What s Ahead in Cyber- Counselling for Adolescents?

Transcription

1 Kids Help Phone December 3, 2015 Alisa Simon, VP, Counselling Services and Programs What s Ahead in Cyber- Counselling for Adolescents? Development, Delivery and Evaluation of a Live Chat Service

2 Kids Help Phone Fostering Mental Health and Well-Being in Young People Across Canada Mission, Vision & Services Critical Pathways to Live Chat Live Chat Implementation Evaluation of Live Chat Lessons Learned Mobile and Online Tools Q & A

3 1 Mission, Vision & Services

4 1 Mission, Vision & Services OUR MISSION Kids Help Phone will improve the wellbeing of children and youth in Canada by providing them anonymous and confidential professional counselling, referrals 2 and information in English and French through technologically-based communications media.

5 1 Mission, Vision & Services Young People Reach Out to Kids Help Phone s Professional Counsellors Every Day

6 1 Mission, Vision & Services 2

7 1 Mission, Vision & Services Helping Young People Nine Options for Accessing Support 2

8 1 Mission, Vision & Services 2

9 1 2 CRITICAL PATH TO LIVE CHAT

10 2 Critical Path to Live Chat KIDS HELP PHONE S CRITICAL PATH A B C D E Clarify Principles Survey Users Literature Review Discussion with Organizations Review Organizational Capacity

11 2 Critical Pathways to Live Chat A. Clarify Principles Our counselling philosophy requires that: Technologies ensure anonymity and confidentiality Responses must meet individual clients needs Counselling available 24/7 Responses should be as immediate as possible All services are free

12 2 Critical Pathways to Live Chat B. Survey Users Kids Help Phone s Teens websites 3 week duration Purpose of the Survey Ask about: 1. What technology is available to them 2. How they talk with their friends (text, chat, phone, , etc.) 3. How they want to communicate with Kids Help Phone counsellors

13 2 Critical Pathways to Live Chat Survey Results 88 % of respondents used Instant Messaging the most to talk with their friends Approximately 75% of respondents used SMS texting (75% English users, 60% French) The majority of respondents wanted Kids Help Phone to develop Instant Messaging counselling

14 2 Critical Path to Live Chat C. Literature Review about Chats and Texts: Online counselling feels more safe and private Appreciate real time access Convenient, can be portable Chat used by older clients (average 14 years old) Chats more likely to include concerns related to emotional problems Issues tend to be more severe Chats focus on need for emotional support less requests for information Structure of chats differ from phone counselling, likely due to limited time in sessions and slower rate of information exchange Ability to focus discussions quickly is critical Must take into account the technological considerations (online security)

15 2 Critical Path to Live Chat C. Literature Review: Examples of advantages and disadvantages of IM Chat Accessibility, Safe space, Decreased emotional intensity Time issues (waiting in the queue, Time issues length of the chat), Weaker therapeutic alliance Examples of advantages and disadvantages of Texting Adolescents have highest rate of texting communication Medium forces clients to express themselves briefly and concisely Often cannot save or print out texts Short length of message constraints therapeutic effectiveness Not reliably synchronous texts can be delayed or dropped, affecting service experience

16 2 Critical Path to Live Chat D. Consultations Child Helplines Internationally (CHI) - Texting versus IM Chat: Anonymity a concern while texting Dropped or missed texts Texting leads to demand overwhelming available capacity Texting can be costly depending on one s plan Challenging to counsel because of character limitations Chat concerns tend to be more serious than phone Most chat services are not 24/7 Counsellors require additional training Technology is critical to success

17 2 Critical Path to Live Chat E. Organizational Capacity Considerations Counsellors thoughts on new technologies Resources required Technological Counsellor needs Training of counsellors How to provide a new service without impacting the current service already provided Considerations for piloting Evaluation is critical dearth of research on impact of online counselling

18 2 Critical Path to Live Chat KIDS HELP PHONE S CRITICAL PATH A B C D E Clarify Principles Survey Users Literature Review Discussion with Organizations Review Organizational Capacity = Decision to move forward with Chat

19 13 LIVE CHAT IMPLEMENTATION

20 3 Live Chat Implementation Youth Engagement Young people were asked about their preferred interface

21 3 Live Chat Implementation Technological Steps Surveyed Chat technology Created and built internal Live Chat technology to fulfill promise of anonymity other programs on the market did not include this feature The hours of service were selected based on a review of traffic patterns for our phone and web contacts

22 3 Live Chat Implementation Preparing Counsellors Wrote Live Chat training manual for counsellors Guidelines Transferring counselling skills Responding in a Chat session Important points to ensure a meaningful chat session 5-Phase Model Counselling techniques for Chat interventions

23 3 Live Chat Implementation Guidelines: Based on of brief, solution-focused counselling Aimed at addressing an immediate need Counselling framework is results focused based on the notion that young people can put their strengths to use The client is the expert in his/her situation, whereas the counsellor is the guide in the helping process. The client is the only person who can tell us what we can do to help. Transferring skills for online counselling Many foundational counselling skills are transferable Unique challenges No visual or verbal cues Challenges reading subtlety or nuance

24 3 Live Chat Implementation Responding to a Chat session Need to develop an understanding of the person chatting ( the chatter ) by looking at all the information he/she has given Emoticons Nickname Cognitive level of the chatter Age Content of the Chat

25 3 Live Chat Implementation 5-Phase Model: Important points to ensure a meaningful session A Warm Welcome: Make a connection Clarifying the questions Ask questions to understand the situation Determine the goal with the chatter Work together toward the goal (intervention) Closing the circle

26 3 Live Chat Implementation Piloting Live Chat Alpha testing (2 weeks) Internal training and testing no public users Opportunity to track bugs in the system Beta testing (2 weeks) Public, with limited hours of service (3 hours, 2 days a week) More counsellor training Pilot went live Pilot paused for retraining counsellors based on learnings

27 4 EVALUATION OF LIVE CHAT 1

28 4 Evaluation of Live Chat

29 4 Evaluation of Live Chat Self-identified reason for chatting (n= 317, multi-choice) Substance use or addictions (3%) Information about laws or rights (3%) Sexual orientation or gender Becoming independent (6%) Bullying (8%) Physical or sexual health (9%) School (14%) Violence or abuse (15%) Suicide (18%) Self-injury (19%) Dating (23%) Friend/peer relationships (32%) Family relationships (35%) Mental or emotional health (41%) # of respondents

30 4 Evaluation of Live Chat Why Live Chat? I feel too nervous or uncomfortable to call (75%) Because you're anonymous nobody will know that it s me or tell on me (75%) I don t have enough privacy to talk on the phone (62%) I can t talk to anyone around me (53%) I didn t know any services where I live that could help me (18%)

31 3 Evaluation Results 31

32 3 Evaluation Results 96 % of phone clients say they would call Kids Help Phone again if they need help 9% of phone clients received the support they hoped for 32

33 Evaluation Results The 2014 evaluation built on our 2012 evaluation. It achieved the following: Re-affirmed findings of 2012 evaluation Allowed for greater comparisons between our phone and chat services Introduction of a new clinical measure: hope 96 % of phone clients 2014 Evaluation Highlights say they would call Kids Help Phone again if they need help 9% Phone and Live Chat positively influence a young person s: Distress Perceived difficulty of the problem Problem clarity Self-efficacy (confidence) Hope of phone clients received the support they hoped for.89% of chatters would contact Kids Help Phone again 33

34 Evaluation Results Reaching a Diverse Audience 36% of Live Chat participants identified with non-heterosexual orientations 96 % Essential Part of phone of the clients Continuum of Mental Health Care Using Youth say they Self-Report would call Tool (Achenbach), 60% 9% of potential chatters scored in Kids the Help clinical Phone or borderline range for anxiety and 83% of again if they need of phone potential chatters scored in the clinical or borderline range for help clients received depression the support 31% of chatters are either currently on a wait they list or hoped are currently for seeing a counsellor or therapist Young People Bring More Serious Issues to Live Chat Young people seeking help for mental health or suicide-related challenge are more likely to do so using chat than phone 34

35 1 5 LESSONS LEARNED

36 5 Lessons Learned Need for specialized training Chat and telephone counselling skills are unique and sessions look different Ensure counsellor supports are in place Length of counselling sessions by chat An average chat time is 44 minutes while a phone call is on average 18 minutes long Need to stay open to mobile technology 18% of respondents noted that they chatted via their phone or mobile device Chat is another medium to provide referrals 24% of respondents noted that they received a referral Ending a chat can be challenging Young people still want to use all channels to receive counselling Demand for counselling continues to be consistent

37 5 Lessons Learned Primary benefits of Live Chat: It allows young people to contact us if phoning is not an option for them. Privacy Fear of talking to a stranger, fear of crying, fear of not being able to express the problem clearly. It allows clients to really say what s on their mind. Young people are very comfortable with chatting and it helps the flow of conversations. Reaching youth who have not accessed our other services. Chat is motivating for counsellors as it allows them to learn new abilities.

38 5 Lessons Learned Top challenges: Scheduling Long chats affect multiple counsellors schedules Heaviness of chats serious topics Repeat chat clients (night-to-night or in the same night) Start up pains Limits of the chat software

39 16 MOBILE AND ONLINE TOOLS

40 6 Mobile and Online Tools/ Resources Around Me Young people will be able to access our Community Resource Database through a new feature, Resources Around Me, on both our English and French websites as well as our mobile app, Always There. To be launched later in 2013.

41 6 Mobile and Online Tools/ Resources Around Me After selecting a location, users can select different categories (such as counselling or housing ) to look for local resources that will be pinned to a map.

42 6 Mobile and Online Tools/ Resources Around Me After clicking on a local resource, youth will be provided information about that service including details such as hours of operation, address and phone number.

43 6 Mobile and Online Tools/ BroTalk Service Creating a website that speaks to teen guys (and those who identify as guys) Providing counselling primarily through Chat

44 6 Mobile and Online Tools/ BroTalk Service Interactives

45 6 Mobile and Online Tools/ BroTalk Service Interactives

46 6 Mobile and Online Tools/ BroTalk Service

47 6 Mobile and Online Tools/ BroTalk Service Videos

48 Our Funding Reality Kids Help Phone s annual operating budget to deliver its core services to kids and teens aged 5-20 across Canada is approximately $16 million. As a charity, we secure donations to operate Kids Help Phone from individuals, foundations, corporations, and community fundraising events like Walk so Kids Can Talk. Government funding currently is received only through projectspecific grants and agreements, and makes up between 10 and 15% of total funds associated with core service delivery. Our goals from 2016 to 2020 are to continue to grow revenue and financial sustainability, ensuring we have the resources to meet future needs.

49 I just want you to remember that you DO make a Q difference & A for kids like me. You made an awesome difference in my whole entire life. Thank you! Thank you! Thank you! (posted to kidshelpphone.ca) Je tenais à ce que vois sachiez que Jeunesse J êcoute a jouê un rôle vital durant mon adolescence. (un message affiché à Pose ta question en ligne) If you know a young person who is struggling with a problem, big or small, please encourage them to visit kidshelpphone.ca or jeunessejecoute.ca or call today. 49