Abstract
We detail the nascent stages of the
development of a program of training in Cybercounselling and Cybersupervision
within a Doctor of Counselling program at an Australian University with strong teaching links with
S.E. Asia. The difficulties, frustration (and successes) of locating and mastering an array of
software and hardware applications for the realistic and practical use of a new generation of counsellors are
discussed. Although technological advances proceed apace, we have not yet determined a
software/hardware combination that can be recommended to others unequivocally, though we remain
confident that such a package is only a matter of time. More essential to the progress of
Cybercounselling and Cybersupervision as a useful community aid is the training of a generation of
counsellors with the necessary confidence and technique to make best use of the technological developments
when they arise. We discuss one approach to this vital requirement.
The practice and experience of counselling
usually takes place in a face to face encounter. Practicality commonly
necessitates this encounter taking place in the counsellor’s fixed
location office. However, other practical considerations, for example
distance, and travelling time, may place serious limitations on a
client’s ability to comply with such a requirement. This is particularly
so in countries like Australia with sizable populations far removed from
the coastal urban locations favoured by the majority of counsellors.
However, the progressive evolution in, and widespread distribution of,
digital and internet technology suggests the possibility of overcoming
this ‘tyranny’ of distance’ by delivering counselling services to rural
and remote clients electronically.
It is not so much that simple contact with
distant clients is difficult to establish; the telephone system in
Australia is very well developed and reliable, and virtually every home,
including remote communities, is connected to it. However, the
counselling experience is commonly an interpersonal experience,
frequently involving the expression of significant emotion and the
revelation of intimate information by the client. The counsellor
requires trained insight and interpretive skills in order to manage such
a potentially intense inter-reaction. It is arguable that the majority
of counsellors, and their clients, feel that the simple audio
communication of the telephone is generally inadequate to enable a
minimum condition of personal trust and empathy to be established
between a counsellor and naïve client to permit such a level of intimate
interaction to occur. In the absence of this, many counsellors would
feel that little useful work of therapeutic value can be achieved.
Therefore, it can be argued that if ‘cybercounselling’ of distant
clients is to not only be effective, but acceptable to both client and
counsellor, it must include the capacity of both to be able to see each
other, as well as the converse. The same principles apply to the
introduction of cybersupervision (Kanz, 2001;
Schnieders, 2000).
From the counsellor’s perspective, the
ability to see the client is commonly regarded as highly significant.
Visual clues and cues in body language and facial expression are
regarded, and indeed taught, to be important to assess responses that
may be concealed, or ambiguous, in a purely oral interview. From the
client perspective, seeing, and being reassured by the sight of, the
counsellor can be of importance in their willingness to engage difficult
areas of the essential sharing experience. Having said that, most of
the current research on developments in online counselling approaches
rely heavily on email or chat room text based communication, either
synchronous or asynchronous in format (Lundberg and Cobitz 1999). This
is understandable in the light of the limitations that have existed in
access to efficient audio/video communication for most counsellors and
clients. The major exception to this has been the use of
videoconferencing facilities often based on ISDN 2 ,3 or 4 technology,
where high quality face to face communication is now possible. However,
the current cost implications of this approach rule out its use by any
other than large scale business, or government agencies tasked with
providing ‘cyberhealth’ services to remote areas. It cannot be
considered practically realistic as a regular counselling tool for the
average counsellor. Similarly, with regard to distance supervision of
counselling students, the literature relates largely to the use of the
telephone and email, supported by audio tapes. Videoconferencing has
been tried and shown to be effective in settings where high speed
connections are possible, but again these are usually not available, and
hard to justify in cost terms when they are.
Hence, this paper does not rely on past
experience of others, but rather looks forward to what can become
normative in five to ten years time (Coursol and Lewis, 2001;
Watson,
2003). Substantial improvements in technological solutions have occurred
even since the project upon which this paper is based was conceived.
Indeed, so much so that we have come to the view that it is technically
possible, and financially realistic to see cybercounselling and
cybersupervision as viable modalities in the short term future. It has
to accepted that there are many teething troubles to be overcome, and
many ‘traps for young players’; nevertheless, we are convinced that the
future offers promise of new ways for counsellors to communicate that
will permit greater access to counselling services for a wider
demographic of clients . We are also of the view that existing
technology permits us to interact with offshore students of this
University (in South East Asia) more efficiently than before, and spare
many of them the expense of studying in Australia for extended periods
of time.
It is a major focus for the Doctor of
Counselling program offered by University of South Australia is to
prepare those who will become leaders in the profession over the next
decade. Consequently, it has been logical to involve the current cohorts
of doctoral candidates in the process of discovering what works and what
does not. Achieving this has also been an opportunity to address a
crucial issue underlying any endeavour in this area, namely; challenging
technophobia among counsellors and students of counselling and enabling
them to ‘catch a vision’ of a new paradigm for the application of their
skills.
We regard this as particularly important.
During our researches into available modalities, both authors attended a
presentation by an Australian psychologist with experience
in the delivery of mental health services to the offshore islands of
North East Scotland. A notable remark was made that, although Government
provided ISDN 4 communication facilities had been established to these
islands at considerable cost, and were extensively used by doctors and
nurses for ‘telehealth’ purposes, they were rarely used by psychology or
counselling staff. The main reason for this most surprising admission
was that the psychology staff ‘…didn’t feel comfortable with the
medium”.
Clearly, no matter what technological
solutions to ‘cybercontact’ problems are eventually achieved, if the
relevant generation of counsellors “…don’t feel comfortable using them”,
what is the gain? The hardware, software and ‘humanware’ components must
all interact for Cybercounselling to be a viable function in the 21st
century. This approach is in line with many calls for adequate training
and establishment of minimum acceptable standard in the new and
expanding field of webcounselling. Currently there is a great deal of
service delivery but little formal training available for it. The
webcounselling review prepared for the Dept of Health and Ageing
remarked by way of summary to their findings that “The main challenges
for the tele- and web counselling sectors, and for mainstream and
allied health professionals are to …facilitate access to developing
practice wisdoms and learnings;
enhance professional support, training, peer support and supervision,
and rationalise resource
allocation. Examples of integrated approaches involving the tele and web
counselling sectors and
mainstream health should be further investigated and documented to
demonstrate the ‘what, where
and how’ of these developments.” (National Review of Telecounselling
and Web counselling services, 2003, p.10:Dept of Health and Ageing Report
prepared by Urbis Keys Young. (www.urbis.com.au.
)
In detailing our experiences, we hope to
provide “hope tempered by realism” to those others in academic
environments who are contemplating entering this interesting field.
Aims of our research project
The aims of our project were initially expressed
as representing “ …the first phase of a four stage development that can
provide new impetus to our existing Masters of Counselling program, and
enable introduction of our Doctoral program in an offshore format.
In summary:
1. To develop training in cybercounselling in 2005 through collaboration
between staff and students in Adelaide and Singapore.
2. To extend this to cybersupervision of Singapore students from
Adelaide, and allowing Singapore students to observe staff providing
counselling sessions in Adelaide (in our Counselling Service
facilities).
3. To develop substantial parts of the existing curriculum into a
distance format using the same technologies (e.g. Centra).
4. To develop current doctoral courses into a similar format so that the
program can be offered offshore (supplemented by visits already
scheduled for Masters teaching) This paper is principally concerned with
the first phase (as a proof of concept) of a complex undertaking, with
the anticipation that this will lead to the easier adoption of the other
components.
Goals for the successful completion of the project were
1. To identify software options for Cybercounselling and check on their
suitability/limitations.
2. To deliver a successful Cybercounselling course to doctoral
candidates to equip them to take a
lead in this new area.
3. To make use of links with Singapore colleagues working in this area
in order to benefit from their
practical experience and to build foundations for our Singapore students
to learn Cybercounselling
skills..
4. To explore the possibilities presented by specific ‘virtual
classroom’ software (Centra) for CyberSupervision both on and offshore.
5. To prepare the ground by way of experimentation for off shore
Doctoral level counselling candidates to enroll.
To achieve these outcomes arrangements were made for:
-
Active participation by doctoral candidates enrolled in a
course of Cybercounselling at the University of South Australia, to
ensure that skills and knowledge gained would be utilized in applied
settings
-
Involvement of the UniSA Flexible Learning Centre staff to
facilitate the introduction of Centra software as one method for
achieving the desired goals
-
IT support to overcome technical problems associated with
this exploration into communication in new ways both on and off campus.
-
Consultation with colleagues in Singapore in order to draw on
their expertise and to establish continuing links for future teaching
and research purposes.
Telecommunications background
The use of telephone and web-based
counselling services has grown dramatically in recent years, to become a
major part of the health care industry. However it is also unable to
keep up with demand. An (Australian) Department of Health and Ageing
survey reported in 2003 that in Australia: “Two of the largest service
providers answer some 400,000 calls annually. Notwithstanding this high
level of usage, service demand exceeds service capacity. For example,
three ‘core’ providers (Lifeline Kids Help Line and Care Ring) report
that as many as 62% to 90% of calls to their service go unanswered.”
(National Review of Telecounselling and Webcounselling services, 2003,
p. 5 : Dept of Health and Ageing Report prepared by
Urbis Keys Young.
www.urbis.com.au. An effective practical model for cybercounselling
can be argued to have certain criteria. These include, but are not
confined to: appropriate computer based hardware and software that
permits both audio and video components, plus a readily available
electronic connection. During the 21st century to date there has been a
wide take up of both computer ownership and internet connection in
Australia. For example, it has been estimated that in 2005 approximately
83% of Australian households are internet connected; implying a
necessary computer ownership and associated skill to use both. Whilst
most of internet connections are currently based on 56K dial-up systems,
the penetration of faster broadband connections has been significant,
and expected to continue to the point of dominating the internet
connection market including rural and remote areas. Indeed, the Federal
Government’s understanding of the significance of internet access is
such that it is a stated policy objective of the supervision of the
national telecommunications carrier, Telstra, to ensure that rural and
remote areas are not disadvantaged compared with urban users. (Webcounselling
Review, 2003).
An additional development is that,
‘webcams’, or simple cameras for capturing and transmitting visual
images electronically have become relatively inexpensive, frequently
costing less than $100. These are readily linked to microphone headsets
to enable audio/video communication based on simple procedures and low
cost. Further still, there has been a variety of free software programs
developed for practical use of these technologies via the internet. The
convergence of these technologies is now such that we no longer refer to
telephone counselling or internet-based counselling as separate options,
nor do we need to distinguish text based from voice-based communication.
The managing director of a South Australian initiative, Internode (www.internode.on.net) , Simon Hackett, describes the introduction of ADSL2+ broadband
services in SA “which run 16 times faster than the current high-speed
broadband plan from Telstra….In the not-too-distant future, you will see
a range of television-style channels delivered over your broadband
connection… Video, voice and super-fast internet over broadband will
revolutionise how we do everything, from learning and working right
through to how we entertain ourselves”. (Hackett, 2005)
Such is the interface between desktop
computers, laptops, and 3G phones, (and, soon enough, arrival of the
2005 Xbox as a complete family communication package) that it is easy to
move between modalities, using text, audio and video flexibly. With high
speed links internationally, these tools can assist our students
offshore equally with those on campus. All of these possibilities can
link with person-to-person counselling in real time to make for a fully
interactive interpersonal experience, without the limitations of email
that have made counsellors reluctant to pursue virtual options.
Similarly, the highly expensive supervision aspect of counselling
programs can be managed more efficiently and economically by having
access to this range of communication strategies, with cybersupervision
not an alternative, but a valuable adjunct to traditional modes.
Objectives
In addition to the potential for electronic
technology to be used for counselling practice itself, there is the
potential for it to be used in the training (particularly the
supervision) of counsellors themselves. This potential is of particular
interest to UniSA, which has a significant offshore training program for
counsellors in South East Asia (notably Hong Kong and Singapore).
Accordingly, we have undertaken to investigate the use of electronic
media for both training of counsellors (including training in
cybercounselling) as well as the actual practice of cybercounselling. At
the outset, it was decided that we needed to go beyond the widely used
textbased approach and ensure sound and image can be shared between
participants in real time. The issue of frame rate (the ‘liveness’ of
the image) and latency (the gap between the sending and receiving of the
sound and image) and the synchronicity of sound and image were seen to
be of crucial significance, particularly in the area of distant
supervision of counselling students, or the ability of students to
observe their teaching mentors in actual counselling sessions. This
latter requirement was seen to be of special importance to overseas
students who complained that they
have inadequate training in, and opportunity to observe, what a well
conducted counselling session looks and sounds like. This form of
training is very much in keeping with Vygotsky’s views of ‘proximate
learning’ value.
TV programs are transmitted at a rate of 25
frames per second. In order to achieve the equivalent quality picture as
a TV, or indeed anything close to this standard (particularly a ‘full
screen’ image in real time) requires the transmission of a very large
amount of data over some communication channel. The only internet system
capable of anywhere near these levels of data transmission is arguably
the ultra high speed ADSL 2 or 2+ protocols. ADSL 2 is capable of
upwards of 8-10 megabytes per second data transmission, while ADSL 2+
can deliver a peak speed of 24Mbps. This compares with the common 56K
modem which delivers only app. 30-40 kilobytes of data per second!
However, such systems are only now becoming available in very limited
areas of Australia, principally in the CBD’s of major, capital cities.
It will be some time before such systems are available in rural and
remote areas, but the developers are optimistic. The identification of
suitable hardware and software to achieve reliable levels of data
transmission capable of generating an image that is at least acceptable
(if nowhere near TV transmission quality) with currently available
transmission speeds has proven to be a more difficult (and frustrating)
task than was initially envisaged.
Initial investigations
Initial and informal discussions with
friends and colleagues, with greater familiarity with the area,
indicated that the question of frame rates of image transmission was
very much controlled by the bandwidth of transmission (the capacity of
the connection to ‘push’ data down the connection ‘pipeline’ at speed).
Other discussions indicated that colleagues had successfully used
existing commercial hardware and software to conduct successful
interactions with distant PhD candidates, for example. This promised
that the adaptation of existing systems for cybercounselling purposes
should be possible.
In company with many universities with
multiple campuses, UniSA has a large and sophisticated IT network.
Furthermore UniSA has a strong commitment to online delivery of
material, and a significant interest in adapting cutting edge technology
to the educative process. Accordingly, detailed advice was sought from a
colleague with considerable experience in the online delivery of
material within UniSA, and who also had knowledge of the experience of
others within the university who had sought to do the same.
This discussion suggested that there might
be a significant difference between the promises, and anecdotal reports,
of various software (and hardware) packages, and their actual delivery
of service outcomes in a simple and reliable way. In particular, it was
pointed out that past program activities that had been attempted, had a
rather high tendency to fail. Frequently this was because of the ongoing
need for sophisticated IT knowledge on the part of users, supplemented
by high order outside support (at short notice) to overcome technical
‘glitches’ which were to be expected in this electronic area. In
addition, difficulties that were beyond the influence and control of
local users could be anticipated to disrupt planned activities online in
an unpredictable manner. As part of our preparation and orientation we
attended several demonstrations of possible software solutions,
including CaptureCam and Centra as they were being introduced to
teaching staff. These were almost invariably full of frustrating and
disappointing complications, making it clear that we are still near the
beginning of making the systems reliable. It was also clear that, even
as the technical sophistication of the software is advancing to make
online counselling a potential reality, there is at the same time an
increasing limitation to its use in the highly controlled IT system that
exists within the university in order to achieve system integrity.
Several difficulties were identified as
being predictable sources of frustration. Not the least of these was the
high order protection systems that are necessarily in place within a
large network such as that in place at UniSA. Such protective systems
can have the effect of reducing the functionality of many software
programs by the denial of access (without appropriate ‘administrator
level’ privileges within the university IT network). This is
particularly true of software intended to communicate from within the
university network to outside places, and the reverse. In addition, the
functionality of a network as large and complex as that present in UniSA
cannot be realistically relied upon 100% of the time. The reasons for
such failures may not be obvious to less sophisticated users, nor
resolvable by them. It is clear that counselling cannot be undertaken
using this approach unless very careful plans have been made with
potential clients to manage functional linkages between counsellor and
client, and to ensure adequate back up in the event of interruptions to
contact . Quite apart from university based limitations, the more
general concerns about secure communications online mean that some
software that might be otherwise suitable for counselling and supervision
have to be bypassed as having unacceptably high risks.
Specific software programs investigated
ICQ
www.icq.com
This is a widely used chat program that is
used by some online counsellors. It is widely used in the community
(along with similar programs like
Yahoo and
Skype), and hence provides
an easy platform for communicating with those who are computer literate.
An earlier project developed the potential for using ICQ and created a
learning resource for students. It has the facility for synchronous and
synchronous text based communications. In addition, in some versions it
is possible to use audio and video, as well as a form of chat
communication that circumvents some of the security concerns by
by-passing the ISP once it is established. We explored its suitability
but decided against pursuing it as it is a concern within the university
system that it can be too readily open to hacking. The experiment in
using this was nonetheless valuable, and directed by a counselling
colleague Dr Barry Lloyd who has assisted in creating a CD-ROM learning
resource for the course, and introduced his way of working with ICQ in a
regular counselling practice (Court, Lloyd & Van der Neut, 2003)
MSN Messenger (http://messenger.msn.com
).
This is also a widely accessible program,
and available within the university suite of software resources. Using
its Passport version, everyone signed in to use this for its text-based
chat facility. In addition, it was possible to use VOIP (Voice over
Internet Protocol) facilities as the teaching space was equipped with
webcams and headphones, and several of the class invested in these
resources for use in their own workplace.
In considering its potential for
cybercounselling several issues arose. It is possible to communicate
within the university using text and VOIP, but only text is possible in
communicating between sites, due to firewall restrictions. Between
external locations it was possible to use voice and camera, but the
quality of the signal was limited when using 56K dial-up connections.
There is too much time lag on regular phone lines to make for
comfortable communication. With broad band connections, the system
worked well, and shows promise. However, there are further obstacles
with users of Windows XP, since the Service Pack 2, now widely installed
for protection makes it impossible to use this system’s VOIP facility
without first disabling some security features. Clearly this limits its
potential for working with clients who would be reluctant to do this,
even if they knew how.
One further surprising complication with
this program was that we found one version of Messenger was not always
compatible with another version. During the time of this study, three
different versions were available (6.0, 6.2 and 7.0). For full
compatibility (text, audio, video) participants had to be using the same
version. This also limits the extent to which one might use this with
clients. This is less of an obstacle when considering cybersupervision
since such compatibility could be organised as part of the supervision
process.
METOYOU (http://www.metoyou.org.sg
)
An important feature of this exploration was
to invite a Singapore colleague, Ms Irene Chua, to consult with the
group over a weekend and introduce the use of a purpose built software
program that is currently in use with Singapore teenagers through the
Marine Parade Family Service Centre. We engaged with the program and
were able to see how clients and counsellors interact in chat mode. We
all engaged in experiencing the modality together with exposure to the
careful supervision that is possible in real-time as well as through
recorded scripts. The Singapore program requires 144 hrs of training for
its counsellors and is perhaps the most thorough such program available
anywhere at present.
The program has been in development over
several years but is still not available for franchise, but it does
contain important elements that were most instructive. The consultation
was an invaluable part of the total learning experience, and will enable
further contact for our students in Australia and Singapore.
CENTRA
(http://www.centra.unisa.edu.au)
UniSA has a commitment to a program
called CENTRA, which is designed for multiple participant simultaneous
access within what might be viewed as a ‘virtual classroom’. This
environment is intended to include, text, voice, video interaction. At
an early stage of the investigation, we attended demonstrations of this
software within the university. They convincingly revealed the potential
difficulties that had already been flagged by colleagues. The
demonstrations were fraught with persistent failure to establish
connectivity and difficulty in demonstrating various components by the
colleagues tasked with making the demonstration. This was despite the
fact that they had experience in, and familiarity with, the program. The
phrase; “…I’ve never had this problem before, I can’t imagine what is
wrong”, was one that we were to hear on a number of occasions during our
investigations.
Several later attempts to demonstrate this
software were also fraught with persistent difficulties in demonstrating
its capacity. Problems associated with incompatibility of versions of
the software on the various PC’s attempting to communicate with each
other; incomplete/ or inappropriate ‘authorisations’, or password
acceptance, among participants were identified later as the cause of
some of these failures. As we proceeded to practise to gain familiarity
in spite of setbacks we found invariably that one or more participants
was refused access after being authorised to participate. These
difficulties are not insuperable but they certainly pose hazards when
developing comfort among those who start with technophobia.. And it is
not realistic to have IT and support staff on hand at all times.
The first author made a later attempt to use
the CENTRA software from within the University to communicate with the
second author in a remote location outside the university, and
encountered significant connectivity difficulties, despite the presence
of a university IT support person present for troubleshooting. This
difficulty was later identified as being associated with protective
firewall mechanisms with the remote PC, but which were neither readily
identifiable nor remediable by the IT support person present. This
experience highlighted the difficulties that can be anticipated in the
use of any software to connect remote PC’s, whose local configuration of
the increasingly necessary anti-virus and anti-hacker software may
prevent connections. In overcoming these difficulties we
acknowledge the excellent support received from members of the UniSA
Flexible Learning Connection, especially from Dale Wache and Kelly
Martin. These difficulties have been particularly associated
with the ubiquitous Windows XP operating system with Service Pack 2.
The resolution of such PC settings, which interfere with connection, may
require a high level of technical and PC expertise. It would be foolish
to expect such expertise exists uniformly among, for example, every
client that one might wish to connect with in a cybercounselling role.
Once these difficulties were overcome, it became possible for the two of
us to communicate between Singapore and Adelaide, over a hotel-based
broadband connection. This experience was compromised by difficulties in
initialising the Singapore webcam, but this was merely part of the
learning experience. It was nonetheless possible to receive images from
UniSA successfully with an acceptable frame rate and latency. This
experience encouraged us to believe that CENTRA is a software system
with some promise. This international communication also highlighted the
significance of communicating the timing of such ‘meetings’ between
remote parties using a common GMT time, rather than an estimation of
local time equivalency. (The experiment occurred on the weekend of clock
changes in Australia, leading to ambiguity without the use of GMT). The
unreliability of ensuring that all systems are working for all
participants is such that the use of such programs must be still seen as
exploratory. As we were trying to co-ordinate all participants in Centra
sessions, an article was published on line entitled ‘Did everybody get
that?’ the challenges of international teleconferencing. (Topps, 2005),
in which the author commented “It seems typical of such online meetings
that, despite all the technological advances at our disposal, the most
commonly asked question is ‘Can you hear me?’
We learned to be cautious in a trial CENTRA
session in which the leader attempted to send a URL to all participants
believing that a visual display would appear (based on previous
testing). In reality the programme was taken over so that the leader
lost control of the program, and a running message began to occur which
became increasingly offensive. The intrusion could only be managed by
closing down the program.
SQIZBIZ (http://www.momentumgroup.com.au)
The
chance viewing of a national TV program (New Inventors; ABC Channel 2:
http://www.abc.net.au/newinventors/txt/s1186349.htm) promised an
alternative and newly developed means of easily transmitting a live
video-cam image via the internet. This was seen as a potential solution
for the requirement of counselling student supervision requirements.
Accordingly, contact was made with the developers of this equipment and
associated internet server support, and a demonstration arranged.
This demonstration was quite impressive.
Connection from interstate (Victoria) was effected easily and through
the UniSA firewall. There were some problems with latency in the image,
but these were still well within the acceptable range. Further
developments to address these issues were promised, and recently have
been advised to be complete, though no opportunity to test these has
occurred at the time of writing.
The principle difficulty with this potential
solution was one of cost. The total hardware cost (including videocam)
was of the order of $AUD 3000, although the use of the essential
hardware with existing video cameras was assured, hence reducing this
start up cost substantially In addition, however, ongoing ‘IT support
packs’ and essential dedicated internet server use fees were applicable.
These could vary between a total of $AUD 450 and $AUD 950 per month
depending on usage levels and other considerations. It was clear that
such a solution was dependant on regular and reasonably frequent use to
achieve an adequate ‘economy of scale’ within an academic environment,
rather than a commercial one for which it is principally designed. It is
unclear whether such an economy of scale could be attained by UniSA in
the immediate future. Nevertheless, this solution seemed to work as
promised, and does represent a definite future possibility.
Other systems
We attended a seminar in which the
videoconferencing system used in North East Scotland or cybercounselling
purposes and other health service delivery was presented by an Adelaide
trained psychologist, Dr Susan Simpson, now working in Aberdeen. This
system is based on a very sophisticated, government supplied backbone of
ISDN 4 connection, with equipment costing some $AUD 6000 at each end of
the connection. The value and implementation of this approach has been
reported in the textbook used in our doctoral course (Simpson,
2003) The presenter was enthusiastic about the benefits of this high
order distance communication, and reported good client satisfaction, but
she had no knowledge of internet-based connectivity and was unable to
progress our understanding of the less expensive and more widely
available approach using the PC. Of interest however; was mention of
unanticipated client difficulties that might exist even with an
otherwise successful sound and image remote conference system. These
included the potential difficulty of the client having adequate privacy
within their own home to conduct a successful counselling session,
unless they were dependably alone in the house at the time. In addition,
where connection was made via a local (but still remote) location such
as a Health Clinic, particularly where this was located in a small rural
community, the simple act of attending the Clinic (or having the car
parked outside it) could be viewed by some clients as ‘advertising’ to a
curious local community that they had difficulties for which they were
seeking assistance. This observation was interesting, suggesting that
finding adequate ‘privacy’ for counselling in remote locations may be
much more difficult for clients than had been somewhat automatically
assumed. Further, it was observed that despite the existence of this
very sophisticated communication system that was being readily and
widely used by other Health professionals, the psychology/counselling
staff were unexpectedly reluctant to utilise it. No conclusions were
reached as to why this might be, beyond the notion that not having the
client within ‘touching distance’ reduced a level of control of the
session by the counsellor to an unacceptable level.
The cautions expressed above were confirmed
in our own work where videoconferencing was attempted between Glenside
Hospital and the Women’s and Children’s Hospital facilities (both in
Adelaide, South Australia). Personal experience of those who set up
sessions was that a surprising range of procedural difficulties arose
before comfort was achieved. Background information from the technical
staff indicated that there are many procedural difficulties that make
the system less useful than it should be in offering services to rural
and remote areas. Hence in addition to the major cost in equipment and
upkeep, there are also practical reasons for developing a system that
does not call for so much specialised availability. VOIP looks as if it
may be able to replace videoconferencing links before long.
SMS texting (http://www.netlingo.com)
It is being noted among telephone and
e-counselling services that SMS text messaging is becoming commonplace.
This is not a vehicle for substantial counselling in itself, but,
especially with young people, it can provide a useful conduit between
clients and counsellors in establishing a first contact, and making
practical arrangements for more substantial communication. Since this is
now part of the counselling environment we spent time getting exposed to
what has become a new linguistic style, since awareness of this may be a
key issue in establishing rapport with SMS enthusiasts. In addition to
the developments among young people, with 95% claiming access to a
mobile phones in the UK, this interest is
now also spreading among older people, dubbed the ‘Silver Texters’ with
over a million over 55s reporting using SMS texting in the UK.
(http://www.mori.com/polls/2001/pdf/egg.pdf). Clearly this is an
important developmental area for counsellors to understand
Digital storytelling
A member of the counselling class introduced
us all to the potential of digital story telling as a vehicle for
expressing personally significant material in a safe and coherent way.
This was explored using an online example at
http://www.bbc.co.uk/wales/capturewales, and related to the increasing
popularity of blogs as a vehicle for personal expression.
Some results
As part of the course development that has
been facilitated here, several evaluative procedures were included in
order to determine the effectiveness of the course in achieving teaching
and learning goals. The course was created with the assumption that it
would be largely paper free, so that, apart from the textbook and
initial study guide, all other work was conducted electronically. At
the start of the study period the Computer Attitudes Scale, (Loyd and
Gressard, 1984) a 40-item instrument that seeks to identify levels of
comfort with computer based activities, was completed at that time by
only two thirds of the class, and then the test was re-administered at
the end of the course when all students went to the online format (using
TellUs) and responded. Scores on all scales moved in a positive
direction, and it should be noted that the second sample includes those
previously most reluctant to embrace the technology. Individual data
have not been analysed in order to preserve confidentiality of
responding.
It was a requirement that the whole group
should participate in an online discussion board
located at the
Course Home Page (http://www.unisanet.unisa.edu.au/Courses/course.asp?Course=welf
5067 ). All participants were required to engage in ongoing dialogue using a
course discussion site online. This was a novel experience for some. However the
level of activity for the group of nine was impressive and well-sustained
throughout the course. These interactions were made more relevant to offshore
teaching by the inclusion of a Singapore student who was able to participate for
much of the time. Course Evaluation Instrument (UniSA) data were routinely
collected even though there are indications that the reliability of this
instrument is questionable. The results may have some value in that there was a 100%
response from the class. Qualitative data relating to the input from our
Singapore colleague also indicated a very high level of satisfaction
with her weekend consultation.
Conclusion and commentary
The requirements for successful
cybercounselling of remote clients can be identified to include:
1. A common and compatible version of a communication software package
installed on both counsellor and client PC’s (or laptops) enabling both
audio and video connection with adequate video frame rate and minimal
latency, in addition to the now customary text facilities.
2. That this software permits connections to be made easily and without
sophisticated IT or PC skills on the part of both client and counsellor.
3. A system that will provide requirement
1 over a dial-up 56 K internet
link.
Subsidiary requirement include:
4. Framing of expectation of both client and counsellor that unexpected
disruption of connection can occur.
5. Having a back up always in place (such as fixed or mobile phone) to
continue an interrupted session.
6. Counsellor training and experience such as to provide appropriate
confidence in managing any and all developments arising in a given
cybercounselling session.
The requirements for successful real time
training and/or supervision of remotely located students of counselling
include:
1. A stable high speed broadband connection, with appropriate IT support
readily available, capable of providing adequate frame rates in video
transmission.
2. Appropriate hardware to generate and disseminate the real time
images/sound to students, or in the case of supervision, the supervisor.
3. Adequate funds to support requirement 1 & 2.
To date, we have yet to
identify a system that will provide an adequate and/or practically
affordable solution to any of the essential technical requirements for
either client counselling or counsellor training. The training of
counselling students both locally and overseas may be progressed to a
limited degree using the Centra software. However further testing of
this with a mixture of broadband and dial-up 56K users will determine to
what extent the dial up user can obtain value from the experience. It is
foreshadowed that with further beta-testing, this approach could be
offered from the facilities in the Psychology Clinic and Counselling
Service in the School of Psychology. This can greatly extend both
training and service provided, by access to a wider range of clients,
and incorporating this technology to exploit the developments now
occurring in on-line psychological assessment
One might have confidence
that the continuation in the spread of broadband connections, including the high speed ADSL 2 technology, will progressively overcome
some of the hardware barriers imposed by dial-up connection speed
limitations. However, the difficulties of finding software that is
readily and easily configurable to permit connectivity in the presence
of a great range of possible anti-virus and firewall applications
presents real challenges.
One might also imagine that if and when an
adequate software package is developed that meets these requirements, part of the remote counselling process will
include the counsellor sending the remote client a copy of it, with
comprehensive instructions for its installation and testing, before any
counselling may be undertaken. This mode is also appropriate to the
development of cybersupervision that can arise not only for students
located in other areas of Australia, but also for our cohorts in
Singapore and Hong Kong.
Increasing familiarity and confidence of
contemporary trained counsellors in using cybercounselling as a regular
activity can be expected to generate a wealth of knowledge and
understanding of the strengths and limitations of the process. In
addition, one might anticipate that appropriate protocols for safe and
appropriate practice, in areas as yet unimagined, will be developed.
However, our experience to date suggests
that these promises remain a future development
towards which one may work and plan, rather than an immediately
achievable goal using existing systems and hardware. At this stage
developing these approaches will call for a slow and well-supported
transition away from the familiar into the unknown, especially when
technical obstacles intrude.
An interesting observation that arose from
the Cybercounselling course was the use made by the group of the
discussion board made available for frequent contact. Not only did it
serve to assist communication on course requirements, but it also became
a valuable resource for debriefing on problems, and offering creative
ideas. A high level of interactivity was maintained through the study
period.
We cannot claim to have explored any and every available
commercial product that might be more successful than those so far
examined and found wanting. However, it is clear that, as we were
advised by our experienced colleague at the outset, within the world of
electronic digital communication technologies, there can be a
significant gap between their promise and the practical achievement of
these promises. This is particularly so where they are to be utilised by
persons of relative inexperience, or confidence, in this area and who
may not have ready access to sophisticated IT support to sort out
individual and particular local difficulties.
That we are at the forefront of a
development in counselling is affirmed by the conclusion of the Federal
review, which states that
“In conclusion, tele and web
counselling services are at an exciting and dynamic stage in their
development. They are dealing with some of the greatest challenges
they have ever had to face: at the same time, they have the
potential to be breaking new ground in service delivery and
counselling modalities. Arguably, they are at the forefront of some
of the latest developments in the counselling field.” (National
review of tele counselling and web counselling services, 2003,
p.19:Dept of Health and Ageing Report prepared by
Urbis Keys Young).
We remain optimistically of the view that
digital communication is the direction of the future, for which planning
and training of counsellors must be commenced now. To this extent, the
‘light in cyberspace’ shines brightly. However, it may yet be a while
further off before that light illuminates the daily world of counselling
in general, and the individual counsellor’s practice in particular. The
prospects for the early introduction of cybersupervision shine a little
brighter, as many of the problematic aspects of the counselling
relationship do not affect supervision as strongly.
References
Coursol, D. H. and J.
Lewis (2001). Cybersupervision: Close Encounters in the New
Millennium.
http://cybercounsel.uncg.edu/book/manuscripts/cybersupervision.htm
Court,J.H.,
Lloyd,B. & Van der Neut,M. (2003) CD-ROM Introduction to OnLine
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Hackett, S.
(2005). Internode: Launching an Internet revolution. The Independent
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Kanz, J., E
(2001). Clinical-Supervision.com: Issues in the provision of on-line
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I. Cobitz (1999). Use of technology in counseling assessment: A
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(2003) Video counselling and psychotherapy in practice. In S.Goss &
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(No longer avaialble)
Topps, D.
(2005). 'Did everybody get that?' The challenges of international
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Urbis
Keys Young. (2003).National Review of Tele counselling and Web
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http://www.urbis.com.au
Watson, J.
C. (2003). Computer-based supervision: Implementing computer
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Authors' Biography
Dr John Court is program director in the
Division of Education, Arts and Social Sciences in the School of
Psychology, City East Campus, University of South Australia.
The staff homepage is located at:
http://www.unisanet.unisa.edu.au/staff/homepage.asp?Name=John.Court
Peter Winwood
is a
PhD candidate, in the Division of Education,
Arts and Social Sciences in the School of Psychology,
City East Campus,
University of South Australia.
