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On-line counseling at Therapeutic Services Rone Gerber (M.Psych.) Marcia Minnaar (M.Psych.) Birgit Schreiber (PhD) University of the Western Cape South.

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Presentation on theme: "On-line counseling at Therapeutic Services Rone Gerber (M.Psych.) Marcia Minnaar (M.Psych.) Birgit Schreiber (PhD) University of the Western Cape South."— Presentation transcript:

1 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

2 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)

3 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’

4 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

5 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)

6 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

7 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)

8 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)

9 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

10 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)

11 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 e- counseling (no online courses available in SA, some training in USA (University of XXX)

12 Types of presenting issues

13 Types of responses to presenting issues

14 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..www.uw.edu/doit/Brochures/Academics/equal_access_ss.html http://www.zaw3.co.za


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