Counselling by Telephone

SAGE Publications

Maxine Rosenfield

• Publisher: SAGE Publications Ltd
• Year: 1996
• Print ISBN: 9780803979994
• eBook ISBN: 9781446225226
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

`Well written, well researched... [the book] contributes to undermining ideas of professional hierarchy, in which long-term face-to-face is top of the pile, and short-term and the phone are the province of the amateur who knows not what they are up to. On the contrary, the counselling process as well as the use of counselling skills are resources that can be much more widely used than is possible if they are restricted to relatively long-term counselling. This is an excellent book covering a great deal of recent thinking about confidentiality, skills, training, quality and supervision in relation to the telephone [with] a useful chapter on its technology in relation to counselling? - Counselling and Psychotherapy, The Journal of the British Association for Counselling and Psychotherapy

This book explores the essential skills needed to carry out effective telephone counselling - such as welcoming and establishing a relationship with clients; listening and responding; understanding silences; working with transference and fantasy; and recognizing and reacting to feelings - which are necessarily very often distinct from those involved in face-to-face counselling.

Maxine Rosenfield challenges the view that telephone counselling is a poor relation to face-to-face counselling, arguing that for certain clients it may be the therapeutic medium of choice. She examines the benefits to both clients and counsellors of working by telephone, and highlights the technical and practical issues of which counsellors should be aware. She also covers the relatively new concepts of group counselling by telephone and counselling by other media, such as e-mail or letter.

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What is Counselling by Telephone?

In simple terms, counselling by telephone may be defined as a service whereby a trained counsellor works with a client, or a group of clients, by telephone, to enable the client(s) to explore personal situations, problems or crises in a one-off or in an ongoing longer term therapeutic relationship.

A contract of some sort is agreed between the counsellor and client(s) and there may be a financial relationship as well, particularly for ongoing work.

Since counsellor and client are unlikely ever to meet in almost all cases of counselling by telephone, some time must be taken, during a preliminary session perhaps, for both parties to get used to each other’s voice tones, accents, patterns of speech and other aspects of contact which would be obvious or easily integrated if they met, such as visual impressions of each other or a sense of the physical surroundings where the sessions take place.

Not all counsellors will find that they are able to work effectively on the phone. Of course, this does not mean that they are any less effective as face to face counsellors; simply that the telephone medium does not suit them.

Similarly, not all clients have a telephone and nor will all potential clients find the telephone a comfortable medium. A report from OFTEL (1994) stated that those households least likely to have a telephone are those in lower socio-economic groups, those headed by an economically inactive person or those on a low income. On the other hand, according to the 1992 General Household Survey (OPCS, 1992), 89 per cent of the population of the UK in 1992 had a telephone in their home, compared with 72 per cent in 1980 and 42 per cent in 1972, so the telephone has clearly become an increasingly popular, readily accessible and familiar tool.

There are, of course, other, more common reasons than counselling for working with people on the phone:

• advice may be offered
• advocacy may be provided
• information may be provided
• support can be offered
• befriending can take place

The continuum of the relationship between the different methods of working by telephone: Advice → ← Advocacy → ← Information → ← Counselling → ← Support → ← Befriending

For the purposes of this book, my definitions of these are as follows:

Advice giving

This is when the caller is offered a course of action to follow. In response to a question or a situation being explained by the caller, action can be suggested. It might be phrased as ‘If I were you I’d . . .’ or ‘You must do . . .’

By way of example, a call to a gas company, when someone thinks there may be a gas leak, would lead to advice being given:

Gas Company: Gas Service Emergency Line. How may I help you?

Caller: I think I can smell gas in the kitchen and I don’t have a gas cooker, or anything using gas except the heating.

Gas Company: How long is it since you noticed this?

Caller: Since I got up this morning. It’s getting stronger.

Gas Company: You must turn off your supply until someone can come and check it. In the meantime, don’t strike a match or switch on a light or do anything that could cause a spark. Do you know how to switch off your supply?

Caller: Yes.

Gas Company: OK, can I have your details please so that I can arrange for someone to come round?

Caller: Yes, it’s . . .

Gas Company: Someone will be there within two hours.

Caller: Thank you. Goodbye.

So here is a straightforward call with the caller seeking advice from someone with more knowledge about the issue.

Advocacy

This requires the person answering the phone to support and to act on behalf of the caller, or perhaps on behalf of the person the caller is talking about in the case of a child protection helpline. To be an advocate, the person answering the call has to have knowledge of the issue being discussed and be able to interpret or assess needs as well as knowing how to progress the enquiry.

Taking the example of a child protection telephone service, at the NSPCC Child Protection Helpline the person answering the phone may advocate on behalf of the caller or on behalf of the child about whom the caller is speaking. If the caller is an adult and is talking about a child whom the helpline counsellor perceives to be at risk, the counsellor is able to refer information to local social services, for example, whether or not the caller agrees, although clearly every effort is made first to try to gain the caller’s co-operation in such situations. The Helpline’s primary responsibility is to advocate on behalf of a child.

Child Protection Helpline (CPH): Hello, this is the Child Protection Helpline.

Caller: I don’t know if I should be calling . . . you see I’m very concerned about a child in a particular situation. Can I speak to you in confidence?

CPH: Yes you can speak in confidence, but if you give us details of a child who is at risk, we have a responsibility to act to ensure the protection of the child. Would you like to give me a general idea of what your concerns are?

Caller: I’m a grandmother and the child lives with its mother. Its father is my son and we have concerns about how the child is being looked after . . . .

CPH: Can you give me some detail of what are your actual concerns and perhaps tell me when you last saw the child . . . ?

The CPH counsellor needs to establish how urgent the concerns might be. Using counselling skills to work with the caller, the counsellor must explore the situation in order to be able to make a judgement, there and then, of how to focus the call, on the basis of the information received. So in the above example, the counsellor would possibly move on to establish whether the grandmother’s concerns are significant enough to indicate that the child might be at risk. If the counsellor perceives that this is the case, the counsellor might then try to encourage the grandmother to willingly disclose more information in the child’s interests so that action to protect the child can be taken.

Information

This is the delivery of facts about a situation, in answer to a question or presenting circumstances. Although requiring a friendly tone of voice, there is no engaging in any in-depth conversation except for further clarification of what has been said. The person answering the call must have, or be able to access readily, the information sought. A welfare benefits enquiry to a carer’s service may offer this type of service.

Carers’ worker. Hello, this is the carers centre.

Caller: Hello, I wonder if you can answer a question I have. . . .

Carers’ worker. I’d be pleased to help if I can. . . .

Caller: I’m sure it’s very simple, in fact I think I was told, but I can’t remember. . . . The person I am caring for has been in hospital for five weeks. Does her attendance allowance stop?

Carers’ worker. Yes, it stops after four weeks.

Caller: I see. That’s what I thought. Does this happen automatically?

Carers’ worker. No, you have to inform the attendance allowance unit and send the payment book to them.

Caller: Right. . . .

Carers’ worker. Were you wanting to know about anything else?

Caller: Well, I saw a notice on the board at the library – that’s how I got your number – and it said you run support groups for carers. Could you tell me a bit about that?

Carers’ worker. Yes, of course. We run a group every Friday morning from 10 until 12 at the health centre and one on a Tuesday afternoon from 2 until 4 p.m. at the library meeting room. Both are drop-ins, so you can turn up whenever you find it convenient. We also run some special carers’ meetings here at the centre on topics like Community Care and if you like I could add you to our mailing list for information. . . .

Caller. Yes, that would be good. Meeting other carers could help me to feel less isolated. My name is ______ and I live at _______

Carers’ worker. OK, I’ll send you information and look forward to seeing you at one of the drop-ins perhaps, or at a meeting here. . . .

Caller: Thank you. That’s been really helpful. I will see you soon, I’m sure. Goodbye.

Carers’ worker. Goodbye.

A straightforward request for information is made by the caller. The worker answers the question and because the caller seems to hesitate, checks out whether the caller might have been wanting anything else. This enables the caller to move on to talk further and to ask questions. The worker answers and leaves space for the caller to talk further in case the caller wants to, but in the above example, information was all that was wanted.

Many helplines will report that calls to the service often present themselves as an initial enquiry requesting information. If the worker provides openings in case there are any other issues to be discussed, as happened above, the caller can choose to take them up or not.

Support

This involves responding with empathy to a caller. Some people have this ability quite naturally but others do not and I would question whether it can be distinctly taught for application to the telephone, or indeed for face to face work. I do not believe counsellors can be taught the instinct of empathy; rather they are born with the natural instinct and training enables them to develop an awareness of the instinct and how to use it with a client. If the fundamental instinct to be able to be alongside someone without jumping in to offer sympathy, an opinion or instruction is lacking, a person is unlikely to be able to modify their attitude over the telephone. This is because the person does not have the visual clues which might otherwise warn them, if they could see the impact their remarks were having, that they were not responding appropriately.

Telephone support may be sought either from someone who has been through a similar experience to oneself, that being their primary ‘qualification’, or from someone who has detailed knowledge and awareness of a particular situation and an ability to empathise. Many helpline services advertise that they offer support, which I believe means using counselling skills to listen, empathise with the caller and perhaps provide factual information or details of other specialised agencies with whom the caller might wish to make contact for additional support or help. Whether offering support based on professional training or on personal experience, the supporter must be clearly aware of when their professional or personal experience of the situation can become a limiting factor in the support that they can offer. In other words, there must be awareness of the boundaries or limits of the service which can be offered and knowing when it could be more helpful for the caller to also talk to other people or to consider alternative suggestions.

Self-help groups may offer a supportive type of telephone service:

Caller: Is that the Eastbridge breast cancer support group?

Supporter. Yes, I’m Maria. How can I help?

Caller: Well, it says in your leaflet, that I got from the hospital, that you’re there to support and help people who have cancer. I’ve just been told that I have got breast cancer . . . and I’m really scared. What will happen?

Maria: It is very hard to be told that you have cancer and there can be lots of things to think about. . . .

Caller: Have you had canc...

Table of contents

• Cover Page
• Title
• Copyright Page
• Contents
• Foreword
• Acknowledgements
• Introduction
• 1 What is Counselling by Telephone?
• 2 Skills and Attitudes Needed when Counselling by Telephone
• 3 Training, Supervision and Quality Control
• 4 Theoretical Orientations
• 5 The Counsellor-Client Relationship
• 6 Telephone Group Work
• 7 Technology and Counselling by Telephone
• 8 Counselling by Other Media
• Appendix of addresses
• References
• Index