Brain Injury Matters (NI) was established in 1999 to help rebuild the lives of children, young people and adults living with Acquired Brain Injury (ABI) to enable them to reach their full potential in family and community life. Today we deliver a range of clinical, creative and community services for those affected by ABI and their families around Northern Ireland. In 2018-19 we supported over 400 individuals.
Over the past 10 years BIM has offered an in house counselling service for those with an ABI and their family members. This service is exclusively face-to-face currently and serves those mostly from the Belfast area, predominately east Belfast were we are based. Our current counselling package offers six 1 hour sessions and is free at point of entry.
Service Development Proposal
Our in-house experience indicates that service users can feel embarrassed or shamed to be “seen” especially if they have not adjusted to, or rejecting of physical “disfigurements”/ presentations, experience limited mobility, or find the reality of face-to-face contact too personal especially at the early stages of engagement, or soon after acquiring an ABI. Clients have said it can be stressful and or difficult to attend appointments physically - often connected to physical/mobility and or carer restraints. We have also noted that face-to-face clients only refer into the counselling service within a very limited distance from the east Belfast office. We are not aware of any other ABI telephone counselling service however we are aware and mindful of the long established tradition and track record of telephone counselling carried out by Lifeline, Childline, Samaritans, ParentingNI and the MS Society.
We are keen to provide a telephone counselling service to support clients from across NI, catering for their individual needs, supporting empowerment and individual preferences. We have discussed the proposal with other organisations working in the field including Headway and have received a very positive response
Finally, it is obvious that BIM’s current face-to-face counselling referrals limits this valuable and much needed support to those within Belfast. As a regional service we owe it to our service users to give them choice and reduce feelings of isolation and geographical disadvantage whilst empowering greater convenient and access.
Making the case for Telephone Counselling
Research comparing the efficacy of telephone counselling to in-person counselling and to no treatment exists. For example, a recent study found that more than half of clients (58%) who had experienced both in-person and phone counselling preferred phone counselling. (Reese et al 2006). Furthermore, a 2002 study found that telephone counselling clients rated their counselling relationship similarly to face-to-face clients, demonstrating that the therapeutic alliance which has the largest impact on therapeutic change, is effective using non-face-to-face counselling approaches. (Reese et al 2002).
Wampold’s comprehensive 1997 review of counselling approaches say that “all approaches appear equal…”. Asay and Lambert 1999 research supported a view that only 15% of change is attributed to the modality (type of therapy) with a huge 85% attributed to; client factors 40%, relationship factors 30%, and placebo affect 15%.
Unlike other forms of counselling, telephone counselling is potentially free of certain constraining factors that affect traditional therapy, including geography, time, duration, and cost, making this form of counselling more accessible for a number of people who would be unable to attend traditional psychotherapy. It also provides a degree of anonymity that is comforting to some callers, reducing the intimidation that some people may feel at the prospect of seeking treatment with a traditional in-person therapist and encouraging disclosure. Research also shows telephone counselling to have better results among patients with depression. (Gregory 2004). People tend to feel more comfortable in their own homes and do not get as anxious.
Some specific advantages to telephone counselling are,
- Increased access to rehabilitation for underserved populations,
- Increased efficiency in the delivery of rehabilitation and health services, particularly rural access, and
- Lower cost of services without sacrificing the quality of care. (Liss et al 2002).
A further study by King et al (2006) states that, “this study revealed that factors such as privacy and lack of emotional exposure attracted…” clients and younger people to non-face-to-face counselling environments, suggesting convenience and increased exposure to online and telecommunications services is becoming their norm.
Although a common perception in mental health is that visual contact is a requirement for interventions, this perception was not shared by consumers with disabilities and their families and is not supported by other study’s findings. (Glueckauf et al 2002).