On-line counseling at Therapeutic Services
Rone Gerber (M.Psych.)
Marcia Minnaar (M.Psych.)
Birgit Schreiber (PhD)
University of the Western Cape
South African Federation of Student Affairs and Services
4-6 August 2014
Durban
Higher Education Landscape in South Africa
Green Paper for PSET (2012): vastly expanded higher education landscape
demands flexible provisions
- ODL – open and distance learning centres across South Africa and
the BRICS
- NOLNET (Namibian Open Learning Network Trust) – 45 centres
across Namibia
- BOCODOL in Botswana – 75 study and support centres
- Open Educational Resources (OER) – innovative and online
provisions
- Open Licence Network across regions – practices are shared
- MOOCS – pervasive and enabling online support
- dramatic increase of bandwidth and affordability of digital devices
- collaborations with the dept of communications
“ICT is increasingly becoming a critical ingredient for participation in a
globalised world, as well as being an indispensable infrastructural component
for effective education provision, especially in the post schooling sector” (pg 58)
Online and virtual environments broadly utilised
- Massive growth of online services, smart phones, virtual resources (Bosch, 2009)
- joining 15-35 year old population for 98% of this age group
- high comfort with online environment (Nitsckie & Parker, 2009)
- Cell Life, Maths-on-Mixit, SIMPill and online chat support at UWC (Bosch, 2009;
Schreiber & Aartun, 2011)
- South African Depression and Anxiety Group (SADAG)
- Teen SMS Helpline and the Drug Advice Support (DAS)
- P&T 2005: focus on innovative and online medium for support
Fiscal re-visioning
vision to increase 900 000 to 1700 000 students in 7 years
DHET 2015 funding increase: 4.5%
DHET 2016 funding increase: 3.5%
increased smarter work
increased alternative funding
increased student centered and deliver ‘where students are at’
Participation and UDL
- SA Social Justice framework: access and participation
- to change positionality, power and privilege => service the underserviced
- flexible learning as normative framework
- Participatory Parity (Fraser, 2009)
- to participate on an equal footing
-offer interventions, services and programs in way which enables diverse access
- Universal Design for Learning (Burgstahler, 2007)
- multiple means of representation: offering in different ways, modes and
media, via real and virtual, individual and social, and in short-term project and
medium-term process focussed models
- multiple means of expression: multiple avenues to express development and
learning
- multiple means of engagement: many avenues to entice students
=> plurality of offerings and engagements to enable access for range of diversity
On-line Counseling at Therapeutic Services,
The Centre for Student Support Services (CSSS) at
The University of the Western Cape (UWC)
Types of on-line Counseling:
Synchronous vs. Asynchronous Counseling
Synchronous interactions occur with “little or no
gap in time between the responses of counselor
and client (Shaw & Shaw, 2006) i.e. Chat room,
Skype, Video-conferencing, Telephone
Asynchronous interactions “occur with a gap in
response time” i.e. e-mail (Shaw & Shaw, 2006)
Dedicated e-mail Counseling (Asynchronous)
Use of e-mail counseling
*Dedicated e-mail advise-line *E-mail usage by
Counselors to
augment traditional
face-to-face
counseling
Implementation of a dedicated e-mail advice-line for
registered students at the University of the Western
Cape (UWC)
• Created a dedicated e-mail account accessible to
registered staff and students at UWC
• Marketing of Advice line:
– Link from existing CSSS webpage
– Advertising via pamphlets, posters and
electronic notices to students (little pamphlet)
Ethical Considerations
• Disclaimer covering the following topics: (copy of
disclaimer in little box)
– Limits of Confidentiality
– Response Time
– Record-keeping
– Credentials of counselor/psychologist
– Appropriateness of e-mail counselling for
certain presenting issues (warn-and-inform)
– Advantages of e-mail Counselling (Optional)
– Limitations of e-mail Counselling (Optional)
Skills needed by Counselor
•
Assign dedicated, experienced staff-member to manage the service
•
Proficiency in electronic media (tensions)
•
Ability to transfer face-to-face skills to on-line communication in
absence of verbal and body-language queues. i.e. communicating
empathy in written format (transcript of own session)
•
Creating rapport and building a working alliance in this format
(example: ‘we’, explicit reflection/clarification, ‘it must have felt …’,
use emoticons, ‘I feel so sad hearing you say this’ = make it explicit,
complete sentences, clarification is extra important) (potential for
misunderstanding is high – so clarify a lot), ‘let me understand, you
say …’, ‘I hear you say …’, ‘do you mean …’)
•
Knowledge of referral resources – on- and off-campus
•
Willingness to learn new skills and be creative
Advantages experienced of e-mail counseling
•
Allowing students to test/convenience
•
Reducing initial anonymity of counselor and reduce apprehension around face-to-face counseling
(especially anxiety, social phobia, agoraphobia, when relationship is intimidating, low self esteem,
difficulty with help seeking behaviour, focus of concern is relational, etc.)
Allowing a “sense of anonymity” for the student – allowing more freedom to express
Offering another medium of engagement
Reaching more and underserviced population
Reaching off campus and after hours population
Effective triaging and referral without using limited face-to-face resources (cost effective), time
effective
Staff development around broadening skills and scope of interventions, appreciation of different
media and non-traditional engagements
Literal transcript of what transpires, detailed record keeping, Rx plan, diagnosis, (some challenges
for medico-legal context, breach of online environment, etc.)
clients evaluate impact consistently better than therapists (Mallen, Vogel & Rochlen, 2005)
online and cell phone the preferred avenue for avoidant clients (Mallen et al. 2005)
on-line counseling reduces clients’ anxiety-related symptoms after one semi structured session
(Mallen et al. 2005)
freedom from geographical restrictions, accessibility, early and immediate response to clients’
distress, earlier intervention than traditional counseling, and that the role of this type of service in
delivering flexible, cost-effective help to the community is expanding (Beattie, Cunningham, Jones
& Zelenko, 2006)
•
•
•
•
•
•
•
•
Challenges experienced
• Confidentiality (online breach)
• Record-keeping (online breach and medico-legal
implications)
• Transferring face-to-face counselling skills to e-mail
counseling (up skill staff, and self-driven)
• Appropriateness of e-mail counseling for particular
presenting issues
• No clear guidelines from HPCSA
• Lack of evidence-based research and training in ecounseling (no online courses available in SA, some
training in USA (University of XXX)
Types of presenting issues
Types of responses to presenting issues
Type of response
10
9
8
7
6
5
4
3
2
1
0
THANK YOU
References:
DHET (Department of Higher Education and Training). (2012). Green Paper on Post School Education and Training.
Pretoria. South Africa.
Beattie, D., Cunningham, S., Jones, R. & Zelenko, O. (2006). “I use on-line so the counselors can’t hear me crying”:
Creating design solutions for on-line counseling. Media International Australia Incorporating Culture and Policy, 118, 43-52
Bosch, T. (2009). Cell phones for health in South Africa. In: Lagerwerf, L., Boer, H. & Wasserman H. (Eds.) Health
Communication in Southern Africa: Engaging with Social and Cultural Diversity. South Africa: UNISA Press.
Burgstahler, S. (2007). Equal access: Universal design of student services. Seattle: University of Washington. Accessed on
2/7/2014 from www.uw.edu/doit/Brochures/Academics/equal_access_ss.html
Fraser, N. (2009). Scales of justice. Reimagining justice in a globalising world. New York: Columbia University Press.
Schreiber, B., Aartun, K. (2011). Online Support Services via Mobile Technology – A Pilot Study at a Higher Education
Institution in South Africa. Journal of Psychology in Africa, 21(4), 635-642.
Mallen, M.J., Vogel, D.L. & Rochlen, A.B. (2005). The practical aspects of on-line counseling: Ethics, training, technology
and competency. The Counseling Psychologist, 33, 776-818.
Nitsckie, W.B. & Parker, M.B. (2009). Mobile instant messaging: “Help at the fingertips of addicts”. Proceedings of the 11 th
Annual Conference on World Wide Web Applications, Port Elizabeth, 2-4 September 2009. Retrieved on 3/3/2011 from
http://www.zaw3.co.za.
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