There have been four
predominant movements in technology. In the 1960s, the first movement
included mainframe computers which allowed for high speed computation
used mostly for administrative and scientific tasks. The second movement
took place during the 1970s, when personal computers allowed individuals
to have increased computer access at home and in the workplace. The
third movement allowed the internet to provide a different level of
communication between individuals during the 1990s. The last movement in
technology is evolving. The cornerstone of this fourth movement is
small, mobile, wireless technology (Pownell & Bailey, 2002).
As a result of
this movement to mobile technology, handheld computers (commonly
referred to as Personal Digital Assistants or PDA’s) have become an
integral part of the working tools of many professions. In fact,
handheld computers have been referred to as “the hottest emerging
technology” (Pownell & Bailey, 2002, p. 50). The newest handheld
computers are more portable and less expensive than desktop or notebook
computers and have the capability for fast processing and large data
storage. Given this usefulness, portability, and affordability, handheld
computers have become a viable option for individuals on a small budget.
Handheld computers have
been used effectively to training medical students, assist in surgical
procedures, manage patients in a family practice, and manage patient
medication (Fischer et al., 2002; Galt et al., 2002; Kurth, Silenzio, &
Irigoyen, 2002; Lewis, 2001; Shiffman, et al., 2000). In the medical
profession, handheld computers have also been effective in accessing
vital patient information such as medical histories, drug information,
and previous medical records (McCreadie, Stevenson, Sweet and Kramer,
2002). Handheld computers have also been effective tools in psychiatric
settings. Ryan and Kotze (2001) conducted a three year longitudinal
study in two large hospitals in Sydney Australia to demonstrate the
utility of handheld computers in gathering psychiatric information.
Handheld databases on diagnostic criteria, pharmacological requirements
and interactions, treatment options, etc were developed and successfully
implemented. The results of this study indicated that handheld computers
are a viable means for obtaining psychiatric information in a quick and
user friendly manner.
Handheld
computers have been found to be an effective tool for individuals with
disabilities. Furniss (2001) discovered that individuals with severe
developmental disabilities prefer handheld computers over traditional
adaptive devices in completing vocational tasks. In a study by Davies,
Stock and Wehmeyer (2003), there was a significant difference (p = .001)
between adults with intellectual disabilities who possessed handheld
computers and those who did not when increasing independence and support
in vocational endeavors. Individuals with intellectual disabilities who
used handheld technology made fewer decision making errors, required
less prompting to successfully complete tasks, and fewer errors in
completing and overall task. Furthermore, Fruchterman (2003) found that
handheld computers provided individuals with visual impairments more
tools “that will help lower barriers to educational employment” (p.
585).
In education, handheld
computers are becoming more commonplace in both K-12 settings and higher
education. For example, handheld computers are required for all freshmen
at the University of South Dakota (Carlson, 2002). Students have used
handheld computers for note taking, remembering assignments, map
drawing, word processing and report writing, monitoring cultural
diversity, reading texts, data collection and data entry (Robertson, et
al., 1997; Shim, 2003; Tinker, Staudt, & Walton, 2002; Wishengrad,
1998).
Teachers have successfully
used handheld computers for a variety of classroom purposes. These
purposes include monitoring and
observing student behavior, supervising and monitoring student-teacher
activities, recording grades and keeping progress notes. The handhelds’
capabilities also allow for beaming lecture notes and assignments to
students, reading books via the internet, reminding students to take
medication, communicating with parents, and facilitating student
collaboration and peer support (Bauer & Ulrich, 2002; Crippen & Brooks,
2000; Kuhng & Iwata, 1998; Saudargas & Bunn, 1989).
Administratively, handheld
computers have changed the following school practices: time was no
longer spent installing wires for computer access, there was no more
need for computer labs therefore allocating additional space for
classroom instruction, student productivity increased, and the cost and
time of photocopying was decreased due to a paperless system (Pfeifer &
Robb, 2001). School administrators use handheld computers to access
student information such as student name, photos, class schedules,
grades, attendance, emergency contact information, etc. Handheld
computers allowed school administrators who were faced with crisis
situations to rapidly access student information (Fasimpaur, 2002).
Based on the literature from other professions, handheld computers could
be beneficial to counseling practice in five ways: cost, size and
portability, ease of use, data storage, and client - counselor
communication. First, the cost of handheld computers typically ranges
between $50 and $600. Compared to desktop and notebook computers,
handheld computers are a much more cost efficient mode of technology.
The second benefit of handheld computers to counseling practice is size
and portability. Handheld computers truly fit in the palm of your hand
and they are they can be taken anywhere. Counselors can use handheld
computers d
uring individual sessions without having to restrict
themselves by sitting behind a desk. Third, many handheld computers
today are easy to
use especially if counselors have experience in desktop or notebook
computers. Many handheld computers work off of the same operating system
(Windows) and applications (e.g., Pocket Word ®, Pocket Excel ®, etc.)
as traditional computers. Fourth, modern handheld computers have the
capacity to store large amounts of data and could be used to maintain
easily accessible databases. Lastly, clients with available handheld
computers could benefit by having their counselors beam them data e.g.,
important dates, medication side effects and schedules, and thought
stopping techniques to be used in a more mobile fashion.
Given the
usefulness of handheld computers in other professions, it is surprising
that the usefulness of handheld computers in the counseling profession
has not been studied. Research by the authors of this article was an
effort to address that void. As part of that research counselors and
health educators with novice technological skills were asked to develop
specific applications useful in their fields. This article focuses on
describing these applications and discussing the use of the applications
in the counseling field.
Participants
Twenty-seven individuals
participated in this study from a counselor education and supervision
program and a health education and promotion program at a large
university in Ohio. This population consisted of five counselor
education faculty, two health education faculty, sixteen counselor
education doctoral students, and four health education doctoral
students. There were five males and 22 females while 24 were Caucasian,
one was Korean, one was Macedonian, and one was from the middle-east.
Faculty that participated
in this study were chosen to participate in this study because they have
advanced competencies in technology and obtained the grant from Compaq /
Hewlett Packard. The doctoral students that participated in this study
were within their first, second, or third year of doctoral studies and
were chosen because they had an interest in the advancement of
technology.
Utilized Technology
The following
technology was obtained through grant funding from Compaq / Hewlett
Packard and Kent State University and was distributed to each
participant in the study:
iPAQ Pocket PC H3870.
This handheld computer was obtained due to the high speed, amount of
storage space, and Windows Operating system that allowed for better use
of compressed video and wireless capabilities.
128 Megabyte DS Memory
Chip.
Additional memory was obtained to allow participants to store large
files on their handheld computer. The additional memory allowed storage
of large files on the computer.
Compaq Foldable Keyboard:
A portable and actual size keyboard allowed easier data entry.
PC Card Expansion Pack
Plus: Mobile
Internet and email functions were added to the computer with in this
expansion pack.
Training Procedures
Participants
in this study were enrolled in a 17 week workshop that facilitated
handheld computer training and application development. The purpose of
this workshop was to assist doctoral students in becoming more familiar
with Personal Digital Assistants (PDAs) and understanding the importance
of PDAs in their future careers. Ten hours of training in the basic
functions of PDA’s, six hours in customizing the PDA to meet the unique
needs of individual students, six hours in project development, and six
hours in critiquing and presenting projects. The Workshop utilized
experiential demonstrations, small group activities, supplemental CD-Roms
and websites, along with lectures presented via Smart Board / SB
Whiteboard technology.
One of the main objectives
of this study was for students to work independently and develop two
individual applications. The goal of this assignment was to develop two
basic applications for their iPAQ 3950 that can currently be used on the
iPAQ and could be accomplished given their level of PDA competency. Each
application would directly impact the student’s specific areas of
specialty or interest and was not available for purchase or free
download from the internet. Each application was summarized and
demonstrated in class.
Self-Produced Counseling Applications for Handheld Computers
The purpose of having
participants develop counseling applications for handheld computers was
to get them to transfer skills learned with standard software packages
to potential applications useful with counseling. This process has been
described by Jencius (2000) as developing a digital vision,
seeing their current working environment as counselors and viewing the
incorporation of technology into teaching and practice. The process is
further articulated in Jencius and Paez (2004) in addressing technology
resistant counselors. In order to expand the participants thinking about
technology incorporation using handheld devices we encouraged them to
think of possibilities for transferring traditional paper and pencil
counseling tasks to handheld format. Many participants envisioned the
regular assessment and paperwork as something that they could benefit
from having in an electronic portable fashion.
Most available assessments
are copyrighted and cannot be altered to be produced in another form
without the copyright holder’s specific permission. Acknowledging that
fact, participants wishing to transfer copyrightable assessments did so
only for the purpose of a demonstration project for the training. The
learning outcome from the exercise was to have participants being to
think how they could transfer tasks from traditional to digital format
given copyright permissions were granted from current holders. Use of
any copyrighted material was limited to the demonstration project and
not for purposes outside the demonstration project. On the other hand,
many if not most of the participants either created unique tasks that
could be transferred to a digital platform or found things in the public
domain that could be transferred for use to the handheld technology.
Applications to Assist in
Counselor Organization and Efficiency
Many of the
basic functions of handheld computers were found to be applicable to
helping counselors become more organized and efficient. For example, the
calendar function was used to schedule client appointments and keep
track of short term and long term treatment goals and the word
processing application was used to keep progress notes. Specific
applications could be beamed to clients who have handheld computers to
assist with keeping the client organized. Clients could use calendar
function to keep track of scheduled appointments and times to take
medication. Clients could also use the word processing application of
handheld computers to journal and make notes on progress away from
counseling sessions. The beneficial and unique function of handheld
computers is that, due to their portability, they promote clients
working on their own growth and development outside of the counseling
session.
School
counselors could use the calendar function to keep track of daily
activities and of how the American School Counselor Association National
Model (ASCA, 2003) is being implemented on a daily basis. These data
could then be presented to principals and superintendents to further
advocate for school counselor services.
Applications for Assessing
Clients
Client
assessments were the most promising applications developed in this
study. According to Piotrowski and Zalewski (1993) among the most used
psychological measures in practice include such assessments as the
Thematic Apperception Test, the Minnesota Multiphasic Personality
Inventory – II, the House-Tree-Person test etc. The portability of
handheld computers was beneficial to assessing clients. Counselors could
administer assessments in real life or timely situations such as on the
playground, in group settings, or in times of crisis when utilizing such
technology. Also, counselors do not have to be bound to an office
computer when writing or interpreting tests due to the mobility of such
devices. Participants in this study developed report writing guides in
the word processing function of the handheld computer along with
reference guides for a variety of tests such as the Millon Clinical
Multiaxial Inventory-III (MCMI-III) (Millon, Davis, & Millon, 1997), the
Minnesota Multiphasic Personality Inventory-2 (MMPI-II) (Butchner, et
al., 2001), and the Rotter Incomplete Sentence Blank (Rotter & Rafferty,
1950).
The following assessments
were piloted specifically for use handheld computers utilizing the word
processing function: mental status examinations, suicide assessments,
bullying assessments, the Beck Depression Inventory-II (Beck, Steer, &
Brown; 1996), assessments for individuals in prison, career inventories
(link with specific criteria), and alcohol abuse assessments.
A unique
outcome of this study was the development and adaptation of projective
tests to be used on handheld computers. The House-Tree-Person (Buck,
1948) could be used in the “draw” function of the handheld device. The
Bender Visual Motor Gestalt Test (Bender, 1938) cards and Thematic
Apperception Test (TAT) (Murray, 1943) cards could be electronically
scanned and displayed on the handheld device. Both tests could be
administered on a handheld computer but such technology could also be
used to record the client verbal responses (stories) form the TAT for
increasing the reliability of coded responses.
Applications for Research
and Program Evaluation
Some of the piloted
projects of gathered from the participants included ways in which the
handheld device could be used for counseling research and for counseling
program evaluation. Since the handheld training was done with doctoral
students engaged in research, it is not a surprise that many of the
proposed applications involved using the technology in research. The
counseling program at Kent State University is a CACREP accredited
masters and doctoral program so some of the participants saw the
advantage of digitizing standards and making them readily available for
program planning and even site team review. Some examples of research
and program evaluation applications include:
Q-Sort in Pocket Excel ®.
Q-sort methodology typically involves sorting statements into an array
with weighted values. Typically this data is input directly from paper
documents directly into PQ-Method software (Schmolck, 2002) which
calculates factors sorted from the array. One participant developed an
adaptation using spreadsheet software for data input which makes the
process paperless and portable. The collection of data can be done using
the handheld and later easily entered into PQ-Method.
Qualitative analysis.
One participant suggested that the microphone and audio recorder could
be useful for collecting interview information for qualitative analysis.
Audio information can also be collected using other devices, digitized
and transferred to the handheld. The PDA device would simultaneously
have word processing capabilities allowing the user to listen and
transcribe interview information on the same device instead of separate
audio and word processing device. The portability of the device and the
earphone for audio would allow a researcher to do the transcription in
multiple locations.
Mobile consent form.
The word processing and touch pad graphic signature capabilities of the
PDA would allow for paperless consent forms which researchers could use
while collecting field research or crisis workers could use as the
situation demanded.
Nighttime data collection
with backlight.
One participant was actively involved in research gathering data from
college students at night in the campus town streets. Using a paper and
clipboard system she found that often there was insufficient lighting
available for transcribing the survey responses onto documents. After
transferring survey documents to the handheld device the backlighting
would allow for better transfer of survey responses in the field.
Program evaluation.
CACREP standards were imported and placed into separate Word files or
HTML files with hyperlinks. This kind of formatting would allow
students, faculty and potential site team evaluators a opportunity to
bring conveniently carry them with them and access them as needed. With
the portability of the handheld device, notes could be taken on each one
of the standards. With standards placed with a hyperlinked structure
using HTML, suers can jump easily from one section to another.
Applications for Counselor
Supervision
Many of the participants
in the project were involved in clinical supervision, either as part of
their training in the doctoral program or as part of their employment.
These participants envisioned the practicality of having a PDA to aid in
the process of supervision. Examples of applied application included:
Supervision notes template
and supervisee tracking system.
One participant actively involved in supervision of our Masters students
developed a template for supervision notes including areas for client
information, session number supervisee report of client, supervisee
performance, supervisor report observations and or directive and
recommendations provided. In addition a tracking system for supervisees,
their clients and client contact hours was developed using Pocket Excel
® spreadsheet program. The size and portability of the PDA and attached
keyboard allows for the supervisor to generate notes or do tracking of
their supervisees’ work while observing the supervisee-client session or
during the supervision session without having to have access to a large
desktop system.
Supervision treatment
plan. Another
participant was involved in a doctoral level course on counseling
supervision. To assist her in her course, a Supervision Treatment Plan
was developed using the calendar function. This application was used to
track short-term and long-term goals of supervisees and integrate the
dates in which such goals were to be accomplished.
IM / beaming during live
supervision.
The handheld devices used in this project had attachable wireless
internet cards to allow for wireless connection to the Internet. A
participant in the project combined the wireless capability and the
Pocket PC Instant Messenger ® function to be able to provide real time
popup supervision messages to a similar device used by a counseling
student while in session with a client. This is a high-tech way to do
“bug in the ear” supervision. Previously Scherl and Haley (2000)
demonstrated the use of computer monitors in training labs as an
alternative unobtrusive method for supervisors to send messages to
supervisees working with clients. The use of the smaller handheld device
for this type of supervision removes the obstruction of the large
computer monitor and obvious effort to read it when it has to be out of
the line of sight of clients.
Applications for Counselor
Education
Using technology for the
teaching of counseling offers many benefits to the instructor and
student. The following applications were developed to assist counselor
educators: a timeline in which to complete a dissertation or study for
comprehensive examination questions, an accreditation site team
checklist, a grade sheet that kept track of absences, a multicultural
competencies rubric in Pocket Excel®, and means to organize and stay on
track with lectures.
Doctoral timeline.
One participant developed a timeline for preparation of doctoral
comprehensive exams. The timeline was a clock-back calendar including
various tasks for preparation for comprehensive exams. The calendar was
done in a word processing table format, however the timeline could be
input in the calendar function of the handheld. A similar timeline was
created for the development and completion of a dissertation using a
step-by-step list.
Grading spreadsheet.
There are some commercial teacher grade books available for handheld
devices. They can be pricey and not configurable for the specific needs
of the class. One participant used Pocket PC Excel ® to simply create a
course spreadsheet that could be customized for classroom assignments
and automatically tally grades for students. The participant used the
application in a class and liked the immediacy of having all of the
grading data. A student who had questions about their total progress or
a request for grade adjustments could be addressed immediately.
Multicultural counseling
competencies checklist.
One of the participants developed a checklist with Likert scale
evaluations for each of the Association for Multicultural Counseling and
Development’s Multicultural Counseling Competencies (Sue, Arrendondo, &
McDavis; 1992). It was felt that the checklist could be used for student
self evaluation with immediate calculation and guidelines for areas of
growth.
Anonymous grouped
questions and responses.
Another participant suggested that a class should be equipped with
handheld devices because it would allow for students to instant message
information to the teacher in a confidential fashion. This could be
helpful in teaching situations where students are asked to submit
critiques or other students work or presentation. Students could instant
message their evaluation to the instructor which can then be anonymously
shared with the student being evaluated.
The wireless function of
handheld devices could also assist counselor educators in that they
could have students communicate to the instructor in class without
others knowing. For example, if a student is embarrassed to ask a
question in class, they could use the wireless function of a handheld
device to ask the instructor a question without other students knowing.
The instructor could also use the wireless function to administer
quizzes and the first student who responds via instant message may get
additional points.
General Applications for
Working with Clients
Many participants in this grant were licensed counselors and wanted to
develop applications that would assist their clients. The handheld
device was used to view video clips of couples communicating in
different ways; clients could critique such video clips and relate them
to their own situations. The handheld devices could also be useful in
hospital settings due to its portability from room to room to provide
patients with educational materials that they could read on the screen
regarding their specific disorder. Small, handheld computers would not
be intrusive in a group setting so that the group leader could refer to
notes on a specific activity or referring to group rules or screening
procedures. Handheld devices could also be valuable during individual
sessions a
s a quick reference tool. Checking diagnostic criteria or
navigating a client through a diagnostic decision tree were found to be
viable practices.
Discussion
This study shed light on
the applicability and utility of handheld computers in the counseling
profession. It was also shown that novice users of technology could
easily develop unique applications for handheld computers to fit their
specific professional needs. The new technology takes many of the
function found in non-mobile computers (e.g., Microsoft Word ® and
Microsoft Excel ®) and provides the same functionality on a handheld
computer platform (e.g., Pocket Word ® and Pocket Excel ®). Participants
considered the mobility factor in designing handheld computer
applications that focused the usefulness of having the applications in a
portable digital platform. There was an added value to the mobility of
the developed applications versus traditional application methods.
Any new adoption of
technology comes with its obstacles. This project brought together
students and faculty of a diverse range of ability with technology and
as a result we were able to identify some of the obstacles similar
technology adoptions may face. An initial concern was the willingness of
participants to adopt a mobile lifestyle. There were two participants
who dropped from the project before it began once they understood the
time demand and the shift in commitment to the technology. Participants
involved in the study would fit under Rosen and Weil’s (1995) technology
archetypes for mental health professionals as eager adopters or
hesitant prove-its. Eager adopters embrace new technology and
feel as if everyone should adopt it. Their excitement can be contagious
and are helpful in working with the hesitant prove-its. Hesitant
prove-its are those on the sidelines waiting for someone to show
them the advantages and possibilities of technology and how it applies
to their life and work. In this project we were able to use all
participants broken into in smaller teams which often paired energetic
eager adopters with hesitant prove-its. This kind of pairing helped the
project group manage itself and many concerns and questions were
answered through the group without undue demand on the project leaders.
The other obstacle faced
in the project was the handheld technology itself. The project team
consisted of the three authors, all three eager adopters at a fairly
sophisticated level of technology ability. Troubleshooting software and
hardware technology glitches became the responsibility of the authors.
Software problems with syncing the handheld technology to the
participant’s desktop computer, addressing incompatibility of email and
home internet connections with the syncing software, keyboard driver
problems, desktop software output matching handheld software output and
file transfer and attachment glitches had to be resolved. Many of the
hardware problems that were faced had to do with the newness of the
technology. We were fortunate to be testing the limits of top of the
line handheld devices. Battery life and recharge resiliency was a
technology obstacle that has improved with recent models of handhelds.
In a few cases, equipment failed for other hardware reasons in which
case the equipment had to be replaced under warrantee even before the
research project had concluded.
Other limitations have
been seen in the handheld platform, most notably the screen size of the
hardware and the resolution of documents being used. Without the
attached keyboard handheld computers can be tedious in using the touch
screen keyboard or shorthand input for some users. Some proposed
projects might work better with the larger Tablet PCs, affording the
same portability with larger screen size and better writing recognition
software. The Tablet PC also offers full computing processing
capabilities and the same software packages found on desktop computers.
The true value of this
project was in the participants’ exploration of the possibilities that
handheld technology holds for counselor education and counseling
practice. Jencius (2000) pointed to various teaching methods and how
they can be replicated using various technology platforms. In the case
of this project, the possibility exists that much of what we present in
the classroom and what we provide in counseling and supervision could be
transformed to a variety of multimedia based material which would run on
the handheld. This shift towards incorporating technology would raise
the question “What can we do in the client - student meeting that
utilizes the uniqueness of the gathering clients - students in one
place?” Educators and counselors would return to the uniqueness of that
human interaction.
Future Directions of
Handheld Technology for Counselors
As presented
above, handheld technology creates a vast amount of opportunities for
counselors. The future lies in three areas for both counselor educators
and practicing counselors: (1) portability, (2) communication, and (3)
knowledge and awareness building.
First, a handheld
technology needs to promote its portability for students, clients,
counselors, and supervisors. Handheld technology can be used to get work
done anywhere and at anytime. A student or client phrase such as “I did
not have time to do my homework” is not as understandable with handheld
technology. You don’t need to be in front of a computer or have your
journal ready at hand. Handheld technology allows students computer
access to get homework done, clinicians to complete treatment plans,
supervisors to complete supervision notes, and clients to monitor
medication and therapeutic homework assignments.
The second area
(communication) builds off of portability. The future of handheld
technology rests in access to communication. In many circumstances,
handheld technology has integrated cellular phones, video phones,
e-mail, text messaging, and Bluetooth technology to allow for instant
access to others. Group assignments for students and faculty, instant
text messaging for clients in crisis, consultation for counselors and
supervisors… the communication possibilities are endless. The point is
that this communication is not bound to home or office phones, we can
communicate at any time and in any place.
The third and
last area of the future of handheld technology is knowledge and
awareness building. A primary goal for any counselor educator,
counselor, supervisor, or agency administrator is to allow access to
information and promote self awareness. Building off of area two
(communication), the future of handheld technology will promote ready
access to information and personal awareness. For example, the latest
models of handheld computers incorporate capabilities to access to the
Internet and on-line databases. Also, specific software packages have
been developed for counselors that make diagnostic and treatment
planning software compatible with handheld technology. The more we have
access to information the more we learn about ourselves.
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About
the Authors
Jason McGlothlin,
Marty Jencius and Betsy J. Page are faculty members in the
Counseling and Human Development Services Program, College and Graduate
School of Education, Health, and Human Services Kent State University,
Kent, Ohio 44242-0001.
