Contemporary Media Forum: Online Clinical Case Study and Peer Supervision Groups

In an earlier piece for this forum (April 1999, vol. 1, no. 2), I discussed the benefits of joining an Internet mailing list, which is a group of people who communicate with each other via e-mail in order to discuss some topic of mutual interest. Using services as yahoogroup.com, it's quite easy to set up and manage such a group. One very useful application of this technology for the psychotherapist is the ability to create an online clinical case study or peer supervision group, particularly if the lifestyles or geographic locations of the participants prevents them from meeting in-person, and if their clinical cases are very specialized or unique. Exactly how the group is set up and managed will depend on the preferences of the members and the purpose of the group. Many different formats may be quite effective. Here I will describe some basic issues to consider, as well as mention some specific strategies that have worked well for the Clinical Case Study Group of the International Society for Mental Health Online (ismho.org)—a group that I and Michael Fenichel created in 1999 and continue to facilitate.

First, let me mention the possible pitfalls. A problem with an e-mail group is its potentially amorphous membership and process. Without the visual cues of a face-to-face meeting, you're not sure who is present and listening. If the membership is open, you may not even be sure who and how many belong to the group at any given moment. Traditionally, in e-mail lists the implicit norm is that you can subscribe and unsubscribe whenever you want, participate or lurk as you wish, respond to others, ignore them, or digress. These ambiguities and this lack of structure sometimes result in a group that is fragmented, disorganized, and lacking in group spirit and identity—especially if it's a large, open membership list. Also, the partial anonymity due to missing face-to-face contact sometimes “disinhibits” people, resulting