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Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm
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OhioLINK EJC - Problem presentation and responses on an online forum for young people who self-harm

OhioLINK EJC - Problem presentation and responses on an online forum for young people who self-harm | Sharptalk | Scoop.it

Problem presentation and responses on an online forum for young people who self-harm

Smithson, Janet ; Sharkey, Siobhan; Hewis, Elaine; Jones, Ray; Emmens, Tobit; Ford, Tamsin; Owens, Christabel

 

Discourse Studies, Volume 13, issue 4 (August 2011), p. 487-501.
ISSN: 1461-4456 DOI: 10.1177/1461445611403356
SAGE Publications

 

In this article we investigate the nature of problem presentation and responses on an online forum for young people who self-harm. Previous studies have raised concerns about the peer
encouragement of self-harming behaviours in online forums, and this analysis considers the nature of peer interaction on a specific forum, ‘SharpTalk’. This was a research forum which explored the potential of online communities to foster engagement and shared learning between NHS professionals and young people who self-harm. This analysis draws on conversation analysis methods to study problem presentation and responses, and nature of advice given. Analysis highlighted both the tendency to offer advice where it was not asked for, and the mundane ‘safe’ nature of advice. This awareness of how young people interact and provide support online is important for those setting up online interventions to support young people who self-harm.

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Online discussion forums for young people who self-harm: user views

Online discussion forums for young people who self-harm: user views. The Psychiatrist. 2011;35(10):364-8.

Online discussion forums for young people who self-harm: user views
Ray Jones, Siobhan Sharkey, Tamsin Ford, Tobit Emmens, Elaine Hewis, Janet Smithson, Bryony Sheaves and Christabel Owens

 

Abstract

Aims and method To explore what young people who self-harm think about online self-harm discussion forums. SharpTalk was set up to facilitate shared learning between health professionals and young people who self-harm. We extracted themes and illustrative statements from the online discussion and asked participants to rate statements.

Results Of 77 young people who participated in the forum, 47 completed the questionnaire. They said they learned more about mental health issues from online discussion forums than from information sites, found it easier to talk about self-harm to strangers than to family or friends, and preferred to talk online than face-to-face or on the telephone. They valued the anonymity the forums provided and reported feeling more able to disclose and less likely to be judged online than in ‘real life’.

Clinical implications Mental health professionals should be aware of the value of anonymous online discussion forums for some young people who self-harm, so that they can talk about them and assess their use with their patients.

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Membership and boundary maintenance on an on... [Qual Health Res. 2011] - PubMed - NCBI

Qual Health Res. 2011 Nov;21(11):1567-75. Epub 2011 Jun 29.
Membership and boundary maintenance on an online self-harm forum.
Smithson J, Sharkey S, Hewis E, Jones RB, Emmens T, Ford T, Owens C.
 j.smithson@exeter.ac.uk

 

Abstract
In this article we explore how young adults became members and sustained membership in an online self-harm support forum, SharpTalk. We take a discursive approach to consider resources young people used to establish themselves, how others responded to their attempts, and how membership categories were developed and applied. Participants displayed expectations about appropriate ways of discussing self-harm, and about responses and advice. New posters made reference to other self-harm sites, provided biomedicalized narratives of their "story," and asked for help in particular ways. Participants were active in shaping interactions on the forum, requesting input from site moderators, and challenging each other both on perceived infringements of posting content, and on style of posting pertinent to membership. On the SharpTalk site, perceived deviance in posting behavior, and also the giving of health care advice, were most commonly addressed by other young people who self-harmed, rather than by the site moderators. We consider implications for creating sites that enable young people who self-harm to become members and sustain membership, and therefore access support.

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Ethical practice in internet research involving... [J Med Ethics. 2011] - PubMed - NCBI

J Med Ethics. 2011 Dec;37(12):752-8. Epub 2011 Sep 24.
Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).
Sharkey S, Jones R, Smithson J, Hewis E, Emmens T, Ford T, Owens C.
siobhan.sharkey@pms.ac.uk
Abstract
The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.

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Communication & Medicine

Contents of Next Issue
Volume 9 Issue 1

 

Communication & Medicine Volume 9(1) (2012), 71–82

http://equinoxpub.com
Supportive interchanges and face-work as ‘protective talk’ in an online self-harm support forum
Siobhan Sharkey, Janet Smithson, Elaine Hewis, Ray Jones, Tobit Emmens, Tamsin Ford  and Christabel Owens

 

Within a context of concern about inappropriate advice-giving online, we examined how young people who self-harm behave online, and how professionals might engage with them. We use Discourse Analysis to focus on participant interactions (posts) from a forum’s crisis/support rooms, and highlight the prevalence of disclaimers, hedges, questions and tags in the young people’s online interactions. We use the concept of face-work as a framework to help understand interactions in the forum SharpTalk. The findings demonstrate the use of a range of mitigation devices, and suggest that the young people orientate to a ‘protective’ line in their supportive interactions. These findings echo Goffman’s (1967) ‘supportive interchanges’ in that the young people’s online interactions may help to preserve face, in an emotionally complex setting, whose vulnerable members also need ‘protective’ and sensitive support. Taking this ‘line’ may enable members to create a more open and trusting context for support, and to remain in a forum which they find both helpful and challenging. In light of concerns about online support, the findings provide a new perspective on online peer-support for young people who self-harm.

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Using metrics to describe the participati... [J Med Internet Res. 2011] - PubMed - NCBI

J Med Internet Res. 2011 Jan 10;13(1):e3.
Using metrics to describe the participative stances of members within discussion forums.
Jones R, Sharkey S, Smithson J, Ford T, Emmens T, Hewis E, Sheaves B, Owens C.

ray.jones@plymouth.ac.uk

 

Abstract
BACKGROUND:
Researchers using forums and online focus groups need to ensure they are safe and need tools to make best use of the data. We explored the use of metrics that would allow better forum management and more effective analysis of participant contributions.
OBJECTIVE:
To report retrospectively calculated metrics from self-harm discussion forums and to assess whether metrics add to other methods such as discourse analysis. We asked (1) which metrics are most useful to compare and manage forums, and (2) how metrics can be used to identify the participative stances of members to help manage discussion forums.
METHODS:
We studied the use of metrics in discussion forums on self-harm. SharpTalk comprised five discussion forums, all using the same software but with different forum compositions. SharpTalk forums were similar to most moderated forums but combined support and general social chat with online focus groups discussing issues on self-harm. Routinely recorded time-stamp data were used to derive metrics of episodes, time online, pages read, and postings. We compared metrics from the forums with views from discussion threads and from moderators. We identified patterns of participants' online behavior by plotting scattergrams and identifying outliers and clusters within different metrics.
RESULTS:
In comparing forums, important metrics seem to be number of participants, number of active participants, total time of all participants logged on in each 24 hours, and total number of postings by all participants in 24 hours. In examining participative stances, the important metrics were individuals' time logged per 24 hours, number of episodes, mean length of episodes, number of postings per 24 hours, and location within the forum of those postings. Metric scattergrams identified several participative stances: (1) the "caretaker," who was "always around," logged on for a much greater time than most other participants, posting but mainly in response to others and rarely initiating threads, (2) the "butterfly," who "flitted in and out," had a large number of short episodes, (3) two "discussants," who initiated many more discussion threads than anybody else and posted proportionately less in the support room, (4) "here for you," who posted frequently in the support room in response to other participants' threads, and (5) seven "people in distress," who posted many comments in the support room in comparison with their total postings and tended to post on their own threads.
CONCLUSIONS:
Real-time metrics may be useful: (1) by offering additional ways of comparing different discussion forums helping with their management, and (2) by identifying participative stances of individuals so allowing better moderation and support of forums, and more effective use of the data collected. For this to happen, researchers need to publish metrics for their discussion forums and software developers need to offer more real-time metrics facilities.

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Building an online community to promote commun... [Health Expect. 2012] - PubMed - NCBI

Health Expect. 2012 Oct 18. doi: 10.1111/hex.12011. [Epub ahead of print]
Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study.
Owens C, Sharkey S, Smithson J, Hewis E, Emmens T, Ford T, Jones R.

 

Abstract
BACKGROUND:
Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa.
AIM:
We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice.
METHODS:
We allocated 77 young people aged 16-25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; 25%; 50% respectively) to allow us to observe the effect of the professionals on online interaction.
RESULTS:
The young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private-professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators.
CONCLUSIONS:
Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.

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