Researchers are increasingly investigating the efficacy of various types
of counselling service, including electronically mediated, and
counsellors are still debating the appropriateness of counselling via a
distance. However, few researchers have investigated the experience and
interest various client groups have in distance counselling mediated by
the telephone or the Internet. The current study investigated the
counselling experience as well as counselling wants and needs of a group
of carers receiving support from an Australian carers support program.
Method
Participants
Carers are individuals who care for a friend or relative in need of
psychological, physical, or developmental support. A random sample of
500 carers, from a population of carers involved with an Australian
carers support program, was chosen to receive surveys. A total of 106
surveys were returned. Thus, a return rate of 21.2% was achieved. The
majority of carers who returned their surveys were female (78.3%) and a
minority are male (19.8%). The carers’ average age was 60.8 years (SD
13.69). The youngest carer was 26 years of age and the most mature 85
years of age.
The carers
were mostly married (59.4%) but a sizable proportion were single,
divorced/separated, or have survived the death of a spouse (14.2%,
12.3%, and 7.5% respectively). The majority had children over 20 years
of age (55.7%), between 10-20 years of age (12.3%), between 5-10 years
of age (9.5%), and children under 5 years of age (5.6). The average
number of children was 1.82 (SD 1.62) but a sizable proportion of the
carers sample had no children (23.6%).
The
majority of carers reported living in urban areas (82.1%) with 15.1% of
the sample living in remote or rural areas. The sample was predominantly
Caucasian in composition (52.8%). Only .9% indicated being Asian or .9%
Indigenous. People with Non English Speaking Backgrounds comprised 1.9%
of the sample and a sizable proportion noted their ethnic background as
other. When the other category was examined, it became
clear that Australian was the most common response. The majority
of the sample indicated holding Christian beliefs (75.5%). Other
religions (22.6%) were also noted. This generally included Anglican,
Pagan, and Catholic beliefs.
On average the carers reported having contact with their carer
supporting agency for 2.29 years (SD 2.71). Carers most often reported
caring for a spouse or partner (43.4%), child (26.4%) or parent (25.5%).
The majority of carers indicated they were caring for someone with a
physical disability (32.1%), psychological difficulty (8.5%), or a
developmental problem (3.8%). However, a sizable proportion indicated
caring for someone with an other problem. When examined the
other category generally indicated the care recipient as having both
a physical and psychological difficulty.
Procedure
In autumn 2004 the random sample of carers was sent a paper survey via
the postal system. Surveys and a postage prepaid return envelope were
sent to carers by, and returned to, the carers’ support agency involved.
The survey was designed to measure carer demographic characteristics (as
described above), counselling experience, counselling wants and needs,
areas in need of counselling focus, preferred counsellor
characteristics, and client proposed fees for counselling. The survey
developed for this study purposefully asked about face to face,
telephone, and Internet counselling, including email and Internet chat
services.
Results
Counselling
Experience
The
majority of carers report no personal experience of counselling (59.4%)
with a sizable proportion having engaged in counselling (38.7%). The
most popular type of counselling was individual (30.2%), followed by
couple (4.7%), and then group counselling (3.8%).
Counselling
was generally engaged in using face to face contact (34.9%), the
telephone (10.4%), and via teleconferencing (7.5%). Only a small
proportion indicated engaging in counselling via Internet chat services
(.9%) or other Internet services such as email (.9%). Of those who
indicated engaging in Internet related counselling, 75% indicated that
this counselling support occurred in real time. Only 25% of those who
have engaged in Internet related counselling indicated time delayed
(i.e., email) services.
Carers who
have engaged in counselling indicated having done so mostly in their own
home (19.8%) and other locations (23.6%), usually indicating a private
psychologist or counsellor office or other service centre. Only .9%
indicated receiving counselling at a Carers NSW centre.
Carers who
engaged in counselling said that their counselling was mostly arranged
by their carer support agency (23.6%). Others, including self and other
sources of community support, were also reported to help arrange
counselling services.
Counselling
Wants and Needs
A number of
the carers surveyed indicated wanting counselling services in the near
future. Specifically, 55.6% would like individual counselling, 14.1%
group counselling, 8.5% couples counselling, and 6.6% family
counselling. The vast majority of carers indicated they would seek a
referral via their carer support agency (72.6%). A minority would seek a
referral privately (6.6%) or through their religious organization or
carer support agency (10.4%).
Of the
carers interested in counselling 68.9% indicated being interested in
face to face service. A sizable proportion also indicated wishing to
receive services via the telephone (29.3%). Only 5.7% of the respondents
interested in counselling were interested in Internet counselling. Of
those interested in Internet counselling 1.9% were interested in email
and .9% interested in chat services. A total of .9% of individuals were
interested in both email and chat services. Of those interested in
Internet service, 69% would prefer said service in real time versus
delayed (31%) time. Teleconferencing was also not popular, accounting
for only 1.9% of respondents.
The carers
surveyed indicated that home was their preferred location for
counselling service (48.1%). However, the carers support agency office
was also indicated as a possible meeting place (18.9%). Only a minority
(18.9%) indicated requiring respite support to engage in counselling
services. A total of 54.7% indicted not requiring respite support to
make use of counselling.
Areas in
Need of Counselling Focus
Carers were asked about the need areas that would bring them into
counselling. Table 1 indicates the issues carers indicated would bring
them into counselling, in descending order of importance.
Table 1:
Areas Carers Indicate are in Need of Counselling Focus
|
Area
of Concern/Issue |
Percentage of Carers |
|
Anxiety |
49 |
|
Support |
44.4 |
|
Short
Term Counselling |
34.9 |
|
Depression |
31.1 |
|
Stress |
24.5 |
|
Long
Term or In Depth Counselling |
20.6 |
|
Grief |
13.2 |
|
Family |
12.3 |
|
Physical Problems |
12.3 |
|
Isolation |
3.8 |
|
Advocacy |
2.8 |
|
Work
Issues |
2.7 |
|
Anger |
1.9 |
|
Money |
.9 |
|
Sleep
Difficulties |
.9 |
As one can
see from the data provided, both short and long term/in depth
counselling are seen as needed by the carers who responded to the
survey. In addition, anxiety, support, depression, and stress are listed
as the most common focus areas for counselling. Other areas indicated as
in needed of service focus included exhaustion and multiple problem
areas, such as isolation combined with grief issues.
Preferred
Counsellor Characteristics
Carers were asked their views on the importance of a number of
counsellor characteristics. Carers indicated that it was very important
or important for counsellors to be able to listen (79.2%) and give good
advice (78.3%). Only 3.8% and 4.7% thought that listening and advice
giving were not important or of little importance, respectively.
The
significance of training in counselling was seen as important to very
important for 71.7% of the sample, versus not important or little
important (9.4%). Similarly credentials in counselling were seen as
important to very important more often (63.2%) than not or little
important (9.5).
Only a
moderate number of individuals felt that counsellors needed to be
similar to the care recipient (40.5%), with 27.4% believing this was
not important or of little importance. Various other qualities were seen
as important and these ranged from availability to ability to work as an
advocate on behalf of the carer.
Counselling
Fees
The
majority of carers surveyed indicated they believed counselling should
be provided free of charge (70.8%). Of those who indicated a fee could
be appropriate a trend in responding was evident. Mainly, face to face
service was to be most highly compensated, followed by telephone,
teleconferencing, and Internet service. Individual and couple
counselling were to be most high compensated, followed by group
counselling. These results are summarized in Table 2. Please note that
these results are in Australian Dollars.
Table 2: A
Summary of Client Proposed Fees for Counselling Service Per Hour (Fees
in Australian Dollars)
|
INDIVIDUAL COUNSELLING |
Face
to Face |
Telephone |
Teleconferencing |
Internet |
|
Mean |
27.52 |
20.64 |
9.50 |
4.50 |
|
Standard Deviation |
20.24 |
15.95 |
8.80 |
4.64 |
|
|
|
COUPLE COUNSELLING |
Face
to Face |
Telephone |
Teleconferencing |
Internet |
|
Mean |
30.62 |
20.00 |
6.00 |
2.00 |
|
Standard Deviation |
22.43 |
16.25 |
20.95 |
2.50 |
|
|
|
GROUP COUNSELLING |
Face
to Face |
Telephone |
Teleconferencing |
Internet |
|
Mean |
10.00 |
6.00 |
2.00 |
2.00 |
|
Standard Deviation |
10.29 |
9.09 |
5.29 |
2.52 |
Discussion
In addition to the
difficulties experienced by the general population, carers confront a
number of difficulties in their efforts to care for a cared for person’s
physical, psychological, or developmental difficulty. As a consequence,
carers may indicate a high interest in counselling support. This is
especially true for those carers who have already sought support from a
carer support agency. An increase in a need for support by carers might
explain the high level of carers reporting previous counselling and an
interest in future counselling.
Despite the increase in discussions regarding the provision of
counselling by distance through the use of email and Internet chat, face
to face services continue to be the norm. As a result, it is not
surprising that most previous counselling reported and future
counselling desired are of a face to face and telephone nature. This is
especially true given the mature and female nature of the sample
examined, two groups who have not been stereotypically interested in
technology.
Carers indicated being interested in counselling related to anxiety and
depression issues. This is as expected as depression and anxiety
are common client difficulty areas (Court,
Ireland, Proeve, Pelling, & Cescato, 2003;
Pelling, 2003). Carers
indicated wanting trained and credentialed counsellors who listen and
provide advice. Thus, carers expect more than simple support,
friendship, from counsellors.
Despite wanting professional counsellors, carers
indicated that counselling services should be provided free of charge.
Moreover, those who indicated that it was appropriate to charge for
counselling services believed that couple and individual face to face
was worth more in terms of payment than group counselling or any type of
counselling provided by telephone or the Internet. It would appear that
carers value, in monetary terms, face to face and telephone contact more
than contact via the Internet.
Limitations and Suggestions for Future Research
The return
rate achieved in the current study was relatively low. As a consequence,
the results obtained should be interpreted cautiously. It is possible
that additional, repeated, mailings could have improved the response
rate achieved and future studies may best include such repeated
mailings. Also, the sample examined is a select group of mature
individuals, mostly women. A more diverse sample would allow the results
obtained to be generalized better to the greater Australian population.
Nevertheless, the sample examined is one interested in, and likely to
self select into, counselling services and thus are an important group
of potential clients.
Regarding
the design of the current study, only the carers’ experience and
interest in counselling was examined. Future studies could examine
various possible influences on possible clients’ interest in
technologically mediated distance counselling. For instance,
individuals’ familiarity and comfort with technology could be examined
for its influence on clients’ email and Internet chat counselling.
Additionally, pre-post tests regarding comfort with and the efficacy of
electronically mediated distance counselling could be conducted.
Similarly, future studies can examine carers’ beliefs regarding the
monetary worth of various counselling services and what impacts same.
Conclusion
Distance counselling is occurring in Australia and this includes
telephone, email, and Internet chat counselling. Carers are interested
in counselling and favour face to face and telephone services.
Nevertheless, some are advocating the development of further distance
counselling services mediated by various technologies. If counselling
organisations or practitioners are to offer technologically mediated
distance counselling services they need to be informed about the
interest their clientele has in such services. The carers investigated
in this study show a strong interest in counselling that is face to face
and by telephone. Internet forms of counselling were much less popular.
Agencies are encouraged to listen to the counselling wants and needs of
their clientele, in this case face to face service and telephone
service.
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Author's Biography
Nadine
Pelling is a Senior Lecturer in Psychology and Counselling at the
University of South Australia in Adelaide. She has presented and
published extensively on the topic of Email and the Internet in
counselling and psychological work. She can be contacted via
nadine_pelling@yahoo.com.au or on +61 04 0259 8580.
Acknowledgement: This article is the result of a survey conducted as
part of the Online and Telephone Counselling Project, part of the
National Carer Counselling Program, an Australian Government Initiative.
People interested in the Carers NSW contact for this project can call
Adam McLean, Counselling Coordinator Carers NSW, on +61 02 9280 4744.
