Using the Internet to Facilitate the Rehabilitation Process.

Since the Technology-Related Assistance for Individuals with Disabilities Act of 1988, the value of technology in enhancing the quality of life and employment opportunities for people with disabilities has been undisputed. In addressing the impact of technology on the lives of people with disabilities, Franklin (1991) noted that the technology explosion "has redefined their abilities to successfully learn, work, live, and play in their communities" (p. 6). One type of technology, the computer, has not only enhanced employment opportunities for individuals with disabilities (e.g., Mather, 1994), but serves as an essential component of the management information systems of most rehabilitation agencies (Akrokiasamy, Benshoff, McLean, & Moss, 1992).

An element of computer technology that has not yet become routinely available in all rehabilitation offices is access to the Internet. Budget considerations and articles on the hazards of the Internet (e.g., Hooked online, 1998), ranging from abuse and misuse to addiction, have contributed to this situation. However, the benefits the Internet brings to the rehabilitation process and to professionals and consumers would appear to far outweigh any disadvantages. Therefore, the purpose of this article is to identify the impact of the Internet on the rehabilitation process, as well as some professional and ethical considerations related to its use.

Internet Applications in the Rehabilitation Process

Regardless of setting, the rehabilitation process includes assessment, rehabilitation planning, and service delivery (Jenkins, Patterson, & Szymanski, 1998). The Internet has the potential to greatly enhance the rehabilitation professional's effectiveness and efficiency in all of these areas through immediate access to assorted types of rehabilitation information, e.g., vocational, medical, assessment information, and job readiness tools.

Vocational Information

Resources that become outdated or are often lacking in rehabilitation offices, such as the Occupational Outlook Handbook (OOH) [13], are immediately available via the Internet. (See Table 1 for all Internet addresses. For ease in reading, the addresses are listed numerically in the text). When a consumer indicates an interest in a specific field, the OOH is an invaluable resource for both consumer and counselor in comparing salary requirements with those anticipated by the consumer, the amount of training required, physical and intellectual capacities, and the future outlook for the proposed vocation. Instead of assigning homework to the consumer and delaying' vocational planning until the information is obtained, an initial on-line review of the OOH by the consumer and professional can prevent some of the "down time" in the vocational exploration process. For example, the consumer who is initially interested in becoming a veterinary assistant will find that (a) the median weekly salary is $290, (b) growth in employment is expected, (c) the work often requires hard physical labor, and (d) the work is often seasonal. Any one of these findings may cause the consumer to look at alternative vocations or indicate a need for further exploration.

Table 1 Internet Addresses

Meta Search Engines

1    Mamma                   http://www.
                             mamma.com/         [ 8 search engines]
2    Dogpile                 http://
                             dogpile.com/       [14 search engines]
3    Inference Find          http://
                             infind.com         [ 6 search engines]
4    MetaCrawler             http://
                             metacrawler.com/   [ 8 search engines]
5    Metafind                http://
                             metafind.com/      [ 5 search engines]

Medical Search Engines

6    Medline                 http://www.healthgate.com/res/
                             index.shtml
7    Internet Oracle         http://internetoracle.com/medical.htm
8    Netmedicine             http://www.mdchoice.com
9    Med Site Navigator      http:www.medsitenavigator.com/
10   Galaxy                  http://galaxy.einet.net/galaxy/
                             Medicine.html
11   Gateways                http://www.webcom.com/pgi/
                             gateways.html
                             [Directory - medical meta
                             search engines]
12   Physician's Guide       http://www.physiciansguide.com/
     to the Internet

Vocational Information/Career Development

13   OOH                     http://stats.bls.gov/ocohome.htm
14   Common Majors/          http://www.udel.edu/CSC/mrk.html
     Associated Careers      http://www.ksu.edu/acic/career/
                             options.html
15   DOT                     http://www.oalj.dol.gov/libdot.htm
16   O-Net                   http:www.doleta.gov/programs/onet/
17   Career Counseling       http://careerplanning.miningco.com/
     Resources               nobody.htm?PID=2772&COB=home
18   First Job               http://careerplanning.miningco.com/
                             msub7.htm
19   Resume/Cover            http://www.explore.cornell.edu/
     Letter Development      careers/cover%20letters.htm
20   Critique a Resume       http://204.168.91.166/htlm/career/
                             dinores.htm.
21   Cover Letters:          http://www.rpi.edu/dept/11c/
     Information             writecenter/web/text/
                             coverltr.html
22   Resumes:Information     http://www.liglobal.com/b_c/career/
                             res.shtml
                             http://www.wm.edu/csrv/career/
                             stualum/resmdir/
                             contents.html
23   Mock Job Interview:     http://www1.kaplan.com/view/article/
     Practice                0,1898,2562,00.html
24   Interview Network       http://www.pse-net.com/interview/
                             interview.htm
25   Informational           http://danenet.wicip.org/jets/
     Interviewing            jet-9407-p.html
26   State & Federal Jobs    http://www.statejobs.com

27   Career Planning         http://careerplanning.about.
     Process/                com/business/careerplanning
     Self-Assessments
28   Career Mosaic           http://www.careermosaic.com/
29   Career Planning         http://www.careerplanning.com
     Information
30   Choosing a Career       http://safetynet.doleta.gov/
                             choose.htm
31   Job Readiness           http://www.sciences.drexel.edu/
     Resources               teachereducation/jobint.html
                             http://www.rpi.edu/dept/cdc/student/
                             gss/careenav.html
                             http ://www.labor.state.ny.us/
                             html/youth
                             http://www.labor.state.ny.us/
                             html/library.htm
32 Placement Resources       http://www.jobweb.org/catapult/
                             catapult.htm

Medical Information
33   Addictions              http://www.well.com/user/woa/
34   Anatomy Lessons         http://www.innerbody.com/
                             indexbody.html
35   Behavioral and          http://www.the-center.org/behav.html
     Medical Links
36   WebDoctor               http://www.gretmar.com/webdoctor/
     Information by          disease.html
     disease
37   Diagnostic              http://medicinenet.com
     Procedures
38   Drug References         http://www.mayohealth.org/usp/di/
                             uspA-AM.htm
                             http://www.rxlist.com

Assessment Resources

39   The Career Key          http://www.ncsu.edu/careerkey/
40   Career Interests Game   http://web.missouri.edu/~cppcwww/
                             holland.shtml
41   Birkman Method Career   http://www.review.com/Birkman/
     Style Summary
42   Keirsey Temperament     http://keirsey.com/cgi-bin/keirsey/
     Sorter II               newkts.cgi
43   Career Influences       http://www.topjobs.co.uk/scripts/
     Survey                  questions.exe
44   Microsoft's IT          http://partnering3.microsoft.com/
     Aptitude Test           skills2000/default.asp
45   Career Net              http://www.careernet.org/assess.htm
46   On-line Assessment      http://www.namss.org/uk/jobassess.htm
47   Self-Directed Search    http://self-directed-search.com/
                             taketest.html

Consumer Organizations

48   American Foundation     http://www.afb.org
     for the Blind
49   National Multiple       http://www.nmss.org
     Sclerosis Society
50   National Alliance       http://www.nami.org
     for the Mentally Ill
51   Disability-Specific     http://www.eskimo.com/
     Organizations           ~jlubin/disabled/org.htm

General Disability Resources for Professionals and Consumers

52   Visual Impairment       http://www.viguide.com/orgs.htm
     Guide
53   Disability/Medical      http://www.coast-resources.com/
     Resource Mall
54   rehabNET                http://www.rehabnet.com/index.html
55   Disability              http://vaview.vavu.vt.edu/
     Information             disabled.html
56   Cornucopia of           http://codi.buffalo.edu
     Disability
     Information
57   disAbility Resources    http://www.eskimo.com/
                             ~jlubin/disabled.htm
58   Meningitis Foundation   http://www.musa.org
     of America

Continuing Education and Professional Resources

59   World Lectures          http://www.utexas.edu/world/lecture
60   LearnWell Online        http://www.learnwell.org
                             Credentialing/Education
61   Healthtalk              http://www.healthtalk.com
62   National                http://www.nchrtm.okstate.edu
     Clearinghouse of
     Rehabilitation
     Training
     Materials
63   ABLEDATA                http://www.abledata.com
64   DRM Guide               http://www.geocities.com/
                             CapitolHill/1703/
     Disability Resources    index.html
65   Job Accommodation       http://janweb.icdi.wvu.edu/
     Network                 [e-mail address for JAN]
                             [e-mail].
66   APSE Bulletin Board     http://www.apse.org/bb.html

NOTE: When sites are updated, addresses may be changed. If difficulties in accessing some sites are encountered, use the address preceding the first slash mark and then click on links from the home page.

The ability to identify vocational information is enhanced through search engines [1-5] such as Mamma and Metafinder and the use of key words. For example, the rehabilitation professional may be challenged to identify occupations available for a consumer who wants to major in art history. Instead of sending the consumer on informational interviews, the consumer or professional might type "jobs in art history" in the "mamma" search engine. One of the listings that will appear is Rosenberg's (1998) site titled "Career Alternatives for Art Historians," which includes an extensive list and descriptions of career options. Other sites [14] contain lists of common majors and associated career alternatives.

Although consumers and employers generally do not use the Dictionary of Occupational Titles (DOT) or its codes, rehabilitation professionals in many settings (e.g., Department of Veterans Affairs) are required to identify employment goals in terms of DOT codes. The DOT [15] and its replacement O-Net [16], are immediately available through the Internet. Although the O-Net currently contains a data base of 1100 jobs, once it is fully in operational it will include: (a) career counseling tools to assist with school-to-work transition initiatives; (b) integrated federal, state, and local labor market information; and (c) a comprehensive database of worker characteristics, worker requirements, experience requirements, occupation requirements, specific occupations, and occupation characteristics.

A number of sites provides a vast array of linkages to other sites. For example "Career Information" [17] contains over 50 links to career counseling resources. The link to "First Job" [18] includes reading that may be beneficial to a consumer (e.g., 22 career lessons, becoming a valued employee, characteristics of a good employee, and your first day on the job). At other Internet sites, consumers fill in the blanks to develop an initial resume or cover letter [19], or they can critique a resume [20]. Other sites provide more in-depth information on cover letters [21] and resumes [22] that counselors may find helpful if they are leading job-readiness groups. Practice in a mock job interview, in which the individual selects the best response to various statements by an employer may assist some consumers in discriminating between appropriate and inappropriate responses [23]. Other sites assist individuals in choosing and preparing for careers [28, 30], whereas others focus on job interviewing [24] and conducting informational interviews [25].

Another important component of vocational information relates to job readiness [31] and jobs. Most cities and states have job listings available on the Internet. As part of the O-Net system, an individual can search for a job by geographic area (i.e., state), industry, or check on state and federal jobs [26]. Some sites are very user-friendly for consumers and professionals, whereas others may require the rehabilitation professional's expertise. For example, some sites include both state and local jobs, whereas others separate jobs by various state departments or by types of occupations (e.g., computer technology). The rehabilitation professional may need to assist the consumer in identifying appropriate agencies or determining the hiring requirements.

Placement resources and job banks [32], are numerous on the Internet. Professionals can research companies and identify available jobs, training and experience requirements, and closing dates, all of which can assist in job placement efforts. Additionally, many state agencies as well as other companies provide for on-line applications and/or request that resumes be sent via the Internet. Although the Internet cannot replace job development efforts, it offers another valuable tool for career exploration, placement resources, and the identification of potential employers.

Medical Information

The Internet provides access to a wealth of current medical information. It is not uncommon for counselors and consumers to seek additional information related to particular disabilities. Although the search engines previously noted are the most helpful in acquiring specific medical information, there are also medical search engines. For example, Gateways [11] and the Physician's Guide to the Internet [12] provide links to a number of medical Internet sites such as WebDoctor [36] or Galaxy's Medical List [10]. Other sites that allow rehabilitation professionals to search for information on a specific disability include Medline [6], Internet Oracle [7], Netmedicine [8], and Med Site Navigator [9]. Some sites provide disability-specific information, such as information on addictions [32], whereas the information on others ranges from basic anatomy lessons [34] to information on assistance animals and adaptive clothing [53]. Some sites combine psychological, behavioral, and medical links [35]. Other sites provide information on diagnostic procedures [37] or drugs [38]. Information on new drugs that has not yet appeared in the Physician's Desk Reference can be obtained using the search engines, which access manufacturers' information, as well as research studies related to the drug.

A number of disability-specific sites [52-58] will be of interest to both professionals and consumers. The information from national and state consumer organizations [51 ] (e.g., the American Foundation for the Blind [48], National Multiple Sclerosis Society [49], or the National Alliance for the Mentally Ill [50]) is usually of high quality and, most importantly, contains links to consumer discussion groups or lectures on related topics [49, 61]. Many consumers will appreciate the opportunity to review such information, participate in the discussion groups, or at least be placed on the mailing lists of these organizations.

Assessment

Assessment information is available to professionals and consumers via the Internet. Examples of assessments that provide immediate information for consumers include The Career Key [39] and The Career Interests Game [40], both of which help consumers evaluate their abilities or match interests with careers. Various personality assessments, such as the Birkman Method Career Style Summary [41] and the Keirsey Temperament Sorter II [42] are available on-line and at no cost. Although there is no charge to take the Self-Directed Search [46], the cost to receive the 8-12 page personalized report is $7.95.

Promoting self-knowledge is one of the greatest values of many of the free Internet assessments. For example, the Career Influences Survey [43] is a 45 item instrument designed to assess items of individual importance such as "have opportunities for promotion" or "have control over the pace of work you do". Another on-line assessment is Microsoft's Information Technology Aptitude Test [44], which can assist consumers in determining whether their skills and interests are applicable to the field of information technology. Some sites contain multiple career, personality and interest assessments [45-47].

As with any assessment, rehabilitation professionals need to use these tools selectively and as a basis for career exploration or counseling sessions. Their purpose is to promote self-knowledge, identify potential problems (Luciano, 1997), and enhance career counseling, not replace it.

Support Groups

Because of the benefits associated with support groups, they are often included in the programs available through Independent Living Centers and Community-Based Rehabilitation Programs. There are two types of support groups available on the Internet: peer support groups and counselor-led support groups. Both offer a number of benefits including: (a) empathy and support; (b) immediacy (e.g., 24 hours a day every day); (c) a global community [e.g., support beyond one's community or country]; (d) vast resources in terms of types of treatment methods and sources of additional information; (e) cost-effectiveness, in terms of the cost of an on-line service; and (f) anonymity (Weil, 1996). Disability-specific Internet support groups can be helpful to individuals who have less common disabilities, who live in rural areas, or who have transportation or scheduling problems. Burgstahler (1998) found that peer support group diminished social isolation, advanced both academic and career goals, and helped "overcome the geographic, temporal, and disability-related barriers to establishing peer support groups" for students with disabilities (p. 3).

There are, however, drawbacks to on-line support groups. These include instant intimacy, abandonment (e.g., finding that an individual's e-mail address is no longer valid) (Weil, 1996), confidentiality, and misinformation. Also, research on Internet support groups is still in its infancy. DeAngelis (1997) reported on a study by Winzelberg, in which the messages of one on-line support group for individuals with anorexia or bulimia were categorized into four types: (a) disclosure of personal information (31%); (b) information and advice related to medical, psychological, and nutrition areas (23%); (c) provision of emotional support (16%); and (d) other information (15%). The importance of 24-hour access was evident from the times messages were sent: "37 percent were sent between 7 a.m. and 7 p.m.; 32 from 7 p.m. to 11 p.m., and 31 percent between 11 p.m. and 7 a.m" (DeAngelis, 1997, p. 2). However, in analyzing the 300 messages from the 70 individuals, Winzelberg found that 12% of the messages included "inaccurate or unhealthy" information. Future research of on-line support groups will be important for rehabilitation professionals in weighing the benefits of utilizing such groups or informing individuals of their existence.

Continuing Education

The rehabilitation process is enhanced when rehabilitation professionals maintain their competence, which is a requirement of many codes of ethics. The Internet is an excellent vehicle to maintain one's competence through on-going formal and informal education. In addition to formal web-based courses, such as World Lectures [59], the Internet includes formal continuing education programs that can assist professionals in maintaining their competence and obtaining the required number of continuing education units to retain credentials. For example, LearnWell Online [60] offers fee-based learning modules for health professionals.

The Internet also provides informal, on-going immediate access to information at the time it is needed. Rehabilitation professionals do not need to wait to attend a training conference. One can quickly update one's knowledge at any number of disability-specific Internet sites, e.g., the National Clearinghouse of Rehabilitation Training Materials [62], the National Institute on Disability and Rehabilitation Research's (NIDRR) ABLEDATA [63], or the DRM Guide to Disability Resources [64].

The Internet can enhance communication and consultation among rehabilitation professionals; for example, accommodation questions can be submitted through electronic mail to the Job Accommodation Network [65]. Listserves and bulletin boards provide the opportunity for individuals to discuss topics of mutual interest. For example, the Association for Persons in Supported Employment [66] sponsors a bulletin board for individuals to share and discuss topics related to this initiative.

The benefits of the Internet may be summarized as follows:

1. Accessibility. It provides for immediate access to information (e.g., medical, vocational) which can enhance the professional's effectiveness and efficiency in delivering rehabilitation services and equalizes the accessibility of resources between professionals with and without disabilities. The accessibility of the Internet allows consumers to conduct their own research, review information that they have discussed with their counselors, and benefit from the experiences of other individuals with similar disabilities.

2. Immediacy. It provides access to current information, sometimes before the information is in print. For example, Gorman (1999) reported that the National Cancer Institute called for new treatment for cervical cancer with the information released on the Internet prior to the research being published in the New England Journal of Medicine. The immediate access limits the "down" time in the rehabilitation process, when consumer and professional can access information and then discuss it. As more consumers have access to personal e-mail, the e-mail component of the Internet will enhance communication between the consumer and professional that is now tied to time in returning phone calls.

3. Advocacy. It allows rehabilitation professionals to better advocate on behalf of consumers by making information equally available to consumers and professionals and facilitating consumer involvement in consumer-related organizations.

4. Competency. It provides for low-cost, life-long learning for professionals.

Together, accessibility, immediacy, advocacy, and competency should enhance choice and collaboration between rehabilitation professionals and consumers. However, the Internet is a tool and, like many tools, it has drawbacks. There are also issues associated with the Internet that need to be considered by rehabilitation professionals.

Professional and Ethical Issues Associated with the Internet

The Internet is an excellent adjunct to and means of enhancing the rehabilitation process and facilitating consumer-professional communication. Though the projections vary, the number of computers in households and the number of households accessing the Internet are expected to be between 20 and 45 million by 2000 (Paralax Media, 1999) with Internet doubling in size each year (Matrix Information and Directory Services, 1998). This means that some consumers (a) will have researched topics before they ever meet a rehabilitation professional and (b) will choose to maintain contact with the professional via e-mail as the preferred mode of communication. Both of these events have implications for professionals.

One implication relates to accuracy of information. Although much of the information on the Internet is excellent, there is also much misinformation. As Silberg, Lundberg, and Musacchio (1997) noted in their discussion of medical information on the Internet, "The problem is not too little information but too much, vast chunks of it incomplete, misleading, or inaccurate, and not only in the medical arena" (p. 1). When consumers ask questions or share information with rehabilitation professionals, it will be incumbent upon the rehabilitation professional to clarify erroneous "facts" and point out the differences in the quality of information at various Internet sites. This is particularly crucial if the professional has recommended an Internet site to a consumer. For example, an individual who has been told about the Meningitis Foundation of America [58] may link to a "Discussion Forum," in which individuals discuss a variety of topics related to meningitis, including treatments. Informing consumers that the links within a site (e.g., consumer discussion groups) may contain misinformation is also a responsibility of rehabilitation professionals.

A second implication relates to confidentiality. Security issues related to the Internet have received much attention (e.g., National Institute of Standards, 1999); nonetheless, rehabilitation professionals who communicate With consumers via e-mail on non-secure lines need to communicate this fact as it relates to the possibility of limited confidentiality. Disclaimers that indicate that a communication is confidential should be a standard statement with any e-mail message.

Another issue relates to assessment (Holmes, 1997) and ethical issues related to on-line assessment. For example, Maheu (1997) stated:

   I understand our APA ethics principles to require that our testee know what
   items of a question might mean, and they must also understand the test
   results. If people are offering tests online, how are they assuring that
   these and other related ethics principles are being addressed? (p. 1).

The validity and reliability of many Internet tests are not discussed. Rehabilitation professionals should take any assessment, before recommending the assessment to a consumer.

Other ethical issues related to the Internet that may have more indirect implications for rehabilitation professionals are associated with WebCounseling and Telemedicine/telehealth. WebCounseling has been defined as "the practice of professional counseling and information delivery that occurs when client(s) and counselor are in separate or remote locations and utilize electronic means to communicate over the Internet" (National Board for Certified Counselors, 1998, p. 1). Telemedicine/telehealth, which refers to any means of interacting with the patient "besides hands-on, direct patient contact" is used for "patient teaching and education, follow-up, medication monitoring, monitoring of cognitive and functional status, and mental health counseling" (Wrinn, 1998, p. 18-19). WebCounseling and Telemedicine have implications in terms of counseling losing its human touch. Although it is unlikely that these two areas directly impact a majority of rehabilitation professionals, rehabilitation professionals and their related associations will undoubtedly be faced with problems similar to those faced by psychologists. The Chair of the American Psychological Association's Board of Professional Affairs stated, "the profession will be tempted to incorporate new technologies into the practice of psychology although we do not yet understand all the ramifications of their use...We need to advise practitioners on when, where and how to use these new technologies" (Sleek, 1995, p. 1).

The following Internet benefits and limitations noted by Sampson, Kolodinsky, and Greeno (1997), though related specifically to counseling, have implications for all rehabilitation professionals:

   (a) improve client access to counseling in remote areas; (b) improve client
   orientation to the counseling process; (c) facilitate completion of
   assessment instruments and homework assignments; (d) enhance record keeping
   and monitoring of client progress; (e) enhance counseling referrals; (f)
   expand access to assessments and support for test interpretation; (g)
   reduce scheduling complication in couples and family counseling; (h)
   encourage individuals to seek counseling via self-help resources; (i)
   increase options for supervision and case conferencing, and (j) enhance the
   collection of research data. However, without careful design, use, and
   evaluation, counseling services offered via the information highway may (a)
   limit the confidentiality of the counseling relationship; (b) deliver
   invalid information; (c) lack necessary counselor intervention; (d) be
   misused by inadequately trained or overworked counselors; (e) limit
   counselor awareness of important location-specific counseling variables;
   (f) restrict equality of access to counseling resources; (g) limit needed
   privacy for counseling; and (h) encourage service delivery by counselors
   without appropriate credentials. (p. 211).

The ethical guidance to address the limitations raised by Sampson et al. is sparse. Noting that the topic would be considered in future revisions of the code and highlighting a number of standards that psychologists should consider, the Ethics Committee of the American Psychological Association (APA) issued a "Statement on Services by Telephone, Teleconferencing, and Internet" (1997), which noted:

   The Ethics Code is not specific with regard to telephone therapy or
   teleconferencing or any electronically provided services as such and has no
   rules prohibiting such services. Complaints regarding such matters would be
   addressed on a case by case basis. (p. 1)

In contrast, the National Board for Certified Counselors (NBCC) (1998) created "Standards for the Ethical Practice of WebCounseling." The 13 standards address issues such as encryption and security measures, parental consent when minors are provided counseling, links to certification and licensure sites, and the potential for misunderstanding when visual cues are not present.

Rehabilitation Guidelines

Until the codes of ethics for various rehabilitation professionals (e.g., Code of Professional Ethics for Rehabilitation Counselors, 1988) are revised and to the extent they address Internet issues, the following guidelines may assist professionals who use the Internet as an adjunct to their work with consumers:

1. Recommend only those sites that the professional personally has previewed.

2. Use the Internet during meetings with consumers when it is appropriate to provide immediate information.

3. Inform consumers of the benefits and limitations of disability-specific chatrooms.

4. Use any on-line assessments completed by the consumer as a basis for counseling or career exploration, keeping in mind reliability and validity issues. Holmes' (2/24/97) statement is appropriate to repeat to consumers: "If you take a test on the net, consider the source. If the results don't seem accurate, they probably aren't..." (p. 2)

5. Address issues related to confidentiality before using e-mail to communicate with consumers. Issues of possible miscommunication should also be raised.

Internet technology is a tool worthy of consideration by rehabilitation professionals. When judiciously used, it has the potential to facilitate the rehabilitation process, enhance the consumer-counselor partnership, and promote choice. It should not replace the human connection, but is an excellent complement to human interaction.

References

Akrokiasamy, C.M., Benshoff, J.J., McLean, L.S., & Moss, G.L. (1992). Computer applications in program evaluation: Basic guidelines. Journal of Rehabilitation Administration, 16, 5-12.

American Psychological Association (1997, November 5) Services by telephone, teleconferencing, and Internet. Washington, D.C.: Ethics Committee, Author. www. apa.org/ethics/stmnt01.html

Burgstahler, S. (1998). Peer support: What role can the internet play? Information Technology and Disabilities, 5(1). www.lib.ncsu.edu/stacks/I/itd/ itd-v5n1-burgstahler-peer.txt

Code of professional ethics for rehabilitation counselors. (1988). Rehabilitation Counseling Bulletin, 31,255-268.

DeAngelis, T. (1997, March). Do online support groups help for eating disorders? APA Monitor. www. apa.org/monitor/mar97/internet.html.

Franklin, K.S. (1991). Assistive technology: Where are we? Where are we going? Journal of Vocational Rehabilitation, 1(2),6-7.

Gorman, C. (March 8, 1999). Fire both barrels. Time, 153(9), p.88.

Holmes, L. (1997). Are those psychological tests on the net valid? Mental Health Resources. http://mentalhealth.tqn.com/library/weekly/aa022497.htm

Hooked on line. (1998, October 12). Time. http://cgi.pathfinder, com/time/magazine/1998/dom/981012 /time_select.quarterly_b3b.html.

Jenkins, W.M., Patterson, J.B., & Szymanski, E.M. (1998). Philosophical, historical, and legislative aspects of the rehabilitation counseling process. In R.M. Parker & E.M. Szymanski (Eds.), Rehabilitation counseling: Basics and beyond (pp. 1-40). Austin, TX: Pro-Ed.

Luciano, G. (1997). On line assessments: Fact and fiction. The Journal.www.arf.org/internet.html

Maheu, M.M. (1997, July 27). Ethics for online assessment. Webpsych. www.cmhc.com/mlists/webpsych/0519.html

Mather, J. (1994). Computers, automation, and the employment of persons who are blind or visually impaired. Journal of Visual Impairment and Blindness, 88, 544-549.

Matrix Information and Directory Services. (6/29/98). More than 100 million Internet users as of January 1998. Austin, TX: Author. www. mids.org/press/pr 199801 .html

National Board for Certified Counselors (1998, April 1). Standards for the ethical practice of webcounseling. www.nbcc.org/wcstandards.htm.

National Institute of Standards and Technology. (1999). An introduction to computer security: The NIST handbook. Computer Security Resource Clearinghouse, Special Publication 800-12. http://csrc.ncsl.nist.gov/nistpubs/800-12/

Paralax Media. (1999). Internet facts. www.parallaxweb.com/internetfacts.html

Rosenberg, C.M. (1998). Career alternatives for art historians. www.nd.edu/-crosenbe/jobs.html

Sampson, J.P., Kolodinsky, R.W., & Greeno, B.P. (1997). Counseling on the information highway: Future possibilities and potential problems. Journal of Counseling and Development, 75,203-212.

Silberg, W.M., Lundberg, G.D., & Musacchio, R.A. (1997). Assessing, controlling, and assuring the quality of medical information on the Internet. Journal of the American Medical Association. www.ama-assn.org/sci-pubs/journals/archive/jama/vol_277/ .../ed7016x.ht

Sleek, S. (1995, November). Online therapy services raise ethical questions. APA Monitor. www. apa.org/monitor/nov95/online.html

Technology-Related Assistance for Individuals with Disabilities Act of 1988, 29 U.S.C. '2201 et seq.

Weil, M.W. (1996, September/October). From the couch to cybertherapy. National Psychologist. www. csudh.edu;psych/article.htm.

Wrinn, M. (1998). The emerging role of telehealth in health care. Continuing Care, 17(8), 18-22, 40.

Jeanne Boland Paterson, Ed.D., CRC, University of North Florida, 4567 St. John's Bluff Road. S., Jacksonville, FL 32224-2645. Email:[e-mail]