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Ptsd Forum 2013 Discussion

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anthony

Founder
I thought I would create a new thread from the announcement of future changes thread: [DLMURL]https://www.ptsdforum.org/c/threads/ptsd-forum-network-2013.18643/[/DLMURL] so that discussion doesn't interrupt the announcement of the limitations posted in that thread.

This is more apt for just all out, have your say type approach.

What is going through my mind on future development as the administrator? More importantly, what is going through your mind on what you want from an online resource that actually helps you get better, along with how to achieve it... being extremely important?

Ideas are all good and well, but implementing them must also be possible and reasonable.

Like I said in the announcement, and then further clarified about the usage of "my" within the naming to do with ownership, being "I" inference, which is appropriate in acknowledging trauma, the proposed structure is something like:
  • myptsd.com (main PTSD resource, 18+ as provides medical information)
  • mysexabuse.com (handles sexual abuse from 13+ (COPPA compliance), non-mental health focused)
  • mycombatptsd.com (handles veterans only with PTSD)
  • mydomesticviolence.com (handles all types of DV, 13+ (COPPA compliance))
  • mysupporter.com (An addition as a single supporter resource, considering a single signin system will be in use, regardless which forum you use.)
The three (3) umbrella sites at this stage will all become linked into the main site database, so there is a single login process, regardless which website you're using, to enable a quick and easy access stream into a single more expensive and complicated chat system, which is installed here now, yet will expand in the future.

Chat Expansion

Creating rooms for each forum is a nothing aspect... we have expanded chat to already include a report and vote to kick self moderation system. There is one more system I am reviewing for the "possible" future inclusion, which uses all resources already paid for here, but expands the video system to be more personal again, being an email feature offered by Flashcoms allowing members to video email one another within the site.
  • Cost US$700 for unlimited user license - unlimited users required as "users" is based upon how many will use it over time, and putting a limit of 1000 max on it, being the lesser license maximum offered by Flashcoms, is not really effective for a forum that already exceeds that in membership, and will exceed that in usage over a period of time for the product.

    Must also factor in, this would then be used across all four websites, as users run from a collective single database, not how it is now, with single sign on for each site you specifically fit.
Business or Non-Profit Registration

An area of future issue is this decision, which of yet I do not know the full complexities or consequences, from both legal and accounting aspects... much more to look into before any decision will be made on this in 2013 itself. Example:
  • Business / Company - Making the new MyPTSD entity into this can exclude specific parts of the site, ie. the forum, leaving a fee for service approach for therapy. Problem with this, is that I can only perform limited hours of actually one on one help, otherwise I fall down ill. Employing other therapists if it grows, will be costly to you the sufferer, which completely defeats the entire purpose and aim for MyPTSD with helping in the PTSD realm... due to my own direct suffering and experience with PTSD.
  • Non-profit - Now this is my preferred option, yet extremely tricky and lots of legalities in Australia, yet possibly do-able, maybe not a realistic option at all... unsure. This really is quite a complex adventure, but once established, no more real work than a registering a company and running it.

    A non-profit still allows for payment to persons for their time, ie. pay therapists to perform work, cost of the site, accounting, etc, however; the kicker here is that it can exist on donations and raise money / collect money from businesses, individuals, etc, as possible tax-deductible donations (Maybe - strict laws apply here for tax-deductible non-profits), yet provide global therapy services to those diagnosed with PTSD via online methods through MyPTSD. This fits my more personal thoughts and wishes, that everyone get available help for PTSD, not just those with the $$$ to afford it. This way, some could get totally free assistance, others could get cheap assistance quickly, being that the difference is funded via a charity.

    Again, not real sure on all the legalities or whether this is the best, or even viable... and there are lots of legalities and requirements to be classified as "charitable" under Australian law. The best thing though, is that as a charity then everything becomes completely public and open, and my ex-wife can't screw me for money personally by screwing what MyPTSD is trying to accomplish for those who have PTSD. If it was a business, and as an extremely money hungry person she is, she would try to get money from anything it made, so as a charity, she could not do a thing, as she does not care about anyone suffering PTSD... she only cares about herself. So this would completely absolve any possible avenue in this country for her to take, thus cannot get near what is deemed charitable monies for her own greed and financial gain through trying to get more child support or such from me personally.

    Easy to say, not so easy to put together though from a legal perspective here in Australia, as charities that are tax deductible are not just handed out because you apply, and are vastly different from being a non-profit who is exempt from x, y or z taxes... which doesn't mean you're an actual tax deductible charity in the this country, it just means you are not for profit and are exempt from some or all taxes... tax deductible donations are different again.

    Basically, if it can be approved as a charity, then more can be done for PTSD... and payment can be made for services rendered by the charity, and as a charity vs. business, if the charity got closed, then any profits must be dispersed under Australian law to a similar charity to assist them in what is deemed a similar purpose. So in other words, all monies would go to a charity that is mental health related and based in Australia, so there is never any worries about donations become private funds for anyone, including myself.

    Then there is International implications and requirements... the simple problem of the site being web based and not physical in nature... could pose issues, really just unsure and only have more questions than answers about this avenue at this time.
It cannot be left as hobby based if the forum in any way, shape or form, legally, provides a pay for service arrangement, under Australian law... as that would then be construed as a service, which means legalities, insurance and I personally must have my qualification first to perform even limited hours of providing a service. Right now, people donate to help pay for the hobby of PTSD Forum, to keep it online and developed.

One possible aim is to be able to accept professionals who give their time towards a charity model, helping people with PTSD, thus expanding the realm globally for online assistance. Without that protection for them when they provide such a charitable service, they would be negligent, thus unable to do it. Where here, now, they are exempt from such things under the legal policy as anything they say here is not under a "fee for service" arrangement, thus they participate as any other member does.

Whilst the legal policy can reflect specifics of what is and is not a service under the MyPTSD brand, which it will, the moment the forum is used or included in any way with payment for services, then we must act under the laws of providing a mental health service, not a bunch of us all helping each other out, which is how forums exist now without complicated legal aspects. Any forum that provides services, would be a business or paying taxes... this being mental health, comes under medical, and complicates things that little bit further.

And the forum, or part of it, will get used for services, ie. a group therapy forum would be one of the first things that come to mind, where information can remain within a forum environment, yet closed to those within the group therapy itself, as its not individual counselling, which would come with privacy legalities.

So these are two current thought processes that must be reviewed and decided in 2013 as things get established.

There are so many possibilities and options, avenues, etc, that can be taken to expand this site to help those who suffer PTSD, without complicating it with expensive services or pricing, period, so the aim of the site always remains PTSD sufferer and supporter focused.

WOW... That All Sounds Complicated, Why?

What have I learnt from this forum over these past years? The main points are easy, being:
  1. Conventional therapy by people who don't have PTSD, just doesn't seem to really be effective and drags out over a lifetime for severe and complex sufferers, when it doesn't need too. The recovery percentages are low from conventional therapy. A short, concentrated, burst of around one months direct attention with help, daily / near daily, is usually enough to kickstart the person on the road to recovery and get a good majority of the aspects out in the open and the person self motivated into healing.
  2. Medication is more counter-productive than productive for the treatment of PTSD in most cases as any type of solution beyond short-term 1- 3 years maximum.
  3. The cost and availability of any real therapeutic solution just doesn't exist across the world, as lifetime PTSD sufferers (severe and complex) are majority unemployable and limited by any free services available, as well as therapy time itself, hence they endup here looking for answers, help and support. Their partners often wear the burden for insurance / therapy ongoing costs, which privately is expensive, free type clinics / low cost, cumbersome and difficult to get in to and the level of care often unsatisfactory for the level of distress.
They would probably be the top 3 points of concern for the treatment of PTSD.

Now, me alone... I cannot help the world. I tried that years ago and ended up falling apart worse myself, thinking I could help everyone else, and forgot about me. Sure, lots of people got better, but I got worse, and that took a toll again on my own life. So that's not sustainable. So the above ideas are thoughts on what is possibly sustainable in the future.

Nothing here is concrete, these are all just thoughts, opinions, ideas, vision for the future. If SGB becomes the cure for PTSD that people have been looking for by 2013, then I don't need to worry about any of this... but from looking at the results pool myself already, its not looking that way, and seems more only targeted at a select group of PTSD sufferers, again not working on complex and severe cases. Time will tell...

An example of why a non-profit type model would fit best, is:

The best type of therapy is usually that from someone who "gets it", being those with PTSD, though also who have the qualifications to provide therapy. I am getting such, others already have them, ie. social workers, counsellors, psychologists, nurses, etc. There are many fields that qualify to provide therapy for a fee service.

Knowing I, like most, if they could help others, then they can only do it for brief periods in order to maintain their own health with PTSD. So really a group of global, qualified, therapists who all have PTSD, treating others with PTSD from here and being paid for it, as the non-profit sustains from charitable donations to pay part-time therapists with PTSD who can work from home and provide video and/or text based therapy over the web at little to no charge to the sufferer, and be dedicated for x hours a week with that person initially, then tapering it out over time, then reducing back to just forum support.

More complications based on therapy! Therapy is the type of service where there are laws that must be complied based on your physical location. So lets say, using user Becvan as an example here, being a Social Worker and Canadian. Lets say the organisation employed Bec to provide therapy services through the site. Bec works part-time from home and helps sufferers for the non-profit, is paid by the non-profit. Because Bec is providing that service from Canada, then she must comply with that countries laws for providing therapy services, as well as Australian laws by working for the Australian entity. Then, each client has laws for their rights based on medical services based on their physical location. This is the complication of the WWW at this present time... nobody knows which law trumps what, however; good legal policies and contracts can get around most things by the client signing them prior to the service being provided. That is how people are delivering therapy across the world via websites at present. Will such loopholes get closed in the future? Do not know. Will each therapist simply be limited to providing clients within their country only? Don't know...

As you can ascertain... the more questions asked, the more complications and questions are raised.

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There is a vast knowledge and experience base on this forum, and I would like to tap into that for feedback on what options exist based on the above, that you know of / have experience in that area, etc... what is around that simply hasn't been mentioned here yet that could benefit the members in the future, etc etc.

What do you have to say?
 
I've been working on this in private for a few days now, and feel happy to release it for continued discussion with forum members for feedback... as the coming changes take time and patience.
 
Thank you very much for sharing your thought process, Anthony! Obviously, you have put a lot of energy and time into understanding how the system works. I am extremely impressed.

I personally like the idea of a not-for-profit agency that could call on experts in the treatment of PTSD (especially those with PTSD themselves). You have helped so many people with your hard work and I would love to see that expand even farther around the globe.

I am neither as computer- or internet-savvy as you are, but I enjoy thinking issues through. For the moment three things stand out to raise as questions:

1. If you are able to set it up as the ideal site you can imagine, would that enable you (and Nicolette, if she is interested) to earn a decent salary (livable wage) so it is not just a "hobby?" That might take significant stress off of your shoulders if this were actually your full time job. This of course would also apply to various other professionals who are or would be paid fee-for-service.

2. These questions might be minor and detailed. You mentioned that the professionals on the site would have to adhere to the laws and licensure in their own countries as well as those in Australia. What about countries which have distinct differences in licensing and laws from one state to another (e.g. in the US)? What kind of insurance to practice would the professionals need to use? I just wouldn't want someone who is devoting their valuable time and knowledge to helping others end up being screwed by someone who is out for revenge or is simply angry. Is there even such a thing as a global mental health practice license?

3. How can we (the members) help?

Take care!
 
1. If you are able to set it up as the ideal site you can imagine, would that enable you (and Nicolette, if she is interested) to earn a decent salary (livable wage) so it is not just a "hobby?" That might take significant stress off of your shoulders if this were actually your full time job. This of course would also apply to various other professionals who are or would be paid fee-for-service.
Firstly, I am fortunate enough that I actually don't require any money, and I actually am paid enough to get by on, which has nothing to do with the forum, hence retired. Nicolette runs her own company, which she did before we met, and I was retired before we met, so both of us have our financials well and truly in order, regardless of the forum, hence why we just pay for it, and donations assist in covering the cost.

We all need to do things though to keep our minds active, which keeps us alive, hence my passion with giving back to PTSD.

Would I take a wage from the charity? I would take a wage purely only for any time I provide if the charity could cover it (primarily it is a goal for me to be able to work a few hours a week), the same as other specialists with qualifications, for services provided for the hours I actually provide such services for. In my mind, the entire idea of a charity is that the money is used to focus on providing the help, so that money would be used to pay therapists globally to provide services via online means either free or extremely reduced.

These questions might be minor and detailed. You mentioned that the professionals on the site would have to adhere to the laws and licensure in their own countries as well as those in Australia. What about countries which have distinct differences in licensing and laws from one state to another (e.g. in the US)? What kind of insurance to practice would the professionals need to use? I just wouldn't want someone who is devoting their valuable time and knowledge to helping others end up being screwed by someone who is out for revenge or is simply angry. Is there even such a thing as a global mental health practice license?
The laws for the provision of therapy services, regardless of location within the world, typically require some type of indemnity insurance to be had by the therapist. In other words, If it costs $1000 a year to get the insurance, then the person must obviously be dedicated to providing x hours per annum to make money and pay their costs.

If the person was located within Australia, maybe even a country of the Commonwealth, then all persons could be employed under the Australian company, however; those outside such countries would more than likely be employed as individual contractors, which means, they run their own business, pay their taxes, insurance, etc, and MyPTSD would simply provide them the work and pay them for their time. Basically, a middle man to connect the client to the therapist, and the therapist is subsidised / paid by the middle man, however; if any legal issues arise, due to licensing of the services provided, the client skips the middle man and goes directly to the therapist, being the business they have signed a contract with. MyPTSD would sign a contract with the therapist to fund them... so the client has no contract or legal obligations, vice versa, to MyPTSD.

How can we (the members) help?
Presently, there is nothing really to do, other than for members just to use the forum, use the services provided, and for those who can afford to donate to assist in the running costs, all such help is very much appreciated and used to improve the free resources made available to all PTSD sufferers and their supporters, family, etc, globally.
 
Basically, if it can be approved as a charity, then more can be done for PTSD... and payment can be made for services rendered by the charity, and as a charity vs. business, if the charity got closed, then any profits must be dispersed under Australian law to a similar charity to assist them in what is deemed a similar purpose. So in other words, all monies would go to a charity that is mental health related and based in Australia, so there is never any worries about donations become private funds for anyone, including myself.

I favour the charity option b/c (for me) it further legitimises the fact that the ptsd forum is there for the people, provided by the people. If it were registered as a business, then the inference is that the site is driven by a privately owned company which is motivated by a commercial imperative instead of being motivated by a desire to help others.

Does that make sense?

I'm not saying that registering the site as a business would be a bad thing, but personally, I would find it probably quite upsetting if I had plucked up enough courage to search out ptsd help online, then found the site, then registered .. only to find it was owned by a company. My first thought would probably be that the company was privately funded and had no need for donations and no business to be asking for donations (my assumption is that donated money for a business would go into a slush fund for disco themed Christmas parties and Fluffy Ducks LOL). Oh yeh, and that the company would onsell my registration information to 3rd parties.

Whereas, in its current model, I'm totally happy to donate b/c you have transparently provided the information re the costs of running the site I can read it and think, "woah, this is expensive!" whereas if the site were registered as a business, I'd think, "Meh. You're a business. You can afford it. Sack some staff. Simple."

I think the world is tending toward supporting NFPs & charities more now than at any other time in history b/c our awareness of people as living, breathing, feeling humans is growing collectively, as is our understanding that people are not robots - but flesh and blood individuals. I feel that once a privately owned business or corporation gets involved, the caring aspect goes out the window and it becomes all about profit.

Sorry that was such a long note but I hope it made sense! And thank you for throwing these points up for discussion :)
 
I would say, my exact sentiments ifonly.

If the charity option is simply unfeasible due to its legal requirements and obligations here, and it does have to go the business route, then there is still nothing stopping me making public the business side of things, so people can publicly see what is happening, what money exists, where it goes, etc... just the same as you must publish as a charity or public company.

If a business / company model is adapted, then what you say about employee's I have thought about already, being the only employee would ever be me... which means I would only ever get paid for actual work I did one on one, as I can give my time freely still without touching donations. Therapists can be employed on contractual basis as contractors, not as employees, which means less issue for transparency.

Either way it goes, all members have my word that I will ensure the site remains completely transparent, as I have always had it that way, and regardless how the future evolves the site, whilst I am the administrator of it, it will continue that way. I prefer the open and honest method when it comes to running this website. It has worked extremely well since its inception, with little scope for any member to cast doubt over who we are and what we're about, collectively.
 
Thanks heaps for your feedback, Anthony. Yep, the transparency and honesty on this forum was one of the first things that struck me. Whilst I was pretty nervous to start making posts, after a couple of days, the transparency made me feel comfortable - on the forums there was nothing to hide, information was out there for all to see, and the attention to detail is phenomenal. That transparency and honesty reflects very high integrity.

So yeh...if it's a business model or a charity model, the transparency and honesty will still be there b/c you are the awesome common denominator :) Which means that on reflection, the model chosen becomes pretty much immaterial for me b/c you'd make available relevant info on whatever model was chosen anyway.

This is how I kinda see it: as long as you're in the big chair (or other people you nominate) then either model is cool b/c what is changing is the machinery - not the driver. The road is still the same, the scenery is still the same, you're still driving the car, we all (members) still visit the same places together but it's a different car with maybe a manual gearbox instead of an automatic.

Does that make sense or does it sound too obtuse or silly?
 
OK, wow, Anthony, is all I have to say, because I had no idea running a site like this was so complicated. Thank you for everything you do, this is an excellent site (and I have been on a number of them over the years). Even things like letting people "like" someone's post, or have a trauma diary that other people can comment on in a supportive way, it's like an online version of group therapy. Even if someone doesn't have something to say, or they do but they are not in a place they can write something, the person who wrote the post knows it wasn't just ignored, and that other people relate and understand.

Although I got a number of the main points, I have to say that that was complicated enough my brain just kind of went on overload. But I want to say that I really appreciate what you are doing. I think it is a great idea to link IDs for all the sites (for instance, the sex abuse site I will probably join, but not ready to yet, but I would have to register there too, instead of just using my user ID here.)

I also think that using the word "my" as an acknowledgement in the names is a good idea. And I don't know if it was something you were planning to do, or just using as an example, but I would sure like to see a domestic violence site, I think it would be very helpful to be able to see how others are affected and what we have in common, making it possible for me to identify those characteristics in myself (which I might otherwise never identify, or it take me years to do so).

I think it really helps to go on a site like this and realize, for someone who has this, I'm actually normal (like PTSD). Because out in the world, it can leave a person just feeling different than everyone else, or like there is something wrong with me because I have these symptoms.
 
The largest problem is the subjects. It is one thing to run a general chit chat type forum, hobby site about knitting or such, where you can just shut it down, not turn up, not maintain the site, etc...

Do that to people who have been traumatised to the severity of PTSD, the result differs immensely. So members of these type sites need security and stability, therefore, running the site must be done in some what a more upscale approach to ensure people aren't screwed around.
 
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