For many, the thought of speaking out and sharing a recovery experience with friends, coworkers, community leaders, civic groups,
and support groups is a daunting experience. Some just do not feel comfortable going into meetings and just opening up.

Computer
technology is now altering the traditional ways some
people handle distress and is also changing their standard
patterns of communication.
Computers and the Internet are now accessible to 50%
of Americans through a combination of private ownership,
office computers, and computers at libraries,
after-school programs, computer centers, and community
centers.
Since the 1980s, people have been discussing their
predicaments, distress, and coping skills with others in
anonymous cyberspace groups through online support
groups and online self-help groups. The terms support
and self-help tend to be used interchangeably, but
minor differences exist between these two types of
groups. Both groups: (a) share emotions;
(b) encourage support and the creation of a support
system; (c) emphasize the value of affiliation
around a common topic, issue, or life predicament; (d)
strive for behavioral change, healthy coping skills, or
both; and (e) have group leaders who are typically
struggling with the same predicament as the membership.
Neither type of group promotes the placing of
blame for the predicament or the responsibility for
solving the situation on someone else.
Support groups
tend to be started by a professional helping organization
or individual whereas self-help groups tend to
start without a designated leader and emphasize autonomy,
helping oneself, assuming personal responsibility,
and taking action to resolve the issue.
The popularity of these online groups, henceforth
called online support groups, has soared because of
increased access to reasonably priced computers and
advances in technology. The online support group is a
relatively new and growing cyber service that uses a
computer and a connection to the Internet. People
communicate with others who are experiencing common
issues such as coping with alcoholism, eating disorders,
and depression, among other issues. They participate with a level of safety, privacy, and control from
the comfort of their home, library, computer center, or
community center.
In this article, we have described the nuts and bolts
of online support groups, their role as an adjunct to
counseling, their membership, their therapeutic
effects, and their benefits, limitations, and future direction.
We have assumed that the reader possesses basic
computer knowledge but may be unfamiliar with
online support groups and their therapeutic effects.

SUPPORT GROUPS AND THERAPEUTIC FACTORS
Research on the efficacy of face -to -face support
groups has indicated that members benefit from group
participation and a combination of therapeutic factors.
Mutual support is offered and received, aiding members
in adjusting to significant changes and major
stressors in their lives by learning from the experiences
of others. Members develop a sense of normalization
as others disclose similar reactions and members feel
empowered about decision-making abilities and personal
control.
Yalom has asserted that self-help groups
offer the opportunity for personal growth, social experimentation,
and behavioral change through seven therapeutic
factors:
1. Universality. Group members realize they are
not alone and that others experience similar
issues and reactions.
2. Imitative behavior. Members model different
coping skills used by peers.
3. Altruism. Participants recognize an ability to
help others and this may increase their selfesteem,
stimulate a desire to take risks and
reduce their dependency.
4. Instillation of hope. Positive experiences of
peers can motivate others to seek solutions.
5. Imparting of information. Peers can evaluate
options not previously considered.

Online support groups are expanding as the general public becomes more comfortable using computer-mediated communication technology. These support groups have certain benefits for users who may not be able to or do not have the desire to attend face-to-face sessions. Online support groups also present challenges when compared to traditional face-to-face group communication. Communication difficulties may arise resulting from lack of visual and aural cues found in traditional face-to-face communication. Online support groups have emerged within health care as a result of the need individuals have to know more about health conditions they are confronting. The proliferation of these online communities may provide an opportunity for health educators to reach target populations with specific messages. This paper reviews the development of health-related online support groups, examines research conducted within these communities, compares their utility with traditional support groups and discusses the implications of these groups for health education.

There are many benefits associated with online support groups. With asynchronous communication, participants in online groups have access 24 h a day, 7 days a week, at times most convenient to them. Asynchronicity allows individuals to carefully develop responses at their own speed. Geographic and transportation barriers are absent. People with mobility problems, speech and hearing difficulties or caregiving responsibilities can participate with ease.

In particular, people with stigmatizing disorders like AIDS or breast cancer, or persons recovering from sexual abuse may find online support a more welcoming venue to discuss sensitive issues. The anonymity provided by online groups allows discussion of potentially embarrassing topics or otherwise taboo subjects, increases the possibilities for self-disclosure, and encourages honesty and intimacy. The visible effects of treatments like chemotherapy and late stages of disfiguring diseases are avoided.

In addition, sociodemographic factors such as age, gender, racial or ethnic identity, income and social status are not readily obvious. Weight, disability and other signs of physical appearance as well as social skills and vocal characteristics also are eliminated. For those with uncommon diseases, online groups may provide the only way to communicate with others who are dealing with similar problems. Sometimes, distress that accompanies learning of a diagnosis can decrease motivation to attend face-to-face groups. The physical demands of treatment for particular diseases may cause debilitating side effects and make attendance at a traditional group unlikely. The convenience and accessibility of online support may have strong appeal to these individuals.

Advantages Of Online Support Groups

Online support can be a useful adjunct to more traditional support groups .Illness may preclude attendance at a face-to-face group on occasion. During these times, online support can be beneficial. For those who require a great deal of support, online groups can provide supplemental help between meetings of traditional groups.

Unlike traditional support groups, bounded by space constraints, the number of participants in an online group can be unlimited. On the Internet, coverage spans the globe. This international scope permits group members to draw from a wide variety of perspectives, experiences, disabilities and points of view, while at the same time promoting a feeling of universality.

Online support groups empower consumers by serving in an advocacy capacity, means of organizing and networking politically for a particular cause or disease. Such groups may champion concerns and priorities to local, state, national and international organizations.

Disavantages Of Online Support Groups

Online groups have disadvantages, too. Although computer-mediated communication is a cost-effective way to send messages to many people simultaneously, the individual who joins an online group must have access to a computer and to the Internet. This eliminates much of the world's population from participating. In the US, shared Internet access is available from most public libraries (American Library Association, 1998), allowing those without computers at home (or even a home address) to have E-mail accounts and join online groups. However, the `digital divide' still separates the information poorâ??particularly the poor, women, minorities and older peopleâ??from those who can afford to pay. In addition, individuals must be able to read, write, and have a rudimentary knowledge of how to use a keyboard and computer.

While online groups theoretically can involve participants from all over the world, thus enhancing group cultural and social perspectives, very active forums often produce a large volume of postings. Reading each message may require a serious time commitment on the part of members.

Online messages may be easily misinterpreted upon being read. Absence of visual and aural cues can be a disadvantage. To overcome lack of facial expressions, touch, vocal tone and inflection, eye contact, and body language, many online support group members use a paralanguage composed of brackets, embedded text, capitalization, emoticons and acronyms.

Issues of group process may be a concern. Lack of visual, aural and contextual cues contribute to the relative impersonal nature of online communication . Many online groups are unmoderated and open to everyone, allowing less inhibited members, covered by the cloak of anonymity, to `flame' or harass other members, disrupt or intentionally deceive the group.

Since health care professionals do not facilitate most publicly accessible online groups, opportunities exist for the appearance of inaccurate, dangerous or mistaken medical information. While other members may correct erroneous information, all members may not read the corrections in a timely manner. For example, Culver et al. examined 1658 messages sent to an electronic bulletin board for people with painful hand and arm conditions. They studied author qualifications, message purpose, message content, the nature of the medical advice and expressions of dissatisfaction with the health system. Results illustrate the preponderance of messages on medical topics were from people without medical training. In addition, over one-third suggested use of unconventional treatments.

Computer-based groups also may be addictive, especially in instances where one `substitutes life on the screen for life in our bodies and physical communities'. If online relationships replace real-life social interactions, a decline in quality of life may result.


Basically in a nutshell what I have been doing for 5 years isn't so messed up or abnormal as my husband has always said.
Some of us just feel better and feel more comfortable "being online".

Love and Peace,

Louise