[dr. bob]

by Dr. Bob


One of the goals here is to help us understand how online communities work and affect the mental health of their members. This site is not currently considered a research study, but research has been conducted here in the past and may again be in the future. Case studies are not considered research, and Dr. Bob may at any time publish case studies on his web site or in a book or an academic journal.

I welcome opportunities to collaborate on research.

Publications and presentations


The best of both worlds

Hsiung, RC. (2000 Dec). The best of both worlds: An online self-help group hosted by a mental health professional. CyberPsychology & Behavior, 3 (6), 935-950.
Online mental health groups can be classified as autonomous self-help groups or support groups led by mental health professionals. An online self-help group hosted by a mental health professional, in which the mental health professional focuses on maintaining the supportive milieu and the members of the group focus on providing the support for each other, is hypothesized to combine the best of both worlds. Psycho-Babble, a group of this type hosted by the author, serves as an example. Between January and August 2000, 1,516 members posted 21,230 messages in 3,028 discussion threads. Forty-eight percent of posters posted just once. Thirteen percent of threads consisted of only the initial post. In July 2000, 534,219 Psycho-Babble pages were served. Samples of educational and supportive posts, misinformation, "Internet addiction," help-rejecting, limit-setting, and member feedback are given. The usage statistics and the anecdotal evidence of the posts themselves support the effectiveness of the group. The hypothesized key ingredients are discussed. The asynchronous online (message board) format is highly usable and makes the group accessible and safe. Drawbacks, however, are the potential for "multiple identities" and the technical difficulty of effectively preventing determined individuals from gaining at least temporary entry into the group. This hybrid type of group combines the best of the two worlds of self-help (empowerment) and leadership by a mental health professional (maintenance of the supportive milieu).

Complete article (PDF format, 316 KB, requires the free Acrobat Reader)


Reaching out across cyberspace

Hsiung, RC. (2002 Feb 4). Reaching out across cyberspace: Online peer support groups. Paper presented at the University of Chicago Department of Psychiatry Grand Rounds.

Does a doctor-patient relationship arise from online moderating?

Hsiung, RC. (2002 Aug 5). Does a doctor-patient relationship arise from online moderating? American Medical News. 45 (29): 18.

Complete article


User perspectives on the impact of an online peer support group

Hsiung, RC. (2004 Nov 13). User perspectives on the impact of an online peer support group. Paper presented at the World Psychiatric Association International Congress.



A suicide in an online mental health support group

Hsiung, RC. (2007 Aug). A suicide in an online mental health support group: Reactions of the group members, administrative responses, and recommendations. CyberPsychology & Behavior, 10 (4): 495-500.

Suicides in online mental health support groups are inevitable. This case report of such a suicide describes the responses of the group members and the moderator and makes recommendations.

Members of a large, public, mental health message board supported each other, and the moderator, a mental health professional, managed the milieu. A member joined in February 2001 and killed herself in April 2002.

The initial response of the members was grief. The moderator attempted to minimize suicide contagion by not making any special announcements and to facilitate mourning by starting a memorial thread. There were no reports of self-injury in response to the suicide, and the online ventilation of grief may in fact have had some preventative effect. One member went to the funeral, and gradually, the group moved on. The moderator later implemented a memorial page.

The responses of online groups to suicide may, like those of real-life groups, have resuscitation, rehabilitation, and renewal phases. Diffusion of dependency, a searchable archive, and threaded, asynchronous discussion may facilitate mourning, but anonymity may increase vulnerability to false reports. A thread started in memory of a deceased member may function like a virtual memorial service. A memorial page may function like a virtual cemetery. Preliminary recommendations can be made regarding suicide prevention and responding to suicide in moderated online mental health support groups.

Complete article (PDF format, 64 KB, requires the free Acrobat Reader)

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[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Revised: September 6, 2010
URL: http://www.dr-bob.org/babble/research
Copyright 2001-10 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.