The New Clinic and Ethical Qualms.

Well hello fellow therapists, Second Life-ians and anyone else bothering to read this blog.

I have been particularly busy this week working on my new clinic in Second Life (SL). Yes, out with school work, in with work-work. You might protest at the idea that a job entailing moving around in a virtual world is called "work", but I beg to differ. Anyone who's ever used SL will be aware of the frustrations of searching through endless inventory items, setting objects up in a 3D environment with limited viewing and of course trying to get your scripts functioning without digital hiccups. Despite all the frustrations I've experienced bringing this project to fruition, I'm quite excited about the prospect of holding group therapy and individual therapy in SL.

My previous clinic, which existed digitally last summer (yes Australia has hot Christmases-- haven't you heard 'Hey luv! Put another shrimp on the barbie will ya?' Here's a translation link if you're feeling a little confused about that Aussie Slang ), was mainly an information clinic where clients could make appointments in SL and then flesh out the details through email. From there we would set up appointments using Windows Live Messenger and Skype.

I do have qualms about counselling in virtual environments, at least if I use Windows Live Messenger I can encrypt chat with Bitdefender. Emails can be encrypted, there are ways to make sure you're practising ethically online. SL is not a great environment ethically. You're probably asking 'so why counsel there then?'. The simple truth is that the private IMing system in Second Life is fairly secure. Not completely, but I don't think Linden Labs really cares about what goes on in Private IMs unless you're discussing ways to penetrate the SL mainframe or organising a terrorist attack. Clients can be made aware of the possible consequences of continuing in a virtual environment but still, people I don't know can access the private messages between myself and a client -- I feel uneasy about this.

When I think of ethical issues, I'm reminded of Psychology301 - a psychological testing subject I studied recently at university. When conducting research it is ethical to use people in experimentation provided the possible findings are worth a bit of discomfort. Participants are given every bit of information they need to make an informed decision, I believe this exact protocol should be followed by SL therapists. Anyone entering a therapeutic contract in a virtual world should be made fully aware of the ethical and confidentiality issues.

So what do I do to reduce the risks? Well, I do as much as I can.


I make sure client information is not stored online. In fact, all client information is stored on my password protected external hardrives (that are only connected to my main computer for the retrieving and storing of information) up until 6 months after the conclusion of any therapy, then that information is transferred into a locked filing cabinet in my house.

I make sure clients receive an informed consent document before they begin sessions.

I try to encourage clients to chat over Windows Life Messenger or Skype (or any other chat program).

I do not enter a therapeutic relationships with people under the age of 18.

All counselling is conducted in private IM so that other SL residents cannot 'overhear' our discussions.

The clinic is a Skybox that is very high up in the sky. I allow only one person there at a time so that client Avatars cannot be identified (except for group counselling). I also have moderation rights to the Sim, so that anyone who intrudes will be quickly ejected.

Lastly, I only see people with normal everyday issues. People that, while they're stressed or concerned over an issue, are not usually prone to psychosis or volatility. This can be fairly easy to gauge with a first session where therapists can get a feel for the perceptional and emotional state of a client. And yes, this can be achieved online, and no I will not be discussing this at this point in time (later okay? *grins excitedly* ).

I think the most important thing as a counsellor is to help and support others without putting them in unnecessary risk. Online services are very affordable and have been proven to be just as effective as face-to-face therapy. In my opinion those with more serious issues would be less likely to benefit from online therapy, but many issues people seek help with are problems that can be overcome with a little caring support, problem solving, and coping skills training. It is because of these reasons that I continue to counsel as a SL therapist and advocate online therapy practices.