Crisis Intervention and Counseling by Telephone

Abstract

DAVID LESTER (ED.): Crisis Intervention and Counseling by Telephone. Charles C. Thomas Publisher, Springfield, IL, 2002, 306 pp., $62.95, ISBN 0-398-07324-4. Crisis Intervention and Counseling by Telephone first appeared in 1973. This 2002 update is divided into six components: overview of telephone counseling, how telephone counseling fits into a variety of therapeutic modalities, dealing with specific client behaviors in counseling, the use of adjunct techniques like e-mail, selecting/training telephone counselors, and evaluating telephone counseling services. Psychotherapists who consider telephone therapy as to face-to-face contact should recall that traditional talking therapies often restrict cues available to both the client and therapists. Traditional psychoanalysis places that therapist out of sight behind the client. The Roman Catholic confessional also restricts cues. A survey of psychiatrists found that 45% use the telephone as an adjunct for face-to-face therapy and 19% use the telephone as the primary mode of treatment (p. 7). Therapists who look at telephone therapy as inferior might want to review whether their own values are interfering with sound therapeutic judgment. For example, older people grew up in an era when use of the telephone was restricted to business and emergencies. Younger people, on the other hand, consider the telephone a recreational tool. Talking to a counselor over the phone might be more natural for a young client while unnatural for an older therapist. A second problem revolves around the issue of control. During sessions, clients are in their home and not on therapists' turf. Termination can be accomplished by simply hanging up. This more equal power relationship can produce anxiety for therapists. A third problem concerns the stereotype of telephone counseling being linked to short-term crisis intervention. The book cites a case of a 19-year psychotherapeutic relationship on the phone and hypnotherapy conducted by phone. Certain types of clients are more appropriate for telephone counseling, particularly, suicidal and highly dependent clients like to know that support is close at hand. Ambivalent clients can use the telephone to maintain both distance and control over the therapeutic relationship. Hostile clients may be better able to express themselves. The mechanical and electronic nature of telephones may appeal to certain obsessionals and schizophrenics. Those who suffer from anxiety find telephone counseling of particular value. …