August 6, 1999

It's hard to know what psychoanalysis's founding father, Sigmund Freud, M.D., would make out of the contemporary psychiatrist's relation to his or her computer, but he would certainly be surprised to see an image of himself holding a laptop.

That image greeted APA members who visited the Office of the Future display at this year's annual meeting in Washington, D.C. The computer program that annual meeting participants accessed at the display is scheduled to be up on APA's Web site later this month. The Office of the Future Project was chaired by Ronnie Stangler, M.D., a clinical professor of psychiatry at the University of Washington in Seattle and a private practitioner.

The future is here, Stangler warned her fellow psychiatrists, and if psychiatrists don't pay attention to the development of computer technology, they may find themselves the passive recipients of those who control the technology.

"It's like anything else," she commented. "If we're there, we can shape our own future, and if we don't do it for ourselves, it's going to be done. Just as managed care happened while we were looking the other way, the technological revolution is occurring, and we need to be active players."

Computer technology is already an inextricable part of most people's lives, she noted. "We are the beneficiaries of a unique time in the history of technology, because we can see the possibilities on a daily basis. But we still have to deal with technology in its infancy and the inevitable frustrations of the software conflict" as well as the potential for information overload that has accompanied the explosive growth of the Internet, Stangler added.

The exhibit provides viewers with clinical vignettes suggesting how the psychiatrist of the future might employ new technology. For example, using a portable "webpad" that "provides full Internet access anywhere, anytime," a psychiatrist notes that she has "identified seven new articles pertaining to treatments" that a distant colleague is using. Another psychiatrist uses his computer to do an instantaneous consultation with a colleague carrying her own wireless webpad.

The exhibit addresses confidentiality issues and the use of virtual reality to aid clinicians with desensitizing phobic patients. It also addresses the potential impact of technology on education.

The evolution of telemedicine raises similar issues, according to Stangler. The July issue of Psychiatric Annals is devoted to telemedicine.

More information is available by contacting Stangler at stangler@u.washington.edu. The Web address for Psychiatric Annals is www.slackinc.com/psyann.htm.