Myths and realities of online clinical work

An international, multi-disciplinary group of online mental health professionals, under the auspices of the International Society for Mental Health Online, presents this 3rd-year report. This article highlights the experiences of ISMHO's Clinical Case Study Group members with regard to online clinical work across several Internet-based modalities as well as integrated online/offline approaches to mental health treatment and consultation. A number of online approaches and paradigms are presented, often combining several aspects of synchronous and asynchronous online mental health practice. The discussion is organized around case presentation material shared among colleagues as part of a unique model combining peer supervision with systematic efforts to further develop a body of shared experience and observation relevant to online clinical practice. Readers are invited to virtually "listen in" to the collective voice of the group as it reconsiders whether 10 common conceptions of Internet-based practice are in fact myth or reality. Topics range from the nature of online behavior, communication, and technology, to cultural and ethical issues, to working with populations commonly seen as not being amenable to online clinical work.