Representations of Adolescent Social Anxiety Online
Social media platforms are becoming significantly important in understanding adolescent mental health experiences. One of the most visited websites in the world, Reddit, attracts approximately 52 million daily active users and has a significant adolescent user population (users aged 13-19). Reddit is based on individual communities (called ‘subreddits’) focusing on specific topics, such as mental health conditions (e.g., depression, anxiety) and experiences (e.g., phobias). Under the guise of non-identifiable pseudonyms, Reddit users are able to express their views and experiences and interact with other anonymous strangers, with designated community moderator support. This makes Reddit a suitable space to convey sensitive information pertaining to mental health and psychological wellbeing.
Recent research studies investigating mental health representations online show that at times young people are more likely to self-disclose mental health experiences and seek out support in anonymised online spaces rather than disclosing this in formal mental health support settings (e.g., counselling, psychotherapy) or face-to-face interactions with close relatives and friends. It is likely that such online mental health disclosures have increased in frequency during the COVID-19 pandemic, given the self-isolation restrictions and generally lower access to face-to-face therapeutic services.
Given the high prevalence of anxiety disorders, this study will seek to understand how young people convey their experiences of this mental health condition online. By analysing anonymous posts about social anxiety, we anticipate that our study results will shed light on help-seeking behaviours, development of coping strategies, and stigma attitudes (particularly around perceptions of ‘legitimate’ or ‘authentic’ anxiety and ‘inauthentic’ or ‘fraudulent’ mental health experiences). These findings will provide important insight into populations that are experiencing mental health distress but, for various reasons, are not seeking (or are not able to seek) formal mental health interventions and are therefore underrepresented in psychological research.
The impact of digitalization on psychotherapy processes
Online psychotherapy has become incredibly important during the COVID-19 pandemic, when clients were unable to see their therapists face-to-face and had to find an alternative arrangement through digital mediums. Even before the pandemic, however, research by Kruger & Johanssen (2016) and earlier, Gabbard (2001), discovered that our ever increasing online presence has begun to impact the practice of psychotherapy, which historically has been thought of as an intensely private endeavor. For example, Freud (1912) often described the necessity of being opaque to patients and showing them nothing but their own thoughts and feelings. His daughter, Anna Freud, explicitly defined the concept of therapeutic neutrality in which the therapist ‘takes his stand at a point equidistant from the id, the ego, and the superego’ (1936, p. 28).
Although the view of a ‘blank screen’ neutral therapist has changed since the emergence of relational and interpersonal psychoanalytic approaches, it is inevitable that the increasing use of online platforms and social media networks will – and already has – changed the landscape of therapeutic relationships. Patients actively seek out information about their therapists that is not necessarily professional in nature (e.g., personal photos, family information) (Kolmes & Taube, 2016). This can lead to significant ethical challenges and stumbling blocks across different therapeutic relationships. Despite this, the pandemic showed that it is important to maintain an open-mind toward digital platforms for psychotherapy: while some patients find it difficult to engage with, others praise online counselling and psychotherapy as a more accessible and flexible alternative. This project therefore seeks to document the challenges as well as the benefits of all forms of online therapeutic mediums and their impact on therapeutic relationships and processes.
Published research from this project:
Kotera, Y., Kaluzeviciute, G., Lloyd, C. M., Edwards, A., Ozaki, A. (2021). Qualitative Investigation into Therapists’ Experiences of Online Therapy and Implications for Working Clients. International Journal of Environmental Research and Public Health, 18, 10295. https://doi.org/10.3390/ijerph181910295
Kaluzeviciute, G. (2020). Social Media and its Impact on Therapeutic Relationships. British Journal of Psychotherapy, 36(2), 303-320. https://doi.org/10.1111/bjp.12545