Helplines: From phone line to online

Many helplines are starting to offer email and text services. Radhika Holmstrom looks at the challenges these new technologies present and how charities are responding.

Helplines, you might think, are all about personal contact and one-to-one conversation. The caller pours their heart out, while the person at the other end of the telephone nods, maybe jots things down and, above all, listens attentively - the caller's tone of voice, choice of words and silences are all crucial.

However, an increasing number of helplines are moving over to a quite different form of support: email and even text counselling. It may not be a huge percentage of the overall volume of calls to charity helplines, but still represents a significant number of individuals needing support.The Samaritans, for example, receives about 1,750 emails a week and responds to them all within 24 hours.

The move to email, internet and text message helplines has not always been a conscious decision. Often it is simply the knock-on effect of including contact details on a website that leads, unsurprisingly, to being contacted with the sort of queries that would previously have gone through to a call centre. However, it is raising a whole new set of concerns for specialists in the helpline field.

The new medium brings great advantages. Young people are an obvious target group, but there are also those who find using the telephone physically impossible because they cannot hold it for long or speak clearly enough to be understood by a stranger. Men are also much more likely to prefer email to picking up the telephone.

"Our research showed that simply having an awareness of our email service made young people more likely to feel the Samaritans was a good option," says Samaritans chief executive David King of the charity's latest campaign to promote its email service among 16- to 25-year-olds.

AOL agony aunt Susan Quilliam supported the campaign. "Online support is an effective way of helping people in distress because they don't form negative perceptions about the person or organisation helping them," she says. "They are more likely to get in touch and be open about the issues that worry them because they're not analysing someone's accent or tone of voice. Email also allows people to work out exactly what they want to say without feeling pressured to get the words out."

However, the Telephone Helplines Association (THA) is concerned about this trend because the use of less sophisticated email and internet sites raises issues of confidentiality and the quality of counselling. "Helplines that start answering emails need to look at their policies much as if they were setting up a new service," says THA chief executive Kathy Mulville.

"Some services have thought about this. Many others find that it's happening to them and only then start wondering if they should have separate policies."

Some organisations, such as Childline, have decided against setting up any email service at all, feeling that they are not yet in a position to do it effectively (see box, above). Others have a limit of two or three emails before switching to the phone.

For those organisations that do move into the online arena, the challenge is to take advantage of the opportunities without falling prey to the pitfalls. Effective online counselling needs a lot of forethought, plus a website that has professional standards - when email enquiries start coming in, there are implications for security and confidentiality.

The THA favours a website form or a secure online chat room rather than email, so that enquirers can remain anonymous. "Callers can create their own identity and log-in details, get information and go back to the site to receive responses," says Mulville. "This prevents emails being downloaded on to private PCs, where they could potentially be accessed by others." Mulville also feels that emails should be directed to a cyber-figure such as the Samaritans' "Jo" rather than a real, named person.

Most organisations do not bear in mind that websites are available globally, which means they are likely to receive queries from all over the world.

There are other considerations: who answers enquiries? What format do they take? How quickly are emails answered? Who has access to them? How accessible is the site? In all of this, confidentiality and security have to be paramount.

Above all, there is the issue of moving from the spoken word to the written.

It involves a completely different quality of exchange - all the nuances of tone and silence that a trained counsellor works with in a phone conversation disappear, just as the visual cues vanish in the move from face-to-face to phone support.

Some people are happy with this move and may even prefer it; others find it almost impossible to set their concerns out clearly in writing. It is the same for counsellors - those who are extremely good at verbal communication might not be very happy with writing, which requires different skills.

Nor is it always the quickest option - it can take 20 or 30 emails to cover as much ground as a relatively short conversation.

For those organisations that do decide to provide email support, the THA is keen to develop good-practice guidelines.

The association aims to develop standards against which email services are specifically addressed and is seeking funding for this. In the meantime, its key concerns are that organisations should evaluate their email services alongside those offered by their telephone facilities (a service the THA offers) and should review any policies they have about email services, updating these as necessary.

Email support is undoubtedly a very useful tool, and for some organisations it is absolutely the right way to go. For others, it may just not be the right - or feasible - option at the moment. "You need to be thinking about what is appropriate for the person, the organisation and the client group," Mulville concludes. She and her colleagues are most concerned that if email support is to be appropriate, it is arrived at by means of a conscious, planned and fully resourced decision.

CYBER-SUPPORT SPECIALISTS: Muslim Youth Helpline

The Muslim Youth Helpline is a confidential service, staffed by approximately 40 volunteers, all aged between 18 and 30, and six paid staff. Between them they speak 10 languages and provide both phone and email services.

"It was set up as a dual service," explains helpline development worker Layli Uddin (pictured). "We recognised there was a need for email support.

Many of our clients have easier access to the internet than to the phone, especially if they aren't free at the time when the lines are open. Email also guarantees more anonymity, and young people who are unable to articulate their emotions can find the phone quite intimidating." MYH was one of the first organisations to develop specialist email counselling, and all counsellors have to be trained in offering advice, both on the phone and by email. "It's about extending the general principles of counselling to email," Uddin says. "You can't pick up verbal cues on email and the language is a lot more informal, with a lot of slang and acronyms, which counsellors have to know about." About 50 per cent of enquiries to the helpline come in by email, and about 60 per cent of initial emailers, split fairly evenly between men and women, will continue to use the medium.

EXTENDING SUPPORT STRUCTURES

In 2004, MYH launched a separate website, www.muslimyouth.net, which offers various means of support and has received about 150,000 hits so far. As a result, the helpline has decided that from September 2005 it will be extending its online support beyond email to specific internet counselling. Instead of enquirers sending emails and waiting for responses, counselling will be more like the 'real-time' exchanges that go on in chat rooms or services such as MSN. Only a few organisations in the UK provide this at the moment - but, as Uddin points out: "We have realised there is a need for it. It can be quite frustrating to wait several days for a response. Young people are now using the internet to form their own communities and develop peer support, and they have developed their own language for this too. We are piloting the new service and are going to develop a training programme specifically for this type of support."

THE TRADITIONAL APPROACH: Childline

ChildLine has nearly 20 years' experience of supporting abused and bullied children, and only uses counsellors who are highly skilled and trained. Apart from a small textphone service for children with hearing problems, it has so far chosen to retain the more traditional phone contact.

Chief executive Carole Easton (pictured) explains: "If ChildLine had unlimited resources there is no doubt we would want to offer a range of quality services to young people so they could seek help on their terms and via whichever medium best suited them. However, young people tell us that online or text services are not high on their list of things they want from ChildLine, so the helpline remains our priority.

ChildLine does not have sufficient funding at the moment to help every child who calls our helpline. Diverting much-needed resources from the helpline to set up other services for the same children simply wouldn't be the best use of our funds. What we are looking at instead is developing services based on new technologies for those children who are unable to use the helpline - such as children who are deaf or hard of hearing - so that we can target our resources where they are most needed."

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