improved graphic cards and software rendering engines—they can now be three-dimensional. Some games are realistic enough to stimulate nausea and vertigo.
Overexposure to especially graphic computer games has been blamed for causing violent behavior in some individuals.1 Jeanne B. Funk, PhD, of the University of Toledo department of psychology, testified before the U.S. Senate Commerce Committee regarding the impact of interactive violence on children.2
Avatar psychotherapy. Some computer games also have therapeutic properties, however. John Suler, PhD, of the psychology department at Rider University (Lawrenceville, NJ), writes about “Avatar psychotherapy,” in which an avatar—a personal manifestation in a virtual world—can be used to facilitate psychotherapy.3 Such an environment can permit role-playing, enable fantasies, and allow psychiatrists to explore transference and countertransference issues.
“The Sims,” a popular people simulator game (http://thesims.ea.com/), has also been considered useful for therapy as a “technology of self.”4 One resident physician at the UC Davis psychiatry department uses this game in therapy with adolescents to facilitate expression of family dynamics. Although this technology does not replace traditional psychotherapy, it clearly augments and provides unique benefits.
Virtual fears. In 1995, members of the Georgia Tech computer science department and Emory University department of psychiatry in Atlanta created the Graphics Visualization & Usability Center,5 a project using virtual reality and exposure therapy. Patients wear a head-mounted display and other devices to track their movements in the virtual world. With virtual reality technology, patients can be exposed to a feared stimulus in a safe, computer-generated environment.
This technology has been used to treat acrophobia, fear of flying, and posttraumatic stress disorder. Its benefits include cost effectiveness, high patient acceptance, and effective therapy for patients with imagination deficits.
The developers of virtrual reality therapy have now formed a company called Virtually Better to provide this technology to other therapists.6 Although the technology currently is not applicable to the individual psychiatrist, this tool is expected to be widely available in the coming years with ever-improving and more affordable computing power.
Telemedicine. Virtual reality is also being used to link providers and patients through telemedicine or video conferencing. In clinical practice, telemedicine offers many advantages, such as the ability to reach patients in wide geographic areas, cost effectiveness, and linking of specialists to primary providers.7
Patients appreciate traveling less and are quite satisfied with their virtual visits. In fact, patients with schizophrenia prefer telemedicine to real office visits.8
One of telemedicine’s downsides has been its expense, requiring dedicated ISDN lines and specialized equipment. Other issues include licensing, confidentiality, reimbursement, and adherence to practice guidelines.9 For readers interested in this technology, the American Telemedicine Association Web site (www.americantelemed.org) is a good starting point. As high-speed Internet access becomes more widely available, telemedicine is poised to overtake e-mail as the next communication tool.
Summary. These virtual methods are still considered quite novel and are not yet part of mainstream psychiatry. The technology is not quite mature but is rapidly improving with new hardware and software developments. Its cost, although a barrier today, is diminishing fast. Patient acceptance is likely to grow over time among our increasingly technology-savvy public. With Internet connectivity and improved visual and audio capabilities of computers at affordable prices, virtual reality could soon play a significant new role in psychiatric care.
1. Sources about Role Playing Games: http://www.rpg.net/252/quellen/sources.html. Accessed Aug. 8, 2002.
2. Testimony of Jeanne B. Funk, PhD, before the U.S. Senate Commerce Committee on violent computer games. Available at: http://www.utoledo.edu/psychology/funktestimony.html. Accessed Aug. 8, 2002.
3. Avatar Psychotherapy: http://www.rider.edu/users/suler/psycyber/avatarther.html.
4. Tufts University: The SIMS—the people simulator game—as a technology of the self. Available at: http://www.tufts.edu/~istamm01/The%20SIMS3.htm. Accessed Aug. 8, 2002.
5. Georgia Institute of Technology, Graphics Visualization & Usability Center: http://www.cc.gatech.edu/gvu/virtual/index.html. Accessed Aug. 8, 2002.
6. Virtually Better: http://www.virtuallybetter.com. Accessed Aug. 8, 2002.
7. Hilty DM, Luo JS, Morache C, Marcelo DA, Nesbitt TS. Telepsychiatry: an overview for psychiatrists. CNS Drugs 2002;16(8):527-48.
8. Zarate CA, Jr, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry 1997;58(1):22-5.
9. The American Psychiatric Association Resource Document on Telepsychiatry by Videoconferencing. Available at: http://www.psych.org/pract_of_psych/tp_paper.cfm. Accessed Aug. 8, 2002.
Many of us—and our patients—enjoy computer games, and at first glance computer gaming and psychiatry appear to have little in common. Yet computer gaming has spurred the growth of cyber technology by demanding high-level capabilities in computer hardware and software. Games initially were developed and played in two dimensions, but—with improved graphic cards and software rendering engines—they can now be three-dimensional. Some games are realistic enough to stimulate nausea and vertigo.
Overexposure to especially graphic computer games has been blamed for causing violent behavior in some individuals.1 Jeanne B. Funk, PhD, of the University of Toledo department of psychology, testified before the U.S. Senate Commerce Committee regarding the impact of interactive violence on children.2
Avatar psychotherapy. Some computer games also have therapeutic properties, however. John Suler, PhD, of the psychology department at Rider University (Lawrenceville, NJ), writes about “Avatar psychotherapy,” in which an avatar—a personal manifestation in a virtual world—can be used to facilitate psychotherapy.3 Such an environment can permit role-playing, enable fantasies, and allow psychiatrists to explore transference and countertransference issues.
“The Sims,” a popular people simulator game (http://thesims.ea.com/), has also been considered useful for therapy as a “technology of self.”4 One resident physician at the UC Davis psychiatry department uses this game in therapy with adolescents to facilitate expression of family dynamics. Although this technology does not replace traditional psychotherapy, it clearly augments and provides unique benefits.
Virtual fears. In 1995, members of the Georgia Tech computer science department and Emory University department of psychiatry in Atlanta created the Graphics Visualization & Usability Center,5 a project using virtual reality and exposure therapy. Patients wear a head-mounted display and other devices to track their movements in the virtual world. With virtual reality technology, patients can be exposed to a feared stimulus in a safe, computer-generated environment.
This technology has been used to treat acrophobia, fear of flying, and posttraumatic stress disorder. Its benefits include cost effectiveness, high patient acceptance, and effective therapy for patients with imagination deficits.
The developers of virtrual reality therapy have now formed a company called Virtually Better to provide this technology to other therapists.6 Although the technology currently is not applicable to the individual psychiatrist, this tool is expected to be widely available in the coming years with ever-improving and more affordable computing power.
Telemedicine. Virtual reality is also being used to link providers and patients through telemedicine or video conferencing. In clinical practice, telemedicine offers many advantages, such as the ability to reach patients in wide geographic areas, cost effectiveness, and linking of specialists to primary providers.7
Patients appreciate traveling less and are quite satisfied with their virtual visits. In fact, patients with schizophrenia prefer telemedicine to real office visits.8
One of telemedicine’s downsides has been its expense, requiring dedicated ISDN lines and specialized equipment. Other issues include licensing, confidentiality, reimbursement, and adherence to practice guidelines.9 For readers interested in this technology, the American Telemedicine Association Web site (www.americantelemed.org) is a good starting point. As high-speed Internet access becomes more widely available, telemedicine is poised to overtake e-mail as the next communication tool.
Summary. These virtual methods are still considered quite novel and are not yet part of mainstream psychiatry. The technology is not quite mature but is rapidly improving with new hardware and software developments. Its cost, although a barrier today, is diminishing fast. Patient acceptance is likely to grow over time among our increasingly technology-savvy public. With Internet connectivity and improved visual and audio capabilities of computers at affordable prices, virtual reality could soon play a significant new role in psychiatric care.
Many of us—and our patients—enjoy computer games, and at first glance computer gaming and psychiatry appear to have little in common. Yet computer gaming has spurred the growth of cyber technology by demanding high-level capabilities in computer hardware and software. Games initially were developed and played in two dimensions, but—with improved graphic cards and software rendering engines—they can now be three-dimensional. Some games are realistic enough to stimulate nausea and vertigo.
Overexposure to especially graphic computer games has been blamed for causing violent behavior in some individuals.1 Jeanne B. Funk, PhD, of the University of Toledo department of psychology, testified before the U.S. Senate Commerce Committee regarding the impact of interactive violence on children.2
Avatar psychotherapy. Some computer games also have therapeutic properties, however. John Suler, PhD, of the psychology department at Rider University (Lawrenceville, NJ), writes about “Avatar psychotherapy,” in which an avatar—a personal manifestation in a virtual world—can be used to facilitate psychotherapy.3 Such an environment can permit role-playing, enable fantasies, and allow psychiatrists to explore transference and countertransference issues.
“The Sims,” a popular people simulator game (http://thesims.ea.com/), has also been considered useful for therapy as a “technology of self.”4 One resident physician at the UC Davis psychiatry department uses this game in therapy with adolescents to facilitate expression of family dynamics. Although this technology does not replace traditional psychotherapy, it clearly augments and provides unique benefits.
Virtual fears. In 1995, members of the Georgia Tech computer science department and Emory University department of psychiatry in Atlanta created the Graphics Visualization & Usability Center,5 a project using virtual reality and exposure therapy. Patients wear a head-mounted display and other devices to track their movements in the virtual world. With virtual reality technology, patients can be exposed to a feared stimulus in a safe, computer-generated environment.
This technology has been used to treat acrophobia, fear of flying, and posttraumatic stress disorder. Its benefits include cost effectiveness, high patient acceptance, and effective therapy for patients with imagination deficits.
The developers of virtrual reality therapy have now formed a company called Virtually Better to provide this technology to other therapists.6 Although the technology currently is not applicable to the individual psychiatrist, this tool is expected to be widely available in the coming years with ever-improving and more affordable computing power.
Telemedicine. Virtual reality is also being used to link providers and patients through telemedicine or video conferencing. In clinical practice, telemedicine offers many advantages, such as the ability to reach patients in wide geographic areas, cost effectiveness, and linking of specialists to primary providers.7
Patients appreciate traveling less and are quite satisfied with their virtual visits. In fact, patients with schizophrenia prefer telemedicine to real office visits.8
One of telemedicine’s downsides has been its expense, requiring dedicated ISDN lines and specialized equipment. Other issues include licensing, confidentiality, reimbursement, and adherence to practice guidelines.9 For readers interested in this technology, the American Telemedicine Association Web site (www.americantelemed.org) is a good starting point. As high-speed Internet access becomes more widely available, telemedicine is poised to overtake e-mail as the next communication tool.
Summary. These virtual methods are still considered quite novel and are not yet part of mainstream psychiatry. The technology is not quite mature but is rapidly improving with new hardware and software developments. Its cost, although a barrier today, is diminishing fast. Patient acceptance is likely to grow over time among our increasingly technology-savvy public. With Internet connectivity and improved visual and audio capabilities of computers at affordable prices, virtual reality could soon play a significant new role in psychiatric care.
1. Sources about Role Playing Games: http://www.rpg.net/252/quellen/sources.html. Accessed Aug. 8, 2002.
2. Testimony of Jeanne B. Funk, PhD, before the U.S. Senate Commerce Committee on violent computer games. Available at: http://www.utoledo.edu/psychology/funktestimony.html. Accessed Aug. 8, 2002.
3. Avatar Psychotherapy: http://www.rider.edu/users/suler/psycyber/avatarther.html.
4. Tufts University: The SIMS—the people simulator game—as a technology of the self. Available at: http://www.tufts.edu/~istamm01/The%20SIMS3.htm. Accessed Aug. 8, 2002.
5. Georgia Institute of Technology, Graphics Visualization & Usability Center: http://www.cc.gatech.edu/gvu/virtual/index.html. Accessed Aug. 8, 2002.
6. Virtually Better: http://www.virtuallybetter.com. Accessed Aug. 8, 2002.
7. Hilty DM, Luo JS, Morache C, Marcelo DA, Nesbitt TS. Telepsychiatry: an overview for psychiatrists. CNS Drugs 2002;16(8):527-48.
8. Zarate CA, Jr, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry 1997;58(1):22-5.
9. The American Psychiatric Association Resource Document on Telepsychiatry by Videoconferencing. Available at: http://www.psych.org/pract_of_psych/tp_paper.cfm. Accessed Aug. 8, 2002.
1. Sources about Role Playing Games: http://www.rpg.net/252/quellen/sources.html. Accessed Aug. 8, 2002.
2. Testimony of Jeanne B. Funk, PhD, before the U.S. Senate Commerce Committee on violent computer games. Available at: http://www.utoledo.edu/psychology/funktestimony.html. Accessed Aug. 8, 2002.
3. Avatar Psychotherapy: http://www.rider.edu/users/suler/psycyber/avatarther.html.
4. Tufts University: The SIMS—the people simulator game—as a technology of the self. Available at: http://www.tufts.edu/~istamm01/The%20SIMS3.htm. Accessed Aug. 8, 2002.
5. Georgia Institute of Technology, Graphics Visualization & Usability Center: http://www.cc.gatech.edu/gvu/virtual/index.html. Accessed Aug. 8, 2002.
6. Virtually Better: http://www.virtuallybetter.com. Accessed Aug. 8, 2002.
7. Hilty DM, Luo JS, Morache C, Marcelo DA, Nesbitt TS. Telepsychiatry: an overview for psychiatrists. CNS Drugs 2002;16(8):527-48.
8. Zarate CA, Jr, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry 1997;58(1):22-5.
9. The American Psychiatric Association Resource Document on Telepsychiatry by Videoconferencing. Available at: http://www.psych.org/pract_of_psych/tp_paper.cfm. Accessed Aug. 8, 2002.
In a virtual world, games can be therapeutic
Many of us—and our patients—enjoy computer games, and at first glance computer gaming and psychiatry appear to have little in common. Yet computer gaming has spurred the growth of cyber technology by demanding high-level capabilities in computer hardware and software. Games initially were developed and played in two dimensions, but—with improved graphic cards and software rendering engines—they can now be three-dimensional. Some games are realistic enough to stimulate nausea and vertigo.
Overexposure to especially graphic computer games has been blamed for causing violent behavior in some individuals.1 Jeanne B. Funk, PhD, of the University of Toledo department of psychology, testified before the U.S. Senate Commerce Committee regarding the impact of interactive violence on children.2
Avatar psychotherapy. Some computer games also have therapeutic properties, however. John Suler, PhD, of the psychology department at Rider University (Lawrenceville, NJ), writes about “Avatar psychotherapy,” in which an avatar—a personal manifestation in a virtual world—can be used to facilitate psychotherapy.3 Such an environment can permit role-playing, enable fantasies, and allow psychiatrists to explore transference and countertransference issues.
“The Sims,” a popular people simulator game (http://thesims.ea.com/), has also been considered useful for therapy as a “technology of self.”4 One resident physician at the UC Davis psychiatry department uses this game in therapy with adolescents to facilitate expression of family dynamics. Although this technology does not replace traditional psychotherapy, it clearly augments and provides unique benefits.
Virtual fears. In 1995, members of the Georgia Tech computer science department and Emory University department of psychiatry in Atlanta created the Graphics Visualization & Usability Center,5 a project using virtual reality and exposure therapy. Patients wear a head-mounted display and other devices to track their movements in the virtual world. With virtual reality technology, patients can be exposed to a feared stimulus in a safe, computer-generated environment.
This technology has been used to treat acrophobia, fear of flying, and posttraumatic stress disorder. Its benefits include cost effectiveness, high patient acceptance, and effective therapy for patients with imagination deficits.
The developers of virtrual reality therapy have now formed a company called Virtually Better to provide this technology to other therapists.6 Although the technology currently is not applicable to the individual psychiatrist, this tool is expected to be widely available in the coming years with ever-improving and more affordable computing power.
Telemedicine. Virtual reality is also being used to link providers and patients through telemedicine or video conferencing. In clinical practice, telemedicine offers many advantages, such as the ability to reach patients in wide geographic areas, cost effectiveness, and linking of specialists to primary providers.7
Patients appreciate traveling less and are quite satisfied with their virtual visits. In fact, patients with schizophrenia prefer telemedicine to real office visits.8
One of telemedicine’s downsides has been its expense, requiring dedicated ISDN lines and specialized equipment. Other issues include licensing, confidentiality, reimbursement, and adherence to practice guidelines.9 For readers interested in this technology, the American Telemedicine Association Web site (www.americantelemed.org) is a good starting point. As high-speed Internet access becomes more widely available, telemedicine is poised to overtake e-mail as the next communication tool.
Summary. These virtual methods are still considered quite novel and are not yet part of mainstream psychiatry. The technology is not quite mature but is rapidly improving with new hardware and software developments. Its cost, although a barrier today, is diminishing fast. Patient acceptance is likely to grow over time among our increasingly technology-savvy public. With Internet connectivity and improved visual and audio capabilities of computers at affordable prices, virtual reality could soon play a significant new role in psychiatric care.
1. Sources about Role Playing Games: http://www.rpg.net/252/quellen/sources.html. Accessed Aug. 8, 2002.
2. Testimony of Jeanne B. Funk, PhD, before the U.S. Senate Commerce Committee on violent computer games. Available at: http://www.utoledo.edu/psychology/funktestimony.html. Accessed Aug. 8, 2002.
3. Avatar Psychotherapy: http://www.rider.edu/users/suler/psycyber/avatarther.html.
4. Tufts University: The SIMS—the people simulator game—as a technology of the self. Available at: http://www.tufts.edu/~istamm01/The%20SIMS3.htm. Accessed Aug. 8, 2002.
5. Georgia Institute of Technology, Graphics Visualization & Usability Center: http://www.cc.gatech.edu/gvu/virtual/index.html. Accessed Aug. 8, 2002.
6. Virtually Better: http://www.virtuallybetter.com. Accessed Aug. 8, 2002.
7. Hilty DM, Luo JS, Morache C, Marcelo DA, Nesbitt TS. Telepsychiatry: an overview for psychiatrists. CNS Drugs 2002;16(8):527-48.
8. Zarate CA, Jr, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry 1997;58(1):22-5.
9. The American Psychiatric Association Resource Document on Telepsychiatry by Videoconferencing. Available at: http://www.psych.org/pract_of_psych/tp_paper.cfm. Accessed Aug. 8, 2002.
Many of us—and our patients—enjoy computer games, and at first glance computer gaming and psychiatry appear to have little in common. Yet computer gaming has spurred the growth of cyber technology by demanding high-level capabilities in computer hardware and software. Games initially were developed and played in two dimensions, but—with improved graphic cards and software rendering engines—they can now be three-dimensional. Some games are realistic enough to stimulate nausea and vertigo.
Overexposure to especially graphic computer games has been blamed for causing violent behavior in some individuals.1 Jeanne B. Funk, PhD, of the University of Toledo department of psychology, testified before the U.S. Senate Commerce Committee regarding the impact of interactive violence on children.2
Avatar psychotherapy. Some computer games also have therapeutic properties, however. John Suler, PhD, of the psychology department at Rider University (Lawrenceville, NJ), writes about “Avatar psychotherapy,” in which an avatar—a personal manifestation in a virtual world—can be used to facilitate psychotherapy.3 Such an environment can permit role-playing, enable fantasies, and allow psychiatrists to explore transference and countertransference issues.
“The Sims,” a popular people simulator game (http://thesims.ea.com/), has also been considered useful for therapy as a “technology of self.”4 One resident physician at the UC Davis psychiatry department uses this game in therapy with adolescents to facilitate expression of family dynamics. Although this technology does not replace traditional psychotherapy, it clearly augments and provides unique benefits.
Virtual fears. In 1995, members of the Georgia Tech computer science department and Emory University department of psychiatry in Atlanta created the Graphics Visualization & Usability Center,5 a project using virtual reality and exposure therapy. Patients wear a head-mounted display and other devices to track their movements in the virtual world. With virtual reality technology, patients can be exposed to a feared stimulus in a safe, computer-generated environment.
This technology has been used to treat acrophobia, fear of flying, and posttraumatic stress disorder. Its benefits include cost effectiveness, high patient acceptance, and effective therapy for patients with imagination deficits.
The developers of virtrual reality therapy have now formed a company called Virtually Better to provide this technology to other therapists.6 Although the technology currently is not applicable to the individual psychiatrist, this tool is expected to be widely available in the coming years with ever-improving and more affordable computing power.
Telemedicine. Virtual reality is also being used to link providers and patients through telemedicine or video conferencing. In clinical practice, telemedicine offers many advantages, such as the ability to reach patients in wide geographic areas, cost effectiveness, and linking of specialists to primary providers.7
Patients appreciate traveling less and are quite satisfied with their virtual visits. In fact, patients with schizophrenia prefer telemedicine to real office visits.8
One of telemedicine’s downsides has been its expense, requiring dedicated ISDN lines and specialized equipment. Other issues include licensing, confidentiality, reimbursement, and adherence to practice guidelines.9 For readers interested in this technology, the American Telemedicine Association Web site (www.americantelemed.org) is a good starting point. As high-speed Internet access becomes more widely available, telemedicine is poised to overtake e-mail as the next communication tool.
Summary. These virtual methods are still considered quite novel and are not yet part of mainstream psychiatry. The technology is not quite mature but is rapidly improving with new hardware and software developments. Its cost, although a barrier today, is diminishing fast. Patient acceptance is likely to grow over time among our increasingly technology-savvy public. With Internet connectivity and improved visual and audio capabilities of computers at affordable prices, virtual reality could soon play a significant new role in psychiatric care.
Many of us—and our patients—enjoy computer games, and at first glance computer gaming and psychiatry appear to have little in common. Yet computer gaming has spurred the growth of cyber technology by demanding high-level capabilities in computer hardware and software. Games initially were developed and played in two dimensions, but—with improved graphic cards and software rendering engines—they can now be three-dimensional. Some games are realistic enough to stimulate nausea and vertigo.
Overexposure to especially graphic computer games has been blamed for causing violent behavior in some individuals.1 Jeanne B. Funk, PhD, of the University of Toledo department of psychology, testified before the U.S. Senate Commerce Committee regarding the impact of interactive violence on children.2
Avatar psychotherapy. Some computer games also have therapeutic properties, however. John Suler, PhD, of the psychology department at Rider University (Lawrenceville, NJ), writes about “Avatar psychotherapy,” in which an avatar—a personal manifestation in a virtual world—can be used to facilitate psychotherapy.3 Such an environment can permit role-playing, enable fantasies, and allow psychiatrists to explore transference and countertransference issues.
“The Sims,” a popular people simulator game (http://thesims.ea.com/), has also been considered useful for therapy as a “technology of self.”4 One resident physician at the UC Davis psychiatry department uses this game in therapy with adolescents to facilitate expression of family dynamics. Although this technology does not replace traditional psychotherapy, it clearly augments and provides unique benefits.
Virtual fears. In 1995, members of the Georgia Tech computer science department and Emory University department of psychiatry in Atlanta created the Graphics Visualization & Usability Center,5 a project using virtual reality and exposure therapy. Patients wear a head-mounted display and other devices to track their movements in the virtual world. With virtual reality technology, patients can be exposed to a feared stimulus in a safe, computer-generated environment.
This technology has been used to treat acrophobia, fear of flying, and posttraumatic stress disorder. Its benefits include cost effectiveness, high patient acceptance, and effective therapy for patients with imagination deficits.
The developers of virtrual reality therapy have now formed a company called Virtually Better to provide this technology to other therapists.6 Although the technology currently is not applicable to the individual psychiatrist, this tool is expected to be widely available in the coming years with ever-improving and more affordable computing power.
Telemedicine. Virtual reality is also being used to link providers and patients through telemedicine or video conferencing. In clinical practice, telemedicine offers many advantages, such as the ability to reach patients in wide geographic areas, cost effectiveness, and linking of specialists to primary providers.7
Patients appreciate traveling less and are quite satisfied with their virtual visits. In fact, patients with schizophrenia prefer telemedicine to real office visits.8
One of telemedicine’s downsides has been its expense, requiring dedicated ISDN lines and specialized equipment. Other issues include licensing, confidentiality, reimbursement, and adherence to practice guidelines.9 For readers interested in this technology, the American Telemedicine Association Web site (www.americantelemed.org) is a good starting point. As high-speed Internet access becomes more widely available, telemedicine is poised to overtake e-mail as the next communication tool.
Summary. These virtual methods are still considered quite novel and are not yet part of mainstream psychiatry. The technology is not quite mature but is rapidly improving with new hardware and software developments. Its cost, although a barrier today, is diminishing fast. Patient acceptance is likely to grow over time among our increasingly technology-savvy public. With Internet connectivity and improved visual and audio capabilities of computers at affordable prices, virtual reality could soon play a significant new role in psychiatric care.
1. Sources about Role Playing Games: http://www.rpg.net/252/quellen/sources.html. Accessed Aug. 8, 2002.
2. Testimony of Jeanne B. Funk, PhD, before the U.S. Senate Commerce Committee on violent computer games. Available at: http://www.utoledo.edu/psychology/funktestimony.html. Accessed Aug. 8, 2002.
3. Avatar Psychotherapy: http://www.rider.edu/users/suler/psycyber/avatarther.html.
4. Tufts University: The SIMS—the people simulator game—as a technology of the self. Available at: http://www.tufts.edu/~istamm01/The%20SIMS3.htm. Accessed Aug. 8, 2002.
5. Georgia Institute of Technology, Graphics Visualization & Usability Center: http://www.cc.gatech.edu/gvu/virtual/index.html. Accessed Aug. 8, 2002.
6. Virtually Better: http://www.virtuallybetter.com. Accessed Aug. 8, 2002.
7. Hilty DM, Luo JS, Morache C, Marcelo DA, Nesbitt TS. Telepsychiatry: an overview for psychiatrists. CNS Drugs 2002;16(8):527-48.
8. Zarate CA, Jr, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry 1997;58(1):22-5.
9. The American Psychiatric Association Resource Document on Telepsychiatry by Videoconferencing. Available at: http://www.psych.org/pract_of_psych/tp_paper.cfm. Accessed Aug. 8, 2002.
1. Sources about Role Playing Games: http://www.rpg.net/252/quellen/sources.html. Accessed Aug. 8, 2002.
2. Testimony of Jeanne B. Funk, PhD, before the U.S. Senate Commerce Committee on violent computer games. Available at: http://www.utoledo.edu/psychology/funktestimony.html. Accessed Aug. 8, 2002.
3. Avatar Psychotherapy: http://www.rider.edu/users/suler/psycyber/avatarther.html.
4. Tufts University: The SIMS—the people simulator game—as a technology of the self. Available at: http://www.tufts.edu/~istamm01/The%20SIMS3.htm. Accessed Aug. 8, 2002.
5. Georgia Institute of Technology, Graphics Visualization & Usability Center: http://www.cc.gatech.edu/gvu/virtual/index.html. Accessed Aug. 8, 2002.
6. Virtually Better: http://www.virtuallybetter.com. Accessed Aug. 8, 2002.
7. Hilty DM, Luo JS, Morache C, Marcelo DA, Nesbitt TS. Telepsychiatry: an overview for psychiatrists. CNS Drugs 2002;16(8):527-48.
8. Zarate CA, Jr, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry 1997;58(1):22-5.
9. The American Psychiatric Association Resource Document on Telepsychiatry by Videoconferencing. Available at: http://www.psych.org/pract_of_psych/tp_paper.cfm. Accessed Aug. 8, 2002.