A new custom-built online platform will allow Laurel House’s clients to take part in counselling sessions via instant messaging.
Laurel House, which provides sexual assault support services for the North and North-West of the state, has invested funding obtained earlier this year through Aurora Energy’s digital capacity building grant program into creating the secure platform.
It is hoped the platform will be up and running by the end of the month.
Laurel House chief executive Justine Brooks said the idea was sparked by the requests of young clients who had asked if they could participate in counselling via text.
“We didn’t trust texting because people’s messages could be found. That’s when we decided to do it online,” she said.
“The peak time for sexual assaults is between the ages of 15 to 19 or 15 to 24 depending on which study you look at. That demographic of people are the ones who drove this idea.
“Older demographics are happy to talk on the phone or meet face-to-face.”
Once the platform is live, it will be used for both crisis support and scheduled counselling sessions.
Laurel House already runs a 24/7 counselling service and a person seeking crisis support will be able to elect to speak to a counsellor through the messaging service instead of over the phone.
“They can chat to a counsellor, like texting but online,” Ms Brooks said.
“They can also choose during the intake process whether they want to have face-to-face counselling, video-conference counselling or chat online.”
She said the service had received excellent feedback from clients about the platform and clients were ready to use it as soon as it was online.
“We will have a trial phase before we go fully live,” she said.
The platform will be integrated into the clinical software used by Laurel House’s counsellors.
Ms Brooks said throughout COVID-19, Laurel House had seen an emergence of clients who would not normally choose counselling via video-conference discover it was not as scary as they had thought.
“People have fed back to us while they have not normally chosen that option, they are now more open-minded to it,” she said.
“There were a few people who paused their sessions but I wouldn’t say that was necessarily driven by a negative thought about it but maybe connectivity issues.”
Prior to the pandemic Laurel House only carried out counselling via video-conference for clients who lived on King Island and Flinders Island.
“All of our counsellors now have some clients who are fully online who do not come into the service,” Ms Brooks said.
Ms Brooks said about 12 per cent of clients have continued with online counselling after coronavirus restrictions were lifted and face-to-face sessions were allowed to resume.
“They probably won’t go fully online but they like the flexibility,” she said.
She said having the option to participate in counselling online had reduced the number of no-shows.
“Someone might wake up in the morning and they just can’t come, they can’t face it or they can’t get there. That dropped off dramatically during COVID,” she said.
“We actually saw a significant increase in attendance because people were able to connect with us in their home.
“They don’t have the stress of getting up, getting ready.
“For people with anxiety issues, and that is a condition which is linked with sexual assault, removing all of that improves the process and speeds it up.”
Ms Brooks said the flexibility offered by online counselling had also benefited staff who were now able to work from home one day a week.
Need before the pandemic
There was a pre-existing need and demand for online counselling before COVID-19, according to University of Tasmania School of Psychological Sciences researcher Kimberley Norris.
“However, during COVID with the government subsidising telehealth services for a range of different professions, we’ve seen a dramatic increase in [telehealth services] and a very strong client demand for this to continue post-COVID,” Associate Professor Norris said.
“There was already a need and demand, for example for rural and remote clients it could take a whole day simply to attend a one hour appointment in person.”
Associate Professor Norris said online counselling had many benefits including allowing those with time constraints to fit in a session during their lunch break, reducing the financial strain of travel, and being more suitable for clients with mobility or severe anxiety issues.
“The increased flexibility increases accessibility to groups of clients who might otherwise might be more disadvantaged than others,” she said.
But she acknowledged there may be challenges in delivering counselling online.
“In a face-to-face setting, we often rely on a range of different cues from our clients to understand their experience and when we have a video-based platform we are still able to engage with those,” she said.
“Telephone only means we lose a lot of those cues. It can sometimes increase the reliance on verbal cues.
“It doesn’t necessarily detrimentally impact the session but it can mean we [counsellors] and clients have to work harder to make sure there is that connection and understanding with one another that we use to do the work to improve their quality of life.”
Associate Professor Norris said research showed using a text-based platform was “a good first step to therapy”.
“The idea would be you use that to ensure the person is safe, then you would direct them to a more direct form of counselling so you can do that deeper level of work that needs to occur,” she said.
“Even via a secure messaging platform you can’t really engage in the full level of detail and you can’t get those cues and clues you can get from tone of voice and body language.”
She said texting was a popular choice for people who felt most comfortable with that medium.
“Particularly for survivors of sexual, physical and other forms of violence, because often they can have increased risks in that the perpetrators of those acts might still be present, then a secure messaging platform is often more feasible for them to use than leaving the house or even taking it to face-to-face intervention,” Associate Professor Norris said.
But she said how counselling was delivered always came down to the preference of the client.
“It really depends on the nature of the condition they are trying to manage, as well as their other commitments around work, care-giving and the like,” she said.
Telehealth ‘a core feature’
Associate Professor Norris said it has been realised that the online delivery of mental health services needs to be a core feature of training programs for counsellors and psychologists.
“The reality is that for many training programs across the country and across the globe there perhaps hasn’t been as much attention to that until now,” she said.
She said UTAS offered a range of counselling and psychology courses, some of which cover off on the delivery of telehealth services.
“I would hope that we continue to be able to provide high quality mental health services through telehealth platforms because it addresses issues of accessibility and equity,” Associate Professor Norris said.