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Though mainly enthusiastic about the new therapeutic medium, Colon is concerned about the people it excludes. Most American online interactions are conducted in English, as are her groups. Participants need a computer and access to the Internet, an expensive proposition for those on limited incomes. They've got to be able to type, be text-oriented, and manage to arrange a peaceful space with no interruptions to ensure concentration equivalent to what they'd get by meeting in a shrink's office.
But beyond these obvious differences, the same dynamics come into play as in face-to-face therapy groups. Resistance manifests itself. "Men tended to be quieter, to joke more, to make light of things instead of really going deeper. They didn't post in the same degree or to the same depth." Colon notes that racial and ethnic differences have less impact in online environments, and that the technology makes it possible to assemble people based in different regions.
Confidentiality is still a concern; though online interchanges can be password-protected and even encrypted, they're still vulnerable to hackers or merely to acquaintances wandering through a room. And old assumptions about face-to-face contact between patient and therapist die hard. "If you do it online," Colon asks, "can you call it psychotherapy? How do you deal with a a suicidal person online? Is that ethically responsible?"
For the less troubled participant, the structure of online communication contributes to the group environment: there's plenty of time to pay attention to others. "There were people who'd produce long and thoughtful posts consistently," recalls Colon. "I thought it was amazing, the level of thought that went into getting their ideas across, and giving feedback in a caring way."
The downside? Quiet people are for all practical purposes missing in action; when you can't see them, you can't invite them in with a question or a glance. And, says Colon, "when I type now, I wear a brace, because I don't want to get carpal tunnel problems."
Colon (firstname.lastname@example.org) plans to assemble a new online group late in 1997.