A Pilot Study of Online Group Leadership Skills: Perceived Usage and Difficulty Level

Online counseling service delivery is increasing in frequency and one such modality is online group work. As such, research needs to thoroughly investigate the utility of online groups, including leadership training, skills, and experiences within online groups. This pilot study investigated the perceptions of applied group counseling skills among nine master’s-level counseling students as they led online groups for at-risk virtual high school students. The findings indicated different types of skills were considered easy, difficult, or not used by a majority of participants, highlighting the disconnection between face-to-face and online group leadership skill development and understanding. Implications for counselor education are discussed.

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title: Defining Internet-Supported Therapeutic Interventions
abstract: BackgroundThe field of Internet-supported therapeutic interventions has suffered from a lack of clarity and consistency. The absence of professional leadership and of accepted governing approaches, terminology, professional standards, and methodologies has caused this field to be diffused and unstructured. Numerous terms have been used to label and describe the activities conducted over the Internet for mental and physical health purposes: web-based therapy, e-therapy, cybertherapy, eHealth, e-Interventions, computer-mediated interventions, and online therapy (or counseling), among others.MethodsFollowing a comprehensive review, we conceptualized Internet-supported interventions, using four categories based on prime practice approaches: web-based interventions, online counseling and therapy, Internet-operated therapeutic software, and other online activities (e.g., as supplements to face-to-face therapy). We provide a working definition and detailed description of each category, accompanied by numerous examples.ConclusionsThese categories may now serve as guiding definitions and related terminologies for further research and development in this emerging field.

title: A Survey of Online Practitioners: Implications for Education and Practice
abstract: In the last decade the helping professions have seen a growing interest in the provision of online counseling and therapeutic services for individuals. Like most fields of work, social work also has experienced a growth in the creative use of technology in various areas of professional work. Based on this growing interest and the need for such services and research on its efficacy, a study was conducted to learn from e-therapists across the United States on their experiences with this mode of service delivery. This paper elicits results from the online survey and provides recommendations to better serve our clients in the tech savvy world and future research endeavors. The main findings of this preliminary study include: (a) Many theoretical perspectives and models are being used to ground online practice, (b) e-therapists are beginning to use videoconferencing for online practice supplementing their face-to-face sessions, and (c) e-therapists believe that online interventions benefit their clients.

title: Development and Initial Evaluation of the Cyber-Counseling Objective Structured Clinical Examination (COSCE)
abstract: This study developed and validated the Cyber-Counseling Objective Structured Clinical Examination (COSCE), a method and tool used to assess the competence level of trainees and professionals who practice cyber-counseling.  The COSCE’s development involved the creation of a cyber-counseling performance rating scale and two simulated client scenarios, and the recruitment and training of three raters. The COSCE was tested on six masters of social work students and six seasoned cyber-counseling practitioners.  We examined the COSCE’s internal consistency, interrater reliability, and interclient reliability. In addition, we assessed the construct validity through exploratory factor analysis and known-groups validation method.  With further improvement, the COSCE can be a reliable and valid tool in assessing the competence of cyber-counseling practitioners.

title: Strategies and Resources for Conducting Online Counseling
abstract: Drawing from clinical, supervisory, and research resources related to implementing online counseling services, the author provides practical suggestions for counselors considering or using the Internet as a counseling medium. The author outlines ethical and technical considerations, counselor characteristics, and some specific strategies to employ during online counseling. The author also includes a checklist to evaluate online practices and details an analysis of state licensure codes related to online counseling.

title: Families in Crisis: Considerations for the Use of Web-Based Treatment Models in Family Therapy
abstract: Psychological interventions have typically utilized the traditional face-to-face office visit with clients. Although this strategy has proven to be effective (Simpson, Bell, Knox, & Mitchell, 2005), an emerging trend is to offer alternative approaches to therapeutic interventions (Schmidt, 1998). The current study considers the merits and shortcomings of Web-based interventions via synchronous videoconferencing (SVC) with families of children with a traumatic brain injury. Recent research suggests that family therapy offered via SVC has the potential for the delivery of family-based therapy. When using SVC, client readiness to address issues coupled with patience with the imperfection of the technology proved to be important factors. Other factors included the diagnosis and readiness to address identified problems in the context of SVC.

title: Effects of Group Counseling Transmitted Through Videoconferencing on Changes in Eating Behaviors.
abstract: To compare the effects of constructivism-based dietary group counseling transmitted through videoconferencing (VC) and face-to-face (FF) counseling on changes in eating behaviors.



Altogether, 74 participants with high risk of type 2 diabetes were divided into FF and VC groups based on their place of residence in northern Finland. Constructivism-based dietary group counseling, a nonrandomized intervention, was performed (evaluations at 0, 6, and 21 months). The Three-Factor Eating Questionnaire-18 was used to evaluate cognitive restraint eating (CR), emotional eating (EE), and uncontrolled eating (UE). Data were analyzed using ANOVA and ANCOVA (significance level of 0.05).



Cognitive restraint eating increased and UE decreased between baseline and 6 months in both groups, but between baseline and 21 months only in the FF group (P = .005 and P = .021, respectively). Emotional eating decreased only in the VC group (P = .016). There were no differences between groups at 6 or 21 months.



Constructivism-based counseling delivered through videoconferencing was effective at improving eating behaviors.

title: Psychotherapy via videoconferencing: a review
abstract: Research into the use of videoconferencing for clinical purposes, in particular psychotherapy, is gradually expanding. A number of case studies and case series have suggested that videoconferencing can be clinically effective and acceptable to patients. Nevertheless, there is a lack of methodologically rigorous studies with adequate sample sizes from which we can draw any generalisable conclusions and a dearth of randomised controlled studies. Many of the preliminary projects in this area have been feasibility studies with minimal focus on outcome and even less on process issues in psychotherapy. Few studies have explored the cost-effectiveness of this compared with other modes of therapy delivery. This paper aims to review the work that has been done to date within this field, and to explore the issues which need to be addressed if videoconferencing is to be taken seriously in the future as a legitimate and reliable means of delivering psychotherapy services.

title: Toward a More Robust Theory and Measure of Social Presence: Review and Suggested Criteria
abstract: At a time of increased social usage of net and collaborative applications, a robust and detailed theory of social presence could contribute to our understanding of social behavior in mediated environments, allow researchers to predict and measure differences among media interfaces, and guide the design of new social environments and interfaces. A broader theory of social presence can guide more valid and reliable measures. The article reviews, classifies, and critiques existing theories and measures of social presence. A set of criteria and scope conditions is proposed to help remedy limitations in past theories and measures and to provide a contribution to a more robust theory and measure of social presence.

title: A Preliminary Comparison of Online and Face-to-Face Process Groups
abstract: The outcomes of student-led, student-participant experiences in both Google Hangout and face-to-face groups in graduate-level counseling courses are compared using process- and experience-oriented measures. Overall, participants assessed face-to-face groups as superior on measures of presence, cohesiveness, safety, and delivery method. Implications for the counseling field are discussed.

title: Experiences in Online Process Groups: A Qualitative Study
abstract: Online group counseling is an area scant with research, as much investigation has focused on the provision of online individual counseling services. During the course of an academic year, 12 master’s-level counseling students participated in 2 online (videoconferencing) process groups. The purpose of this phenomenological study was to gain insight into members’ experiences in online counseling groups. Several themes were identified, including the linear nature of the group, superficial engagement within the group, and feeling disconnected from one another. Limitations and implications are discussed.

title: Experiences of Counsellors Providing Online Chat Counselling to Young People
abstract: Online counselling is a rapidly growing field and, while there is emerging evidence of its comparative effectiveness, there has been little research into what techniques are being applied in practice and which clients will most likely benefit from this medium. Using a focus group methodology, this study examines the experiences of 19 online clinicians employed by a youth mental health service, investigating their perception of online clients, views on their counsellor roles, the approaches and techniques they employ, and the unique aspects of counselling in an online environment. Overall, online clinicians perceived their clients as presenting with highly complex problems and a high level of psychological distress. They noted online clients would most often use the service once or twice, and that some would use online chat as an adjunct to face-to-face counselling. The online clinicians described various roles, including: assessments, gatekeeping, providing emotional support, and therapeutic interventions. According to the online clinicians, they used a variety of techniques online, but favoured person-centred techniques, as these helped keep the clients engaged with the service. Areas of further research and implications for practice are discussed.

title: Groups : Process and Practice
abstract: This book is intended for graduate and undergraduate students majoring in counseling, social work, counseling psychology, and human services who are taking courses in group work. According to a recent e-survey of 102 faculty members teaching this course, the split between undergraduate and graduate courses is 46% undergraduate, 51% graduate, and 1% Ph.D.) It is designed as a primary textbook and is comprehensive in scope. It is also a practical manual for practitioners involved in leading groups. Others who may find this book useful are rehabilitation counselors, teachers, pastoral counselors, correctional counselors, and marriage and family therapists. Courses that most often adopt the book include: Group Counseling, Group Process, Group Procedures, Group Techniques, Practicum in Group Counseling, Groups: Process and Practice.

title: Etherapy: A Training Program for Development of Clinical Skills in Distance Psychotherapy
abstract: This article describes a project by the Virtual Teaching and Cyberpsychology Laboratory of the National Autonomous University of Mexico developed to (1) implement a teaching program for clinical psychology students to learn therapeutic skills in providing online psychological services; (2) evaluate the students' acquisition of knowledge and skills in diagnosis via the Internet, case formulation of treatment, and adherence to treatment protocols; and (3) incorporate technologies for creating training settings and online professional services in order to develop the students' clinical competency in this treatment modality. A pilot study was conducted with 17 clinical psychology students in the first phase of the teaching program and 6 students during the second phase. Preliminary results indicate that students increased knowledge of Internet-based clinical interventions and improved in clinical skills. It is necessary to continue the evaluation of the teaching program with larger samples, and further research is suggested.

title: Training therapists to work effectively online and offline within digital culture
abstract: The speed at which technology evolves, and therefore the speed at which online mental health services evolve and the training required to keep up with them, has become a real concern for the profession. The need for training in transferring face-to-face skills to the online environment has been recognised for some years by leading professional organisations as not only desirable but also essential. In addition, there is an increasing need to keep abreast of digital culture and the type of online environments that clients inhabit. This applies to counsellors and therapists whatever space they are using to deliver services, which may be in the traditional face-to-face consulting room or using tools that enable therapy at a distance, such as the Internet.

title: A descriptive study of e-counsellor attitudes, ethics, and practice
abstract: The purpose of this study was to examine questions related to the process, perceived outcomes, and ethics of therapists who provide counselling and therapy online.  An online survey was conducted (N=93) with identified e-counsellors with at least a Master's Degree. Questions included demographic information and Likert-type scales related to extent of practice, theoretical orientation, training and supervision, attitudes about appropriate practice, referral, legal and ethical issues, practice difficulties, and therapist satisfaction.  Overall, e-counsellors are satisfied with their practice and believe it is effective. They generally do not have formal training or supervision in online practice. Current e-counselling appears to be a part-time, supplemental practice with little overlap to FTF practice. There was little agreement among respondents on attitudes, practice, ethical issues, and knowledge of regulations related to e-counselling.  Lack of consensus ...

title: Exploratory Findings on Novice Group Counselors’ Initial Co-facilitating Experiences in In-Class Support Groups With Adjunct Online Support Groups
abstract: This study focused on 16 Asian novice group counselors’ initial co-facilitation experiences in in-class and online support groups. A qualitative analysis using Grounded Theory produced 16 themes in 5 categories. Participants’ Expectations (Causal Condition) and Readiness (Intervening Condition) to co-facilitate, informed their strategic actions/interactions in navigating Challenges, encountered during support group sessions. The consequences were Growth and formation of Views of Online Group Counseling. The majority of participants reported greater awareness of themselves and co-facilitation issues, as well as a preference for the face-to-face counseling platform, over the online counseling platform.

title: The Preparation of Professional School Counselors for Group Work
abstract: An online survey about the group work training experiences of school counselors was completed by 802 members of the American School Counseling Association (ASCA). Most respondents had one course in group work; a minority had the opportunity to observe or co-lead groups with children and/or adolescents as part of their training. Qualitative analysis of comment data provided more depth and insight about school counselors' training in group work. Implications of the findings are discussed.

title: Group Counseling Collaboration Model: Support for Virtual High School Students
abstract: This paper describes a collaborative approach wherein master’s-level school counseling students provided online group counseling to at-risk virtual high school students. This project describes the utility of collaboration between master’s-level school counseling students and a state-approved virtual high school to employ group counseling to promote student success. The collaborative project met the following needs: (1) School counseling master’s students received experiential training and supervision leading online groups for at-risk high school students; and (2) at-risk, virtual, high school students participated in an 8-week educational and process counseling group emphasizing academic success. Implications for school counseling and counselor education are

title: Facilitating Online Counseling: Perspectives From Counselors in Training
abstract: To address the need for research regarding online counseling, the authors explore the experiences of 4 female and 2 male Caucasian counseling students who facilitated 5 chat-based online counseling sessions. Conducting semistructured interviews based in grounded theory methods, the authors discuss technological barriers, counseling without visual and verbal cues, online counseling techniques, counseling from home, and factors related to the pace of the sessions. They suggest that online counseling requires specific technical, ethical, and clinical considerations.

title: New and old tools in psychotherapy: The use of technology for the integration of the traditional clinical treatments.
abstract: The proliferation of computer-mediatedcommunication has led to theexperimentation with these tools inpsychotherapy. This article examinesthe possible integration betweentraditional and new tools inpsychotherapy, showing pros and consof the use of technology. In particular,the article focuses on the concept ofe-therapy and the technology itrequires. An analysis of the mostfunctional tools and software nowavailable is also presented, with aparticular focus on shared hypermedia,new Internet tools in which differentusers who are simultaneously browsingthe Web can communicate and surftogether.

title: A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions
abstract: Internet-based psychotherapeutic interventions have been used for more than a decade, but no comprehensive review and no extensive meta-analysis of their effectiveness have been conducted. We have collected all of the empirical articles published up to March 2006 (n = 64) that examine the effectiveness of online therapy of different forms and performed a meta-analysis of all the studies reported in them (n = 92). These studies involved a total of 9,764 clients who were treated through various Internet-based psychological interventions for a variety of problems, whose effectiveness was assessed by different types of measures. The overall mean weighted effect size was found to be 0.53 (medium effect), which is quite similar to the average effect size of traditional, face-to-face therapy. Next, we examined interacting effects of various possible relevant moderators of the effects of online therapy, including type of therapy (self-help web-based therapy versus online communication-based etherapy), type of outcome measure, time of measurement of outcome (post-therapy or follow-up), type of problem treated, therapeutic approach, and communication modality, among others. A comparison between face-to-face and Internet intervention as reported on in 14 of the studies revealed no differences in effectiveness. The findings of this meta-analysis, and review of additional Internet therapy studies not included in the meta-analysis, provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity and suggest several insights in regard to its application. Limitations of the findings and recommendations concerning Internet-based therapy and future research are discussed.

title: Online counseling: a narrative and critical review of the literature.
abstract: This article aimed to critically review the literature on online counseling.



Database and hand-searches were made using search terms and eligibility criteria, yielding a total of 123 studies.



The review begins with what characterizes online counseling. Outcome and process research in online counseling is reviewed. Features and cyberbehaviors of online counseling such as anonymity and disinhibition, convenience, time-delay, the loss of social signaling, and writing behavior in cyberspace are discussed. Ethical behavior, professional training, client suitability, and clients' and therapists' attitudes and experiences of online counseling are reviewed.



A growing body of knowledge to date is positive in showing that online counseling can have a similar impact and is capable of replicating the facilitative conditions as face-to-face encounters. A need remains for stronger empirical evidence to establish efficacy and effectiveness and to understand better the unique mediating and facilitative variables.