Mar 9, 2020 | Volume 10 - Issue 1
William H. Snow, J. Kelly Coker
Distance education has become a mainstay in higher education, in general, and in counselor education, specifically. Although the concept sometimes still feels new, universities have been engaged in some form of distance learning for over 20 years. In the field of distance counselor education, it is imperative to understand where we have been, where we are now, and where we are going. This article will lay the foundation for the special section of The Professional Counselor on distance counselor education and will explore the history of using technology in education, recent research about distance education in counseling and counselor education, and topic areas discussed throughout this special section. This special section will bring clarity to current and emerging best practices in the use of technology in the distance education of professional counselors, clinical supervisors, and counselor educators.
Keywords: online, distance education, counselor education, technology, best practices
Counselor educators have become comfortable and adept over the years at fostering students’ development in clinical skills in traditional residential formats. For many counseling faculty, in-class, face-to-face (F2F), personal encounters are foundational and irreplaceable. For educators with this mindset, distance learning is not an opportunity but a threat to what they consider the best teaching and learning practice (Layne & Hohenshil, 2005). No matter one’s personal preference or belief, the advent of distance learning is challenging the sovereignty of the purely residential experience.
For the purposes of this discussion, we are using the term distance education versus the more prolific term online education. The U.S. Department of Education’s Office of Postsecondary Education (OPE) has officially adopted the broader term of distance education, which focuses on the physical separation in the teacher–student relationship (OPE, 2012). This is in contrast to the term online education, which emphasizes the internet-facilitated communication that supports the teaching relationship at a distance.
The number of students in distance education programs has been increasing each year (Friedman, 2018). By 2016, over 6 million students in the United States were engaged in distance education, and nearly half were exclusively taking online classes (Seaman et al., 2018). Over two-thirds of the students were enrolled in distance learning courses at public universities (Lederman, 2018). In contrast, the total number of residential students dropped by over 1.1 million (6.4%) between 2012 and 2016 (Seaman et al., 2018). The growth in enrollment and the future of higher education continues to move toward distance education.
The same trends have impacted counselor education. At the time of this writing, the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) reported that there are 69 CACREP-accredited master’s programs that are considered distance education, 34 of which are clinical mental health counseling programs (CACREP, n.d.). Over 25% of counseling students are now enrolled in academic programs defined as distance education (Snow et al., 2018). Because an increasing number of programs are including distance education opportunities, the need for an exploration of efficacious deliveries of distance education content is imperative (Cicco, 2012).
The growth in distance education programs is often based on mixed motivations. One motivation is the desire to provide greater access for traditionally underserved populations (Bennett-Levy et al., 2012). For example, distance education can benefit students in rural areas as well as those living abroad (Sells et al., 2012). Remotely located service providers can benefit as well. Agencies that lack immediate physical access to counselor education programs now have the online tools to train members of their community locally in advanced mental health skills through distance education so they can continue serving their communities while in school. Distance education programs also can better support working adults and caregivers who in theory are within geographic proximity of a campus but are constrained by complex schedules, responsibilities, and mobility-related issues (e.g., disabilities, difficult travel). The ability to engage in academic studies from any location around the globe, within a more flexible scheduling model, is a game-changer (Bennett-Levy et al., 2012). Additionally, adult learners increasingly prefer the autonomy and self-direction found in these distance education formats (Ausburn, 2004).
Distance education programs allow access to a greater pool of qualified, diverse faculty. Qualified counselor educators anywhere in the world with access to a computer and an internet connection are prospective instructors. Most importantly, distance education programs eliminate the constraints of geographic proximity, worsening traffic commutes, and parking concerns. For the distance education program, it is all about access for any faculty member or student in the world (Reicherzer et al., 2009).
A more pragmatic motivation for universities is to view distance education programming as a source of revenue, growth, and efficiency (Jones, 2015). For example, distance education courses eliminate the costs and limitations of brick-and-mortar classrooms. Unfortunately, students may not benefit when universities increase online class sizes and hire less expensive adjuncts to increase the bottom line (Newton, 2018). Some universities might even tack on special technology or distance education fees.
It is our belief that the counseling profession should take the lead in proactively investigating the promise of the distance education experience, including the technologies, pedagogies, and methods. We must determine which best practices create excellent educational experiences for the ultimate benefit of our counseling students and the clients they will serve. This special section of The Professional Counselor is an essential step in that direction.
A History of Learning Technologies and Their Impact on Distance Counselor Education
If we take a step back, we can see that there has been a continual movement toward infusing technology into the general educational process and, more recently, specifically in counseling and counselor education. We have moved from a strictly oral tradition in which vital knowledge and skills were passed on in F2F interactions to a present-day, technologically mediated set of interactions in which teacher and student may never meet in person and where dialogues are reduced to bits and bytes of information transmitted across the internet.
In ancient times, essential knowledge, skills, histories, and traditions were only preserved in the memories of those able to experience events directly or to receive critical information from others. People were living repositories of essential skills of survival, cultural insight, and wisdom. If they failed to pass it on orally or through example, what they knew and embodied was lost forever. It is a surprise to many that Socrates did not pen a single word. His choice of influence was through discussions with his followers and came to be known as the Socratic method. Socratic concepts would have been lost forever, but fortunately, followers such as Plato put them in writing.
The Written Word
Socrates’s ideas on teaching and learning lived through an early technology: the written word. The technological advancement of written language, writing devices, and the availability of parchment and paper as a set of communication tools was revolutionary in furthering information sharing and learning. Scholarship became associated with the ability not only to think critically, but also to read about the thoughts of others and respond in writing to contribute to the public discourse. Written documents were copied and distributed in what was the earliest form of distance education. During the medieval period, the copying of important texts often fell to those within monastic religious life, usually as a compulsory duty. Copying books for six or more hours per day for years was a noted source of drudgery (Greenblatt, 2011), but the printing press removed the need for such anguish.
The Printing Press
The limitation of scribes hand-copying documents meant that access to readable material was for society’s select few. Gutenberg’s invention of the printing press in approximately 1438 increased access to print (Szabo, 2015). For the first time in history, the works of scholars, philosophers, and artists could be printed in books and made available to a wider public. With written materials available, the literacy rates in Europe rose from approximately 10% in the 1400s to over 90% by the middle of the 20th century (Roser & Ortiz-Ospina, 2018). The printing press laid the groundwork for innovation in education as well. In the 1720s, the printing press allowed for the first distance education correspondence courses in Boston, representing the “written era” of technology-enhanced education (Drumbauld, 2014). More technologies would eventually revolutionize progress in educational methods.
Sound Recordings and Film
The phonograph was invented by Thomas Edison in 1877 as a device to both record and play back sound (Thompson, 2016). It did not replace writing and books but could record and preserve the sounds of music, events, and the words of famous people and other languages. For example, when people could hear what foreign dialects sounded like from the lips of native speakers, language instruction was transformed.
The development of celluloid film recording and motion pictures in 1895 led to newsreels and documentaries in the early 1900s that provided the public with information about current affairs and historical and cultural events. For the first time in history, people could experience significant events in recorded sight and sound versus only reading about them. Moreover, they could now learn by seeing (O’Shea, 2003).
Radio, Television, and the Telephone
Relatedly, the advent of commercial radio broadcasting in the 1920s provided the first live reporting of events (University of Minnesota, n.d.). For example, radio audiences heard powerful first-hand emotions in the reporter’s voice as he watched the Hindenburg disaster unfolding before his eyes. In the 1920s, colleges and universities began to take advantage of this new, powerful medium. For example, Pennsylvania State University was the first university to be granted a broadcast license to begin offering college courses over the radio (Dawson, 2018).
The “radio era” quickly transitioned to the “TV Era” in the late 1960s when televisions were in most homes in the United States. People could both see and hear world events at a distance. Stanford University was one of the first institutions to capitalize on this burgeoning technology for educational purposes. The Stanford Instructional Television Network was started in 1968 and offered instruction for part-time engineering students (LeDesma, 1987).
Radio and television broadcasts were significant innovations. Their drawback from an educational perspective was that they were primarily one-way mediums and the audience was merely a passive recipient of sights and sounds. It was the telephone that provided the masses with the first means to engage in two-way conversations at a distance. For the first time in history, the average person could not just listen at a distance, but also could talk back. An early telephone-based education using this two-way communication medium was offered by the University of Wisconsin in 1965 (Drumbauld, 2014). Computers and the internet would soon become the next revolutionary communications medium.
Computers and the Internet
Computers were useful as standalone information processors, but it was the unifying ability for computers to communicate that set the stage for the next revolution in information dissemination since Gutenberg’s printing press—the internet. The internet is in actuality a shortened version of the term internetworking, which was born in 1969 when the Advanced Research Projects Agency Network (ARPANET) successfully sent the first message between computers (Leiner et al., 1997). That was followed by the standardization of the Transmission Control Protocol/Internet Protocol (TCP/IP) to give all researchers a standard computer language in order to talk together on this small but growing assemblage of internetworked computers (Leiner et al., 1997). Technical advances continued to follow, but the fledgling internet was not accessible to the average person. Defense researchers, academics, and early computer buffs with the drive and savvy to understand and write in computer languages like Unix to execute functions like domain name system lookup, file transfer protocol, and simple message transfer protocol dominated the internet (Leiner et al., 1997). The basic networking foundations were developed, but the average person was waiting for the time when the internet would move from the researchers’ lab to broader computing access.
Personal Computing
For decades, computers were costly in price, massive in size, and difficult to maintain, and required a dedicated, specialized operating staff. This meant computer access was only for select university personnel, government employees, larger businesses, and electronic hobbyists. Access changed with the advent of the Apple II in 1977, the IBM PC in 1981, the Apple Macintosh in 1984, and the Windows operating system in 1990 (Allan, 2001). The era of the personal computer (PC) was born and it soon became a must-have technology and home appliance for an increasing number of individuals in society. Functional, affordable, and easy to operate, computers were now available to the general consumer, opening up a worldwide network of information sharing.
The World Wide Web
Early PCs were standalone machines, and few connected to the government-dominated internet. In the 1980s, there began a movement for PCs to connect to proprietary, fledgling dial-up modem-driven services like America Online (AOL; Rothman, 2015). These computer connection services allowed dial-up modem access, information sharing, and file uploading and downloading for a monthly subscription (Haigh et al., 2015). Email communications could be sent but only for those on closed, proprietary networks.
Some universities began their own networks or used services like AOL in order to connect faculty, staff, and students. These online services were far more comfortable to use than the more complex internet, which still required a level of technical sophistication. Although these services were accessible, they were somewhat isolated as each service provider had an exclusive dial-up modem for access and an entity unto itself.
In 1990, only 2.6 million people worldwide had access to the fledgling internet (Roser et al., 2020). A significant breakthrough occurred with the development of hypertext language in 1991 and the first integrated web browser, called Mosaic, in 1993 (Hoffman, n.d.). Access to the internet and its wealth of resources suddenly became available with a point and click of a computer mouse. The term World Wide Web accurately described internet connectivity that spanned the world and connected smart devices to include computers, tablets, gaming consoles, and phones. If a device had a central processing unit, it could connect. By 2018, 4.2 billion people, or 55.1% of the world population, had internet access (Internet World Stats, 2019). In response, the number of digital websites grew from 130 in 1993 to over 1.9 billion today (InternetLiveStats.com, n.d.).
The Digital Age
Digitization has created a world library and communication platform where text, audio, and video recordings are available to anyone with a computer, tablet, gaming console, or smartphone connected to the internet. Anything that can be digitized can be stored and transmitted in real time. The internet merely has taken our previous modes of physical and analog forms of communication and moved them into the digital stream. Internet publishing is a simple extension of Gutenberg’s printing press. The local library is now a part of the World Wide Web library. Text messaging is the modern-day telegraph, and cellular phone services have cut out the need for copper wiring. Streaming audio and video are what radio and television were. Cutting edge videoconferencing platforms are the new F2F communication mode. Reality has now become a virtual reality. For the counselor educator, all of the world’s accumulated technological advances and resources can rest in the palm of your hand. All of the technologies have come together to support progress toward what we call the distance learning era.
Distance Education
Even though we tend to think of distance education as a recent development, Pennsylvania State University offered correspondence education to rural farmers using U.S. mail in 1892, over 125 years ago (Dawson, 2018). Correspondence courses were the precursors to the more sophisticated distance education approach offered by the University of Phoenix in 1976. The 1990s brought about the most significant changes regarding online educational delivery, with the University of California-Berkeley offering the first completely online curriculum in 1994, and Western Governor’s University, established in 1997, helping Western states maximize educational resources through distance education (Drumbauld, 2014). Today, the distance education student population has grown to over 6 million students in the United States (Seaman et al., 2018). Counselor education programs have developed along with this national trend. Today, 69 counseling programs are offering CACREP-accredited distance education degrees (CACREP, n.d.).
Web-Facilitated Faculty–Student and Student–Student Interactions
In the early 1990s, Moore and Thompson (1990) and Verduin and Clark (1991) defined the core conditions that distance education should achieve to become as effective as F2F instruction. These conditions were timely instructor feedback to students and regular student-to-student interactions. Almost 30 years later, those conditions have been fulfilled. Secure audio- and videoconferencing platforms, such as Zoom and Adobe Connect, now allow faculty and students to connect F2F in real time, synchronously (Benshoff & Gibbons, 2011).
E-learning platforms, such as Blackboard, Canvas, and Moodle, now provide an integrated solution for faculty to asynchronously post syllabi, assignments, and instructional resources for instant download by students. Students can then respond to faculty questions via threaded discussions, upload papers, and take online assessments. Faculty, in turn, can review student work and provide feedback as fast as they can type.
It is now clear that with the combined power of the PC and facilitated technologies, timely instructor feedback and regular student-to-student interactions are possible. The future is here, and all that remains is for counselor education instructional pedagogy to catch up, as well as keep up, with the technological advances that are driving changes in education.
Clarity of Focus: What Is Distance Counselor Education?
Terms like online education, distance learning, and hybrid program, without a clear understanding of their proper use, are problematic. The determination of an academic program as distance education, online, hybrid, or residential has implications for federal financial aid, regional accreditors, and CACREP. So, what is distance education, how is it linked to advances in educational technology, and how does it relate to counselor education?
In practice, various terms, such as distance learning, online learning, and online education, are used. The OPE (2012) has officially adopted the term distance education and further defines distance education as instructional delivery that uses technology in courses for students separated from their instructor to support “regular and substantive interaction between the students and the instructor, either synchronously or asynchronously” (p. 5). The technologies referred to by the OPE are generally internet-based and may include the use of email, audioconferencing, videoconferencing, streaming videos, DVDs, and learning management systems.
Januszewski and Molenda (2013) defined educational technology as “the study and ethical practice of facilitating learning and improving performance by creating, using and managing appropriate technological processes and resources” (p. 1). Simply put, educational technology is about the physical tools we use in education and the processes that we implement to intentionally shape the relationship of the tools to the subject matter, teacher, student, and social learning environment. These tools and processes combine to form the educational pedagogy to support learning and the OPE (2012) mandate for “regular and substantive interaction between student and instructor” (p. 5).
The OPE (2012) categorizes programs as distance education if at least 50% or more of their instruction is via distance learning technologies. In contrast, residential programs, as categorized by the OPE, CACREP, and federal financial aid regulations, are allowed to infuse significant distance education elements into their instructional coursework as long as they do not exceed the 49% threshold. As an example, a 60 semester unit (90 quarter units) residential program could still offer 29 semester units (44.5 quarter units) of distance education coursework and technically remain residential by OPE standards.
The Continuum of Residential to Distance Education Programming
At one end of the spectrum are purely residential programs, offering 100% of courses in person. The next step along the spectrum is residential hybrid programs. These are still considered residential in providing the preponderance of courses in residence, but they can contain up to 49% of their credit units online and technically maintain their residential classification. Next along the spectrum are limited residency distance learning programs. These provide 50% or more of courses online but require some level of on-campus participation. A 2018 study by Snow et al. found that 90% of CACREP-accredited distance education programs were considered limited residency. They required students to attend a campus residency at least once and up to four times during their degree program. Finally, at the opposite end of the spectrum is a small but growing number of programs offering entirely distance education formats. These offer 100% of their coursework at a distance with no campus residency requirement.
The Infusion of Distance Education Technology in All Education
It is difficult to imagine any counselor education in 2020 to be technology-free and without some integration of distance education elements into individual class sessions, full courses, or programs. In concept, one could argue that there is a bit of online educator in the majority of faculty members today, whether they realize it or not. Most universities now require faculty, even the most technophobic, to have access to a computer and read and respond to email communications. Critical information is commonly only accessible on institutional web pages. Confidential information, such as student advising information, is often available online via secure portals—no more hard copy student files. Grades are now commonly put online. All of these widely used technologies support students learning at a distance.
The advent of the modern learning management system in the form of web-based platforms, such as Blackboard, Canvas, and Moodle, has added a level of access and interactivity to all programs in the teaching spectrum, from entirely residential to entirely online. Faculty engaged in all formats can use these educational platforms to post text, audio, video, and recorded lectures. Students can view materials, upload their papers, and post responses for review and grading. Discussion groups can interact using asynchronous, threaded discussions within these portals. Embedded grade books keep students informed of their progress at all times. These learning platforms, along with other educational technologies, are now commonly employed in both residential and distance education courses, making the programs look increasingly more similar than different.
Reducing the Distance in Distance Education
Assuming the presence of residential courses with as much technology infused into them as many distance education courses, what is the difference? Both formats require “regular and substantive interaction between the students and the instructor” (OPE, 2012, p. 5). The key word in distance education is distance. The OPE (2012) refers to distance education where students are physically separated from their instructor. Academic programs are required to support, facilitate, and ultimately ensure that regular and substantive interactions occur between students and instructors. The implicit assumption is that residential faculty in close physical proximity to their students have adequate if not superior amounts of regular and substantive interactions with students and thus greater connection and engagement. But, is that necessarily true?
We suggest that rather than focus on whether a class is considered residential or distance education, the concern should be about the amount of regular and substantive interactions, which decrease the social distance between students and faculty and thus help foster community and quality student engagement. Reducing social distance, a measure of relationship and connection, is a significant factor in promoting student engagement. The Great Schools Partnership (2016) defined student engagement as “the degree of attention, curiosity, interest, optimism, and passion that students show when they are learning or being taught, which extends to the level of motivation they have to learn and progress in their education” (para. 1). There is ample evidence that students who feel a sense of community and connection, no matter what the delivery model, demonstrate better academic performance and higher levels of satisfaction and retention (Benshoff & Gibbons, 2011; Chapman et al., 2011; Rovai & Wighting, 2005). The decreased social distance between faculty and students is a good indicator of “regular and substantive interactions” and thus greater student engagement in the learning process. The physical proximity of faculty and students within residential learning programs can certainly provide opportunities for direct interaction and decreased social distance, but without appropriate faculty desire to connect and engaging pedagogy, there is no guarantee. Numerous studies involving residential programs document cases of student disconnect, alienation, and reduced graduation rates on college campuses (e.g., Feldman et al., 2016; O’Keefe, 2013; Redden, 2002; Rovai & Wighting, 2005; Tinto, 1997). Helping students feel connected to their faculty, fellow students, and campuses is an important task for those operating in both residential and distance learning arenas. Distance education faculty using the appropriate technological tools and pedagogy can overcome the obstacles of physical separation and facilitate meaningful, regular, and substantive interactions.
As we reflect on our educational careers, the authors remember auditorium-style classes in large lecture halls. The physical distance to the instructor might have been 50 feet, but it might as well have been 50 miles as it was difficult to connect with an instructor when competing with 99 other students for attention. Conversely, we have experienced an online class where faculty and students were geographically scattered, but small class sizes allowed us all to make stronger connections. We have come to believe that online education done right can take the distance out of distance education.
The ability of students and faculty to connect at a distance is ever increasing. What was once almost purely an asynchronous model of instruction (i.e., threaded discussion posts and emailed assignments) now has evolved with the addition of interactive videos and training modules, recorded lectures, “real-time” synchronous classes, and live videoconferencing for classroom experiences, advising, and clinical supervision. These tools are allowing students to watch expert counseling role models demonstrate and practice clinical skills themselves while getting real-time feedback from instructors and fellow students. For many counselor education programs, distance education and online learning experiences are now better characterized as virtual remote classrooms.
The Special Section: Distance Counselor Education
This special section reviews the historical context of distance education, seeks to understand the critical elements and best practices for effective distance education, and makes modest projections about future trends. Six additional articles can be found in this issue that provide greater focus on the following areas of consideration: (a) student selection, development, and retention; (b) challenges and solutions of clinical training in the distance environment; (c) distance education pedagogy similarities and differences compared to residential instruction; (d) legal and ethical considerations for distance counselor education; (e) opportunities and challenges of multicultural and international distance education; and (f) student perceptions and experiences in distance education.
Student Selection, Development, and Retention: Who Can Best Succeed?
There are several measures of student success, including retention, academic performance, and graduation rates. Researchers have examined the success of students enrolled in online programs or classes to better understand those factors that lead to or impede student success. Sorenson and Donovan (2017) sought to explore why undergraduate students at an online, for-profit university were dropping out. The authors determined that attrition could be attributed to several factors, including a perceived lack of support by the university and faculty, difficulty balancing multiple priorities, a lack of awareness of how much time is required, and academic issues (Sorenson & Donovan, 2017).
How do we determine the best “fit” through our student selection process? A student’s undergraduate college grade point average does seem to serve as a significant predictor of success in graduate distance learning programs (Cochran et al., 2014). Graduate Record Exam scores, previous work experience, and application essays also are commonly used to select students, but Overholt (2017) did not find them useful in predicting student success among non-traditional graduate student populations. Gering et al. (2018) determined that more salient factors for predicting success included initiative, the ability to take responsibility for one’s education, and time management. Yukselturk and Bulut (2007) have described these factors as representing self-regulated learners.
Gering et al. (2018) also found some external student success factors to be crucial, including a supportive family, strong social connections with other students, strong teaching presence, and receiving prompt and regular feedback and guidance. It is clear then that student success in distance learning courses is partially dependent upon student attributes but also on their level of external support, the actions of the instructor, and a supportive institution.
Clinical Training in the Virtual Remote Environment: What Are the Challenges and Solutions?
It is one thing to offer didactic learning at a distance but quite another when we think about how to conduct engaging clinical skills development in the distance education environment. How do we support the development of appropriate knowledge, skills, and dispositions to help counseling students succeed? The virtual remote classroom allows students to observe faculty experts and student volunteers engaged in clinical role-play simulations. Students can team up with other students in virtual breakout rooms to practice skills they have just watched remotely. Videoconference tools with embedded recording features can capture verbal and non-verbal interactions. Faculty can subsequently observe student role plays live or via recorded sessions.
According to Reicherzer et al. (2012), online and hybrid counselor training programs using a blend of asynchronous, synchronous, and in-person training can produce counselors capable of meeting site supervisors’ expectations of clinical skill preparation before entering practicum and internship. Other researchers found that student learning outcomes are higher for hybrid or blended programs than for fully online or fully residential programs (Means et al., 2010).
Graduates of such programs have an advantage over residential students in their experience with the technologies required for implementing telemedicine and online counseling in their practices—a necessary competency for future practice in the 21st century. With their background in distance learning, these students will have firsthand knowledge of what it takes to properly implement online tools for facilitating strong therapeutic connections. Their remote experiences will provide valuable insights to mental health agency leaders who eventually need to integrate telemedicine into their work to keep pace with future trends and demands (Zimmerman & Magnavita, 2018). This will set these students apart from other clinicians graduating today who lack the training outcomes to participate competently with the proper ethical safeguards in the online world (Barnett, 2018).
Virtual Remote Educational Pedagogy: Similar or Different From Residential Instruction?
In education, the preferred relationship of balancing course content, pedagogy, and technology will vary by institution and instructor. One example is the philosophy of José Bowen (2012). He prefers the live classroom experience, creating more value within the live classroom experience and using technology outside the classroom (Bowen, 2012). He is not against technology, but he believes it is best used outside the classroom to free up more time for richer in-class dialogue. Other programs may adopt a model with more reliance on technology for primary content delivery with the instructor taking a backseat to the online delivery systems. In the context of online and technology-enhanced counselor education, how do those of us who work and teach virtually maximize the available technology to create a vibrant, interactive experience? Can we leverage technological tools to provide the resources needed for success while still creating an impactful and compelling experience? What is the appropriate balance?
In a study of online courses with demonstrated effectiveness, Koehler et al. (2004) determined that three components must dynamically constrain and interact with each other: content, pedagogy, and technology. Faculty must demonstrate expertise in their subject matter, skill teaching in an online environment, and an understanding of as well as effectiveness in utilizing technology in dynamic ways. If all three are present in a course, students report having a better learning experience.
Total distance learning, blended learning, and fully residential learning approaches share another common success—the importance of a positive, supportive learning community. In a study by Murdock and Williams (2011), distance learning students who felt connected and a part of the university community reported more satisfying learning experiences. At least in these cases, successful connection was more important than any particular teaching pedagogy or technology.
Legal and Ethical Considerations in Online Delivery
Online educators are subject to the same statutory and regulatory compliance concerns as their residential counterparts. Online educators have additional complications, challenges, and risks because of their reliance on web-based technologies and online communication. Security, privacy, and access are some of the considerations faced by educators teaching at a distance.
Cybersecurity is now an overarching concern in higher education (White, 2015). Most, if not all, of the student’s personal information, academic record, and submitted course materials are stored in computer files in cloud-based storage. Increasingly, physical student records do not exist as backups. We are moving toward total dependence on reliable, secure access to internet-based storage and retrieval solutions. Distance educators face a level of risk each time student and institutional information is stored, accessed, and shared across cyberspace. There are plenty of bad actors in society focused on disrupting and exploiting these kinds of private information.
The Family Education Rights and Privacy Act (U.S. Department of Education, 2018) requires the protection of the student’s personally identifiable information and education records from unauthorized disclosure. Protection requirements apply to the institution in general; educational service providers providing outsourced services; and every administrator, staff member, and faculty member with access to student records. Although cybersecurity is an important security component, there are other simple, practical questions for the individual educator to ponder. For example, when involved in asynchronous communications via email, how do you know it is the actual student? When a distance learning faculty member gets a phone call from an online student they do not know well, how do they verify identity? In 2007, a residential student impostor lived on Stanford’s campus for 6 months, ate in the cafeteria, and lived the campus experience until finally caught (Novinson, 2007). If it can happen in a residential setting where we interact with students directly, it can surely happen in an online environment.
Compliance regulations for the Health Insurance Portability and Accountability Act of 1996 (HIPAA) govern the security of communications that clinical site supervisors, clinicians in training, and faculty supervisors maintain about client cases (HIPAA, 2015). Clinical faculty conducting individual, triadic, or group supervision via telecommunication must verify that technologies meet HIPAA compliance. There also is the requirement that student clinicians must not be discussing confidential issues within earshot of friends, families, and roommates—and not doing so via the local coffee shop’s wireless hotspot.
Online education provides access to students at a distance, and in many respects, it provides access and opportunities for those who previously had few options to extend their learning. Online courses may not prove accessible to people with disabilities as the reliance on embedded web technologies may present challenges (Edmonds, 2004). The Americans with Disabilities Act (ADA) requires educational institutions to make their physical campuses accessible to people with disabilities and the virtual campuses as well. The ADA government website provides guidelines of what is required to make web-based information accessible to those with various disabilities (United States Department of Justice, n.d.).
Issues of student sexual harassment can occur, necessitating Title IX investigations and interventions (Office for Civil Rights, 2018). University administrators must learn how to handle these and other related issues at a distance with students who may be physically separated.
Online educators must comply with federal statutes and regulations, those in their institution’s home state, and those in the state in which the student resides. State-by-state approval is possible but cumbersome. There are initiatives, such as the National Council for State Authorization Reciprocity Agreements, to establish a state-level reciprocity process (National Council for State Authorization Reciprocity Agreements, n.d.).
Multicultural and International Distance Education: What Are the Opportunities and Challenges?
Another important consideration is how well distance counseling programs effectively attract, retain, and support students from diverse backgrounds. Since its rise in availability, distance education has been a strong draw for people from diverse backgrounds, particularly women of color (Columbaro, 2009). Walden University, one of the largest online universities in the country, reported in 2015 that of its almost 42,000 graduate students, 76.7% were women and 38.7% were African American (Walden University’s Office of Institutional Research and Assessment, 2015).
In addition to the strong representation of students of color in online education, there is a growing number of international students who also are taking advantage of opportunities to learn at a distance (Kung, 2017). Kung (2017) reported data from the Institute of International Education that showed a 7.1% increase in the number of international students studying in U.S. colleges and universities. Distance learning can accelerate this increase as online students do not require an F-1 visa to participate at a distance. With this rise, Kung calls for an increase in cultural awareness, sensitivity, and preparation for working with international students in online settings.
Counselor Education at a Distance: Student Perspectives
Given the rise in the number of distance counselor education programs, it seems that there would be a wealth of literature to help us understand the real experiences of students training to be professional counselors in online formats. Although there have been studies examining general student perceptions of engagement, social presence, and outcomes in online learning environments (Bolinger & Halupa, 2018; Lowenthal & Dunlap, 2018; Murdock & Williams, 2011), specific experiences of online counseling students across the wide variety of delivery methods has not, to these authors’ knowledge, been conducted. As technology improves and options for learning management, videoconferencing, and student assessment platforms increase, programs training counselors at a distance have a widening variety of ways in which this learning can occur.
Asynchronous, synchronous, blended, hybrid, and fully online are just a few modalities that counseling students use to experience their education. A glimpse into the experiences of students will shed light on how our most important players in this ever-changing game of distance counselor education view the efficacy of their respective training, now and in the future.
The Future of Distance Counselor Education
As we examine emerging technologies and near-future possibilities, it can seem like science fiction. The use of avatars and other simulation and gaming technologies in counselor training, for example, have been examined for potential substitutions for counseling practice with peers and real people. Walker (2009) studied the use of avatars in one virtual platform, Second Life, for skills training among master’s-level counseling students. Counseling students’ attitudes regarding the effectiveness of this medium to enhance skills development were measured, and findings suggested that this technological enhancement was efficacious to student learning, engagement, and overall skill development.
Virtual reality (VR) is already used in counseling and is being explored as a way to create environments that can help address trauma and phobias and enhance mindfulness training and techniques. Riva and Vincelli (2001) contend that the use of VR in clinical settings can serve as a “sheltered setting” (p. 52) where clients can explore distress-producing stimuli in a safe and controlled environment.
What potential does this technology have in the training of the next counselors? Might we have “virtual” clients that counselors interact with, in real time, in a VR environment? Buttitta et al. (2018) of California State University, Northridge’s counselor education program are already doing so in training their counseling students. They recently presented initial findings at the 2018 Western Association for Counselor Education and Supervision (WACES) Conference where they demonstrated how they could change the avatar’s voice and physical look to become a person of any age, gender, or ethnicity. Their initial impressions are that student learning is as good with avatars as with role-playing students.
We see this idea tested in training programs in other fields. Plessas (2017) conducted a study of the effectiveness of using VR “phantom heads” for dental students to practice their skills on. Findings suggested that along with concurrent, augmented feedback from supervisors, this training method creates a level of efficiency and safety. Additional platforms for virtual counseling are being developed, necessitating enhanced training of counselors who are equipped to work with new technologies and environments.
Conclusion
As counselor training programs become more technologically savvy, different models and methods of online pedagogy are available to them. What once was almost purely an asynchronous model of instruction (i.e., discussion posts and assignments in a learning management system like Blackboard or Canvas) now has the ability to add interactive videos and training modules, recorded lectures and discussions, and “real-time” synchronous classes and supervision groups using platforms such as Zoom, Skype, or GoToMeeting. The opportunity–capability gap between distance education and residential classrooms is shrinking. According to Cicco (2011), there is greater efficacy of training when online learning includes opportunities for counseling modeling by experts using videos and podcasts as well as opportunities for students to engage in the practice and demonstration of clinical skills. Today’s distance education classroom can do all that and more.
Students in online core counseling skills courses have reported higher self-efficacy (using the Counseling Self-Estimate Inventory) than their counterparts in traditional F2F classrooms (Watson, 2012). Repeated studies draw similar conclusions regarding gains in self-efficacy using online instruction (Smith et al., 2015). Higher levels of internal motivation, student confidence, and self-efficacy are due in part to the structure of online courses and the requirement for students to engage in independent, autonomous learning exercises (Wadsworth et al., 2007).
The evidence we have examined leads us to the conclusion that not only is online and distance education here to stay, but there also are excellent reasons and justifications for its current use and future expansion. We trust that this special section will help to shed light on those aspects of distance counselor education programs proven effective and provide information to the benefit of all counselor training programs—no matter what delivery methods are utilized.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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William H. Snow, PhD, is an associate professor at Palo Alto University. J. Kelly Coker, PhD, NCC, LPC, is an associate professor at Palo Alto University. Correspondence can be addressed to William Snow, 1791 Arastradero Road, Palo Alto, CA 94304, wsnow@paloaltou.edu.
Jun 26, 2015 | Article, Volume 5 - Issue 3
Ryan G. Carlson, Jessica Fripp, Christopher Cook, Viki Kelchner
Intimate partner violence is a problem among young adults and may be exacerbated through the use of technology. Scant research exists examining the influence of technology on intimate partner violence in young adults. Furthermore, young adult couples on university campuses experience additional stressors associated with coursework that may influence their risk of partner violence. We surveyed 138 young adults (ages 18–25) at a large university and examined the relationships between stress, intimate partner violence and technology. Results indicated that those who use technology less frequently are more likely to report inequality in the relationship, thus suggesting a higher risk for partner violence. An exception applies to those who use technology to argue or monitor partner whereabouts. Implications for counseling young adult couples are discussed.
Keywords: intimate partner violence, stress, young adults, technology, couples
Intimate partner violence (IPV) occurs among young adults (ages 18–24) at a comparable rate with the general population. IPV in the general population occurs among 25%–33% of both men and women (National Intimate Partner and Sexual Violence Survey, 2010), with studies estimating the prevalence of physical violence among college students to be between 20% and 30% (Fass, Benson, & Leggett, 2008; Shook, Gerrity, Jurich, & Segrist, 2000; Spencer & Bryant, 2000). Additionally, IPV is regularly underreported due to the embarrassment and shame victims may feel (Bureau of Justice Statistics, 2003). While causes of IPV are not completely understood, its prevalence among both victims and victimizers has been linked to those who witnessed parental violence as children (Straus, Gelles, & Smith, 1995). However, the increase in college student IPV could be provoked by stress associated with the demands of academics (Mason & Smithey, 2012). IPV victims are more likely to experience symptoms of depression and anxiety, with male victims expressing more shame related to the victimization (Shorey et al., 2011).
In the late 1980s and 1990s, researchers identified types of partner violence within adult relationships (e.g., Gottman et al., 1995; Holtzworth-Munroe & Stuart, 1994; Johnson, 1995). Researchers coined these differences as IPV typologies, which helped researchers and practitioners understand that partner violence is heterogeneous, and thus treatment should be tailored to meet the specific needs of the couple (Carlson & Jones, 2010). This perspective differed from the traditional practice of treating all relationship violence as homogeneous, presuming it to be the result of power and control. Additionally, traditional perspectives on IPV assumed that perpetrators were men trying to assert dominance. Typology researchers refuted this perspective, stating that although some violence is male-on-female, the majority is gender mutual and may have more to do with conflict resolution skills than with asserting control. IPV typology research has gained traction due to its potential treatment implications. However, there is a dearth of research examining IPV typologies among young adults and its relationship to the increased use of technology among this population.
IPV Typologies
Traditionally, relationship violence was more popularly termed domestic violence and deemed homogenous among couple relationships. Thus, all violence was thought to originate from a batterer’s attempt to establish or maintain power and control over a victim. Such violence typically occurred with men as the batterers and women as the victims (in heterosexual relationships). This philosophy gained traction with most practitioners, who assumed that all relationship violence resulted from power and control.
Over the past 15 to 20 years, researchers identified types of relationship violence (e.g., Gottman et al., 1995; Holtzworth-Munroe & Stuart, 1994; Johnson, 1995; & Johnson & Ferraro, 2000). Researchers utilized studies indicating that violence is likely to vary in severity, and often the motive is not to establish power and control over one’s partner. As such, relationship violence was deemed heterogeneous among couples. Therefore, researchers began using the term intimate partner violence as a broader term for describing the variances in violence that occur within relationships, as well as the notion that the violence can be gender mutual in some typologies, meaning that violence is just as likely to be female-on-male as male-on-female in heterosexual relationships. Examples of some of Johnson’s (1995) IPV typologies include the following: (a) situational couple violence, marked by violence that is gender mutual and has lower levels of severity; (b) intimate terrorist, marked by violence that is typically male-on-female, the result of one partner establishing power and control over another, and includes higher levels of lethality (e.g., choking); and (c) violent resistance, when the victim attempts to fight back. Other researchers have established typologies (e.g., Gottman et al., 1995; Holtzworth-Munroe & Stuart, 1994); however, Johnson’s appear to be the most recognized.
Carlson and Jones (2010) developed the continuum of conflict and control to synthesize violence typology research. They asserted that violence typologies could be conceptualized through variances in the type and severity of violence, characteristics of the victimizer, and perceptions of the victim. Assessing information across those three domains can help determine the nature and severity of the violence, and have potential treatment implications. For example, some researchers have examined the effectiveness of relationship interventions when couples present with lower levels of severity in relationship violence (e.g., Bradley, Friend, & Gottman, 2011; Braithwaite & Fincham, 2014; Simpson, Atkins, Gattis, & Christensen, 2008). However, such interventions require counselors to make informed and intentional treatment decisions that consider the safety of the couple.
Counselors may not typically screen for partner violence or make treatment decisions based on the safety of a victim (Schacht, Dimidjian, George, & Berns, 2009). Partner violence screening protocols are beyond the scope of this paper; however, readers are referred to Daire, Carlson, Barden, and Jacobson (2014). Counselors who become aware of partner violence typically refer their clients, with the assumption that treatment is contraindicated. However, couples counseling and other relationship interventions, such as relationship education, appear to reduce overall levels of relationship violence and increase relationship satisfaction (Bradley et al., 2011; Simpson et al., 2008). Couples who participated in this research were identified as having low levels of aggression, and as not attempting to establish power and control over their respective partners. Our review of the literature did not yield any research discussing how IPV typologies translate to young adult relationships, and what effect technology might have on the types of violence. Thus, it is not clear what evidence exists supporting best practice guidelines for counselors who work with young adults experiencing IPV in their relationships.
Dating Violence
The Centers for Disease Control and Prevention (CDC) has defined dating violence as the consistent act of physical and/or sexual violence, as well as the possible emotional or psychological distress perpetrated by a current or previous dating partner (CDC, 2014). Additionally, the CDC has reported that dating violence contributes to health risks including, but not limited to, injury, heavy drinking, suicidal ideation, promiscuity, substance use, issues with self-esteem and perpetuating the act of violence in future relationships. When violence is enacted toward adolescents, healthy development of intimacy, identity and sexuality is hindered (Foshee & Reyes, 2009).
Draucker, Martsolf, and Stephenson (2012) studied the history of dating violence among the adolescent population and found that the risk factors correlating with later dating violence include parenting issues, such as inconsistent parental supervision, discipline and warmth. In addition to identifying factors that contribute to violence (e.g., exposure to violence at a young age, experiencing varying styles of parenting), Stephenson, Martsolf, and Draucker (2012) recognized the role of peers in exacerbating dating violence in young adulthood. Adelman and Kil (2007) purported that peers are directly and indirectly involved in adolescent dating violence, including assisting in the confrontation of a friend’s partner or helping a friend make his or her partner jealous. According to Banister and Jakubec (2004), females often feel isolated by their peers in adolescent dating violence, as many of their friends may not approve of the relationship. Thus, it is possible they may not disclose the nature of the violence within the relationship.
Technology and Conflict Resolution
Cyber aggression has been more thoroughly researched in child and adolescent populations than in young adult populations. Among children and adolescents, technology offers young people an additional medium for aggression, but does not appear to contribute directly to the development of cyber aggression among those who are not aggressive in non-cyber roles (Burton, Florell, & Wygant, 2013; Dempsey, Sulkowski, Dempsey, & Storch, 2011; Werner, Bumpus, & Rock, 2010). Werner et al. (2010) demonstrated that among sixth, seventh and eighth graders, higher rates of relational aggression approval predicted higher rates of Internet aggression. Peer attachment, however, is negatively correlated with both cyber aggression and non-cyber aggression (Burton et al., 2013). In addition to correlations between user beliefs and use of technology, Draucker and Martsolf (2010) found that many individuals who experienced dating violence as adolescents described technology as a medium for violence. Among 56 emerging adults who were interviewed about their adolescent dating violence experiences, participants reported technology use for arguing (6), perpetrating verbal or emotional aggression (30), monitoring or controlling (30), and limiting a partner’s access to self (e.g., avoiding partner; 29). It is unclear whether these same patterns hold true for young adults’ dating experiences, as the members of this sample were asked to reflect on their experiences as adolescents.
In addition to studies focused on children and adolescents, research demonstrates a link between individual beliefs about aggression and the use of technology in a way that is consistent with those beliefs among emerging adults. Thompson and Morrison (2013) studied the relationships between several individual-, social- and community-level predictors of technology-based sexually coercive behavior (TBC) among college students. Thompson and Morrison’s (2013) findings suggest that rape-supportive beliefs and peer approval of forced sex were significant predictors of TBC. However, women who are more assertive in the relationship appear to mitigate cyber aggression (Schnurr, Mahatmya, & Basche, 2013).
Technology use has been identified as a key component in conflict resolution strategies and romantic relationship mediation among young adults as well. Weisskirch and Delevi (2013) found that college students who had positive feelings about conflict resolution were more likely to use technology, specifically text messaging, to terminate relationships. Text messaging was the most commonly cited use of technology for the purpose of initiating or receiving a relationship-ending message. In a study of 1,039 adults aged 17 and older, Coyne, Stockdale, Busby, Iverson, and Grant (2011) found that younger participants were more likely to use technology in communicating with their romantic partner, and that technology was used to communicate in a variety of ways within the romantic relationship, including the expression of affection (75%), discussion of serious issues (25%), apologizing (12%) and hurting their partner (3%). Given the extent to which young adults use technology as a medium for relationship communication, and the prevalence of dating violence, more research is needed to understand how technology use may be correlated with risks of partner violence.
Research Questions
Despite researchers’ attempts to understand IPV among college-aged students, as well as to identify primary prevention interventions, IPV typologies have not been determined among the college student population. Further, the emergence of social media has provided a new mechanism for IPV implementation. Schnurr et al. (2013) found that cyber aggression mitigates physical IPV for men. However, few studies have examined the prevalence of cyber aggression in college students or considered the role of cyber aggression within the IPV typology framework. Thus, the current study aims to explore college students’ perceptions of how technology is used in their relationships, as well as the influence of technology, stress and attitudes toward violence on overall risk for IPV. As such, we examined the following research questions: (a) What relationship exists between young adults’ perceptions of partners’ technology use in relationships, risk for partner violence, acceptance of couple violence and perceived stress?; (b) Can perceptions of partners’ technology use, acceptance of couple violence or perceived stress be considered predictors of risk for partner violence? If so, which exerts the most influence on risk for partner violence?; and (c) What differences exist between individual responses (i.e., yes/no) regarding perceptions of partners’ use of technology in relationships and outcomes (i.e., risk for violence, perceived stress, acceptance of violence)?
Method
Participants
Data collection occurred at a large university in the Southeast region of the United States. We invited undergraduate and graduate students aged 18–25 who were currently in a relationship or had recently been in a relationship to participate. We utilized a convenience sampling approach and recruited participants through both active and passive methods (Yancey, Ortega, & Kumanyika, 2006). Active methods included acquiring instructor permission and speaking briefly to students during class about the study. Passive methods comprised posting study flyers around campus, as well as contacting various departments and programs requesting that they send study information to students on their e-mail listserv. All eligible students were invited to complete the assessment packet online using Survey Monkey. Students began the survey by reading the study information form, which included a warning about the sensitive nature of the questions. At the conclusion of the survey, we provided all participants with a list of domestic violence resources.
Recruitment efforts resulted in 155 students attempting to complete the survey. However, we removed 17 participants, 11 of whom indicated an age of 26 or older (making them ineligible) and six of whom did not complete any of the survey questions. We did not offer any incentives for survey completion as participation was voluntary, but it is possible that instructors provided incentives of their own accord. Instructor-initiated incentives could explain the six participants who did not answer any questions. Therefore, the total sample for the study was 138 participants.
Eighty-six participants (62%) indicated currently being in a relationship, with relationships lasting an average of 30 months. Others were recently in a relationship (n = 49; three participants did not indicate relationship status), reporting an average of 20 months since their last relationship. Women (n = 119; 87%) comprised the majority of the sample. The sample included mostly heterosexual participants (n = 127), with some same-sex participants (n = 10; one person did not report). Participants ranged in grade level; most were graduate students (n = 48; 35%), followed by seniors (n = 42; 30%), juniors (n = 28; 20%), sophomores (n = 17; 12%) and freshmen (n = 3; 2%). See Table 1 for additional demographic information and descriptive statistics for constructs of interest.
Table 1
Descriptive Statistics for Study Constructs
Constructs |
M
|
SD
|
Range
|
Age |
21.45
|
1.53
|
18–25
|
Credit hours |
14.67
|
3.04
|
3–23
|
Perceived stress (PSS) |
6.31
|
2.77
|
1–13
|
Intimate justice (IJS) |
26.97
|
10.96
|
15–64
|
Acceptance of violence (ACV) |
5.61
|
1.22
|
5–12
|
Use of technology (UTR) |
8.96
|
1.15
|
5–10
|
Note. M = mean; SD = standard deviation; PSS = Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983; Cohen & Williamson, 1988); IJS = Intimate Justice Scale (Jory, 2004); ACV = Acceptance of Couple Violence (Foshee, Fothergill, & Stuart, 1992); UTR = Use of Technology in Relationships (Draucker & Martsolf, 2010; Schnurr et al., 2013). |
Instruments
Demographic information. The demographic information form consisted of 13 questions and asked participants about basic information such as age, gender, grade, current relationship status, length of relationship (if current) and length of previous relationship (as well as length of time since previous relationship). Participants completed the demographic information form prior to completing the other study assessments.
Perceived Stress Scale. The Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983; Cohen & Williamson, 1988) is a 10-item measure assessing the perception of stress. We incorporated the PSS to examine the relationship of respondents’ perceived stress to relationship violence (or risk of violent behaviors). Respondents indicate on a five-point Likert scale (0 = Never, 1 = Almost Never, 2 = Sometimes, 3 = Fairly Often and 4 = Very Often) the extent to which situations in life are deemed stressful. The PSS asks general questions, such as “In the last month, how often have you been upset because of something that happened unexpectedly?” The PSS is scored by summing the item responses. The factor structure of the PSS has been supported in a sample of community participants as well as college students (Cohen et al., 1983; Roberti, Harrington, & Storch, 2006). There are several versions of the PSS (each consisting of 14, 10 or four items). The short four-item scale comprises items 2, 4, 5 and 10 of the PSS and has shown support in use with data collected during telephone interviews. We utilized the short form in the current study to reduce the overall number of questions asked of each participant. Cohen et al. (1983) reported an alpha coefficient in their study of .84 for the PSS with 14 items. They examined the test-retest reliability utilizing 65 college students and identified an alpha of .85. The PSS 10-item instrument has demonstrated sound reliability in a sample of college students as well (Dehle, Larsen, & Landers, 2001). Cronbach’s alpha was low (.58) for participants in the current study. However, the PSS short form demonstrated better reliability (.72) in the study conducted by Cohen et al. (1983).
Acceptance of Couple Violence. We incorporated the Acceptance of Couple Violence (ACV; Foshee, Fothergill, & Stuart, 1992) questionnaire to assess for attitudes toward violence in couple relationships. Participants received an adapted version of the ACV to include same-sex relationships. The adapted ACV contains 17 items and comprises five subscales (acceptance of male-on-female violence, acceptance of female-on-male violence, acceptance of male-on-male violence, acceptance of female-on-female violence and acceptance of general dating violence). Scores are summed across responses to calculate a total score within each subscale. We used only acceptance of general dating violence for the current analyses. Cronbach’s alpha reliability for participant scores in the current study was .67.
Use of Technology in Relationships. We used questions adapted by Schnurr et al. (2013) from Draucker and Martsolf (2010) to examine how participants perceived their partners’ use of technology in their relationships (UTR). As such, participants were asked whether their partners used technology in the following ways: (a) to embarrass them, (b) to make them feel bad, (c) to control them, (d) to monitor them and (e) to argue with them. Participants responded by indicating either “yes” (1) or “no” (0) and the responses were summed to acquire a total score. Reliability was low (α = .54) in the current study. However, Schnurr et al. (2013) reported internal consistencies of .76 for men and .71 for women in their sample of dating, emerging adult couples.
Intimate Justice Scale. The Intimate Justice Scale (IJS; Jory, 2004) is a 15-item instrument designed for use in clinical practice to screen for psychological abuse and physical violence. The purpose of the instrument is to aid clinicians in identifying violations of intimate justices (e.g., equity, fairness) that are believed to contribute to relationship violence so that appropriate treatment decisions can be rendered. Participants respond to items on a Likert scale of 1–5, with 1 indicating “I do not agree at all” and 5 indicating “I strongly agree.” Scores are summed across responses, with a minimum possible score of 15 and a maximum possible score of 75. Higher scores indicate violations of intimate justice and a likelihood of relationship abuse. Jory (2004) provided the following guidelines when interpreting total IJS scores: “Scores 15 to 29 may suggest little risk of violence, scores between 30 and 45 may indicate a likelihood of minor violence, and scores > 45 may be a predictor of severe violence” (p. 39). To our knowledge, no assessment currently exists to classify specific IPV typologies. Other popular assessments of IPV exist, such as the Revised Conflict Tactics Scale (CTS; Straus, Hamby, Boney-McCoy, & Sugarman, 1996), but the CTS results do not classify types of IPV behavior with considerations for the victim or the victimizer. The IJS has potential to distinguish between degrees of violence severity, and has been used in studies to differentiate between lower levels and higher levels of violence aggression (e.g., Friend, Bradley, Thatcher, & Gottman, 2011). Scores in the current study ranged from 15–64 (M = 27.02). Alpha reliabilities for participants in the current study were .92.
Results
Preliminary Analysis
Prior to data analyses, we conducted preliminary analyses to test for assumptions, outliers and missing data. The ACV, IJS, and UTR did not meet the assumption of normality, with K-S p values falling below .001. The ACV and IJS resulted in a positive skew, while the UTR resulted in a negative skew. The distributions indicated that most respondents did not report favorable attitudes toward violence, the overall existence of relationship inequality (risk for IPV) or perceptions of partners using technology in an unhealthy manner. This finding is consistent with the mean IJS score (27.02), indicating minimal risk of violence in the sample. Thus, we did not implement any transformation procedures. Potential outliers existed for the ACV and IJS scores. However, examination of the 5% trimmed mean indicated minimal influence on the mean score. Furthermore, these scores represented participants reporting different attitudes and experiences with IPV.
Sixteen participants had missing data points. We created a dummy variable to compare some demographics for those who had complete data versus those who did not. No differences existed between those with and without missing data on age and credit hours taken during the semester of survey administration. We determined that the data were likely missing at random, although it is possible data were missing due to some variable not measured. We used hot deck imputation to address the missing variables (Andridge & Little, 2010; Myers, 2011). Hot deck imputation calculates an average score on an identified outcome variable by matching the score to like variables in the sample (i.e., donor variables). We used participants’ gender, grade level and current relationship status as the donor variables. SPSS averaged the score for matching participants and imputed. Matches existed for 13 of the 16 missing scores. Hot deck imputation provides less bias than mean imputation, and is deemed a better overall solution than the oft-used listwise deletion (Andridge & Little, 2010; Myers, 2011).
Primary Analysis
To begin testing the research questions, we conducted Pearson correlations to examine the relationships between demographics and other constructs of interest (i.e., PSS, IJS, ACV and UTR). Pearson correlation indicated (a) a significant positive correlation between gender and IJS scores, (b) a significant negative correlation between gender and UTR scores, (c) a significant positive correlation between PSS scores and IJS scores, (d) a significant positive correlation between the ACV and IJS scores and (e) a significant negative correlation between UTR scores and IJS scores (See Table 2 for correlations). A scatterplot matrix indicated that (a) increases in stress correlate to increases in intimate justice scores, (b) more favorable attitudes toward couple violence correlate to increases in intimate justice scores; and (c) lower perceived use of technology (i.e., more responses of “no”) correlates with higher intimate justice scores.
Table 2
Correlations Between Constructs of Interest
|
1 |
2 |
3 |
4 |
5 |
1. Gender |
1 |
.02 |
.22* |
.13 |
-.17* |
2. Perceived stress (PSS) |
|
1 |
.19* |
.05 |
-.04 |
3. Intimate justice (IJS) |
|
|
1 |
.26** |
-.05** |
4. Acceptance of violence (ACV) |
|
|
|
1 |
-.05 |
5. Use of technology (UTR) |
|
|
|
|
1 |
Note. PSS = Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983; Cohen & Williamson, 1988); IJS = Intimate Justice Scale (Jory, 2004); ACV = Acceptance of Couple Violence (Foshee, Fothergill, & Stuart, 1992); UTR = Use of Technology in Relationships (Draucker & Martsolf, 2010; Schnurr et al., 2013). |
* p < .05. ** p < .001.
The significant correlations supported a hierarchical linear regression analysis to examine the predictive relationships between variables. The IJS served as the dependent variable, while PSS, ACV and UTR scores served as independent variables. The model included three steps, adding predictor variables one step at a time to examine the contribution of each variable. Model one included ACV scores, contributing 6.8% of the variance and demonstrating statistical significance; F(1, 133) = 9.70, p = .002. Model two included UTR scores, adding 18.9% of the variance and achieving significance; F(1, 132) = 33.65, p < .001. Finally, model three added PSS, contributing 2.5% of variance and also achieving significance; F(1, 131) = 4.54, p = .035 (See Table 3). The model as a whole contributed to 26.6% of the variance, although UTR contributed the most variance to IJS scores.
Table 3
Predictors of Partner Violence Risk (Intimate Justice)
Variable |
Δ R2
|
β
|
p
|
Model 1: ACV |
.068
|
.261
|
.002
|
Model 2: UTR |
.189
|
-.435
|
< .001
|
Model 3: PSS |
.025
|
.158
|
.035
|
Note. ACV = Acceptance of Couple Violence (Foshee, Fothergill, & Stuart, 1992); UTR = Use of Technology in Relationships (Draucker & Martsolf, 2010; Schnurr et al., 2013); PSS = Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983; Cohen & Williamson, 1988). |
Next, we examined differences between individuals’ responses (i.e., yes/no) regarding perceptions of their partners’ use of technology in the relationships (UTR) and outcome variables (i.e., IJS, ACV and PSS scores). Table 4 presents the frequency of responses for each of the five items on the UTR. A MANOVA indicated that the only significant differences between responses on all five UTR questions and outcomes existed for question four (“Has your partner ever used technology to monitor you?”), F(1, 112) = 4.08, p = .04, = .04, and question five (“Has your partner ever used technology to argue with you?”), F(1, 112) = 5.12, p = .03, = .04. Simple effects revealed that respondents who indicated “yes” to UTR question four had significantly higher IJS scores (M = 33.38, SD = 11.09) than those who indicated “no” (M = 24.71, SD = 9.81); F(1, 129) = 19.81, p < .001, = .13. Participants who indicated “yes” to UTR question five had significantly higher IJS scores (M = 30.79, SD = 11.13) than those who indicated “no” (M = 24.14, SD = 9.78); F(1, 129) = 13.24, p < .001, = .09. Therefore, use of technology to argue with a partner and monitor a partner’s location appear associated with increases in relationship inequality, and place the young couples in our sample at a higher risk of experiencing partner violence.
Table 4
Frequency of Responses to Questions Regarding Use of Technology
Question (Has partner used technology to . . .) |
% “Yes”
|
% “No”
|
1. Embarrass you? |
6.5
|
89.1
|
2. Make you feel bad? |
15.2
|
15.9
|
3. Control you? |
5.1
|
94.7
|
4. Monitor you? |
28.3
|
67.4
|
5. Argue with you? |
44.9
|
50.7
|
Discussion
The purpose of this study was to understand the influence of young adults’ use of technology in intimate relationships and examine relationships among stress, attitudes toward violence and overall risk for IPV. First, we examined the relationships among the variables, then we used a regression analysis to understand the contribution of each variable to risk for partner violence. Finally, we explored differences between responses regarding partners’ perceptions of technology use and other outcomes.
Results indicate positive correlations between participants’ stress scores and intimate justice scores, suggesting that as stress increases, so too does risk for partner violence. This finding is similar to the conclusions of Mason and Smithey (2012), who utilized Merton’s Classical Strain Theory as the foundation for testing the influence of life strain on IPV among college students. Their results indicated that some forms of strain increased dating violence among college students. However, the results of our study do not suggest the existence of any relationship between technology use and stress. A potential explanation is that increases in IPV-related behaviors associated with increases in stress may present during face-to-face interactions.
We also found that participants who reported perceptions that partners used technology (e.g., to monitor, argue, embarrass, control, make them feel bad) less frequently were associated with increased intimate justice scores, or risk for partner violence. Although initially suprising, this result appears somewhat consistent with the findings of Coyne et al. (2011) indicating that younger participants are more likely to use technology to communicate in a variety of ways. In fact, it could be that communication via technology is an expectation in young adult relationships, and when that expectation is not met, tension arises. However, further research is needed to explore this conclusion.
Perceived stress (PSS: 2.4% of variance), acceptance of violence (ACV: 6.8% of variance) and use of technology (UTR: 18.9% of variance) were all significant predictors of risk for partner violence (IJS), with UTR contributing the most variance in IJS. This finding is consistent with the correlation and appears to support the notion that a lack of communication via technology may contribute to problems in young adult relationships. In fact, 45% of our sample indicated that their current or past partner used technology to argue with them. Again, this finding could support the notion that conflict resolution via technology is normal or expected in young adult relationships. However, results indicate that participants who perceived their partners as using technology as a means of arguing and monitoring them had higher risk for partner violence (i.e., IJS). The IPV typology literature has identified various characteristics associated with types of violence in couple relationships. A more controlling type, such as Johnson’s (1995) intimate terrorist, may exhibit nonviolent control tactics such as monitoring his or her partner’s location. Thus, it is possible that this behavior is more indicative of controlling IPV typologies. However, more research is needed to understand the influence of using technology to monitor a partner on overall risk for IPV.
Implications for Practice
According to Bergdall et al. (2012), emerging adults frequently use technology to establish relationships with others. Conversely, technology use has been a common medium for sustaining and terminating romantic or intimate relationships. Young adults between the ages of 18 and 29 typically use social media, cell phones and the Internet to communicate (Coyne et al., 2011). Although Bergdall et al. (2012) confirmed that young adults rely heavily on technology to form and dissolve relationships, the authors did not factor in the effect technology may have on psychosocial development, sexual behavior or dating violence.
The findings from our study, as well as from others, indicate that technology is frequently used in young adult relationships. Therefore, when screening for IPV, counselors should consider questions related to how partners use technology in their relationship (e.g., for communicating, announcing the relationship, resolving conflict). Daire et al. (2014) described an IPV protocol for community agencies and practitioners that includes screening clients. Such a protocol also should include technology and consider its overall influence on the functioning of the couple.
Continued research in this area may reveal the ways in which young adults communicate with each other via technology. Individuals who have grown up amidst advances in technology have adapted to a lifestyle in which the ability to communicate with friends and gain entry into one’s personal life is readily available. Due to this factor, the ability to communicate with, gain access to or monitor a partner has increased. Draucker and Martsolf (2010) indicated that technology has changed the course of relationship quality and communication because boundaries have shifted. Counselors can incorporate healthy technology communication into their treatment plans. Bergdall et al. (2012) reported that technology does close the social gap between all people, but if utilized in efforts to educate young adults about healthy and safe ways to communicate with each other, it may have a positive effect on intimate relationships and the potential to reduce violence.
Limitations
This study’s findings should be considered with caution because there are limitations to consider. We did not incorporate a random sampling method, as there were no large student lists or databases for generating random samples. We were unable to calculate a response rate due to the nature of our convenience sampling approach. Thus, the study results might not be representative of the young adult population at all colleges and universities. Additionally, the majority of the sample was comprised of white, heterosexual females.
Another limitation is that two of the assessments we used revealed low Cronbach’s alpha scores (PSS and UTR), while the ACV had a Cronbach’s alpha just below the accepted cutoff. Cronbach’s alpha is not a measure of the overall assessment’s internal consistency as much as it is a measure of the sample’s consistent responses to items (Helms, Henze, Sass, & Mifsud, 2006; Lance, Butts, & Michels, 2006). Thus, the low Cronbach’s alpha suggests diversity in responses to items among the study sample. However, the low Cronbach’s alpha scores may indicate higher measurement error, and results should be considered with caution.
This study also is limited because it incorporated self-report measures, with some participants reflecting on past relationships. Self-report, especially when thinking about a relationship that did not work out, may not provide accurate information. Additionally, we did not collect data from both members of a couple. Finally, there were missing data because participants skipped items, marked two items instead of one or skipped enough items that their results were not interpretable. We used a data imputation method with reduced bias, but there is no certainty in the accuracy of the imputed responses.
Conclusion
Recent research has contributed to the formation of IPV typologies and has challenged traditional models, yet much remains unknown about partner violence among young adults. The use of technology in relationship communication and conflict resolution is an expanding area of research due to technology’s increased use in daily living. Given the need for more information about both IPV and the use of technology in relationship communication, this study looked at technology use as a risk factor for IPV among young adults. Our study both confirmed prior results and contributed new results. Results suggest that emerging adults may expect technology to be an important means of relationship communication. Those counseling college-aged couples should consider discussing healthy avenues for incorporating technology. Furthermore, technology use should be considered when counselors screen couples for risk factors associated with IPV. However, more research is warranted regarding the use of technology in young adult relationships.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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Ryan G. Carlson, NCC, is an Assistant Professor at the University of South Carolina. Jessica Fripp is a doctoral candidate at the University of South Carolina. Christopher Cook is a doctoral candidate at the University of South Carolina. Viki Kelchner, NCC, is a doctoral candidate at the University of South Carolina. Correspondence may be addressed to Ryan G. Carlson, University of South Carolina, College of Education, Wardlaw 258, Columbia, SC 29208, rcarlson@sc.edu.
Jun 26, 2015 | Author Videos, Volume 5 - Issue 3
Tyler Wilkinson, Rob Reinhardt
The use of technology in counseling is expanding. Ethical use of technology in counseling practice is now a stand-alone section in the 2014 American Counseling Association Code of Ethics. The Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act provide a framework for best practices that counselor educators can utilize when incorporating the use of technology into counselor education programs. This article discusses recommended guidelines, standards, and regulations of HIPAA and HITECH that can provide a framework through which counselor educators can work to design policies and procedures to guide the ethical use of technology in programs that prepare and train future counselors.
Keywords: counselor education, technology, best practice, HIPAA, HITECH
The enactment of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) brought forth a variety of standards addressing the privacy, security and transaction of individual protected health information (PHI; Wheeler & Bertram, 2012). According to the language of HIPAA (2013, §160.103), PHI is defined as “individually identifiable health information” (p. 983) that is transmitted by or maintained in electronic media or any other medium, with the exception of educational or employment records. “Individually identifiable health information” is specified as follows:
Information, including demographic data, that relates to:
- the individual’s past, present or future physical or mental health or condition,
- the provision of health care to the individual, or
- the past, present, or future payment for the provision of health care to the individual, and that identifies the individual for which there is a reasonable basis to believe can be used to identify the individual. Individually identifiable health information includes many common identifiers. (U.S. Department of Health and Human Services [HHS], n.d.-b, p. 4)
The HIPAA standards identify 18 different elements that are considered to be part of one’s PHI. These include basic demographic data such as names, street addresses, elements of dates (e.g., birth dates, admission dates, discharge dates) and phone numbers. It also includes information such as vehicle identifiers, Internet protocol address numbers, biometric identifiers and photographic images (HIPAA, 2013, § 164.514, b.2.i).
According to language in HIPAA, the applicability of its standards, requirements and implementation only apply to “covered entities,” which are “(1) a health plan (2) a health care clearinghouse (3) a health care provider who transmits any health information in electronic form in connection with [HIPAA standards and policies]” (HIPAA, 2013, § 160.102). Covered entities have an array of required and suggested privacy and security measures that they must take into consideration in order to protect individuals’ PHI; failure to protect individuals’ information could result in serious fines. For example, one recent ruling found a university medical training clinic to be in violation of HIPAA statutes when network firewall protection had been disabled. The oversight resulted in a $400,000 penalty (Yu, 2013). Moreover, the recent implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 increased the fines resulting from failure to comply with HIPAA, including fines for individuals claiming they “did not know” that can range from $100–$50,000 (Modifications to the HIPAA Privacy, 2013, p. 5583). The final omnibus ruling of HIPAA–HITECH, enforcing these violations, went into effect on March 26, 2013 (Modifications to the HIPAA Privacy, 2013; Ostrowski, 2014). Enforcement of the changes from the HITECH Act on HIPAA standards began on September 23, 2013, for covered entities (Modifications to the HIPAA Privacy, 2013).
Academic departments and universities must understand the importance of HIPAA and HITECH regulations in order to determine whether the department or university is considered a covered entity. Risk analysis and management need to be employed to avoid violations leading to penalties and fines (HIPAA, 2013, §164.308). Some counselor education programs that have students at medically related practicum or internship sites also may be considered business associates (see HIPAA, 2013, § 160.103) and would need to comply with HIPAA regulations (see HIPAA, 2013, § 160.105). The authors recommend that all counselor education programs confer with appropriate legal sources to understand any risks or liabilities related to HIPAA regulations and relationships with practicum and internship sites. Many states also have their own unique privacy laws that must be considered in addition to those described in HIPAA regulations. The purpose of this article assumes that a counselor education department is not considered a covered entity by the regulations set forth by HIPAA. However, as an increasing number of counselor education programs incorporate the use of digital videos or digital audio recordings, a need for a set of policies and procedures to guide the appropriate use of digital media is evident.
The authors believe that the regulations set forth by HIPAA and HITECH create a series of guidelines that could dictate best practices for counselor educators when considering how to utilize technology in the collection, storage and transmission of any individual’s electronic PHI (Wheeler & Bertram, 2012) within counselor education programs. HIPAA regulations (2013, §160.103) describe electronic protected health information (ePHI) as any information classified as PHI, as described above, either “maintained by” or “transmitted in” (p. 983) electronic media. For example, audio recordings used in practicum and internship courses are often collected electronically by digital recorders. If the recordings remain on the device, this protected information is being maintained in an electronic format. If the data is shared through e-mail or uploaded to a computer, then it is being transmitted in electronic format. As it relates to counselor training, the PHI that is collected could be real or fictitious (i.e., from someone role playing in the program). Though fictitious information is not necessarily protected, encouraging students to engage in implementing a set of policies and procedures guided by regulations of HIPAA and HITECH creates an experiential milieu whereby students become aware of and learn the importance of security and privacy when handling digital ePHI. The authors will discuss throughout this article how specific regulations from HIPAA and HITECH can be utilized to create a set of policies and procedures that guide the ways in which members of counselor education programs can handle any ePHI they encounter during their training. These direct experiences will give faculty and students greater familiarity with current HIPAA and HITECH regulations, thus making them better prepared to work ethically and legally in modern mental health culture.
This article is not meant to cover HIPAA and HITECH regulations in a comprehensive manner. Overviews of these standards have been written concerning the regulations of HIPAA and HITECH regarding the work of mental health practitioners (see Letzring & Snow, 2011). The degree to which the myriad regulations of HIPAA will be implemented in various counselor education programs will need to be decided by the members of individual programs and by necessary stakeholders. The authors hope to introduce a dialogue regarding the thoughtful use of technology in counselor education programs guided by the parameters set forth by HIPAA.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2013), the trend in mental health care treatment spending is in the direction of public (i.e., Medicare and Medicaid) and private insurance growth as a means of payment. Spending for all mental health and substance abuse services totaled $172 billion in 2009; moreover, this spending accounted for 7.4% of all health care spending that year. Additionally, it is projected that spending on all mental health and substance abuse services could reach $238 billion by 2020 (SAMHSA, 2014). However, the rate at which individuals pay out-of-pocket for mental health and substance abuse services is expected to decrease steadily (SAMHSA, 2014). Historical trends show out-of-pocket spending decreased from 18% of all spending in 1986 to 11% in 2009 (SAMHSA, 2013, 2014). It is projected that out-of-pocket spending for mental health treatment will level off to account for approximately 10% of all spending while Medicaid, Medicare, and private insurance will account for approximately 70% of spending (SAMHSA, 2014). The trend toward greater insurance use will increase the number of professional counselors who will be seen as or will be working within organizations that are considered HIPAA-covered entities. Implementing policies and procedures in counseling departments that incorporate some of the HIPAA regulations is a useful way to prepare future professionals for the working environment they will enter (SAMHSA, 2013).
The implementation of the HITECH Act (2009) as a supplement to HIPAA emphasized the need to make sure future counselors understand the importance of the increasing role of technology in the practice of counseling (Lawley, 2012). The HITECH Act established an expectation that professionals in health care must be familiar with technology, specifically as it relates to policies guiding the storage and transmission of ePHI. The objectives of HITECH include “the electronic exchange and use of health information and the enterprise integration of such information” and “the utilization of an electronic health record for each person in the United States by 2014” (HITECH, 2009, §3001.c.A, emphasis added). Additionally, HITECH strengthened the enforcement of penalties for those who violate HIPAA (Modifications to the HIPAA Privacy, 2013). A multi-tiered system of violations allows for civil money penalties to range from $100–$50,000 per violation (Modifications to the HIPAA Privacy, 2013). The American Counseling Association’s (ACA) 2014 Code of Ethics acknowledged the increasing use of technology by professional counselors by introducing a new section (Section H) addressing the ethical responsibility of counselors to understand proper laws, statutes, and uses of technology and digital media. Ethical counselors are expected to understand the laws and statutes (H.1.b), the uniqueness of confidentiality (H.2.b), and the proper use of security (H.2.d) regarding the use of technology and digital media in their counseling practice.
The mental health care system exists inside the broader health care system. As such, graduates of counseling programs must be familiar with HIPAA regulations and the various modes of technology to implement these regulations (ACA, 2014; Lawley, 2012). Students will be expected to understand what security and privacy standards are required of them once they begin working as counseling professionals (ACA, 2014). For example, the movement toward increased use of ePHI across health care will place increasing demands on students to understand how to appropriately keep electronic data private and secure. Counselor educators need to be mindful of how the use of technology in the practice of counseling is being taught and implemented with counseling students. Counselor educators should thoughtfully consider how students will learn the ways in which technology can be used professionally while maintaining ethical and legal integrity (Association for Counselor Education and Supervision [ACES] Technology Interest Network, 2007; Wheeler & Bertram, 2012). Having standards to guide the use of ePHI throughout counselor education programs is a way in which students can become knowledgeable and skilled regarding the laws and ethics surrounding digital media. Policies and procedures should include information guiding the ways in which students collect, store and transmit digital media (e.g., audio recordings or videotapes) while a member of the counseling program. By requiring students to utilize the ePHI (real or fictitious) they collect in accordance with policies and procedures informed by HIPAA and HITECH, students crystallize their understanding of these complicated laws.
HIPAA Compliance and Technology
Complying with HIPAA Privacy and Security Rules requires individuals to be mindful of policies and procedures, known as “administrative safeguards” (HIPAA, 2013, §164.308, p. 1029), and work to implement safeguards consistently. The HHS has made clear that it does not provide any type of credential to certify that an individual, business, software or device is HIPAA compliant (HHS, n.d.-a; Reinhardt, 2013). Complying with HIPAA rules requires organizations and individuals to address many different processes where choice of hardware or software is only one aspect (Christiansen, 2000). Being HIPAA compliant is less about a certification or a credential on a device and more about having a set of policies and procedures in place that ensure the integrity, availability and confidentiality of clients’ ePHI (Christiansen, 2000; HHS, n.d.-b). Hardware and software technology companies who make claims that a product or an educational resource is HIPAA compliant are likely doing so for marketing purposes. Claims of this type are mostly meaningless (HHS, n.d.-a) and would not provide protection in the case of a breach (HITECH, 2009). Being HIPAA compliant is an “organizational obligation not a technical specification” (Christiansen, 2000, p. 7). The distinction is important for educators to understand as they seek to implement technology in counselor education programs. When establishing a set of policies and procedures within a counseling department, the recommendations set forth in describing the security and privacy of PHI in Part 164 of HIPAA (2013) can be an appropriate framework for establishing best practices for counselors and counselor educators. The general requirements in complying with HIPAA security standards are to ensure the confidentiality, integrity and availability of individuals’ ePHI while protecting against any reasonably anticipated threats to the security and privacy of said ePHI (HIPAA, 2013, §164.306.a). The key phrase to consider is that covered entities are asked to protect against any “reasonably anticipated” (HIPAA, 2013, §164.306.a, p.1028) threat. Educators must understand the importance of spending time considering reasonable, foreseeable risks. A primary responsibility is to create administrative safeguards that address any reasonable, foreseeable risks, which the individual, department or covered entity establishes.
Before looking at key aspects of HIPAA Privacy and Security guidelines, key definitions should be understood:
- Administrative safeguards include policies and procedures used to manage the development, selection, implementation and security in protecting individuals’ ePHI (HIPAA, 2013, § 164.304).
- Authentication includes “the corroboration that a person is the one claimed” (HIPAA, 2013, § 164.304, p. 1027).
- Confidentiality defines “the property that data or information is not made available or disclosed to unauthorized persons or processes” (HIPAA, 2013, § 164.304, p. 1027).
- Encryption is “the use of an algorithmic process to transform data into a form in which there is a low probability of assigning meaning without the use of a confidential process or key” (HIPAA, 2013, § 164.304, p. 1027).
- Security incident is described as “the attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operation in an information system” (HIPAA, 2013, § 164.304, p. 1027).
HIPAA (2013) standards are categorized as either required or addressable as indicated in Section 164.306.d.1. The rest of this document will highlight the standards that the authors believe shape a set of best practices for counselor educators when implementing technology into their counselor education programs. The degree to which a counseling program decides to implement those standards that are considered required or addressable will be determined by their status as a covered entity, state laws, needs of their counseling program and the financial feasibility of implementing these standards.
Safeguards
HIPAA requires that all covered entities maintain policies and procedures that (1) ensure confidentiality and availability of all electronic PHI, (2) protect against any reasonably (emphasis added) anticipated threats or hazards to the security or integrity of ePHI, (3) protect against any reasonably anticipated uses or disclosures of ePHI, and (4) ensure compliance by the workforce. The following sections will discuss ways in which HIPAA Privacy and Security rules can be utilized as best practices in counselor education programs so that foreseeable risks, threats and vulnerabilities may be minimized. Please note that this interpretation of safeguards is intended for the consideration of counselor education programs that are not covered entities, but may use HIPAA Privacy and Security rules to establish a set of policies and procedures as a means of best practice. (For a sample guide for counselor educators to use in developing policies and procedures, please contact the first author).
Administrative Safeguards
Administrative actions and oversight make up an important component of the language within HIPAA (2013). Administrative safeguards consist of the policies and procedures designed to “manage the selection, development, [and] implementation” (§ 164.304, p. 1027) of the security and privacy of one’s ePHI. This section describes HIPAA standards to consider when establishing administrative safeguards.
Assigned responsibility. A faculty or staff member within the counselor education program should be identified as responsible for the development, oversight and implementation of the policies and procedures for the department. The faculty member needs to be familiar with the privacy and security policies of HIPAA in order to implement the policies and procedures and to facilitate student training in ways that address the specific needs of the program. Developing a relationship with a staff member in the university information technology department may result in collaborative efforts regarding specific procedures for the use of technology within the university.
Risk analysis. Before counselor educators can design a set of policies and procedures to guide appropriate technology use, the foreseeable risks must be analyzed. An accurate and thorough assessment is needed to identify potential risks to the protection and security of ePHI (HIPAA, 2013, §164.308) that is collected, stored and transmitted in the counseling program. Analyzing potential risk is essential to the minimization of potential disasters in the future (Dooling, 2013). HHS (2007) makes clear that it is important to spend time considering reasonably anticipated threats and vulnerabilities and then to implement policies and procedures to address the assessed risks. HIPAA security standards do not state that covered entities should protect against all possibly conceived threats, but those that can be “reasonably anticipated” based upon the technologies employed, work environments and employees of the covered entity. The National Institute of Standards and Technology (NIST; 2012) defines a threat “as any circumstance or event . . . with the potential to adversely impact organization operations . . . through an information system via unauthorized access, destruction, disclosure, or modification of information” (p. B-13). A risk is a measure of the probability of a threat triggering a vulnerability in the procedures that an organization uses to ensure the privacy and security of ePHI (NIST, 2012). Vulnerabilities are technical and non-technical weaknesses, which include limitations in utilized technology or ineffective policies within the organization (HHS, 2007). In counselor education programs, risk analysis may include looking at the threats and vulnerabilities associated with counseling students traveling between their residence, campus, and practicum or internship sites while carrying ePHI. Moreover, the analysis must include assessing the potential risks associated with the transmission and storage of protected information using technological media (e.g., e-mail, personal computers, cloud-based storage, external storage devices).
Risk management. Risk management is the ongoing process of implementing measures to reduce the threats that were determined as a part of the risk analysis (HHS, 2007). Once a counseling program has assessed and identified potential risks associated with the collection, transmission and storage of any identifiable information, it must begin to manage these risks. HHS has provided an example list of steps to assist organizations in conducting risk analysis and risk management (see Table 1). Members of counselor education programs can begin to incorporate programmatic policies and procedures that address how media containing ePHI should be handled by members of the program. The previously mentioned document (available from the first author) provides sample policies and procedures developed to serve as a guide for counseling programs. Many counselor education programs utilize student handbooks that detail policies related to the academic and professional expectations of students enrolled in their program. Incorporating an additional set of policies to address the treatment of ePHI is a seamless way to begin managing the risks of technology use in mental health. By implementing policies and procedures across the curriculum, students become increasingly knowledgeable and skilled at handling ePHI in an ethical manner.
Table 1
Example Risk Analysis and Risk Management Steps
Risk Analysis
|
1. |
Identify the scope of the analysis. |
2. |
Gather data. |
3. |
Identify and document potential threats and vulnerabilities. |
4. |
Assess current security measures. |
5. |
Determine likelihood of threat occurring. |
6. |
Determine potential impact of threat occurrence. |
7. |
Determine level of risk. |
8. |
Identify security measures and finalize documentation. |
Risk Management
|
1. |
Develop and implement a risk management plan. |
2. |
Implement security measures. |
3. |
Evaluate and maintain security measures. |
Note. Adapted from “Basics of Risk Analysis and Risk Assessment,” by the U.S.
Department of Health and Human Services, 2007, HIPAA Security Series, 2(6), p. 5.
Sanction policy. It must be communicated to all members of counselor education programs that failure to comply with the policies will result in sanctions. HIPAA (§164.308, 2013) requires organizations to enforce sanctions against individual members for failing to comply with their organization’s policies and procedures. A counselor education program should have clearly documented policies and procedures for students and staff involved with the facilitation of ePHI. The language of HIPAA makes no attempt to clarify as to what these sanctions should entail; however, language needs to exist that addresses individuals’ failure to comply. For counseling students, a potential option is to consider a tiered sanction policy similar to that of the structure established by the HITECH Act (Modifications to the HIPAA Privacy, 2013) and § 1176 of the Social Security Act (2013). Varying categories of violations from “did not know” (p. 5583) to uncorrected–willful neglect result in increasingly severe fines (Modifications to the HIPAA Privacy, 2013). Since this experience is most likely educational for students, varying degrees of failure to comply could exist. For counselor education programs, this language also could easily be tied to student remediation processes that many counseling programs utilize.
Information review. Ongoing review of the activity of students, faculty and staff that involves the creation, storage and transmission of ePHI is a required safeguard according to HIPAA standards (2013, §164.308). As an educational unit, it is understandable that individuals might make mistakes regarding the implementation of HIPAA safeguards. A regular review of the activity and records of the individuals whose ePHI are being collected is important. It is required for organizations to have policies in place for recording system activity, including access logs and incident reports (§ 164.308). Additionally, protections must be in place to ensure that only those individuals who should have access to any ePHI are able to access this protected information. In the case of the sanctioned university medical training clinic cited earlier, the breaches might have been avoided with an ongoing review of the system’s firewall settings (Yu, 2013). Monitoring and developing policies regarding information review may require developing relationships and discussions with the appropriate information technology personnel at the organization.
Response, recovery and reporting plan. HIPAA regulations require that a covered entity have a plan in place should ePHI be breached or disclosed to an unauthorized party (HIPAA, 2013, § 164.308). When developing departmental policies and procedures, it is important to have such a plan in place. Whether the breach or disclosure is intentional or unintentional, each individual whose information has potentially been compromised needs to be notified. Moreover, in cases where more than 500 individuals’ PHI have been breached, the entity may need to report this information to local media or to HHS (HIPAA, 2013, §164.406–164.408). It should be noted that covered entities could be exempted from breach notification through employing security techniques such as encryption (Breach Notification, 2009; HIPAA, 2013, §164.314). The regulations of HIPAA require that a plan be in place to address emergencies (HIPAA, 2013, §164.308). In the case of theft, emergency or disaster, counseling departments need a data backup and recovery plan in place to retrieve ePHI.
Physical Safeguards
Establishing policies and procedures that protect against unauthorized physical access and damage from natural or environmental hazards is critical to maintaining the security and privacy of PHI (HIPAA, 2013, §164.310).
Access control. When using technology to store and transmit ePHI, the recommendation is that policies address ways in which physical access to protected information will be limited. For example, many counseling departments now incorporate the use of digitally recorded data from counseling sessions (e.g., audio or video). Policies need to clearly address how to best limit physical access to these recordings. Students need to understand what it means to keep data physically secure. The HITECH Act (Modifications to the HIPAA Privacy, 2013) includes the category “did not know” as a punishable violation. Students need to understand the consequences of failing to implement such physical safeguards. For example, keeping devices stored under lock and key when not in use is just one important step in moving toward a set of best practices. Many universities already require students to utilize login information with a username and passcode in order to access computers affiliated with their respective university. Consideration may need to be given regarding policies and procedures for accessing ePHI off campus, where the technical security may be less controlled.
Disposal and re-use. HIPAA requires covered entities to implement policies that address the disposal and re-use of ePHI on electronic media. A detailed discussion of the various types of disposal, also known as media sanitization, and re-use is beyond the scope of this article (see Kissel, Regenscheid, Scholl, & Stine, 2014). Counselor education programs must recognize the importance of properly removing protected information from media devices after it is no longer required. Media sanitization is a critical element in assuring confidentiality of information (Kissel et al., 2014). For example, in counseling internship courses, students may be asked to delete recorded sessions during the last day of classes so that the instructor can have evidence of the appropriate disposal of this information. NIST identifies four different types of media sanitization: disposal, clearing, purging and destroying (Kissel et al., 2014). The decision as to which type of media sanitization is appropriate requires a cost/benefit analysis, as well as an understanding of the available means to conduct each type of sanitization. (The authors recommend counseling departments consult with an individual from the university information technology department).
Technical Safeguards
The language in HIPAA is clear regarding the implementation of technical safeguards, requiring that access to electronic media devices containing PHI be granted only to those who need such access to perform their duties.
Unique user identification. If a device allows for unique user identification, one should be assigned to minimize the unintended access of ePHI. HIPAA standards (2013, §164.514) state that an assigned code should not be “derived from or related to information about the individual” (p. 1064).
Emergency access. Covered entities are required to have procedures in place that allow ePHI to be accessed in the event of an emergency (HIPAA, 2013, §164.310). The procedures can be addressed within counselor education programs so as to ensure that the student and the supervisor have access to the ePHI at the designated storage location.
Encryption. Encryption is a digital means of increasing the security of electronic data. Using an algorithmic process, the data is scrambled so that the probability of interpretation is minimal without the use of a confidential key to decode the information. Though the language of HIPAA categorizes encryption as addressable rather than required, the implementation of encryption policies is a best practice to help ensure the protection of ePHI. The language of HIPAA makes it clear that an “addressable” item must be implemented if it is “reasonable and appropriate” (HIPAA, 2013, §164.306, p. 1028) to do so. Huggins (2013) has recommended that ePHI be stored on drives that allow for “full disk encryption” at a minimum strength of 128 bits. With the availability of many different types of software packages that can encrypt at a recommended strength, implementing encryption standards in a counseling department is affordable and reasonable. Most modern computer operating systems have options to encrypt various drives built into the functionality of the system. Full disk encryption is recommended because of its higher level of security and also because it can provide exemption from the Breach Notification Rule mentioned earlier (Breach Notification, 2009). In case of a breach, the burden is on the covered entity to prove that the ePHI was not accessed; otherwise, Breach Notification Rules must be followed. The assumption is that if a disk is fully encrypted, even if accessed by an unauthorized person, it is highly unlikely that an unauthorized party will obtain access to the ePHI (Breach Notification, 2009). The authors strongly encourage the use of encrypted devices as a standard policy for the collection and storage of ePHI (see Scarfone, Souppaya, & Sexton, 2007). The policy creates greater protection against the accidental disclosure of an individual’s ePHI. Additionally, organizations that use commercial cloud storage service providers should investigate whether these providers are willing to sign a Business Associate Agreement, in which the provider agrees to adhere to regulations of HIPAA (2013, §160.103). If not, the storage of ePHI may not be in alignment with HIPAA standards.
Disk encryption works well for the storage and collection of protected information while at rest (Scarfone et al., 2007); however, counselor education programs also should consider assessing the risk associated with the transmission of ePHI (HIPAA, 2013, §164.312). Protected information often remains encrypted while at rest, yet becomes unencrypted while in transmission. Programs need to “guard against unauthorized access to electronic PHI that is being transmitted over an electronic communication network” (HIPAA, 2013, §164.312, p. 1032). Commonly used e-mail systems, for example, often do not transmit information in an encrypted state. Assessment of the risks in sending protected information by an unsecured means should be conducted.
Discussion
The language of HIPAA allows each covered entity some leeway in how it wants to implement policies. However, HIPAA standards (2013, §164.316) are very clear that entities should “implement reasonable and appropriate policies”(p. 1033) that include administrative, physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of electronic PHI that it creates, receives, maintains or transmits. The implementation of HITECH (2009) and the meaningful use policies of the Affordable Care Act (Medicare and Medicaid Programs, 2014) emphasized the movement of the broader health care system toward increasing use of health care technology such as Electronic Health Records. Students graduating from counseling programs find themselves working in myriad settings, many of which are considered covered entities as defined in the HIPAA standards (2013, §160.103). It is imperative for counselor educators to recognize the trend toward increased technology use in the health care market and to consider ways that technology can be infused into counselor education so that students are entering the workforce with greater technological competence. Specifically, counselor educators have an imperative to teach the ethical and legal technological mandates that exist as they relate to regulations of HIPAA (2013) and HITECH (2009) so as to create competent counselors. As the health care industry continues to incorporate more technology, counselor educators must stay informed regarding ways in which graduates will utilize this technology in their professional careers.
Recommendations for Counselor Educators
ACES (2007) published a document that recommends guidelines for infusing technology into counselor education curriculum, research and evaluation. This document provides a basic overview by which programs should guide the very broad use of technology in counseling programs. Technology is presented as a useful enhancement or supplement to practice. The shift in the broader health care culture has moved technology from a supplementary role into one in which it is primary to the ongoing success of a practitioner. The authors believe that counselor educators can utilize HIPAA and HITECH regulations to continue to infuse technology into counselor education programs, and recommend the following:
- Counselor educators need to increase the importance placed on technology in counselor education programs. The movement of technology into increasingly primary roles in health care is indicative of the need for it to become a primary focus during the education and training of counselors. Counselors and counselor educators must stay abreast of the trends and developments regarding health care law and technology. The implementation of Section H, “Distance Counseling, Technology, and Social Media,” in the 2014 ACA Code of Ethics also is indicative of this need. The counseling profession needs to increase the research, education and training available to counselors and counselor educators.
- Counselor educators need to have policies and procedures in place guiding the use of technology in their departments. The overview of HIPAA regulations will help provide guidelines for developing a set of policies and procedures. All policies and procedures must be in writing and accessible to students, faculty and staff who have access to any ePHI. Many counseling programs maintain a student handbook in which a set of standards that dictate the use of technology could easily be incorporated. Departmental policies should be in place that dictate the consequences should an individual fail to adhere to the stated policies and procedures.
- Counselor educators should be actively seeking ways in which technology and HIPAA can be incorporated to best prepare students for their future work environment. The regulations and language of HIPAA and HITECH should be addressed in course activities. Are counseling students getting opportunities to become familiar with Electronic Health Records? Are students having opportunities to write and store notes electronically? Have students addressed the ethical and legal concerns related to the use of technology in practice? Do students understand what it means to maintain encrypted files or how to appropriately de-identify ePHI? Do students understand how to submit health insurance claims electronically? Questions like these are necessary for students to understand so they can be prepared to work in the current mental health environment as competent professionals.
The use of technology in counseling is moving from a secondary to a primary place in counselor education. The expectation that students can find this information after graduation in the form of a workshop is no longer acceptable. The shifts in the language of HIPAA and HITECH have moved the broad health care field in an electronic, digital direction. The familiarity with technology seems to be growing toward a core competency of counselor education programs and faculty. The laws dictated by HIPAA and HITECH provide a framework by which counselor educators can continue to infuse technology into the classroom and clinical experiences.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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Tyler Wilkinson, NCC, is an Assistant Professor at Mercer University. Rob Reinhardt, NCC, is in private practice in Fuquay-Varina, NC. Correspondence may be addressed to Tyler Wilkinson, 3001 Mercer University Drive, AACC 475, Atlanta, GA 30341, Wilkinson_rt@mercer.edu.
Oct 6, 2014 | Article, Volume 2 - Issue 2
Vivian H. Wright, Joy J. Burnham
This study sought to develop meaningful and engaging virtual cyberbullying scenarios in digital environments that reflect the educational needs of today’s adolescents. In order to inform and script these scenarios, a three-stage study was implemented with middle schools. This paper describes how data collected in each stage informed the cyberbullying scenarios’ development. The authors share implications for educational use in middle school counseling.
Keywords: cyberbullying, technology, adolescents, middle school counseling, digital environments
Today’s adolescents are often referred to as the Net Generation (Tapscott, 1998) because they communicate with each other through a multitude of digital and electronic technologies, including the Internet, social networking tools (e.g., Twitter, Facebook, MySpace), cell phones, and online games. Because these digital and electronic tools function as the “lifeline to their peer group” (Keith & Martin, 2005, p. 226), adults can underestimate the importance of technology to adolescents. While the expansion and availability of technology offer many positive benefits to our youth (e.g., educational and social benefits), access to the Internet and mobile technologies have the potential to render negative effects, including increased incidences of cyberbullying.
Defining Cyberbullying
Cyberbullying is a form of bullying, yet unlike the traditional schoolyard bully, the cyberbully lurks in online spaces, often unseen and anonymous. Cyberbullies misuse technology (e.g., they impersonate others, share embarrassing information and photos, threaten, gossip, and fight online) (Willard, 2006). With the use of technology, the cyber landscape has expanded into easy and continuous access, and is described as operating like “the Wild West once did, where anything goes” (Hoff & Mitchell, 2009, p. 661). In this light, youth can engage in computer-related activities without boundaries or parental supervision.
While negative assertions about technology are disconcerting and cannot be ignored, online and mobile technologies continue to evolve and present positive and beneficial ways to teach the students of today and tomorrow. With the value of technologies in mind, the obstacles in cyberspace and the virtual world need to be addressed. Thus, for teachers, principals, and school counselors, an overarching challenge is presented by such questions as: (1) How do we teach students to protect themselves in digital environments and prevent negative interactions such as cyberbullying? and (2) How can technology be used as a vehicle to educate adolescents and to raise their awareness of cyberbullying?
The purposes of this study were threefold: (1) to use adolescent feedback to script and create cyberbullying video scenarios in a safe, virtual environment; (2) to offer free access to the videos for educational use; and, (3) to raise awareness of cyberbullying and to underline the need for prevention. This study focused on middle school students because the literature has shown a peak in cyberbullying during these school years (Beale & Hall, 2007; Cassidy, Jackson, & Brown, 2009; Hinduja & Patchin, 2008; Kowalski & Limber, 2007; Li, 2007; Pelligrini & Bartini, 2000; Williams & Guerra, 2007). Because few studies have recreated cyberbullying situations, assessing the effectiveness of such scenarios in the field of education is important. Addressing this gap can provide valuable, alternative educational methods to school counselors and other mental health professionals, as well as parents, school administrators and teachers (Carney, 2008; Wright, Burnham, Inman, & Ogorchock, 2009).
Review of the Literature
Virtual worlds, digital videos, and gaming can supplement education, making concepts that are abstract or difficult to understand interesting, relevant, and concrete through modeling and interaction (Williamson & Facer, 2004). Virtual technologies also provide students with a safe place that replicates the real world, allowing for ongoing educational interactions (Paperny & Starn, 1989). Yet, research on the use of virtual worlds, digital videos, and gaming to teach adolescents about cyberbullying is limited (Wright et al., 2009), even though technology has been effectively used to teach skills and train youth.
Several published studies have illustrated the value of virtual technology. For example, Cobb et al. (2002) reported that completing tasks in a virtual social café helped adolescents and adults with Asperger’s syndrome improve their social skills. Similarly, Padgett, Strickland, and Coles (2006) reported success in using a virtual reality game to teach five children with fetal alcohol syndrome fire safety skills. In another study, Amon and Campbell (2008) used a virtual game to teach relaxation skills to children with attention-deficit/hyperactivity disorder (AD/HD). Researchers also have reported success in using virtual scenarios and simulations to raise awareness of concepts, including the development of professional skills in teacher education graduate programs (Collins, Cook-Cottone, Robinson, & Sullivan, 2004), improving attitudes for decreasing teenage pregnancy (Paperny & Starn, 1989) and coping with fears such as public speaking (Slater, Pertaub, & Steed, 1999) and flying (Krijn et al., 2007).
Using a Virtual Environment to Create Cyberbullying Scenarios
The virtual world environment was chosen for this study because of a significant need to provide access to factual and authentic cyberbullying scenarios in an environment that was safe and one that would not compromise the well-being, psychological health, or rights of youth. Studies have suggested that using a virtual environment can be a valuable and safer alternative for conducting research (Zoll, Enz, Schaub, Aylett, & Paiva, 2006) and may make collecting sensitive data more appealing in educational research. Further, researchers have reported that interactions in virtual environments “are governed by the same social norms as social interactions in the physical world” (Yee, Bailenson, Urbanek, Chang, & Merget, 2007, p. 119), making it possible to compare the virtual interactions with interactions in the real world. Finally, adolescents are often motivated to learn about issues and concepts through video or computer games rather than through traditional instructional methods (Ritterfeld & Weber, 2006). With these factors in mind, we reiterated an interest in using virtual world scenarios to raise awareness of cyberbullying and to simultaneously offer an “attractive, but also a potentially powerful means of getting the attention of adolescents” (Wright et al., 2009, p. 40). Having cyberbullying videos to prompt discussion among youth offers school counselors, as well as classroom teachers, additional ways to deal with the challenges they face with cyberbullying.
Choosing Second Life
Second Life (SL) was chosen as the virtual environment for this current study because it “dominates the virtual world landscape” (Warburton, 2009, p. 423) in education. Linden Lab launched SL in 2003. The immersive, three-dimensional (3-D) virtual environment of SL offers users an opportunity to create or re-create situations, interactions and experiences through the use of avatars, which are animated figures that represent real people. Complete communities, schools and businesses have been recreated in SL. Although educators have benefited from specific Linden Lab invitations to explore SL for teaching, learning and research (O’Conner & Sakshaug, 2009), SL and other virtual communities (e.g., Active Worlds, WebKinz) are considered new innovations on the technological landscape. In recent years, researchers have collected anecdotal and empirical data related to virtual environments including potential uses and effectiveness in role-play and student-centered learning (Inman, Wright, & Hartman, 2010).
Second Life Challenges
Second Life offers users the ability to create virtual content that replicates the real world, truly providing a “second life” (hence, the name). However, creation within SL is not without its challenges (O’Conner & Sakshaug, 2009). The challenges often faced with SL are multifaceted. First and foremost, there is a learning curve for a developer to overcome before creating objects and simulations within the SL environment (Luo & Kemp, 2008; O’Conner & Sakshaug, 2009). Warburton (2009) noted that “even simple things can take a long time” and may require “multiple skills” (p. 423). Furthermore, SL computing requirements are high; if developers are not using high-capacity computers (e.g., fast processors, graphics cards) and broadband Internet (e.g., cable or DSL connections or faster), they could experience difficulty with such problems as operating the SL software, intermittent freezes, and software system failure. Institutional financial support of SL-designed environments is advantageous, although not always available.
With the need for virtual environment scenarios to combat cyberbullying, this study included three stages of data collection with middle school students in one school district in the southeast. Data from the first two stages (i.e., a quantitative cyberbullying survey and a focus group, respectively) informed the scripts of the cyberbullying scenarios produced from this present study. The goal for each scenario was to most accurately reflect the students’ beliefs about and experiences in cyberbullying and address their perceived needs for cyberbullying education and prevention. The present study included the following steps: (1) scripting and building the cyberbullying scenarios, (2) using screen-capturing software to capture the videos, and (3) saving the videos as separate files. By following this plan, the researchers maintained a “safe” environment for the students by screen-capturing the scenarios created in SL, thus preventing the students’ need to go online to view the scenarios.
Method
Participants
After Institutional Review Board (IRB) and school system approval, the researchers worked with five middle school principals to conduct this study. Approximately 450 middle school students in Grades 7 and 8 (ages 12–14) were invited to participate in the quantitative study, which was the first stage of data collection. Of the invited students, 114 returned signed parental informed consents and assented to take part in the study. Of the 114 students, 50 were male and 64 were female; 73 were in 8th Grade, with the remaining participants in 7th Grade. The racial backgrounds included: 33 White students, 67 African-American students, 3 Hispanic/Latino students, 2 Asian-American students, and 9 who did not identify their racial background.
At the end of the survey, the respondents indicated a willingness to participate in subsequent stages of the study. From these, the researchers recruited a convenience sample of 20 students from two of the five middle schools (one high-poverty school; one low-poverty school) to participate in the qualitative study, stage two of our data collection. Of the invited, 13 students participated from two schools. School A included seven students (4 boys, 3 girls) and racial backgrounds were: 1 White student, 5 African-American students, and 1 Hispanic student. School B included six students (4 boys, 2 girls) and racial backgrounds were: 4 White students and 2 African-American students.
Lastly, two 8th Grade students (1 White male and 1 White female) who indicated willingness to participate in all stages of the study were recruited to view the pilot cyberbullying scenarios, which were scripted and informed by data collected in the first two stages of this research study. Both students viewed the scenarios individually and provided feedback to assist with final editing of the videos.
Instruments
For the first stage of the study, the researchers were given permission to adapt Li’s (2007) Cyberbullying Survey. Data included middle school students’ responses to various cyberbullying questions (e.g., “Have you been cyberbullied?” “Do you know a cyberbully?” and “Where did cyberbullying most often occur?”). Contextual examples were given in each question, such as for “have you been cyberbullied?” examples included e-mail, Facebook, cell phone, online video, chat rooms, and virtual games.
For the focus group stage, facilitators generated discussions between the participants about how they recognized, defined and responded to cyberbullying. For example, questions included: “If you or someone you know have been cyberbullied, how have you/they been cyberbullied?” “What did you/they do immediately after you/they were cyberbullied?” “Did you/they tell someone? Retaliate online?” After this stage, cyberbullying scenarios were developed based on the data gathered from this aspect of the study.
Following the development of the cyberbullying scenarios, the researchers sought to record participants’ reactions and comments as they watched the two video scenarios created as a result of data collected in the first two stages of data collection. Following the participants’ individual viewing of the scenarios, the researchers also asked specific questions (e.g., scenarios’ clarity, misinterpretations experienced, the setting of the scenarios, and perceived value of the scenarios in cyberbullying education for middle school students).
Procedure
The researchers worked at a major university in the southeastern U.S. where an effort to develop a teaching and research presence within SL was ongoing. The College of Education at the institution had “land” within SL and developed teaching and research spaces within the virtual environment. Several of the university’s computer-based honors students were involved in this development and partnered with university professors to conduct research while simultaneously receiving college credit. The researchers were assigned two honor students who were asked to develop counseling-related scenarios in SL.
To ensure cultural sensitivity, the researchers also consulted with an African-American colleague who works with high- poverty schools. Feedback from the colleague was sought to determine whether or not the language and scenarios were realistic and applicable. In addition, after the SL developers rendered the videos, two additional colleagues (a counselor with expertise in multicultural education and an instructional technology expert) reviewed the videos. These discussions helped to validate the scripting choices and ensure appropriateness and cultural sensitivity for use with middle school students.
The researchers triangulated the focus group and survey data (Stages I and II) to inform the development of the cyberbullying scenarios and to script the two scenarios. In order to achieve meaningful scenarios that reflected the educational needs of the adolescents, we drew heavily upon data from the focus groups to ensure that the scenarios reflected the students’ voices (e.g., language use), their actions (e.g., reactions to cyberbullying situations, linguistics), and the technologies they most used (e.g., social networking) while also providing the needed educational messages.
The data revealed a need for two separate scenarios (i.e., one with a behaviorally-based concept and one with an educational concept). Informed through the focus group data, the behaviorally-based scenario focused on “how gossip escalated into cyberbullying” as two girls wrote on each other’s “wall” on Facebook. Data from the first two stages of data collection indicated a need for adults and educators to better understand how to educate and raise awareness of cyberbullying prevention; therefore, the educationally-based scenario focused on a discussion between a school counselor and a middle school-aged boy who sought advice on how to cope with an online joke that “got out of hand” or escalated.
Once the two scenarios were completed and the videos rendered, we recruited two 8th Grade participants (one male, one female) from the pool of middle school students to participate in the current study. The participants viewed the videos in the presence of two faculty members and one graduate student. The researchers examined the students’ reactions and nonverbal behaviors as they viewed the scenarios. Following each student’s viewing, they were asked specific questions regarding the scenario’s clarity, its setting, the length, and any misinterpretations the students might have about each scenario.
Results
Scenario One
Scenario I, “Mark Goes to the Counselor,” was the educationally-based video (i.e., the school counselor listens to a student regarding a Facebook joke that escalated into a problem). Based on focus group feedback from adolescents, this educational scenario fulfilled a need for adults and counselors to be more aware of how to prevent cyberbullying.
While the students viewed “Mark Goes to the Counselor,” they pointed out minor problems with the rendered scenario. For example, the male participant (Rick) was distracted by the avatar’s movements. He stated that the counselor’s hand movements were “awkward.” Rick’s other major concern had to do with the buildings in the scenario, noting that they “looked too academic” as compared to a middle school setting. The female participant (Bridget) was not as distracted by the avatar’s movements. She noted that the scenario seemed “realistic” to her. From the researchers’ observations, the scenario engaged the participants. In the ensuing discussions following the scenario, both students noted the educational value of the scenario for their peers.
Because “Mark Goes to the Counselor” had an interactive segment at the end which posed questions related to cyberbullying, the students also critiqued this part of the video. Reponses from both students included information about the appropriateness and usefulness of the questions. The students believed that the questions would generate discussions about cyberbullying prevention and how to “deal with it (cyberbullying).”
Scenario Two
Data also informed the scripting of second scenario, “Aisha and LaTosha on Facebook.” This behaviorally-based scenario focused on two adolescent African-American girls who were involved in online gossiping (via Facebook) which quickly escalated into a cyberbullying incident. The social network, Facebook, was chosen for this scenario because it is recognized as the most popular social networking medium (see online data collection venues which monitor web traffic such as Nielsen, Compete, ComScore, and others) and remains popular among adolescents.
For this scenario, capturing the texting exchange between the girls was important to illustrate how the gossip escalated. However, a texting exchange presented problems for the scenarios’ developers. Basically, the initial text messaging exchange that was sought for the “Aisha and LaTosha on Facebook” video was illegible and difficult to understand on the first attempt. Thus, the scenario had to be reworked prior to the students’ viewing.
About two months later, the same male and female participants (n = 2) agreed to critique the second video. While viewing “Aisha and LaTosha on Facebook” on a laptop, the male participant (Rick) paused the video frequently, pointing out technical issues he noticed. For example, a few seconds into viewing he commented on “bad timing” between the sound of the avatars’ typing and the typing movements the girls made on the computers. Moments later, he paused again, this time pointing to a cursor which was located over the text. He noted how difficult it was to read one of the girl’s texts as she posted on the Facebook wall. Rick also believed that some of the text and punctuation was “too grammatically correct.” He remarked, “teens don’t use that” giving a specific example of using a “w” with a slash (/) mark (w/) versus typing the word “with” and that teenagers use “u” for you. He stated that we should make the “grammar more teen-like.” Rick also commented that it would be more likely for the two girls to have this type of conversation (i.e., depicted in the scenario) in “chat” versus “posting on each other’s wall in Facebook.”
Another video quality issue was resolved with participant feedback. While the second scenario was written to focus on the conversation of two girls and their gossip, a third girl (Sierra) also was present at the beginning of the scenario. Rick believed that Sierra’s presence was confusing and thought she should be removed.
Upon completion of the video, Rick had additional comments regarding the actual scenario production. After viewing, we asked if Rick believed the scenario made sense. He said “yes” and that he could “follow along.” We also asked Rick what message he received from the scenario. This question caused him some difficulty and after being prompted a second time, he stated that the scenario depicted how “gossip starts” and illustrated how students should not “jump to conclusions so quickly.” Lastly, we asked Rick his opinion regarding our choice to use Facebook in the scenario versus other social networking sites. Rick emphatically agreed that Facebook was the right choice. He stated, “…no one uses MySpace anymore.”
Bridget, also in 8th grade, watched most of the video without conversation. She had one comment while viewing the “Aisha and LaTosha on Facebook” video, but waited until viewing the video completely before making additional comments. Her initial comment concerned a portion of the script in which one of the girls threatened to get some people together to “jump you.” Bridget laughed quietly as she viewed that portion of the video and remarked, “I’ve heard people say that.” Bridget focused less on the technology in her analysis; however, she did comment that at times the video was “a little blurry” and that the avatars’ movements were “a little fakish.” She also put forth the idea that the video needed a transition at the end (i.e., the first version of the video ended abruptly).
Bridget inquired about how we came up with the idea and thought it was “neat.” Similar to Rick, Bridget also struggled to answer the question: “What was the message in this video?” Once more, we asked a series of questions before an answer was given. After several prompts, Bridget stated, “…students should not accuse people of stuff.” We also asked, would this scenario prompt you to discuss cyberbullying? She noted “maybe.” We asked, “Can teachers and/or counselors successfully use this scenario in a group setting with middle school students to discuss cyberbullying?” She answered “yes” and that the scenario seemed “realistic.” Bridget believed the scenario would be very helpful in education because acting it out in person “would be awkward.” She stated that this video “… has elements in it that kids see all the time.” When asked about technological distractions in the video, Bridget indicated that the television in the video needed a better screen, (i.e., “something natural on it”) and it would be nice to have some music in the background for the two girls.
The two students had some level of disagreement in their critiques. Unlike Rick, who indicated that the scenario was more appropriate for 6th grade, Bridget believed that it “sounded like an 8th grade conversation and would probably be good for 7th graders, but “6th graders talk differently.” Bridget also liked the wall-to-wall design in Facebook and did not agree with Rick that the girls’ conversation should occur, instead, through the Facebook chat tool. The way the text was typed was also okay with Bridget; although she noted how she “typed nicely.” Further, the appearance of Facebook was fine with her, and she believed that the attire on the girls was appropriate. She was in agreement with Rick about removing the girl, Sierra, from the video. Both saw her presence as confusing. She also aligned with Rick on the view that “all students used Facebook instead of MySpace.”
From this session, it was apparent that revisions were necessary with the “Aisha and LaTosha on Facebook” scenario. While Rick and Bridget affirmed that the scenario was realistic, when the video ended both were unclear of the overall message of the video (i.e., they needed prompting twice to articulate the message of the video). The interactions with the two middle school students made it clear that some questions added to the video would facilitate interactive discussions among youth. We discussed potential questions with both students. By incorporating the language from the data and student input after watching the videos, we developed the following questions: (1) Whose fault was this fight? (2) If someone is mean to you and spreading rumors, what could you do instead of doing what Aisha and LaTosha did? (3) How would you respond to Aisha? (4) When should you get an adult involved? Who can you turn to for help? And, (5) What are some other steps you could take to make sure this type of situation doesn’t happen to you?
After Rick and Bridget reviewed the video, a list of technical changes for the developers to make on the “Aisha and LaTosha on Facebook” scenario was assembled. They included:
1. Review the punctuation and grammar; make some modifications to better fit with punctuation and grammar that teens do and do not use. (Although the script was initially written using actual statements from adolescents who participated in our focus groups, we realized additional modifications could be made, such as using “w/” instead of with and “u” for you).
2. Revise the first part of the script, eliminating the character, Sierra.
3. The avatars frequently correct typing errors; change this to ensure that the typing text is more “teen-like” and less concerned with spelling errors.
4. Add questions at the end of the video for class or one-on-one discussions (i.e., an educational component for teachers and counselors).
5. Add music to the background at Aisha and LaTosha’s homes.
6. Put a realistic scene on the television.
7. Add a transition at the end; the scenario ended too abruptly—fade to black at the end and then bring up the questions.
The participants also discussed how the argument between Aisha and LaTosha should take place (i.e., via Facebook chat or “wall-to-wall”). While Rick seemed adamant about using chat features of Facebook, Bridget was not as concerned, believing that similar conversations do take place wall-to-wall. After much discussion, we decided to keep the text interaction between the two girls as wall-to-wall postings since the production in the virtual world would be clearer to read, based on previous problems experienced by the developers.
Discussion
As noted earlier, cyberbullying is a growing concern for today’s adolescents. The purpose of this study was to use data to inform the scripting of two counseling scenarios that could be used for cyberbullying prevention with middle school students. Using a virtual environment to “act out” the scripts and later capturing the scenarios for off-line viewing was intentional and purposeful. While research on using virtual environments to teach cyberbullying prevention is limited (Wright et al., 2009), the use of virtual worlds to teach other skills and concepts has been successful (Amon & Campbell, 2008; Cobb et al., 2002). Further, using virtual worlds can offer a safe place to conduct scenarios of sensitive content (such as cyberbullying) (Zoll et al., 2006) while allowing for real world replications that can be engaging (Paperny & Starn, 1989). Thus, the intent of developing the scenarios was to provide a safe, alternative educational method for counselors and other helping professionals, as well as parents, to use in cyberbullying education and prevention, while assuring that the well-being and rights of youth are upheld.
There were limitations to this study. First, this study focused on one school system in one state, thus generalizability to other middle schools is questionable. Second, video feedback from a more diverse population of students (e.g., African-American girl, feedback from 6th and 7th grade students) would have been helpful.
The data informed our production and scripting, thus allowing the students’ voices to emerge in these scenarios. We believe reflecting the students’ voices, their actions, and the technologies they most use throughout the scenarios’ development provides further engagement in what can be more “teen-like” and meaningful to this specific audience. In the future, another phase of this study is needed. Feedback from school counselors, teachers, and students in diverse school settings will inform the researchers about the usefulness of the videos and whether or not additional videos are merited. It will be important to evaluate the effectiveness of the videos in terms of capturing students’ attention and facilitating useful discussions about cyberbullying. If additional videos are made in the future, we would make modifications. For example, we would seek diverse school populations for each phase of the study and note the potential differences across students in grades 6–8.
We learned several lessons from this study that can inform future studies. (1) Iterations of the videos take time. Based on the data, both scenarios were reworked to reflect student participant input and concern; (2) Although working in a virtual environment presents challenges to researchers, we believe it can be a viable and safe medium to educate adolescents about cyberbullying prevention; (3) Creating fluid movements in SL can be problematic (e.g., awkward movements of avatars were sometimes distracting to the students); (4) By capturing the videos for off-line viewing, the scenarios can be utilized in multiple educational settings (e.g.. lecture, small groups, large groups, or individual viewing sessions); and (5) Videos offer “ice-breakers” to generate further discussions about cyberbullying prevention and intervention.
Implications for School Counselors
Cyberbullying-related deaths have continued to rise in recent years (e.g., Jesse Logan [Starr, 2009] and Hope Witsell [Inbar, 2009]) in 2009, Phoebe Prince in 2010 [McCabe, 2010], Tyler Clementi [Freidman, 2010], Natasha MacBryde [Loveland, 2011], and Britney Tongel [Leskin, 2011] and Amanda Cummings [Calabrese, 2012], in 2011 and 2012, respectively). With the fact that many of the given cases reached the point of suicide in high school underlines the need to focus on cyberbullying interventions in middle school, where literature has noted it peaks (Beale & Hall, 2007; Cassidy et al., 2009; Hinduja & Patchin, 2008; Kowalski & Limber, 2007; Li, 2007; Pelligrini & Bartini, 2000; Williams & Guerra, 2007). Reaching students before cyberbullying gets to the point that adolescents would consider suicide is critical.
This study is important because adolescents’ use of digital tools will continue to grow and evolve as technology tools (i.e., smart phones, mobile devices, social networking tools) become more accessible. Counselors, educators and parents cannot underestimate technology’s importance in adolescents’ lives. Instead, adults need to seek positive uses of technology for educational and social purposes, as well as prevention and intervention. We believe this study offers familiar technologies that students use everyday (e.g., videos in this study, Facebook) to raise awareness of cyberbullying and its consequences. Other commonly used tools also could be leveraged in similar educational endeavors (e.g., Facebook groups, Twitter) in the future, assuming the voices of adolescents are considered.
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Vivian H. Wright is an Associate Professor of Instructional Technology at the University of Alabama. Joy J. Burnham, NCC, is an Associate Professor of Counselor Education at the University of Alabama. Correspondence can be addressed to Vivian H. Wright, The University of Alabama, Box 870232, Tuscaloosa, AL 35487, vwright@bamaed.ua.edu.
Sep 8, 2014 | Article, Volume 1 - Issue 1
James M. Benshoff, Melinda M. Gibbons
Recently, many counselor education programs have considered whether and how to offer courses online. Although online counselor education courses are becoming increasingly common, the use of synchronous (real-time) teaching approaches appears to be limited at best. In this article, we provide a context and rationale for incorporating online synchronous learning experiences, discuss the use of simple technologies to create meaningful educational experiences, and present one model for combining synchronous and asynchronous instructional approaches online. We also share our perspectives on the contributions of synchronous learning components, reflect on student and instructor experiences, and discuss issues to be considered in developing online counselor education courses.
Keywords: online teaching, counselor education, synchronous learning, implementation, technology
Use of technology in counselor education is commonplace today. Email, PowerPoint presentations, and online grading are accepted and utilized on a daily basis. In addition, many counselor educators use online teaching platforms such as Blackboard as a way of incorporating asynchronous communication, discussion, and resources to enhance face-to-face (F2F) courses. In this hybrid model of instruction, the asynchronous component is utilized but a significant part of the course is taught in a traditional (F2F) classroom. What is less prevalent, however, is the use of computer-mediated communication (CMC) in place of F2F classroom meetings. Online synchronous discussion (OSD) is one approach to CMC that includes a range of activities which occur online in real time, including chat and instant messaging. These technologies allow participants to have conversations much as they would if they were physically in the same space. The purpose of this article is to review the literature on the effectiveness of CMC, to provide an example of how online synchronous discussion (OSD) (combined with asynchronous use of Blackboard) has been used effectively in counselor education, and to discuss the possibilities and limitations of this approach. This article is intended for those with little or no experience in online teaching as well as for those who have primarily used asynchronous teaching approaches online.
Technology in Counselor Education
Although technology is not the primary focus of this paper, some introductory definitions of terms are necessary to approach this topic. Distance education is an overarching term used to describe teaching that includes the use of various technologies in order to serve students who are not physically present in the classroom. Often, this involves using audio- or videoconferencing tools to allow people from various locations to participate in a course. In video- or teleconferencing, students may report to various satellite classrooms in order to access the technology. Students in each classroom can then view both the instructor and other students (Woodford, Rokutani, Gressard, & Berg, 2001). Computer-mediated communication (CMC), which involves the use of computers and web-based technology as teaching tools, can be divided into two types. Online asynchronous discussion (OAD) involves learning that is not restricted to classroom time and that can be accessed at any time; often, this includes discussion boards, email, and postings of course materials on an Internet-accessible site (e.g., webpage or Blackboard course pages) (Jones & Karper, 2000). Alternatively, online synchronous discussion (OSD) involves audio, text, and/or video connections through the Internet for real-time communication (Slack, Beer, Armitt, & Green, 2003). Because the advantages of distance education often include the opportunity for students to attend class completely on their own schedule, many distance education courses depend on asynchronous approaches to instruction since these do not require that all students and the instructor be in the same space (physical or virtual) at the same time.
Two studies have examined the use of technology in counselor education programs. Wantz et al. (2003) surveyed CACREP-accredited counselor education programs on their use of distance learning and found that the majority of programs reported not using distance learning and that these programs had no current plans to implement these types of courses into their curriculum. A second group (Quinn, Hohenshil, & Fortune, 2002) examined the use of technology in general by CACREP-accredited programs. Although technology frequently was utilized within a traditional classroom setting, few respondents reported offering online courses in their programs. It appears that advancement in the use of CMC has been slow within the counselor education community.
A Conceptual Framework for Online Teaching
Garrison, Anderson, and Archer (2000) created a conceptual framework that includes the required components of what they considered to be a powerful online educational experience. Their model, termed a community of inquiry, included three aspects of the educational experience: Social Presence, Cognitive Presence, and Teaching Presence. Social Presence refers to the ability to bring student and instructor personalities into the learning community. Included in this social component are expression of emotion, open communication, and development of group cohesion. Cognitive Presence is the ability to construe meaning from the educational experience, with critical thinking or inquiry being the major focus. Finally, Teaching Presence refers to the design, delivery, and facilitation of the course content. This component includes three aspects: instructional management, creating understanding, and direct instruction. Garrison et al. suggested that all three components are necessary for a successful online course.
Research on OSD
Studies of online learning communities have been conducted in various realms. Shea (2006) surveyed students participating in various online courses and found that the stronger the Teaching Presence, the stronger the overall learning community. Students rated the classroom community higher when their instructors were more active facilitators, including keeping students on task, creating an open and accepting learning climate, and acknowledging student input and contributions. Results of another study (Perry & Edwards, 2004) revealed that effective online instructors both challenged and affirmed their students, and that high levels of Cognitive Presence and positive Social Presence directly added to students’ positive reactions to online learning. Clearly, research to date supports the potential for successfully creating a community of inquiry online.
Other researchers have conducted studies examining the effectiveness of synchronous learning experiences online (OSD). Wang (2005) found that the use of open-ended and comparison questions in a real-time online classroom was effective in engaging students and fostering cognitive development. Another study (Walker, 2004) helped identify those teaching strategies that could help develop critical thinking and debate in an OSD-based course. Participants in one debate course indicated that Socratic strategies such as open-ended responses, including challenges and probes, were most likely to elicit student response, and that encouragement and countering also were helpful. Slack et al. (2003) found that online discussions where group cohesion had occurred promoted cognitive development in students better than in classes that lacked cohesion. This suggests that instructors must give attention to rapport building in their OSD classes in order to increase levels of critical thinking and involvement. Finally, Levin, He, and Robbins (2006) surveyed preservice teachers before and after their participation in a series of OSDs. Prior to the online discussions, the majority of participants believed they would prefer asynchronous discussion; afterwards, however, the majority indicated that they actually preferred synchronous discussions online. Reasons given for this change in preference included the opportunity to receive immediate feedback, the real-time pace of the discussions, the convenience of having the entire chat completed in one sitting, and the challenge of having to think critically and learn from peers. In addition, participants in OSD demonstrated higher levels of critical reflection than did OAD participants. These studies demonstrate the potential effectiveness of OSD and point to the importance of appropriate facilitation in order to promote student growth.
Although Garrison et al. (2000) stated that “all three elements [Social Presence, Cognitive Presence, and Teaching Presence] are essential to a critical community of inquiry for educational purposes” (p. 92), they also noted challenges involved in developing such an online community of inquiry. These authors proposed that “… the elements of a community of inquiry can enhance or inhibit the quality of the educational experience and learning outcomes” (p. 92). In addition, they clarified that the kind of OAD they addressed, although collaborative, was quite different from F2F environments. It is this difference from traditional F2F learning that makes the obstacles in using online courses to train counselors unacceptable and virtually insurmountable. Because counseling is a person-to-person experience, it can be particularly difficult for counselor educators to envision how counseling students could be trained and evaluated effectively through a text-based, online experience where course participants cannot see and interact with each other in real time.
The online group course described in the following section was designed to address all three of Garrison et al.’s (2000) elements of a community of inquiry by combining synchronous and asynchronous experiences that much more closely simulate an F2F educational experience. Moreover, our experience has been that use of readily-available technology has allowed us not only to more closely simulate face-to-face classroom experiences, but also to take advantage of features unique to the online experience.
The Online Course: Group Counseling in Schools
To meet the needs of practicing school counselors for additional post-master’s degree training in school counseling, the counselor education program at one southeastern university created an online-only Post-Master’s Certificate (PMC) in Advanced School Counseling. This program was designed to provide working school counselors with 12 hours of additional training that also would qualify them for a significant salary increase in the state system. Over a two-year period, four graduate-level courses were developed for this program. The first of these courses, Group Counseling in Schools, was created and used to pilot test an instructional model for the remaining courses. To do this, the first author worked closely with university instructional technology consultants to create an online learning environment that could be process-based and provide a student-focused learning environment in which student participation was critical to the quality and success of the course itself. The result was an online course that incorporated both OAD and OSD components.
The Asynchronous Component (OAD)
Blackboard is well known and widely used as an educational platform “for delivering learning content, engaging learners, and measuring their performance” (http://www.Blackboard.com/Teaching-Learning/Learn-Platform.aspx) in higher education. Blackboard is primarily an asynchronous learning platform which offers a format that provides for easy posting of course information and a wide variety of course resources. Features include a discussion board with forums that provide opportunities for students to respond to prompts, discuss issues, and share ideas in an OAD where postings can be made and responded to at any time. Blackboard currently is used widely to supplement F2F instruction. In our online group course, Blackboard’s discussion board is used to allow students to take more time to reflect on their learning and encourages them to think more critically about online experiences and course material. Because instructors typically do not participate in these discussions, both responsibility and control are shifted to students for the quality and content of their postings. We have been very interested to see how learning conversations develop as students learn to respond not just to instructor-generated prompts, but also to each other, sharing support, differing perspectives, and experiences. Instructors’ review of the weekly postings is then used to help guide course content and discussion in the OSD component of the course.
The Synchronous Component (OSD)
LinguaMOO (MOO) is an interactive, synchronous learning platform that is available in its basic form for free (see http://www.ericdigests.org/1997-4/moo.htm), with technical support provided by each individual institution. MOO was developed as a community that is designed to simulate F2F environments in many ways using technology that is affordable and easily implemented. MOO is text-based and utilizes a very basic chat environment. More capable, commercial software packages that are now becoming widely used include Elluminate (a free, virtual, collaborative web-conferencing system; http://www.Elluminate.com) and Saba Centra Classroom (which offers a complete set of features for recreating interactive classroom learning experiences online; http://www.saba.com/products/centra/details.htm). Both of these packages add greatly enhanced capabilities for using audio, video, whiteboards, and graphics as part of online class meetings, providing a wide variety of tools to use in creating a virtual environment for learning.
In the online MOO class, when students come to class, they enter the instructor’s room, which is the virtual classroom. Each person who enters the online classroom is visible to everyone else already in the room. As with F2F classes, MOO meetings often begin and end with informal chatting among students and instructors. The visual format of MOO is simple and would be familiar to anyone who has participated in online chats. The computer screen is divided into three sections: two sections on the left display the ongoing discussion and provide a place for students and instructors to compose their comments. In addition to text, MOO also provides an emote feature that can be used to add nonverbals and emotions (similar to text-based emoticons) to the discussion, giving participants a different way to express themselves or add expression to their comments. The right half of the screen is used to present PowerPoint slides that support, guide, and facilitate online discussion, as well as provide structure and content for the class meetings. In addition, MOO allows for recording the transcription (complete with links to PowerPoint slides) for each class, permitting students to review what occurred in class if they missed a class or wanted to revisit a discussion topic. This feature also frees students from having to take notes during class.
Class meets for two hours per week during the regular semester. Like F2F courses, class is scheduled for a particular day and time. Thus, students must commit to being able to attend the online class meetings at the same designated time each week; just like F2F, everyone has to attend class at the same time. Unlike F2F classes, however, students do not have to travel, search for parking, and arrive at a physical classroom on time. Both instructors and students have the flexibility to log into class from any location with an Internet connection. Although the same faculty member has taught this course from its inception, different advanced doctoral students, typically with strong background and expertise in school counseling, have been assigned to co-teach each time the course was offered.
Implementation of the Course
A required F2F meeting is scheduled on campus prior to the beginning of the group counseling course. Although the primary purpose of this meeting is to train students in use of the technology to be used in the course, additional benefits include: making social connections with students and instructors; developing a basis for social presence; and getting a feel for the instructors’ teaching style. Starting in a familiar F2F format and using a standard classroom environment to acquaint students with new technology, a new learning format, and each other seems to work well. In addition, students frequently comment on the importance of this first F2F session for having a successful experience in the course; their F2F experiences help reduce anxiety and create a basis for group cohesion and support throughout the PMC program.
Combining Synchronous and Asynchronous Modes of Learning
In this online course, OAD and OSD approaches are combined to create the total learning environment. Blackboard tends to elicit more formal, traditionally academic, and reflective responses as students reply to instructor prompts (and each other) on the Blackboard discussion board. Prompts typically come from readings and OSD discussions. By contrast, MOO has the vitality more characteristic of a F2F class meeting, with more social and informal discussions and responses. Use of PowerPoint slides online helps structure class and provides content to supplement required reading. Like F2F, synchronous online class meetings have immediacy and are fast-paced. The chat aspect of class means that comments, responses, and interactions can move very quickly, challenging students (and instructors) to pay attention. The quick back-and-forth in the chat format requires that traditional academic expectations about such details as spelling and grammar be suspended, helping to create a more relaxed climate online. Also, active participation online requires much shorter comments and responses than in F2F classes because the faster pace requires faster posting of responses and shorter amounts of text for others to read. Thus, online class sessions are reading- and writing-intensive.
Cognitive Presence
In discussing the cognitive presence component, Garrison et al. (2000) emphasized the “potential for facilitating deep and meaningful learning in a [virtual learning] environment” (p. 93). We use MOO to provide opportunities for high levels of in-depth interaction during class. The nature of the OSD component is that it requires verbal participation online in order to be actively engaged in class. Students who are not actively posting in the discussion are invisible in class. This is unlike F2F experiences where students can contribute minimally or choose to be passive learners. In MOO, all students contribute very actively to discussions. In interactions with instructors online, students are encouraged to take responsibility for their own learning, share their knowledge with others in the class, and combine what they know from practice with new or revisited concepts in class. Thus, instructors strive to address the teaching elements proposed by Newman et al. (1996), including actively encouraging and inviting new ideas and perspectives as well as helping link together theories, facts, applications, and professional experiences.
With this expectation of active verbal participation online, many students are challenged to modify their usual classroom style. For example, introverts who might be hesitant to share comments in an F2F class often shine online. Conversely, strong extraverts can feel constrained online by having to compose their comments and keep them shorter and more focused. Students quickly adapt to this change and most tend to be active in every class meeting.
Throughout the course, we utilize various techniques to promote critical thinking. Similar to F2F classes, open-ended questions are frequently posed to students. Often, probes are used to stimulate further discussion on a topic. In addition, we frequently make encouraging comments such as “interesting idea” or “well put” to let students know that their ideas are important to the discussion and highlight these contributions for other students. These encouragers reinforce student contributions to class, help promote additional conversation, and help highlight important points in the transcript. Even more than in an F2F class, it is vital that instructors plan for how to use their teaching skills to promote cognitive presence online. In the synchronous online learning environment, critical thinking results from instructors’ intentional encouragement, supportive comments, and challenging questions.
Social Presence
Garrison et al. (2000) hypothesized that “high levels of Social Presence with accompanying high degrees of commitment and participation are necessary for the development of higher order thinking skills and collaborative work” (p. 93). To create a community of inquiry, students must feel they can be “real” people in the virtual classroom. As noted earlier, we use the on-campus training to help students feel comfortable and competent with the technology. Then, in the first class online, instructors ask students to reflect on their own professional experiences, modeling use of humor, restatement, encouragement, and positive reinforcement along the way. These techniques help build a level of social presence in the online classroom.
As students have successful experiences in the online environment, they find ways to contribute their personalities, ideas, and expertise in the virtual classroom. As that happens, the technology becomes just another tool for learning and sharing information, ideas, and resources with each other. The shared experience of doing something new and the commonalities students have as school counselors also help to foster social connections and relationships online. One strong indicator of success in developing the social component online is that students frequently share both professional and personal issues with each other, at the beginning and end of class as well as (appropriately) throughout discussions. Students typically develop strong connections with the group and its members that provide a working foundation for their ongoing development as a group during the PMC program. As Garrison et al. (2000) have observed, “Social Presence marks a qualitative difference between a collaborative community of inquiry and a simple process of downloading information” (p. 96).
Teaching Presence
Clearly, there is a critical need to establish a strong teaching presence online, since this has been described as “the binding element in creating a community of inquiry for educational purposes” (Garrison et al., 2000, p. 96). One challenge for counselor educators is to provide familiar kinds of structure, leadership, and facilitation online. We have found that the synchronous learning environment lends itself very well to using group facilitation and process skills to stimulate and involve students in very active ways. We present prompts, share selected information, encourage students to think critically about material, and help students relate course material to their own experiences and work settings. For teaching that is more instructor-centered and more lecture-based, MOO is limited and somewhat lacking. As a platform for process-based learning experiences, however, MOO provides the basic elements to create an online experience that can offer a viable alternative to F2F instruction. In fact, what actually takes place in an online class is largely the same as what would happen in an F2F version of the class; the primary adaptations have to do with effectively using technology to do these things online.
Garrison et al. (2000) noted the importance of students having time to reflect on information as a critical part of the learning process. In our course, students have built-in time to reflect and discuss during online meetings. This reflection time, however, is limited, and must be intentionally included in the class structure by the instructors. Enhanced reflection can occur through Blackboard discussion board postings (OAD) and by requiring students to review and comment on transcripts from online class meetings following online class sessions. With co-instructors for this course, there typically are two instructor/facilitators online in the class. As with co-leading groups, this allows one instructor to serve as lead facilitator to guide the process and cover content while the other instructor keeps a closer eye on student responses and responds to their questions and comments, often playing a major role in supporting and reinforcing student contributions. Because the lead instructor role often shifts midway through a class, each instructor has the chance to be more upfront and facilitative in one part of the class and more of the active listener and supporter in another.
Some examples can illustrate how we create a strong teaching presence. First, class size is limited to 12 students. This small number helps the instructors keep track of the students in the class; since students cannot be seen, it is important to watch users’ screen names to ensure that everyone participates. In addition, the smaller class size allows activities to be completed without consuming the entire class time. Activities also are used to engage students and model facilitation skills. For example, in one class students are asked to design a tattoo for themselves and discuss its meaning. The instructors use this activity to demonstrate group processing skills by modeling reflections, open-ended questions, and facilitative comments. This type of activity helps lead to cognitive presence through strong teaching presence. Finally, everything done in the class is purposeful, just as in an F2F classroom. This attention to goals and purpose helps maintain students’ interest, keeps students focused and involved during the class, and helps us maintain a strong teaching presence.
Reflections on Course Format and Learning Experiences
Benefits to Students and Instructors
Surprisingly, one of the benefits for students is a much higher level of consistent, ongoing participation than would be possible in an F2F classroom. One reason is that in a chat (MOO) format, everyone can essentially be talking at the same time, something that can be managed in an online environment, but would create total chaos F2F. In addition, the chat format allows students to address instructors and each other directly to ask questions, share observations, or make suggestions. In many ways, students can have much more contact and interaction with instructors and their peers in the virtual classroom, and we see this as a major benefit of this online learning environment.
Because of the ongoing dialogue in class, students can more readily affect the pacing and depth of material covered in class by having ongoing input into the educational process. We also encourage students to bring their real-life experiences to bear on the material (and vice-versa). This is particularly appropriate for working adult students who consistently have been found to value opportunities to blend experience with new information in the classroom. Many other benefits to students have been mentioned previously, including the opportunity for everyone to participate, availability of class transcriptions, easy access to the class on the Internet, and the ability to use PowerPoint slides to both guide discussion and inject instructors’ personalities into the class (e.g., through selective use of photos, images, or quotes).
Instructors share many of the benefits noted above for students. The most obvious instructor benefit may be the flexibility of being able to teach from any location with reliable Internet connections (e.g., the lead author has taught this class from New Zealand and Italy). Also, guest presenters can easily participate in the class no matter where they are located geographically. One class featured a guest presenter from India who shared information about her culture and responded to students’ lively questions. Additionally, the simple format of MOO allows instructors the opportunity to exercise their creativity by adding color, graphics, photos, and design elements to visually enhance and enliven the online experience. These creative elements also can help to stimulate and harness the live energy and the excitement of collaborative learning experiences. Graduate student co-instructors have found that teaching online has given them additional teaching skills they can market as new counselor educators, in addition to influencing how they view both online and F2F teaching. Even for the experienced faculty member, the online teaching experiences have positively affected how he plans for and conducts F2F classes.
Student Feedback on Online Experiences
As we reviewed student evaluations from several semesters of this online course, the most striking thing was how similar ratings and feedback were to student evaluations of F2F classes taught by the counselor educators. In addition, very little mention was made about the technology used for class; the few comments that were made were positive. The vast majority of student comments focused on instructor effectiveness, skills, and knowledge. Related to teaching presence, students commented positively on organization of the course, group leadership/facilitation, clear communication, and instructors’ knowledge. In the area of cognitive presence, key themes were instructors’ ability to stimulate interest in course content and stimulation of critical inquiry. Finally, students addressed social presence in the course with comments about instructors’ approachability and helpfulness, respectfulness, and ability to foster group cohesion.
Precautions and Practical Considerations
We believe there are three keys to success with online learning: (1) incorporate an energetic and well-planned interactive component; (2) keep things as technically uncomplicated as possible; and, (3) provide necessary training and tech support (e.g., backup) upfront. Students regularly cite the importance of the initial F2F technology training and the comfort of knowing they can contact university tech support if they experience difficulties. As noted above, the MOO platform provides basic tools for creating live classes online without many of the frills that can make things unnecessarily complicated and intimidating to students. Classes really come alive with the interactive component that MOO offers, due in no small part to instructors’ establishing a norm for active and enthusiastic participation in online sessions. Instructors also act as if these classes are F2F, using familiar language (e.g., “see you next week,” “see you in class”) and familiar structures (agendas for class, balance of information-giving and discussion, even having a break midway through class) that subtly replicate familiar F2F instruction experiences.
To be able to accomplish all three areas of presence (teaching, cognitive, and social) identified by Garrison et al. (2000), instructors must be very intentional in designing and conducting the OSD component. For example, to teach effectively in this environment, instructors need to closely monitor student participation so that they can see those who are sitting quietly in the online classroom and encourage or call on them to bring their voices to class discussions. We have found it very helpful to have co-instructors to help keep up with the flow of discussion, maintain energy in the online classroom, and reach out to quieter or less involved students. To create and maintain cognitive presence, instructors need to be very intentional in cultivating an environment of critical inquiry, including asking good, critical questions and encouraging constructive dialogue among students and instructors. Social presence primarily involves encouraging students to connect with their peers and with instructors in class, and can include appropriate use of humor, liberal use of names, and attention to time for socializing at different points in class (beginning, end, break).
Conclusion
Numerous approaches exist for offering and teaching online graduate courses. If the primary goal is communication of large amounts of information, the approach described in this article likely will not be the most effective or efficient option. Counselors and counseling students, however, like to be able to interact with each other—whether F2F or online—and the MOO/Blackboard (OSD/OAD) approach to teaching and learning online allows for much discussion and processing of course material. Over the past several years, we have found that student responses to this online format have been overwhelmingly positive. Even students fearful or skeptical at the beginning, readily become active and engaged class members. This approach has worked particularly well with more advanced students where their F2F coursework prepared them with fundamental counseling knowledge and skills. It is our belief that a community of inquiry can be established effectively in an OSD format and that the elements of teaching that counselor educators hold dear—social contact and interaction—can be created successfully in an online environment. The increasing availability of more sophisticated platforms for synchronous online class meetings (e.g., Elluminate and Saba Centra Classroom) should make it even easier for counselor educators to use OSD for online only or hybrid courses in their programs. For us, the ability to interact with students online in real time has been a key to making online instruction come alive in ways that rival what we do in our F2F classes.
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James M. Benshoff, NCC, and Melinda M. Gibbons, NCC, are professors at the University of North Carolina at Greensboro and the University of Tennessee, Knoxville, respectively. Correspondence should be addressed to James M. Benshoff, University of North Carolina at Greensboro. Department of Counseling and Educational Development, P.O. Box 26170, Greensboro, NC 27402-6170, benshoff@uncg.edu.