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Global Therapy Survey

AGE GROUP:

under 18	19-29	30-39
40-49	50-59	60-69	70 and over

I use the Internet
(check all that apply)

To send and receive e-mail
To research a topic
To play games
To shop for retail items
To shop for personal services

Today I searched the web for
(check all that apply)

Mental health services
Mental health information
Substance abuse services
Substance abuse information
Research material
Other- please specify

What are your impressions of the following

Mental Health resource information

definitely use

might use

would not use

Substance Abuse resource information

definitely use

might use

would not use

Mental Health Assessment

definitely use

might use

would not use

Substance abuse assessment

definitely use

might use

would not use

Mental Health consultation through e-mail

definitely use

might use

would not use

Mental Health consultation through telephone

definitely use

might use

would not use

Mental Health consultation through
private chat rooms

definitely use

might use

would not use

Public chat rooms

definitely use

might use

would not use

Behavioral Assessment through e-mail

definitely use

might use

would not use

How often do you read self-help/psychological material?

always

often

sometimes

rarely

never

Would you like to see reader reviews of current publications?

always

often

sometimes

rarely

never

What topics are of the most interest to you?:

Have you ever-sought help through an
online therapy service?

Yes

If yes, what did you think about the experience?:

Would you use a public chat room if one of the Global Therapy professionals participated in the group?

Yes

Global Therapy Survey

AGE GROUP:

I use the Internet
(check all that apply)

Today I searched the web for
(check all that apply)

What are your impressions of the following

Mental Health resource information

Substance Abuse resource information

Mental Health Assessment

Substance abuse assessment

Mental Health consultation through e-mail

Mental Health consultation through telephone

Mental Health consultation through
private chat rooms

Public chat rooms

Behavioral Assessment through e-mail

How often do you read self-help/psychological material?

Would you like to see reader reviews of current publications?

What topics are of the most interest to you?:

Have you ever-sought help through an
online therapy service?

If yes, what did you think about the experience?:

Would you use a public chat room if one of the Global Therapy professionals participated in the group?

Do you have any comments or suggestions about this proposed service?:

To receive a copy of the Newsletter-please complete the following
Or Just Press "Click Here to Send"

First Name:

Last Name:

Street:

City:

State or Province:

Postal code:

Your Current Email Address:

Global Therapy Survey

AGE GROUP:

I use the Internet (check all that apply)

Today I searched the web for (check all that apply)

What are your impressions of the following

Mental Health resource information

Substance Abuse resource information

Mental Health Assessment

Substance abuse assessment

Mental Health consultation through e-mail

Mental Health consultation through telephone

Mental Health consultation through private chat rooms

Public chat rooms

Behavioral Assessment through e-mail

How often do you read self-help/psychological material?

Would you like to see reader reviews of current publications?

What topics are of the most interest to you?:

Have you ever-sought help through an online therapy service?

If yes, what did you think about the experience?:

Would you use a public chat room if one of the Global Therapy professionals participated in the group?

Do you have any comments or suggestions about this proposed service?:

To receive a copy of the Newsletter-please complete the following Or Just Press "Click Here to Send"

First Name:

Last Name:

Street:

City:

State or Province:

Postal code:

Your Current Email Address:

I use the Internet
(check all that apply)

Today I searched the web for
(check all that apply)

Mental Health consultation through
private chat rooms

Have you ever-sought help through an
online therapy service?

To receive a copy of the Newsletter-please complete the following
Or Just Press "Click Here to Send"