Peering into the Internet's Future (Part II)

David V. Baldwin, PhD

How might Internet capabilities increase communication affect trauma research, clinical work and disaster responses in the future? It's always difficult to predict the 'Net --recent changes have been so rapid that imagining more than several months into the future seems almost ludicrous.

Still, I expect a rapid and continuing expansion of e-mail and Web use. New products, such as WebTV (available now at your local electronics store), connect a modem and RISC chip to existing television sets and provide cheap e-mail and WWW access through a standard TV for those without computers. Democratization of access to information has important societal implications, not restricted to any particular field.

Research collaboration should increase, since close working relationships need not be restricted geographically. This eases the implementation of multi-site and cross-cultural studies, and allows more efficient use of data. This may change the kinds of research questions that can realistically be addressed, in ways that are difficult to predict.

For example, I recently received word that my very small disaster grant application was approved for possible funding by the Natural Hazards Center at UC-Boulder (http://adder.colorado.edu/~hazctr/Home.html).

In the event of a natural disaster in a U.S. city where appropriate ongoing or longitudinal data are being collected -- and given a cooperative principal investigator -- I could travel to the affected area, examine current subjects, and identify high- and low-susceptible PTSD groups with comparable Criterion A exposure. If it is possible to re-test these selected groups, we might learn if variance in predisaster measures predicts vulnerability to PTSD symptoms, if disaster experiences change baseline measures, or both. The ongoing research need not be trauma-focused, it just needs to offer relevant predisaster data and a large enough sample. Using e-mail and the Web certainly simplifies identification of appropriate ongoing research projects, as well as communication with potential collaborators.

The Internet may also offer an avenue for increased mental health responsiveness when whole communities are affected, as by a natural or man-made disaster. Much of the immediate need relates to information, and the Internet can easily provide that. But it can also offer consultation with therapists who are not able to travel to the disaster site, as well as professional supervision and supportive consultation among therapists treating those affected. The idea of a Virtual Trauma Center is not so far-fetched as it might have sounded just a few years ago. For the present, it will offer services that do not require close or personal contact. But future developments in video-conferencing and virtual reality promise to gradually expand the emotional flavor and immediacy of our Internet communications, much as today's email has eclipsed "snail mail."

Finally, online psychotherapy is peeking over the horizon as a potential clinical application, raising difficult ethical and licensing issues. Marlene Maheu, PhD, has created an interactive Web site where professionals can comment on any specific ethical concerns about online therapy -- you can visit her site at (http://cybertowers.com/cgibin/ethics_forum.cgi).