PULLMAN, Wash. — The Internet has become a primary source for people seeking health information. But could it serve as a useful source of therapy as well?
Michiyo Hirai, an assistant professor of psychology at
Hirai, who earned her doctoral degree from Virginia Tech where Clum was her dissertation advisor, said that an Internet-based approach “has a lot of potential to provide therapy to people who lack access to conventional treatment,” including people in rural areas far from available mental-health resources, as well as those who are uncomfortable with or can’t afford one-on-one therapy.
“There may be people who are experiencing relatively mild symptoms, but still want to find a solution to their problem because they feel that it is a significant impairment,” said Hirai.
In her research, Hirai worked with people who had been in serious car accidents, had been victims of violence, had survived a life-threatening disease, had witnessed a violent event or had lost a close relative through suicide or murder. While they did not display symptoms as severe as people with the most serious forms of post-traumatic stress disorder, they did show a range of problems including sleeplessness, bad dreams, depression and anxiety.
The eight-week cognitive-behavioral treatment program is structured in four modules, progressing in difficulty. An on-line exam at the end of each module tests mastery of the material.
The first module provides basic information about traumatic stress and its treatment. The second moves into relaxation training. The third deals with cognitive restructuring, a process that helps people learn to recognize automatic negative thoughts and evaluate and modify thought processes that lead to anxiety and emotional distress.
The fourth, and most difficult, attempts to take subjects back through the traumatic event. People who have experienced such an event often go to great lengths to avoid similar, anxiety-provoking situations. A major factor preventing recovery from the effects of trauma is avoidance of memories, thoughts, feelings and situations associated with the traumatic event. Avoidance increases the likelihood that the person will continue to re-experience aspects of the trauma in flashbacks or nightmares.
Confronting the traumatic experiences — exposure allows sufferers to reduce such problems. However, “simply telling sufferers to expose themselves to a fear-producing situation doesn’t work,” Hirai said, citing an example of a person who has been in a serious car accident being unable to get back into a car, or to travel through the area where the accident occurred.
In Hirai’s Internet-based program, subjects are asked to write a detailed account of the traumatic event and how they reacted to it. Then, they are asked to read their account repeatedly until they become more comfortable with the event and the feelings it creates.
Hirai’s research found that people who completed the program showed significant improvement in coping skills, depression and anxiety levels when compared to people in a control group.
She said she has not yet pursued any possible commercial applications of her work. She has received a grant through the WSU seed grant program and will use that money to support her efforts to tailor the on-line therapy tool to treat victims of sexual assault.
Hirai, who was born and raised in Tokyo, joined the faculty at WSU in August 2004.
