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Telephone Therapy

What is telephone counselling, and the issues to consider when finding a telephone counsellor.

Find a Telephone Counsellor

A definition of telephone counselling

Telephone counselling is a therapeutic relationship between you and a counsellor carried out by telephone.
 
Telephone counselling initially aims to help you address and make sense of the problems you are experiencing. This often involves identifying how you think about yourself and others, the experiences which formed these thoughts, and the impact of these thoughts on your life.
 
Telephone counselling then aims to help you identify your own choices for change, provide you with support during the process of change, and reach some resolution.
 
Telephone counselling is confidential, non-judgemental and based on trust. These qualities are intended to help you speak openly about what troubles you. Your telephone counsellor will then be able to listen attentively to you, think carefully about what you say, and make interventions based on their training and experience.
 
"People talk more freely when they feel they are not being judged and feel safe and this happens quite early on in the telephone counselling relationship, thus it may take fewer sessions to achieve the goals of the therapy than would face-to-face work." (Rosenfield, M. 2003:108).
 

How telephone counselling differs from visiting a counsellor

Telephone counselling is different to face to face counselling. In telephone counselling, there is none of the eye contact and visual cues associated with face to face counselling.
 
Face to face counselling has been around for a long time, and so has telephone counselling.
 
"The use of the telephone for help in times of crisis has been acknowledged for over 40 years." (Rosenfield, M. 2003:93).
 
Counsellors are trained to work within a particular theory (or theories) of the mind. Some of these theories are suited to telephone counselling, other theories are not suited to telephone counselling. For example, a theory where the emphasis is on working with your words and ideas is arguably more suited to telephone counselling. A theory where there is more of a reliance on seeing and observing you tends not to be appropriate for telephone counselling.
 
These theoretical considerations help counsellors determine whether or not they provide telephone counselling.
 

Telephone counselling and access to counselling

Telephone counselling can overcome barriers people experience in accessing face to face counselling, such as:
  • family or work commitments;
  • a physical illness;
  • a mobility problem;
  • a psychological problem;
  • feeling very vulnerable,
  • finding the prospect of sitting face to face with a counsellor too daunting;
  • the mental health stigma;
  • not wanting to see a local counsellor who may be 'bumped' into on the street;
  • living in a rural or remote location where there isn't a counsellor;
  • wanting to speak to a counsellor who specializes in a particular problem but who works some distance away;
  • or the carbon footprint created by travelling to and from a counsellor.

Telephone counselling generally costs less than face to face counselling and there are no travel costs.

Telephone counselling and confidentiality

Telephone counselling is confidential. Confidentiality can be broken when someone is at risk of hurting themself or others, or when authorised by a client or the law. To maintain trust, counsellors discuss any disclosure with their clients beforehand when possible. You and your counsellor can clarify each other's responsibilities concerning confidentiality during the first telephone counselling session.
 
You may also wish to ask your telephone counsellor about their notes, who has access to them, how securely are they stored, and if you have access to them.
 
Counsellors regularly attend confidential clinical supervision to discuss their client work with a more senior counsellor, in order to maintain adequate standards which protect the best interests of clients.
 
If you call your counsellor for a telephone counselling session, bear in mind the counsellor's telephone number will appear on any itemised bill you receive from your telephone service supplier: something to be aware of if you share a bill with someone else. This also applies if you pay for the session by card: the details will appear on your card statement, so if you share your statement with someone else, bear this is mind.
 
For any telephone counselling session, make sure you are in a quiet and private room. You may also wish to check that the telephone you are using does not have any extensions through which someone else could listen in.
 

Choosing a telephone counsellor

To choose a telephone counsellor, ensure the telephone counsellor is recognized by a UK professional body which incorporates a code of ethics and practice and a complaints procedure. These bodies include the:
  • BABCP (British Association for Behavioural and Cognitive Psychotherapies);
  • BACP (British Association for Counselling and Psychotherapy);
  • BPS (British Psychological Society);
  • and the UKCP (United Kingdom Council for Psychotherapy).

When choosing a telephone counselor, you may also want to consider the counsellor's:

  • availability;
  • fee per session;
  • length of session they offer;
  • duration of counselling they offer;
  • level of professional training;
  • years of experience;
  • problems they work with or specialize in;
  • theoretical approach(es) to problems;
  • gender (if you have a preference);
  • language(s) they work in;
  • client group (individuals, couples, groups, families);
  • session cancellation and missed sessions policy;
  • payment method (a secure way to pay as you will probably not see your counsellor);
  • availability for face to face and online work, and their understanding of working in these ways, (during telephone counselling, you may also want to have a face to face session - does the counsellor work near you, or you may want to have some online counselling).

It is also worth considering the actual cost of the call for each session (who pays this, and if you do, is the counsellor's number a UK landline).

Sometimes a counsellor will wish to see you face to face first.
 
If you have a history of mental illness it is advisable to see a counsellor face to face.
 
If you have thoughts of suicide, hurting yourself or others, please consult your GP or visit www.samaritans.org.uk.

 

Initial telephone counselling appointment

During your initial telephone counselling session, normally of fifty minutes duration, you can begin to talk about your problems, ask any questions you may have, and discuss if ongoing telephone counselling would be appropriate for you and the problems you are experiencing/
 
The first telephone counselling session will also be an opportunity for you to decide for yourself if you wish to work with the counsellor. If you are not sure, arrange to speak to another telephone counsellor. Having confidence in your telephone counsellor is essential for the work you do together.
 
The first telephone counselling session is without obligation to continue. You and your telephone counsellor can decide together if:
  • a one off session is enough;
  • if a few sessions are needed for a specific problem;
  • if ongoing sessions of six weeks or more are required where you work on problems in more depth;
  • or if some other form of help would be more suitable.

This decision will depend on the problems you are experiencing, your commitment to the process (counselling can be painful), and your telephone counsellor's ability and availability.

Ongoing telephone counselling sessions

If you and your telephone counsellor both decide to continue, you can both agree a 'counselling contract'. A contract generally includes:
  • the frequency of sessions (normally at regular once a week intervals);
  • the length of a session (normally fifty minutes);
  • the time of sessions (normally a regular time on the same day each week);
  • the duration of telephone counselling (normally six sessions or more);
  • and an agreement about confidentiality.
This type of contract often helps to build a clearly defined, consistent and trusting relationship which aims to help you be open about the problems you are experiencing.
 
At the end of six sessions a review can take place to establish whether or not telephone counselling has helped you, how to proceed, and perhaps a renegotiation of the contract.
 
If further telephone counselling is agreed as the best way forward, a new contract can be arranged.
 
Not all counsellors contract or review in this way.
 

Telephone counselling - what not to expect

Telephone counselling is an activity you choose, not one that others choose for you. A relative, manager or teacher may suggest counselling to you, but it should be offered without any pressure or conditions.
 
Telephone counselling aims to help you make your own decisions but a telephone counsellor will not tell you what to do. If you want someone to tell you what to do, it would be better to read a self-help book, attend a self-help group, call a helpline, or speak to a friend or relative.
 

When finding a telephone counsellor, consider some of the above issues before starting telephone counselling.

 
 
by Richard Snowdon MA (Merit) MBACP (Accred) | View Profile
 
Sources
 
Rosenfield, M., Telephone Counselling and Psychotherapy in Practice, in Anthony, K., Goss, S., (Eds.), (2003), Technology in Counselling and Psychotherapy - a Practitioner's Guide, Palgrave Macmillan, New York.
 
www.bacp.co.uk (Accessed 07.04.08).
 
 

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