ERIC Identifier: ED459378
Publication Date: 2001-09-00
Author: Gary, Juneau M.
Source: ERIC Clearinghouse on Counseling and Student Services Greensboro NC.

Impact of Cultural and Global Issues on Online Support Groups. ERIC/CASS Digest.

People discuss emotionally distressing issues with someone in a similar situation, with a spiritual or indigenous healer, acupuncturist or mental health professional or do not discuss the issue at all. Computer technology is now altering the way individuals handle distress by enabling people from all cultures to discuss personal issues with others worldwide. They could reside in remote or sequestered locations (e.g., Greenland or Fiji), in inaccessible locations (e.g., the Australian Outback or U.S. military bases on Guam) or in under served locations (e.g., Bangladesh or Appalachia).

Since the 1990s, people have been discussing their distress and coping skills with others in anonymous cyber group settings through online support groups, a relatively new and growing cyber service. People participate in thematic topics such as coping with family violence, HIV or trauma and death caused by natural disasters or war. Online support groups can be attractive to a group of new users who may previously have resisted peer support because of culturally-ingrained traditions of non-disclosure of "family secrets", avoided family shame or dishonor or evaded cultural or familial isolation and stigmatization.

In addition to personal distress, people also experience distress from traumatic events occurring in other parts of the world. Incidents that were once considered local dramas can become worldwide events. News coverage of natural disasters such as the fatal floods in Mozambique and the death of Princess Diana demonstrate this point. Such incidents produce a range of emotional reactions from anger to anxiety, depression and fear in people worldwide based on their cultural perspective and worldview. For example, people worldwide joined grief online support groups such as "Gentle Passing's" to mourn Princess Diana's death (Remolino, personal communication).


Online support groups are founded primarily on a western orientation of self-disclosure of personal problems, self-help and supporting others. Typically, English is the common language used regardless of one's country or geographic location and a limited number of groups are offered in different languages. An excerpt from a typical online support group session for loss and grief can be found in Gary and Remolino (2000). Most participants are North American (based on the U.S. Census definition), with Americans representing 50 percent of Internet users worldwide. The terms "American/North American" include many cultural and racial groups who have migrated to North America as well as to native born North Americans.

Online support groups can be accessed through use of a computer and modem in conjunction with a major Internet service provider (ISP) such as CompuServe or a local ISP. Once connected through an ISP, online support groups may also be reached through specialized web sites (e.g., or through Internet portals (e.g., Yahoo). Each ISP, web site or portal sets its own standards and procedures regarding regulations, quality control, crisis management, disclaimers and training of group leaders.


Online support groups facilitate contact with people from other countries and cultures and fosters a pluralistic society of racial, religious, ethnic, cultural and linguistic backgrounds (McFadden & Jencius, 2000). Participants bring culturally-based life experiences, coping mechanisms and personal attitudes, biases, beliefs and knowledge that influence their ability to seek help. The diversity highlights the fact that the cultural perspective and value system espoused in European-American/North American/western society is just one of many value systems and perspectives in use worldwide.


Online support groups are led by "hosts" who function as resource persons rather than online counselors. Hosts make referrals to telephone help lines, self-help resources, face-to-face support/self-help groups, local counseling centers, crisis centers and hospice centers. They also recommend hyperlinks to other online support groups, culture-based web sites (e.g.,, a resource for indigenous cultures worldwide), mental health web sites (e.g., and professionally oriented web sites with a focus on international online issues (e.g., Journal of Online Behavior at

Co-hosting by two culturally competent hosts might ensure that cultural subtleties are attended to while group needs are also met. Culturally competent hosts who are knowledgeable about various cultural systems are more likely to be effective in a culturally diverse online support group. They must transcend communication and cultural barriers in order to be effective across cultures and maintain open relationships as well as present culturally acceptable solutions and offer culturally appropriate support and interventions. They must be aware of the relevance and appropriate use of indigenous support systems, understand how cultural systems operate and influence behaviors and should inquire about participants' traditional cultural helpers.


A handful of countries censors, regulates, monitors or outright forbids Internet use by citizens (e.g., Saudi Arabia, China, Cuba, Iraq, North Korea) (MacKinnon, 2000; Walton, 1999). Such governmental control makes participation in online support groups virtually impossible for these citizens, in spite of their emotional distress or need for emotional support, and even if they own a computer.


* Cyberconnections. Online support groups reduce the sense of isolation for those who reside in under served or remote locations. Participation enables people to seek support from various perspectives if and when support is not available in their country, cultural background or geographic area.

* Specialized Online Support Groups. Some topics discussed in online support groups may be culturally taboo to discuss face-to-face in specific cultures (e.g., family violence or sexual assault), therefore some online support groups may need to be age-specific and/or gender-specific in order to accommodate to cultural mores. For example, older adults may be uncomfortable discussing thoughts of depression or suicide with younger adults, believing that youth are not culturally appropriate individuals to dispense advice and support. Since groups are not limited by geographic boundaries, they can be formed successfully from a global population.

* "Internet Time". Internet Time is a relatively new global concept of time that should facilitate the scheduling of online support groups across time zones (Lockridge, 1999). Internet Time is the concept of time synthesized across time zones to one single, arbitrary time period related to the Internet. An online conversation between someone in the U.S. and someone in Australia takes place regardless of the difference in time zones separating them.

* Universality of Issues as a Therapeutic Factor. Others struggle too. This is not always evident to an emotionally distressed person who may experience isolation related to cultural traditions that reinforce non-disclosure. Universality, one of Yalom's (1995) therapeutic factors, unites participants as they share similar thoughts, feelings, fears and/or reactions with their virtual community.

* Privacy. Online support groups give participants the privacy to seek support about behavior that might be perceived as a cultural stigma and to protect their identity and/or family name without being recognized and shamed. Participants can overcome some of their social barriers and not fear ridicule, cultural stigmatization or vulnerability within their geographic community (Day & Schneider, 2000).


* Government Control. Governmental censorship makes participation in online support groups impossible or illegal for citizens in a small group of countries.

* A Panacea? Online support groups are not appropriate for everyone and are not a panacea. Some participants may need additional medical, educational and/or mental health services or may need a consultation with a spiritual or indigenous healer or acupuncturist.

* Host Competency. Professional degrees and experience for hosts vary among web sites, portals and ISPs. Information about the host's training and education may help the participant to gain insight about the host's competence, value system, worldview and cultural competence. For example, a host who is raised and educated in Costa Rica will most likely have a worldview different from a host who is raised and educated in Australia.

* Members with Limited Language Skills. Participants or hosts with language limitations (such as English as a second language) may be frustrated by the rapid pace, text-based communication and multiple dialogues in English-language online support groups. They may be challenged in communicating feelings and thoughts verbally to others without relying on body language and other non-verbal communication to compensate for any verbal deficits (Day & Schneider, 2000).

In a text-only format with limited interpersonal feedback, communicative misunderstandings are common for all participants and could be exacerbated for those with limited language skills.

* Ethical and Legal Concerns. Several mental health professional organizations, licensing boards and international agencies are grappling with cyber space ethical and legal issues (Bloom & Walz, 2000).

* Crisis Management. Lack of sufficient information makes a referral difficult and awkward, especially when the host may be unaware of participants' geographic locations around the world and their specific needs or local resources.


Online support groups have the potential to improve the access and delivery of services to a wide range of people who reside worldwide. They provide an alternative vehicle of support for people in distress when it may be culturally stigmatizing to seek face-to-face support. They are not appropriate for everyone nor can everyone worldwide access online support groups.


Bloom, J. & Walz, G. (Eds.). (2000). Cybercounseling and cyberlearning: Strategies and resources for the millennium. Alexandria, VA: American Counseling Association.

Day, S. & Schneider, P. (2000). The subjective experiences of therapists in face-to-face, video and audio sessions. In J. Bloom & G. Walz (Eds.), Cybercounseling and cyberlearning: Strategies and resources for the millennium (pp. 203-218). Alexandria, VA: American Counseling Association.

Gary, J. & Remolino, L. (2000). Coping with loss and grief through on-line support groups. In J. Bloom & G. Walz (Eds.), Cybercounseling and cyberlearning: Strategies and resources for the millennium (pp. 95-115). Alexandria, VA: American Counseling Association.

Lockridge, R. (Correspondent). (1999, February 27). Internet time: Will the "beat" go on? Science and Technology Week. Atlanta, GA: CNN.

MacKinnon, R. (Correspondent). (2000, January 27). China tries to keep Internet revolution from becoming threat to power. Atlanta, GA: CNN.

McFadden, J. & Jencius, M. (2000). Using cyberspace to enhance counselors' cultural transcendence. In J. Bloom & G. Walz (Eds.), Cybercounseling and cyberlearning: Strategies and resources for the millennium (pp. 67-83). Alexandria, VA: American Counseling Association.

Remolino, L. (1998, December 12). Personal communication.

Walton, M. (Correspondent). (1999, January 7). Iraq sidelined from information superhighway. Atlanta, GA: CNN.

Yalom, I. (1995). The theory and practice of group psychotherapy (fourth ed.). New York: Basic Books.

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