Australian Psychological Australian Psychological Society Conference Sydney Society Conference Sydney

20042004

APS Interest Group APS Interest Group

Telephone and Internet based Telephone and Internet based Counselling and PsychologyCounselling and Psychology

Bill Campos Bill Campos

ConvenorConvenorBill.Campos@Parra.catholic.edu.auBill.Campos@Parra.catholic.edu.au

OverviewOverview

• Enormous boom in telecommunication Enormous boom in telecommunication (cost & accessibility)(cost & accessibility)

• Helplines more prominentHelplines more prominent

• Case management practices (call Case management practices (call centres)centres)

• Emerging TechnologiesEmerging Technologies

• ResearchResearch

IntroductionIntroduction

• In day to day counselling activities we utilise In day to day counselling activities we utilise the phone and e-mail to connect with clients.the phone and e-mail to connect with clients.

• Remote counselling also has relationship Remote counselling also has relationship building qualities.building qualities.

• Technology is advancing at a rapid rate, more Technology is advancing at a rapid rate, more affordable and utilised more frequently.affordable and utilised more frequently.

• Migrating to Australia (personal experience).Migrating to Australia (personal experience).

Why Telephone/ Internet Why Telephone/ Internet Based ServicesBased Services

• AccessibilityAccessibility

• Cost Cost

• Geographical Geographical accessaccess

• AnonymityAnonymity

Range of ServicesRange of Services

• TelepsychologyTelepsychology

• Counselling linesCounselling lines

• Support/ Support/ information linesinformation lines

• Helplines/ crisis Helplines/ crisis lineslines

• Web based Web based interactive interactive informationinformation

• E-mail (pictures + E-mail (pictures + sound)sound)

• On line support On line support (interactive chat (interactive chat rooms)rooms)

Types of ServicesTypes of Services

• Individuals (Life Coach, Student Supervision)Individuals (Life Coach, Student Supervision)

• Call CentresCall Centres

• Volunteer based servicesVolunteer based services

• Network of operators (FDS)Network of operators (FDS)

• 1800…./ 13…/ 1900 (translation/ TTY)1800…./ 13…/ 1900 (translation/ TTY)

• Combination (F-F + phone + interactive + Combination (F-F + phone + interactive + information) information)

Past few yearsPast few years

• Growth in callersGrowth in callers

• Diversity of Diversity of servicesservices

• Call CentresCall Centres

• Borderless Borderless servicesservices

0

100

200

300

400

500

600

1998 2000 2002

Case Management - CallerCase Management - Caller

A working mother of two young children has recently separated from her husband and is presently very depressed. She is reluctant to discuss the issues with her family, as her relationship with them is poor. She

perceives that to talk to family members may create more stress, from the assumed negative judgments made by people closest to her.

Late one night in a very depressed state, after receiving an email from her separated husband and the children asleep, she logs on to the internet, to an interactive counselling site and completes a 20-item depression checklist. Within a few moments she receives an e-mail

suggesting that her levels of depression are quite severe, she is provided with a phone number of a 24-hour counselling service to talk to a qualified counsellor. She is also invited to join an online self-help chat room. She makes the phone call and whilst discussing concerns

with the telephone counsellor, she is also advised to pursue other services including local psychologist or general practitioner and a

referral to legal support services for further assistance. At the conclusion of the interaction the Mother of two, found the discussion

very helpful and is invited to continue telephone counselling.

Case ManagementCase Management

• Telepsychology (structured sessions)Telepsychology (structured sessions)

• Interactive web and telephone centres Interactive web and telephone centres (counselling + information)(counselling + information)

• Medicine adherenceMedicine adherence

• Triage and managed care (health Triage and managed care (health insurers)insurers)

• Telephone group appointmentsTelephone group appointments

• Legal issues (child protection)Legal issues (child protection)

Is It Effective and Viable Is It Effective and Viable (Research)(Research)

• Very little Empirical research – Very little Empirical research – difficult to review because of difficult to review because of anonymity, poor quality control, no anonymity, poor quality control, no long term studies.long term studies.

• Preventative value (Hornblow 1986).Preventative value (Hornblow 1986).• Continuity of care + managed care.Continuity of care + managed care.• Hours of services (can be extended).Hours of services (can be extended).• Professional staff can be accessed.Professional staff can be accessed.• Services can have no time limit.Services can have no time limit.

Benefits of These Services Benefits of These Services (Mental Health Issues)(Mental Health Issues)• Potential to gather a lot of data Potential to gather a lot of data

(population – litmus paper).(population – litmus paper).

• Information stored and distributed.Information stored and distributed.

• Networking and tailoring services to Networking and tailoring services to callers.callers.

• Cost & geography.Cost & geography.

• Caller is in the “drivers seat” (customer Caller is in the “drivers seat” (customer based service).based service).

• Multicultural access.Multicultural access.

Weaknesses of These Weaknesses of These ServicesServices• Can be too specific.Can be too specific.• Lack the ability to respond to callers Lack the ability to respond to callers

physically (link to services may be physically (link to services may be utilised).utilised).

• Lack of consistency (within and outside Lack of consistency (within and outside agencies).agencies).

• Rely on equipment that can be costly to Rely on equipment that can be costly to maintain and upkeep.maintain and upkeep.

• Staff turnover (training and maintaining).Staff turnover (training and maintaining).• Potential to de-personalise services.Potential to de-personalise services.

Challenges AheadChallenges Ahead

• Integrating services (presently there Integrating services (presently there is an estimated growth of 30% per is an estimated growth of 30% per year in this area)year in this area)

• Quality controlQuality control

• New technologiesNew technologies

• Training and developmentTraining and development

• Legal issues (privacy vs duty of care)Legal issues (privacy vs duty of care)

Why – Remote CounsellingWhy – Remote Counselling

• Safe to do Safe to do counsellingcounselling

• Multiple exposure Multiple exposure to different to different clientele/ clientele/ populationpopulation

• Caller dictates the Caller dictates the relationship relationship

• More focus on More focus on rapport and rapport and engagementengagement