Online Virtual Therapy for Treating Depression

Deborah Gray Health Guide
  • Over the years, since I first set up a chat room on my Web site for people with depression, I've had to take a lot of elements into consideration that many chat room hosts do not. If you're running a chat room centered on a non-mental health topic, it's fairly easy. Get a critical mass of chatters and boot troublemakers out; a lot like throwing a party in real life.


    Things are not quite so simple with a depression chat room. I've developed guidelines over the years to keep people from bringing up "trigger" topics (not discussing details of "cutting" that might trigger someone to self-harm, not discussing sexual topics because it might trigger a flashback in someone who had been sexually abused, etc.). Although I finally had the operation of the chat room down to a science, I found some new problems when I decided to add a chat room in an online virtual world.

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    About ten years ago, I spent some time in a 2D graphical chat room called The Palace. I'm a very visual person, so I enjoyed spending time in there much more than in a standard text chat. I planned on adding it to my forum for people with depression sometime in the future in addition to text chat. By the time I felt that my forum members would be ready for an alternative to the text-based chat room, however, The Palace was already petering out, and I put the idea on hold.


    Last year I came upon a virtual online world called and decided to set up a chat room there. Another virtual online world, Second Life, was more popular, but I felt it was harder to use. Ease of use was important. I knew that a steep learning curve would put a lot of members off.


    In these virtual worlds, members create a virtual representation of themselves called an avatar. I always choose to make mine look exactly like me, but you can give yourself an ideal body and face if you so choose, or even change your gender. In Second Life you can even be another species.


    I initially “bought” a portable zone in that could be placed anywhere in the virtual world, and also bought a small house to put on it. I soon found out, though, that I couldn't restrict access to the house, and that of course made privacy impossible. So I then bought the deed to a house in a fixed location, on the beach. This allowed me and anyone I designated to restrict the access to the house to people from the forum.

    Keeping in mind that not everyone, especially when depressed, likes a bright, sunny venue, I bought another house in an area that was always night and somewhat goth in nature.

    Then a problem that I had been somewhat worried about started escalating. Our beach house was in a great area. Unfortunately, lots of other people felt the same way. The area was constantly busy with people riding hoverboards and dune buggies through our “yard.” Although we could use the house for private conversations, the disruptions ruined casual "hanging out" outside. Worse yet, a raceway had been set up a stone's throw away from our hangout. The number of people driving, flying or walking through our yard tripled, including some lovely people who deliberately knocked our avatars over with their dune buggies.

  • So I ended up buying third, fourth and fifth houses. They were all in lower traffic areas, although still easy on the eyes. I figure that I'll see which ones people seemed to gravitate to, and auction off the other ones.

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    Next I had to consider the interior décor and buy furniture (this was my favorite part!). Should the décor be cozy? Should it be soothing? I created a modern decor, but decided that it looked like a doctor's waiting room and ended up going instead with both Japanese and Moroccan layouts.


    We have an offshoot of the main text-based chat room called the Quiet Room where people in crisis can have a more private conversation with one or two members. I wondered if I should screen off one part of the room for this purpose. But couldn't members just use private messages for that? I finally decided on a compromise. The Japanese décor had a screen that I really liked, and the Moroccan didn't, so I screened off a part of the room only in the Japanese decor.


    (You might be wondering how I can talk about this world and being in it, as though it were real. It probably seems somewhat silly. The reason I do is because otherwise I would have to put quotation marks around half of the words I use and that itself would seem silly after a while.)


    I knew that I needed to increase the members' comfort level with this world. Most of them would be using a virtual online world for the first time. One thing that was absolutely essential was a guide to the virtual world, which I posted on the forum. I included in it getting around and communicating in in general, specific instructions on how to get to the houses we owned (with maps), and information on what areas would be private from non-members. Given that the members would be talking about depression and related issues, it was obviously essential to have complete privacy when needed.


    As people started logging on and spending time in our virtual chat room, I ran into a lot of issues that I never had to consider in a text based chat room:

    • In text based chat, personal space is essentially never an issue, any more than it is when you send an email. In a virtual world, however, you are dealing with the issue of personal space as much as you do in the real world. If there are three couches and two are empty, do you sit on an empty one or on the couch occupied by someone you're chatting with?
    • One of our regular male chatters was constantly coming on to female members in the text-based chat, despite guidelines against it. We finally had impressed on him that this wasn't acceptable. For some reason, however, he didn't think that the same guidelines applied to There he would have his avatar stand very close to those of the female members, kiss them or sit on their laps. If his flirting made women uncomfortable in text-based chat, it made them doubly uncomfortable when he could invade their space and made his virtual passes more "real."
    • I had to consider whether to put out “drinks” in the houses. Little touches like that help you suspend your belief, but would it be difficult for people who have addictions? Taking things like this into consideration (it's not a real drink, after all) may seem silly, but my goal is to provide a safe environment in which to talk. I decided to put out virtual sodas and coffee only.
    • I was in a quandary over whether I should provide dune buggies and hoverboards for people to play with. It might help them unwind and bond, but it also might distract from talking about depression, and after all, you can't discuss your depression just anywhere. Doesn't it make sense to stay on topic here? I'm not completely decided on this question one way or another, but I think I'm leaning toward providing them.
    • I also had to decide whether to play music or not (adds to the ambiance or irritating) and at least for now, I am just playing it "outside."

    Phew. I really didn't anticipate all these new issues cropping up when I began this venture, although I should have. Every new medium that we communicate in brings with it different issues, because people are interacting differently. Now that I've hammered out solutions to the most obvious ones, I'm off to sit on my virtual beach with a virtual drink in my hand.

Published On: May 14, 2007