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##  Impact of Cultural and Global Issues on Online Support Groups.                  ERIC/CASS Digest.                                                            

People discuss emotionally distressing issues with someone in a                 similar situation, with a spiritual or indigenous healer,                       acupuncturist or mental health professional or do not discuss the               issue at all.  Computer technology is now altering the way                      individuals handle distress by enabling people from all cultures to             discuss personal issues with others worldwide.  They could reside in            remote or sequestered locations (e.g., Greenland or Fiji), in                   inaccessible locations (e.g., the Australian Outback or U.S.                    military bases on Guam) or in under served locations (e.g.,                     Bangladesh or Appalachia). 
Since the 1990s, people have been                  discussing their distress and coping skills with others in anonymous            cyber group settings through online support groups, a relatively new            and growing cyber service.  People participate in thematic topics               such as coping with family violence, HIV or trauma and death caused             by natural disasters or war.  Online support groups can be                      attractive to a group of new users who may previously have resisted             peer support because of culturally-ingrained traditions of                      non-disclosure of "family secrets", avoided family shame or dishonor            or evaded cultural or familial isolation and stigmatization. 
In               addition to personal distress, people also experience distress from             traumatic events occurring in other parts of the world. Incidents               that were once considered local dramas can become worldwide events.             News coverage of natural disasters such as the fatal floods in                  Mozambique and the death of Princess Diana demonstrate this point.              Such incidents produce a range of emotional reactions from anger to             anxiety, depression and fear in people worldwide based on their                 cultural perspective and worldview.  For example, people worldwide              joined grief online support groups such as "Gentle Passing's" to                mourn Princess Diana's death (Remolino, personal                                communication). ONLINE SUPPORTOnline support groups are                   founded primarily on a western orientation of self-disclosure of                personal problems, self-help and supporting others.  Typically,                 English is the common language used regardless of one's country or              geographic location and a limited number of groups are offered in               different languages.  An excerpt from a typical online support group            session for loss and grief can be found in Gary and                             Remolino (2000).  Most participants are North American (based on the            U.S. Census definition),  with Americans representing 50 percent of             Internet users worldwide.  The terms "American/North American"                  include many cultural and racial groups who have migrated to North              America as well as to native born North Americans. 
Online support             groups can be accessed through use of a computer and modem in                   conjunction with a major Internet service provider (ISP) such as                CompuServe or a local ISP.  Once connected through an ISP, online               support groups may also be reached through specialized web                      sites (e.g., www.psychcentral.com) or through Internet                          portals (e.g., Yahoo). Each ISP, web site or portal sets its own                standards and procedures regarding regulations, quality control,                crisis management, disclaimers and training of group                            leaders. CULTURAL ISSUES AND ONLINE SUPPORTOnline support                 groups facilitate contact with people from other countries and                  cultures and fosters a pluralistic society of racial, religious,                ethnic, cultural and linguistic backgrounds (McFadden & Jencius,                2000).  Participants bring culturally-based life experiences, coping            mechanisms and personal attitudes, biases, beliefs and knowledge                that influence their ability to seek help.  The diversity highlights            the fact that the cultural perspective and value system espoused in             European-American/North American/western society is just one of many            value systems and perspectives in use worldwide. CULTURAL ISSUES              FOR GROUP LEADERSOnline support groups are led by "hosts" who               function as resource persons rather than online counselors.  Hosts              make referrals to telephone help lines, self-help resources,                    face-to-face support/self-help groups, local counseling centers,                crisis centers and hospice centers.  They also recommend hyperlinks             to other online support groups, culture-based web sites (e.g.,                  www.nativeweb.com, a resource for indigenous cultures worldwide),               mental health web sites (e.g., www.allhealth.com/onlinepsych) and               professionally oriented web sites with a focus on international                 online issues (e.g., Journal of Online Behavior at                              www.behavior.net/JOB). 
Co-hosting by two culturally competent                 hosts might ensure that cultural subtleties are attended to while               group needs are also met. Culturally competent hosts who are                    knowledgeable about various cultural systems are more likely to be              effective in a culturally diverse online support group.  They must              transcend communication and cultural barriers in order to be                    effective across cultures and maintain open relationships as well as            present culturally acceptable solutions and offer culturally                    appropriate support and interventions.  They must be aware of the               relevance and appropriate use of indigenous support systems,                    understand how cultural systems operate and influence behaviors and             should inquire about participants' traditional cultural                         helpers. NO GLOBAL VILLAGE IN MY BACKYARD: SOCIO-POLITICAL                    REALITIESA handful of countries censors, regulates, monitors or             outright forbids Internet use by citizens (e.g., Saudi Arabia,                  China, Cuba, Iraq, North Korea) (MacKinnon, 2000; Walton, 1999).                Such governmental control makes participation in online support                 groups virtually impossible for these citizens, in spite of their               emotional distress or need for emotional support, and even if they              own a computer. CULTURAL BENEFITS OF ONLINE SUPPORT GROUPS*               Cyberconnections.  Online support groups reduce the sense of                    isolation for those who reside in under served or remote locations.             Participation enables people to seek support from various                       perspectives if and when support is not available in their country,             cultural background or geographic area. 
* Specialized Online                  Support Groups.  Some topics discussed in online support groups may             be culturally taboo to discuss face-to-face in specific                         cultures (e.g., family violence or sexual assault), therefore some              online support groups may need to be age-specific and/or                        gender-specific in order to accommodate to cultural mores.  For                 example, older adults may be uncomfortable discussing thoughts of               depression or suicide with younger adults, believing that youth are             not culturally appropriate individuals to dispense advice and                   support.  Since groups are not limited by geographic boundaries,                they can be formed successfully from a global                                   population. 
* "Internet Time". Internet Time is a relatively new              global concept of time that should facilitate the scheduling of                 online support groups across time zones (Lockridge, 1999). Internet             Time is the concept of time synthesized across time zones to one                single, arbitrary time period related to the Internet. An online                conversation between someone in the U.S. and someone in Australia               takes place regardless of the difference in time zones separating               them. 
* Universality of Issues as a Therapeutic Factor.   Others              struggle too.  This is not always evident to an emotionally                     distressed person who may experience isolation related to cultural              traditions that reinforce non-disclosure.  Universality, one of                 Yalom's (1995) therapeutic factors, unites participants as they                 share similar thoughts, feelings, fears and/or reactions with their             virtual community. 
* Privacy. Online support groups give                      participants the privacy to seek support about behavior that might              be perceived as a cultural stigma and to protect their identity                 and/or family name without being recognized and shamed.                         Participants can overcome some of their social barriers and not fear            ridicule, cultural stigmatization or vulnerability within their                 geographic community (Day & Schneider, 2000). CULTURAL LIMITATIONS            OF ONLINE SUPPORT GROUPS* Government Control. Governmental                  censorship makes participation in online support groups impossible              or illegal for citizens in a small group of countries. 
* A                    Panacea?   Online support groups are not appropriate for everyone               and are not a panacea.  Some participants may need additional                   medical, educational and/or mental health services or may need a                consultation with a spiritual or indigenous healer or                           acupuncturist. 
* Host Competency.  Professional degrees and                   experience for hosts vary among web sites, portals and ISPs.                    Information about the host's training and education may help the                participant to gain insight about the host's competence, value                  system, worldview and cultural competence.  For example, a host who             is raised and educated in Costa Rica will most likely have a                    worldview different from a host who is raised and educated in                   Australia. 
* Members with Limited Language Skills.  Participants              or hosts with language limitations (such as English as a second                 language) may be frustrated by the rapid pace, text-based                       communication and multiple dialogues in English-language online                 support groups. They may be challenged in communicating feelings and            thoughts verbally to others without relying on body language and                other non-verbal communication to compensate for any verbal                     deficits (Day & Schneider, 2000). 
In a text-only format with                  limited interpersonal feedback, communicative misunderstandings are             common for all participants and could be exacerbated for those with             limited language skills. 
* Ethical and Legal Concerns.  Several               mental health professional organizations,  licensing boards and                 international agencies are grappling with cyber space ethical and               legal issues (Bloom & Walz, 2000). 
* Crisis Management.  Lack of              sufficient information makes a referral difficult and awkward,                  especially when the host may be unaware of participants' geographic             locations around the world and their specific needs or local                    resources. CONCLUSIONOnline support groups have the potential             to improve the access and delivery of services to a wide range of               people who reside worldwide.  They provide an alternative vehicle of            support for people in distress when it may be culturally                        stigmatizing to seek face-to-face support.  They are not appropriate            for everyone nor can everyone worldwide access online support                   groups. REFERENCESBloom, J. & Walz, G.  (Eds.). (2000).                   Cybercounseling and cyberlearning: Strategies and resources for the             millennium. Alexandria, VA: American Counseling Association. 
Day,             S. & Schneider, P. (2000).  The subjective experiences of therapists            in face-to-face, video and audio sessions.  In J. Bloom & G.                    Walz (Eds.), Cybercounseling and cyberlearning: Strategies and                  resources for the millennium (pp. 203-218).  Alexandria, VA:                    American Counseling Association. 
Gary, J. & Remolino, L. (2000).              Coping with loss and grief through on-line support groups.  In J.               Bloom & G. Walz (Eds.), Cybercounseling and cyberlearning:                      Strategies and resources for the millennium (pp. 95-115).                       Alexandria, VA: American Counseling Association. 
Lockridge,                   R. (Correspondent).  (1999, February 27).  Internet time: Will                  the "beat" go on?  Science and Technology Week. Atlanta, GA:                    CNN. 
MacKinnon, R. (Correspondent). (2000, January 27).  China                tries to keep Internet revolution from becoming threat to power.                Atlanta, GA: CNN. 
McFadden, J. & Jencius, M. (2000).  Using                   cyberspace to enhance counselors' cultural transcendence.  In J.                Bloom & G. Walz (Eds.), Cybercounseling and cyberlearning:                      Strategies and resources for the millennium (pp. 67-83). Alexandria,            VA: American Counseling Association. 
Remolino, L.  (1998, December            12).  Personal communication. 
Walton, M. (Correspondent).  (1999,             January 7). Iraq sidelined from information superhighway.  Atlanta,             GA: CNN. 
Yalom, I.  (1995).  The theory and practice of group                 psychotherapy (fourth ed.).  New York: Basic Books. 
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Juneau            Mahan Gary is an Assistant Professor at Kean University, Union,                 NJ. 
ERIC Digests are in the public domain and may be freely                   reproduced and disseminated. 
This publication was funded by the               U.S. Department of Education, Office of Educational Research and                Improvement, Contract NO. ED-99-CO-0014. Opinions expressed in this             report do not necessarily reflect the positions of the U.S.                     Department of Education, OERI, or ERIC/CASS.                                 **Title:** Impact of Cultural and Global Issues on Online Support Groups.                  ERIC/CASS Digest.                                                            **Document Type:** Information Analyses---ERIC Information Analysis Products (IAPs) (071); Information Analyses---ERIC Digests (Selected) in Full Text (073); **Available From:** ERIC Clearinghouse on Counseling and Student Services, University of            North Carolina at Greensboro, 201 Ferguson Building, P.O. Box 26171,            Greensboro, NC 27402-6171. Tel: 336-334-4114; Tel:                              800-414-9769 (Toll Free); Fax: 336-334-4116; Web site:                          http://ericcass.uncg.edu; e-mail: [email protected].                         **Descriptors:** Computer Mediated Communication, Counseling, Counseling Services,               Counseling Techniques,  Global Approach, International Cooperation,              Internet, Mental Health,  Social Support Groups                             **Identifiers:** ERIC Digests,  Global Networks,  Online Counseling                           
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