In a recent post about the SL Secrets site, I mentioned in passing that I was sad that there were residents who seemed to be in a bad place, and I wished there were somewhere such people could go for help. 1ndustria set me straight on that, mentioning several such places! I hope to blog a little about those in future (especially peer counseling, which sounds like a pretty wonderful thing). But I wanted to be able to post – soon, if I could – about counseling and therapy options in Second Life, and how they work, and who is doing them, and what interested resis could do to follow up.
By the way, I know that some people have reservations about getting help from a therapist or counselor, thinking that if they seek that kind of help, that means they’re “broken” somehow. If you’re in that situation, I hope you won’t be fooled by that. Ever talked to a sensible friend and felt better afterward? That’s what we’re talking about…except that in many cases the “friend” is someone who has spent a lot of time and effort learning how to be a better “friend”. There have been two different times in my life when therapy has helped me figure out what I needed to do and get my feelings straight. I’d hate to think where I’d be if I hadn’t gotten that help. And if that makes me broken, well, then apparently all the coolest people are broken.
So in starting to research Second Life therapy and counseling options I heard about Avalon Birke, a First Life therapist with two Masters degrees (and although she’s fairly private with her First Life identity except with her Second Life clients, she was kind enough to provide copies of her degrees) who is also the director of The Counseling Center in Second Life, which is situated on her Wellness Island sim. (I’ve included some pictures of the sim throughout this post.) She’s also the publisher of the Second Life magazine Wellness. Avalon agreed to talk with me about counseling in Second Life, why she loves it, and what she feels it brings to the Second Life community.
Avalon Birke
Kate: How did you become involved in [Second Life] counseling?
Avalon: I started in SL in 2006 at the suggestion of my husband, who is a Systems Analyst. I had been an avid player of The Sims for years, and he talked about SL as “Internet 2.0.” When he showed me the 2006 article from Wired Magazine, I was intrigued and signed up. Initially I had no thoughts of counseling, let alone opening a Center, doing trainings and speaking engagements, purchasing an island, or publishing a virtual magazine đ It all just fell into place as I talked to people in SL and gradually told them what I did in RL. There was a need there, and I had the interest and the ability to explore it. I never could have foreseen what it would grow into, which has been an extremely fulfilling and busy volunteer project. It could easily be fulltime if I let it, but unfortunately Lindens don’t pay the mortgage, or even tier! So I have a job doing therapy in a hospital, as well as a small private practice in RL.
Kate: Why offer counseling services in Second Life in the first place?
Avalon: Good question, as it is not something I would have expected to be doing, let alone on an ongoing basis. đ There was a need. By that I mean talking to a professional therapist in-world can be the right choice for some people, in some situations. SL residents may be limited by their geographical location – there are no services in their area. Others are very concerned about confidentiality and like the anonymity of sessions in-world. In-world counseling can often be a bridge to reaching out in RL for support and a lot of what I do is about empowering others to gain the information and resources they need in RL. And finally sometimes when a person wants to talk about SL issues, it helps to bring it to someone who understands SL – its culture, its lingo, and doesn’t see it as being automatically pathological that, for example, the relationship in discussion is occurring in-world. It has taken a lot of time, reflection, and working with other SL professionals to define what can responsibly and ethically be called “counseling” in a virtual world. Which challenges can safely be addressed, and which absolutely require immediate RL help.
Kate: I have the sense that a lot of Second Life residents have trouble with getting non-residents to understand their Second Lives. When you talk about the danger of in-world romances being considered automatically pathological, it sounds like some counselors and therapists may have trouble getting what Second Life is about, too. Is that a common problem among Second Life residents you help? Does it make it harder to help them find First Life help that’s a good fit for them?
Avalon: Kate, even *I* have trouble getting non-residents to understand Second Life! To most folks, it’s like saying you think the Mario Brothers are real and their avatars are talking to you. They nod politely and slooowly…back…away. I always keep that in mind when someone comes to me to discuss an SL relationship, and yes, it can be both an [impediment] to getting out there and finding RL help, and also to finding someone who will listen empathetically. It also may be the reason so many residents successfully work as SL “counselors” when they have no qualifications, experience, or training. That’s a whole topic in itself.
Kate: So, if someone’s seeking some support in Second Life – say they’re feeling a lot of loneliness, or are upset about a relationship, or are having some depression issues – what should they be looking for in Second Life? Are First Life qualifications a good guidelines to start with? What are the risks of working with someone who might not have experience or credentials?
Avalon: All good questions! I have an article in the March Wellness Magazine on how to choose a practitioner, and we try to include consumer information in every issue. This one starts on page 10: http://www.slwellness.com/wellness_mar08.pdf and explains what the different titles mean (psychologist, therapist, peer counselor, etc) as well as the pros and cons of each.
First Life credentials are a good place to start, yes, if they are legitimate. There are some wonderful peer counselors in SL as well, and even they go through training (or we encourage them to, and different Groups like Open Gates and Centering Place offer peer training regularly) to understand things like active listening, setting boundaries, not mixing the helper role with a dual relationship (such as sexual), confidentiality, legal and ethical concerns, and ways they can find support for themselves to avoid burnout and vicarious trauma. These are things that some untrained helpers may have an understanding of on their own to some degree, and that’s great! But therapy or counseling is so much more than just listening, and training helps. I have two Masters degrees and am working on a PhD, and am still challenged every day to do the right thing by my RL and SL clients and patients.
Where I worry is when I am approached, as I often am, by new residents saying they joined so they could start a counseling business. No time taken to understand SL or its culture, no assessment of the needs of the residents, just the thought that this might be fun or lucrative to do. It is anything but lucrative, so if it is not a labor of love it’s going to be a disappointment for them. And fun? Sometimes. Sometimes it’s hard, heartbreaking, or stressful. During those times I am glad I have RL training and experience to fall back on.
There are some charlatans in SL, to be sure, but there are many more who are there to help, to make SL a better place, to offer a shoulder to someone in need.
The number one factor in a good therapeutic relationship, though? Fit. Does the resident feel understood, valued, accepted? Do they feel safe? All the degrees in the world can’t guarantee therapeutic fit for each client/counselor relationship.
Kate: Even understanding that the word “expensive” means very different things in Second Life and First Life, it sounds as though coaches, counselors and therapists in Second Life – even ones with First Life credentials and practices – aren’t able to make a living in-world or to charge anywhere near what they would charge for a session in First Life. I read an interview where you said “A session in-world costs about the same as a large Latte at Starbucks”. Why the double standard?
Avalon: I know of a couple of practitioners, one RL licensed, who charges the full RL fee, but in SL the going rates tend to be somewhere between free/donation only to 1500L per hour or so. I could be off on that but probably not by much. I am not sure it is so much a double standard, although I can see that could be one way of perceiving it. I think it is probably more about the two very different economies. For example, I can’t buy a RL car for $2 US, but I can get a pretty cool one to use in SL for less than that. Houses, clothing, services, and even hair – there is a difference in the expected rate of exchange in SL versus RL.
Should that be changed? Maybe, I don’t know. I tend to spend more time with clients and developing materials than giving too much thought to how I could make a SL living in therapy. And I love my RL job and patients, so it works out. I may not be the best person to ask đ I know there are others in SL who very aggressively market their services and I am not sure how successful they are. For me, though, there were maybe two of us when I started this work in SL. There was a need, and I was motivated and passionate about finding my place in it. Still am! That’s what I meant by labor of love. It’s a passion, a vocation, and I get as much out of it as I hope my SL clients do. I saw a recent quote from one RL practitioner stating that no one who charged only a few Lindens for counseling could possibly be legitimate. This is not the case.
Another aspect of cost of services relates to what I am able to reasonably and ethically offer. In-world and real world sessions are different in many ways. There are limitations in SL that I don’t face with my real life clients, and I think I outlined those in another email. Folks presenting with suicidal ideation, hallucinations, physical illness, more serious symptoms needs real life help. Period. I see them every day in RL but not in SL. I won’t waver on this and I cringe when others do. It’s about the person’s safety. If a SL client says they are going to kill themselves, I can pull every technique I have out of my mental toolbox and they can still TP out and do it. In RL, I can order a 5150 hold and ensure their safety for at least 72 hours until they are evaluated. Less dramatic are the little things – seeing a person face-to-face, hearing a voice (although I do use Skype sometimes), having access to medical records and history….those are things that as of now SL doesn’t allow me to do with reliability and consistency. So the services I offer here are inherently limited. Without the ability to fully diagnose and treat, the idea of charging my RL hourly fee, which is substantially more than $1500L per hour ;-), seems inappropriate.
Kate: It sounds as though usually you’re using text for client sessions. Is that accurate? Do many clients prefer text, to help keep their identity hidden or for privacy in their First Life environment or for other reasons? Do voice sessions work differently than text sessions?
Avalon: Many [clients] prefer text because SL voice can be so glitchy and some don’t have Skype or a headset or the means to connect reliably enough to relax and get into the session. That’s my reason for sort of a love/hate relationship with voice myself. (plus they sometimes make fun of my “California girl” voice…lol) A few want to keep it as text for anonymity, and text is also good for saving the session verbatim which some clients do, then go back to it and review their own progress.
Voice sessions work about the same as text sessions, content-wise. We still meet in my SL office and talk on Skype while we are there. Pros – hearing each other’s voices and intonations and inflections. Cons – technology for all of us, and for some, less anonymity.
At this point I asked Avalon if she could share some experiences she’s had with her clients that really show what counseling in Second Life can do, but she pointed out that answering that question, even in general terms, would violate client confidentiality. I then revealed that it was a trick question and she had passed. (OK, not really). But she did say how she enjoyed being part of residents’ personal growth and seeing those changes, and how much she got out of working with other mental health professionals and peer counselors.
Avalon: Any specific incidences could be identified by the person, if no one else, and confidentiality is something I take really seriously. In aggregate, I would say the feedback I have received that clients have been surprised that a therapeutic bond can take place in a virtual environment – that they can feel heard, safe, accepted for who they are, even in avatar form. That part has been pretty amazing to me as well. The use of emotes, the way someone types, the words they choose, even the appearance they fashion for their SL look – all have meaning and all represent parts of them. đ
If you’re interested in more information about The Counseling Center, there’s more information in an interview with Avalon in the Summer 2008 issue of Wellness.
Wellness Island is not usually open to visitors, as it’s mainly a place to work and meet privately with clients, but it is sometimes open for special events.
I hope everyone will excuse me for not putting together a list of all the Second Life counseling resources here, but I thought getting a sense of what Second Life counseling is all about from Avalon might be the most constructive start. đ
^^^\ Kate /^^^
joshooahlove said:
Absolutely fascinating post Kate! I think we’ve all met a few people in our SL travels, or even ourselves, that could use have used these types of professional services at some point in our virtual lives. It’s great to know that there are resources out there where we can refer people when just talking to a friend may not be sufficient for matters that may be beyond the scope of our abilities.
I suspect some of these types of services offered in an unregulated environment may be prone to the occasional unscrupulous practitioner so I wonder how far real life professional governing bodies that license and regulate such therapists are dealing with the offering of such online virtual services. I’m in the medical field and I know my professional regulating body has often struggled with practice guidelines for offering services online. There are huge amounts of ethical and legal issues with offering of such services and I wonder if Avalon’s licensing body has even come close with dealing with such issues in a virtual environment such as confidentiality (LL could potentially access client/patient sessions), retention of medical records etc etc.
Most medical type professions in Canada are self-regulating but the licensing bodies are not necessarily there to protect the interests of its members but to protect the interests of the public. There are specific processes in place where the public may file complaints for misconduct which could potentially lead to some form of disciplinary action up to and including revokation of my license to practice. Not to discount Avalon’s practice in any way as I personally feel she is offering an important service in-world, but I would suspect offering virtual counselling services currently is a bit like the wild, wild west. Kudos to her though for being a groundbreaker in her field and also to you for highlighting that SL is not just about poseballs and shopping for hair.
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kateamdahl said:
Thanks for posting that information, Joshooah, and I worry too about the lack of oversight (although not where people like Avalon are concerned – partly because she’s qualified in First Life and shares her credentials with her clients). I hope that mostly any unscrupulous people who try to set themselves up as counselors but don’t know what they’re doing are getting laughed off the grid or quickly find they’re in over their heads and run away. Since we can’t be sure, though, I certainly hope some group – maybe even just an in-world association with some kind of First Life credibility? – can help sort the legitimate from the no-good practitioners.
“that SL is not just about poseballs and shopping for hair”
But we can agree that those are the most *important* things, can’t we?
^^^\ Kate /^^^
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joshooahlove said:
i just took a minute to read the linked article in wellness magazine and was reassured to read the excerpts about how avalon dealt with the limitations to her practice in second life. it would be interesting to know how her regulatory bodies has dealt with these practice settings and whether they’ve offered any sort of consensus or professional practice guidelines which helped her in developing her island.
All caveats aside, I really think this is such a great opportunity for outreach for those needing mental health services but for whatever reason are unable, unwilling or just don’t know how to seek such help.
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joshooahlove said:
.. and stop “fashion police”
pew pew
el oh el
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kateamdahl said:
*laughing*
I’m itching to see those pictures and video (for anyone who wasn’t there, Joshooah showed up to the Battle of the Fashionistas in a Fashion Police outfit with a gun that shot fashion citations; I could hardly stop laughing)…I’m hoping Eris will be able to send me some in the next few days.
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avalonbirke said:
Thanks for the post, Kate, and everyone for the insightful comments.
Joshooah, you raise an excellent point about our regulating organizations and their roles in virtual worlds. I am a member of the American Psychological Association, the American Association of Marriage and Family Therapists, and the American Psychotherapy Association, and this is an area of discussion in each. For me, I try to follow the same guidelines I would in RL to the best of my ability – from record keeping, protecting confidentiality, not overstepping my boundaries with what I can reasonably or ethically offer. Hence some major limitations compared to RL. My emphasis is more on coaching and psychoeducation by necessity, as well as identifying referrals and RL help when needed. But who governs us? It’s sort of an honor system right now. My best bet was to follow the guidelines I follow in RL.
We do have one SL Group called Health Education Consultants, founded by a RL M.D., Ren Stonecutter, with about 20 of us as verified members. Its group charter reads: “A group of licensed and/or certified health care professionals and educators who provide medical education, support, and general consultation to individuals and groups in Second Life, on request. We encompass multiple support and healthcare disciplines, but refrain from clinical practice, except where permissable. Our services are available free of charge. All members subscribe to the individual codes of conduct for their professions and are self-regulating.”
Industria, glad to hear you are at Centering Place with Amaya…Wellness Island contributed to her library and we have done joint events together from time to time.
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joshooahlove said:
thanks for that clarification avalon. i had a chance to read through more of your website and also a lot of the great reference material. it will definitely be a place worth recommending to people i may encounter that may be in need of some direction for where to find help. great service to the community!
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catecumen said:
Great post! I’m going to add this one to my memories. đ
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