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DrugInfo seminar: Why is online counselling attractive to people concerned about an AOD or gambling problem?
 

DrugInfo seminar: Why is online counselling attractive to people concerned about an AOD or gambling problem?

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Simone Rodda. DrugInfo seminar: Information and communication technology. 22 August 2011

Simone Rodda. DrugInfo seminar: Information and communication technology. 22 August 2011

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  • Gambling Help Online is an initiative of the Ministerial Council on Gambling (MCG) and is funded as part of an agreement between all State and Territory Governments and the Australian Government Attract a new cohort of clients who may not otherwise access face-to-face services Extend the availability of counselling and support by addressing issues around remoteness, anonymity and after-hours availability
  • We built a program with multiple components. There are self-assessment pages to measure risk of a problem, money spent and a descriptor of signs of a problem. Within the website there are 30,000 words of content written by our counsellors. This includes self-help information on how to cut down or quit and an interactive quiz on faulty cognitions that develop around winning. As part of the development we conducted focus groups across Australia and content such as managing finances was derived from these groups. Each jurisdiction signed off on the content and provided local service information housed on specific state information pages.
  • Immediate No appointment Available 24/7 Usually different counsellor each time Not the same as internet therapy – self-help with or without therapist assistance It works similarly to instant messaging where counsellor and client type in a secure environment. While there are no physical cues, the speed of typing, errors in text, punctuation and smoothness of session provide information. A client who has recently gambled will often type quickly and not wait for a response from the counsellor. There will be short incomplete sentences without punctuation and full of typos. The amount of content covered in an online session is about half of that in a face-to-face or telephone session, so we use push-page technology to introduce previously developed content which then becomes a source of discussion within the counselling session.
  • 120,000 promotional materials dispatched in the first year. Just over 200,000 visits to both sites over the past five years
  • In addition 398 email support clients generated almost 1200 emails
  • Females accessing COL slightly more often than directline. in face-to-face AOD treatment 33.5% - almost the exact opposite in online and telephone help seeking Face-to-face gambling 52% female – 48% male opposite to gambling help online chat Email clients more closely represent face-to-face help seeking
  • Barriers Systematic/structural barriers Treatment adjunct Motivational enhancement (Hodgins, 2005) Social support (Wood & Wood, 2009) Online problem gambling services (Wood & Griffiths, 2007). GamAid : Evaluation of 80 service users, online questionnaire Support and advice provided by advisers most valued Almost 1/3 reported online gambling as their preferred modality Environmental scan response time for other services other gambling providers – two in UK one in US provide fee for service - $50 an email and states or sales are final there are no refunds!
  • Around 70 percent outside traditional business hours
  • COL Around half of all sessions to young people aged 15-29 years Two thirds of services provided to women Nearly two thirds of sessions provided to employed people Around 25% of all counselling sessions to people from rural areas Significant number of sessions with those who were born in countries other than Australia (compared to those who accessed face-to-face treatment (in 2007-2008 22% versus 14%) Drug of concerns…
  • Barriers Systematic/structural barriers Treatment adjunct Motivational enhancement (Hodgins, 2005) Social support (Wood & Wood, 2009) Online problem gambling services (Wood & Griffiths, 2007). GamAid : Evaluation of 80 service users, online questionnaire Support and advice provided by advisers most valued Almost 1/3 reported online gambling as their preferred modality Environmental scan response time for other services other gambling providers – two in UK one in US provide fee for service - $50 an email and states or sales are final there are no refunds!
  • Exit survey indicates 9/10 people would recommend the service to a friend Concerns about the home environmnet and who might be listening.
  • Higher current for COL?
  • Barriers Systematic/structural barriers Treatment adjunct Motivational enhancement (Hodgins, 2005) Social support (Wood & Wood, 2009) Online problem gambling services (Wood & Griffiths, 2007). GamAid : Evaluation of 80 service users, online questionnaire Support and advice provided by advisers most valued Almost 1/3 reported online gambling as their preferred modality Environmental scan response time for other services other gambling providers – two in UK one in US provide fee for service - $50 an email and states or sales are final there are no refunds!
  • Exit survey indicates 9/10 people would recommend the service to a friend For some people it is easier to disclose because of the lack of visual and social cues. Greater sense of safety and more control over self-presentation and what others see. This may particularly be the case for those talking to someone for the first time. The service also provides a pathway into services.
  • Where people said that they had previously spoken to a counsellor, the most common method was face-to-face. Interestingly, the rest of the population of previous treatment seekers stated that their treatment was distance based as via telephone or online through GHO or another website. This suggests that peoples views of what constitutes counselling may be shifting.
  • No sig difference
  • Rebranding Moderated forums Formatting for Mobile Phones SMS messaging Self help materials Structured multi-session interventions Including Video/Multi media?

DrugInfo seminar: Why is online counselling attractive to people concerned about an AOD or gambling problem? DrugInfo seminar: Why is online counselling attractive to people concerned about an AOD or gambling problem? Presentation Transcript

  • Why is online counselling attractive to people concerned about an alcohol, drug or gambling problem? August 2011 Simone Rodda
  • HealthLink Network - AOD
    • Only provider of cross-jurisdictional AOD services
    • Only provider of live AOD online counselling in Australia
    CounsellingOnline.org.au
  • HealthLink Network - Gambling GamblingHelpOnline.org.au Gambling Helpline QLD Gambler’s Helpline Ready to Change program Vic Gambler’s Helpline Ready to Change program Tas
  • Counselling Online
  • Counselling Online
      • Websites
      • Service sector
      • Exclusions
      • Referral
    State Information
      • Risk
      • Money
      • Cognitions
      • Signs
      • Readiness
      • Strategies
      • Helping others
    Introductory content
  • Was there anything else different about your lifestyle then? It doesn’t have the same effect it used to, but I guess that’s because of a tolerance I have formed maybe.. It sounds like you’ve had some success stopping in the past I studied harder at uni.. Maybe went out a little more. But having no access was definitely the big one. Now uni has gone downhill, I don’t go out anymore 10:15 AM 10:09 AM 10:12 AM 10:06 AM
  • Website visits Counselling Online & Gambling Help Online Counselling Online Gambling Help Online 2006/2007 33,694 - 2007/2008 29,565 - 2008/2009 54,323 - 2009/2010 67,619 12,853 2010/2011 58,838 60,729 Total Visits 127,151 73,582
  • Real time chat sessions provided Counselling Online & Gambling Help Online
  • Real time chat and email: Gender Counselling Online & Gambling Help Online
  • Online Counselling Research and evidence base
    • Accessibility
      • Availability (convenience, time, location) (Rockloff & Schofield, 2004)
      • AOD CounsellingOnline highest demand after-hours (Swan & Tyssen, 2009) and a higher proportion of regional service users
      • Eating disorders group: 2/3 of posts b/w 6pm-7am. (Shernoff, 2000)
    • Anonymity
      • Shame and stigma – gamblers use of online forums (Cooper, 2004)
      • Lack of visual cues offset by anonymity ( Leibert et al., 2006)
      • I use online so the counsellors can’t hear me crying (Beatie, 2006)
    • Therapeutic Alliance
      • Depth and smoothness = helpfulness (Barak & Bloch, 2006)
      • Faster immersion into the counselling process, more likely to self-disclose (Lewis et al., 2004)
  • Real time chat: Time of Contact Counselling Online & Gambling Help Online Based on 2009/10 Annual Report
  • Real time chat: Age of Contact Counselling Online & Gambling Help Online Based on 2009/10 Annual Report
  • Online Counselling Research and evidence base
    • Accessibility
      • Availability (convenience, time, location) (Rockloff & Schofield, 2004)
      • AOD CounsellingOnline highest demand after-hours (Swan & Tyssen, 2009) and a higher proportion of regional service users
      • Eating disorders group: 2/3 of posts b/w 6pm-7am. (Shernoff, 2000)
    • Anonymity
      • Shame and stigma – gamblers use of online forums (Cooper, 2004)
      • Lack of visual cues offset by anonymity ( Leibert et al., 2006)
      • I use online so the counsellors can’t hear me crying (Beatie, 2006)
    • Therapeutic Alliance
      • Depth and smoothness = helpfulness (Barak & Bloch, 2006)
      • Faster immersion into the counselling process, more likely to self-disclose (Lewis et al., 2004)
  • Real time chat: Anonymous? Counselling Online & Gambling Help Online Based on 2009/10 Annual Report
  • Why clients recommend online counselling (GHO: ARTD External Evaluation 2010)
    • Because it helped me (24 comments)
    • It’s confidential, you can be anonymous (15 comments)
    • It’s a good place to start, an easy first step (16 comments)
    • You can talk to someone immediately (5 comments)
    • It helps you be honest about your problem (7 comments)
    • You can write or say what you think freely (4 comments)
    • You can go at your own pace (1 comment)
    • It’s convenient, easy to access, easy to use (5 comments)
    • Good way of learning about resources, other ways of finding help (4 comments)
    • You can transition to face to face if you need to (3 comments)
  • Gambling Help Online: Treatment seeking – Gamblers only (n=458)
  • Online Counselling Research and evidence base
    • Accessibility
      • Availability (convenience, time, location) (Rockloff & Schofield, 2004)
      • AOD CounsellingOnline highest demand after-hours (Swan & Tyssen, 2009) and a higher proportion of regional service users
      • Eating disorders group: 2/3 of posts b/w 6pm-7am. (Shernoff, 2000)
    • Anonymity
      • Shame and stigma – gamblers use of online forums (Cooper, 2004)
      • Lack of visual cues offset by anonymity ( Leibert et al., 2006)
      • I use online so the counsellors can’t hear me crying (Beatie, 2006)
    • Therapeutic Alliance
      • Depth and smoothness = helpfulness (Barak & Bloch, 2006)
      • Faster immersion into the counselling process, more likely to self-disclose (Lewis et al., 2004)
  • Why clients recommend online counselling (GHO: ARTD External Evaluation 2010)
    • Because it helped me (24 comments)
    • It’s a good place to start, an easy first step (16 comments)
    • It’s confidential, you can be anonymous (15 comments)
    • You can talk to someone immediately (5 comments)
    • It’s convenient, easy to access, easy to use (5 comments)
    • It helps you be honest about your problem (7 comments)
    • You can write or say what you think freely (4 comments)
    • You can go at your own pace (1 comment)
    • Good way of learning about resources, other ways of finding help (4 comments)
    • You can transition to face to face if you need to (3 comments)
  • Gambling Help Online: Previous treatment seeking (n=148)
  • Gambling Help Online: Preferred mode of help seeking: age by gender (n=87)
    • How do we engage another 10% of website visitors in an intervention?
  • Future developments Counselling Online & Gambling Help Online Current Future? Home Resources Counselling Home Reception/ Quick Chat Resources Counselling Self assessment tools SMS Forums