Australian Psychological Society Conference Sydney 2004 APS Interest Group Telephone and Internet based Counselling and Psychology Bill Campos

Overview Enormous boom in telecommunication (cost & accessibility) Enormous boom in telecommunication (cost & accessibility) Helplines more prominent Helplines more prominent Case management practices (call centres) Case management practices (call centres) Emerging Technologies Emerging Technologies Research Research

Introduction In day to day counselling activities we utilise the phone and to connect with clients. In day to day counselling activities we utilise the phone and to connect with clients. Remote counselling also has relationship building qualities. Remote counselling also has relationship building qualities. Technology is advancing at a rapid rate, more affordable and utilised more frequently. Technology is advancing at a rapid rate, more affordable and utilised more frequently. Migrating to Australia (personal experience). Migrating to Australia (personal experience).

Why Telephone/ Internet Based Services Accessibility Accessibility Cost Cost Geographical access Geographical access Anonymity Anonymity

Range of Services Telepsychology Telepsychology Counselling lines Counselling lines Support/ information lines Support/ information lines Helplines/ crisis lines Helplines/ crisis lines Web based interactive information Web based interactive information (pictures + sound) (pictures + sound) On line support (interactive chat rooms) On line support (interactive chat rooms)

Types of Services Individuals (Life Coach, Student Supervision) Individuals (Life Coach, Student Supervision) Call Centres Call Centres Volunteer based services Volunteer 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 + information) Combination (F-F + phone + interactive + information)

Past few years Growth in callers Growth in callers Diversity of services Diversity of services Call Centres Call Centres Borderless services Borderless services

Case 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 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 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 Management Telepsychology (structured sessions) Telepsychology (structured sessions) Interactive web and telephone centres (counselling + information) Interactive web and telephone centres (counselling + information) Medicine adherence Medicine adherence Triage and managed care (health insurers) Triage and managed care (health insurers) Telephone group appointments Telephone group appointments Legal issues (child protection) Legal issues (child protection)

Is It Effective and Viable (Research) Very little Empirical research – difficult to review because of anonymity, poor quality control, no long term studies. Very little Empirical research – difficult to review because of anonymity, poor quality control, no 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 (Mental Health Issues) Potential to gather a lot of data (population – litmus paper). Potential to gather a lot of data (population – litmus paper). Information stored and distributed. Information stored and distributed. Networking and tailoring services to callers. Networking and tailoring services to callers. Cost & geography. Cost & geography. Caller is in the “drivers seat” (customer based service). Caller is in the “drivers seat” (customer based service). Multicultural access. Multicultural access.

Weaknesses of These Services Can be too specific. Can be too specific. Lack the ability to respond to callers physically (link to services may be utilised). Lack the ability to respond to callers physically (link to services may be utilised). Lack of consistency (within and outside agencies). Lack of consistency (within and outside agencies). Rely on equipment that can be costly to maintain and upkeep. Rely on equipment that can be costly to maintain and upkeep. Staff turnover (training and maintaining). Staff turnover (training and maintaining). Potential to de-personalise services. Potential to de-personalise services.

Challenges Ahead Integrating services (presently there is an estimated growth of 30% per year in this area) Integrating services (presently there is an estimated growth of 30% per year in this area) Quality control Quality control New technologies New technologies Training and development Training and development Legal issues (privacy vs duty of care) Legal issues (privacy vs duty of care)

Why – Remote Counselling Safe to do counselling Safe to do counselling Multiple exposure to different clientele/ population Multiple exposure to different clientele/ population Caller dictates the relationship Caller dictates the relationship More focus on rapport and engagement More focus on rapport and engagement