Counseling via Phone or Video

If you live in an area where it is difficult to find a psychotherapist who is grounded in both mindfulness and contemporary psychotherapy you may want to consider counseling via the phone or video-conferencing software.

Working together in this way can be just as powerful and engaging as sitting together face to face in a counseling office, and in many cases, a more effective way to connect. Given the advantage of meeting from the familiarity and safety your own home, you may find that working together in this way can enable you to open more fully to your truth and find better access to inner resources for healing and transformation. In addition, there is no need to drive anywhere thereby saving time and money spent on gas and enabling you to settle down and reflect awhile over our work together before doing anything else.

Benefits of Telepsychology

The following references are provided for your erudition regarding the value of telephone counseling. I have found telephone therapy to be extremely effective with many people and often for some people more effective than traveling to and joining me at my brick and mortar office. Over the last 14 years I have found face to face using video conferencing software ideal for counseling. Skype provides software free of charge over your computer and enables us to see each other as we talk together. In addition, Skype provides free video calling services with quality video and audio transmission from most places in the world.

Learning that phone therapy is effective you can see how being able to see each other as we talk can add all the more benefit to the therapeutic encounter. I've worked with many hundreds of people using online video conferencing tools and I've come to appreciate the value of this way of connecting – both with mindfulness-based psychotherapy and with coaching in mindfulness practices. From the comfort and safety of your home we can do much healing and transformative work together.

Study shows telephone counseling can be effective
American Psychological Association
April 2002, Vol 33, No. 4

As the use of Internet and telecommunications services continues to grow, researchers have questioned the practice of telephone counseling for general mental health. But according to a study reported in the April Journal of Counseling Psychology (Vol. 49, No. 2), telephone counseling appears to be an effective psychological practice.

Based on the 1995 Consumer Reports finding that patients benefit greatly from face-to-face counseling, this study examined free telephone counseling offered to the employees of three large Fortune 500 companies as well as other smaller, regional companies across the United States, Canada and parts of Mexico. Both employees and their immediate family members had access to a telephone counseling agency's toll-free number. Over a three-week period, the authors surveyed a nonrandom sample of adults who called the counseling agency about mental health, relationship or job problems. Master's-level mental health professionals provided the phone counseling, using a solution-focused model of therapy. Most callers received four telephone counseling sessions.

After at least one 30-minute phone session, the counseling agency mailed a packet of questionnaires, including the Consumer Reports Annual Questionnaire (CRAQ), which asks clients to rate their specific improvement, satisfaction and global improvement as a result of telephone counseling. By using CRAQ, the researchers could compare the effectiveness of face-to-face counseling, as measured by Consumer Reports, with the effectiveness of telephone counseling.

The researchers--Robert J. Reese, PhD, of Abilene Christian University, and Collie W. Conoley, PhD, and Daniel F. Brossart, PhD, both of Texas A&M University--found that telephone counseling was beneficial and satisfactory, marked by specific improvement on the issue that lead to counseling and global improvement in emotional state. Of the 186 respondents, 68 percent reported feeling very or completely satisfied with the telephone counseling and 53 percent said they felt somewhat better as a result of counseling. The data also indicate that telephone counseling did not appear to work as well as face-to-face counseling for people who reported feeling very poorly: 31 percent of respondents who initially described that they felt very poorly reported improvement in functioning, compared with 54 percent in the Consumer Reports study of face-to-face counseling.

In contrast to face-to-face counseling, telephone counseling is convenient and less expensive--if provided in a format similar to this study's--and the anonymity of the service may provide clients with a greater sense of control, the authors note. For people who do not have access to affordable mental health care, telephone counseling may be a viable option, they add. The authors also point out that without an office, clothes and physical appearance to potentially distract them, clients being counseled via phone may be inclined to focus better on what the therapist says.

From the American Counseling Association:

Professional counselors develop an appropriate in-take procedure for potential clients to determine whether online / phone counseling is appropriate for the needs of the client. Professional counselors warn potential clients that online counseling services may not be appropriate in certain situations and, to the extent possible, informs the client of specific limitations, potential risks, and/or potential benefits relevant to the client's anticipated use of online or phone counseling services. Professional counselors ensure that clients are intellectually, emotionally, and physically capable of using the online counseling services, and of understanding the potential risks and/or limitations of such services.

Telephone Counseling: Are Offices Becoming Obsolete?
by Maureen C. Kenny , Adriana G. McEachern

Reese, Conoley, and Brossart (2002) conducted research on the effectiveness of telephone counseling and the quality of the counseling relationship. Reese et al. stated that the purpose of the study was to investigate whether telephone counseling as used in the field is effective for providing general mental health counseling" (p. 234). They examined clients' self-reported satisfaction with telephone counseling's treatment of their problems, their self-reported improvement in specific areas of their life, and global improvement in emotional state. Furthermore, Reese and colleagues were interested in whether clients perceived that a therapeutic bond had been developed between themselves and the counselor.

Research of this nature is critical for many reasons. First, more and more companies who have employee assistance programs are using some form of telephone counseling to help them. Second, although telephone counseling is used widely, little is known about its effectiveness compared with traditional face-to-face therapy. Reese and colleagues (2002) make an important contribution to the literature dealing with the effectiveness of such counseling by comparing the results of their study with those from a large scale study of face-to-face therapy conducted by Consumer Reports (CR; "Mental Health,"1995).

In this study, participants were 186 adult clients with various emotional difficulties. These clients were receiving services from a private telephone counseling agency that serves as an employee assistance program for several large Fortune 500 companies. More than 2 million employees had access to the service. The participants were mostly women (73%), a majority were White (76%), and they were 18 to 60 years old. The clients presented with problems in a range of areas including depression, anxiety, substance abuse, eating disorders, work-related difficulties, and grief. The average number of sessions was 12, with a range of 1 to 99 sessions. These clients accessed the counseling using a toll-free telephone number. There was a brief intake over the phone, and then the client was given a time to call back to speak to a counselor. Sessions lasted an average of 30 minutes and were considered to be solution-focused therapy (SFT; De Jong, & Berg, 1998). All counselors were licensed and had a master's degree in counseling, psychology, marriage and family therapy, or social work. All counselors were trained in SFT and received live supervision.

Three measures were used to determine therapeutic effectiveness. The Consumer Reports Annual Questionnaire (CRAQ; "Annual Questionnaire," 1994) was used so that comparisons could be made with the results of the CR study. Three subscales from the CRAQ--Specific Improvement, Satisfaction, and Global Improvement--were used. The Working Alliance Inventory-Bond Scale (WAI-B; Horvath & Greenberg, 1986) was used to "assess the interpersonal aspect of the therapeutic alliance" (Reese et al., 2002, p. 236). The final measure, Counselor Rating Form-Short Version (CRF-S; Corrigan & Schmidt, 1983), was used to measure the client's view of the counselor's influence.

Reese et al. (2002) provided compelling evidence for the effectiveness of telephone counseling. The first question as to the client's perceptions of the effectiveness of telephone counseling yielded very positive results. "Over 80% of the participants felt that the specific problem that led them to counseling had improved" (Reese et al., 2002, p. 236). These mean scores were slightly, but significantly, lower than those for the CR face-to-face group. In terms of global improvement, most of the clients (53%) reported doing "so-so" (Reese et al., 2002, p. 237). These scores did not differ significantly from the CR face-to-face results. Regarding satisfaction, "over two-thirds of the telephone counseling sample (68%) reported being either 'very satisfied' or 'completely satisfied' with telephone counseling" (Reese et al., 2002, p. 237). These results were significantly higher than the CR face-to-face results.

Other analyses revealed significant differences in how the clients rated themselves initially and at the present time in terms of functioning. "Clients who judged themselves to be doing the poorest prior to counseling rated total effectiveness higher than the 'fairly poor' or the 'so-so,' or 'better' groups" (Reese et al., 2002, p. 238). One shortcoming in Reese et al.'s data, as compared with that for CR, is that those clients in the CR study who had rated themselves at the "very poor" and "fairly poor" level, had more improvement in their present situation compared with those in Reese et al.'s sample.

Another interesting finding of the Reese et al. (2002) study was that their clients "rated their counselors no differently than did individuals who saw experienced therapists face-to-face in community health centers" (p. 238)

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