Therapeutic Counselling inhighly sexualized environments.<br />Marco Posadas, M.S.W., R.S.W<br />
Program Objectives<br />Provide professional assessment, counselling, and referral service to men in bathhouses.<br />Prov...
<ul><li> 3 hrs each shift
  Single Session and Walk-in
Anonymous
  Sessions from 10 min to 45 minutes</li></ul>How does it work?<br />
Streamlined Referrals<br />Centre for Addiction and Mental Health<br />David Kelly Service<br />Mount Sinai Clinic for HIV...
Program Evaluation:<br />Needs assessment survey (115 completed)<br />Pre and post interview/focus groups with bathhouse s...
TowelTalk Numbers<br />To September 27, 2010:<br />129Shifts<br />669Contacts<br />142Counselling Sessions*<br />Average s...
Who accessed TowelTalk?<br />
Ethno-cultural background<br />
Does this service augment what is being provided by existing sexual health outreach programs?<br />Issues discussed in out...
Referral patterns are different<br />TowelTalk referrals focused on mental health or counselling referrals<br />ACT outrea...
Support for TowelTalk<br />Bathhouse managers<br />Supportive overall, but did vary according to their knowledge and inter...
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Innovations in Sexual & Mental Health: Towel Talk: Bathhouse Counselling Intervention

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Marco Posada; AIDS Committee of Toronto (ACT) presents: Innovations in Sexual & Mental Health at the 2010 Gay Men's Health Summit.

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  • I am going to talk about a collaborative project called TowelTalk – which places a professionally trained counsellor in male bathhouses in Toronto. The aim of my presentation today is to talk about TowelTalk within the context of sexual health outreach activities in bathhouses. I am going to tell you a bit about who is accessing the counselling service, And how building a program that links sexual health and mental health, offers a new kind of service to men in bathhouses, and is well supported by bathhouse management and other outreach programs, as well as by the patrons who accessed the service.I draw on evaluation data from the fist year of the active program – April 1 2009 to March 31 2010. We conducted a process or formative evaluation. We really wanted to assess if it was even feasible to implement a mental health intervention in a sexually charged environment, and collect data that could support the ongoing development of the program.
  • TowelTalk works to link mental and sexual health, and the objectives for this program include:• Provide professional assessment, counselling, and referral service to men in bathhouses.• Provide an affirming, supportive experience related to sexuality, sexual choices, and sexual identity• Foster the development of a supportive relationship between the counsellor and the patron.• Support the sense of community developed through existing community outreach programs. So building on and reinforcing what already exists in the bathhouse in terms of sexual Health Promotion activities. • Initiate a dialog about the role that drugs and alcohol may play in the sexual lives of men and their ability to maintain sexual health. The Target population includes: men who use drugs and alcohol to have sex straight-identified or bisexual men men who are new to Canada men from racialized communities men at risk for and living with HIV
  • So I am briefly going to talk about who accessed the program in it’s first year –Then focus on how TowelTalk fits in terms of the outreach activities already present in bathhouses
  • Drawing from the data collected through the mixed method evaluationSurveysInterviewsFeedback forms Ongoing program data that the counsellor collects during each shift
  • In the first year of the program we had 75 shiftsHe had brief contact with 436Questions about the programQuestions about sexual healthHit on (which is the most appropriate thing for a guy to do in a bathhouse)The counsellor has to work with that sexual dynamic and transform it into a therapeutic one – he does this by modeling what a counselling session would look like in a sexualized environment where men are not expecting to find or engage in counselling.And 88 sessions, shifts would range from 0 -4 sessions in a shift, with an average of 1.2 session per shift.The average length of a session was 29.5, with some variation depending on the bathhouse. 
  • Majority of men are between the ages of 25 and 55, with some variation between bathhouses.
  • And when we looked at the etho-cultural background of the men accessing the counselling service, we felt that TowelTalk is reaching men from racialized communities.
  • We also saw that we were seeing men who were in relationships with women, many of whom did not identify as gay or bisexual.81.5% of patrons who accessed the service, or 61 men disclosed their relationship status
  • The evaluation committee found that TowelTalk does augment what is already being provided by sexual health outreach programs in important ways.
  • Nature and extent of support varies depending on bathhouseThere is little interaction between Towel Talk and staff at bathhouse; Towel Talk interacted more in the program set up and experienced different levels of openness to the program depending on the bathhouse – consistent with other reports of bathhouse differences in their relationship with outreach programs from promotion to tolerance, from providing specific useful spaces with flexibility in programming approach, to specific, not so useful spaces with rigid rules on how men can operate their programs; bathhouse most rigid with outreach workers more flexible with Towel Talk, once he got to know the program…same manager who reported Towel Talk as ‘real service’ and questioned need for outreach workers, and so many different outreach programs Indications that outreach and Towel Talk are needed in the bathhouse environment because of recognition of patrons with problems. From a business perspective it is important to keep clients healthy and alive; so view of services as good for business  Outreach WorkersAll supportive, but some outreach workers commented on hearing positive feedback more regularly, and some said they had never heard any talk about TowelTalk in the bathhouses or the gay community more generally.
  • Men who accessed the program provided indications of their support for the program. The mean for men who indicated “I would consider talking to a counselor in the bathhouse in the future” was 4.6. This can be seen as signs of support by bathhouse patrons who accessed the program. Some qualitative statements within the forms also provided support for the program, those these were very few. These were: “More counselors should be present in the bathhouses”“What a great program; It’s nice to have someone to talk to.”
  • TowelTalk is funded by the AIDS Bureau and supported by a Program Advisory Committee which includes AID Service Organizations, mental health organization, as well as other stakeholders. The program is housed at ACT.
  • TowelTalk is funded by the AIDS Bureau and supported by a Program Advisory Committee which includes AID Service Organizations, mental health organization, as well as other stakeholders. The program is housed at ACT.
  • Innovations in Sexual & Mental Health: Towel Talk: Bathhouse Counselling Intervention

    1. 1. Therapeutic Counselling inhighly sexualized environments.<br />Marco Posadas, M.S.W., R.S.W<br />
    2. 2. Program Objectives<br />Provide professional assessment, counselling, and referral service to men in bathhouses.<br />Provide an affirming, supportive experience related to sexuality, sexual choices, and sexual identity<br />Foster the development of a supportive relationship between the counsellor and the patron.<br />Support the sense of community developed through existing community outreach programs.<br />Initiate a dialog about the role that drugs and alcohol may play in the sexual lives of men and their ability to maintain sexual health.<br />
    3. 3. <ul><li> 3 hrs each shift
    4. 4. Single Session and Walk-in
    5. 5. Anonymous
    6. 6. Sessions from 10 min to 45 minutes</li></ul>How does it work?<br />
    7. 7. Streamlined Referrals<br />Centre for Addiction and Mental Health<br />David Kelly Service<br />Mount Sinai Clinic for HIV-related Concerns<br />
    8. 8. Program Evaluation:<br />Needs assessment survey (115 completed)<br />Pre and post interview/focus groups with bathhouse staff/managers and outreach workers and volunteers (7 with bathhouses and 13 with outreach programs)<br />Feedback forms (43 completed and entered)<br />Interviews with TowelTalk service users (1 conducted)<br />Interviews with program staff (2 Interviews)<br />Ongoing program data collection (data entered up to Feb 9, 2010)<br />
    9. 9. TowelTalk Numbers<br />To September 27, 2010:<br />129Shifts<br />669Contacts<br />142Counselling Sessions*<br />Average session length: 29.5 minutes*<br />TowelTalk referrals: 53<br />External Referrals: 51<br />*(average of 1.2 sessions each shift and a range of 0 to 4 sessions a shift during the 1st year of the evaluation to April 2010)<br />
    10. 10. Who accessed TowelTalk?<br />
    11. 11.
    12. 12. Ethno-cultural background<br />
    13. 13.
    14. 14.
    15. 15. Does this service augment what is being provided by existing sexual health outreach programs?<br />Issues discussed in outreach vs. TowelTalk<br />Referral patterns<br />Length of session<br />Outreach workers describe their work differently<br />
    16. 16.
    17. 17.
    18. 18. Referral patterns are different<br />TowelTalk referrals focused on mental health or counselling referrals<br />ACT outreach referrals are mainly for sexual health services (37.6% to Hassel Free, 3.9% onsite testing, 15.9% to ACT, 2.7% to Toronto Public Health, and 2.3% to other ASOs)<br />
    19. 19. Support for TowelTalk<br />Bathhouse managers<br />Supportive overall, but did vary according to their knowledge and interest in the program.<br />Supportive of sexual health services in bathhouses (corporate responsibility)<br />Professional vs. volunteer or peer driven<br />Outreach workers and volunteers<br />Supportive, but some workers unsure of TowelTalk’s impact<br />Glad to refer<br />Praise for logistical support<br />TowelTalk seen as adding legitimacy to all outreach services in bathhouses.<br />
    20. 20.
    21. 21. TowelTalk Community Partners <br />Funded by the AIDS Bureau<br />Program Advisory Committee includes:<br />AIDS Bureau (exofficio) Asian Community AIDS Services (ACAS) <br />Hassle Free Clinic David Kelly Services<br />Mount Sinai Hospital HIV Prevention Lab (Ryerson University, Psych)<br />Toronto Public Health AIDS Committee of Toronto (ACT)<br />Africans in Partnership Against AIDS (APAA) <br />Black Coalition for AIDS Prevention (Black CAP)<br />Centre for Spanish Speaking People (CSSP) <br />Toronto People with AIDS Foundation (PWA) <br /> Centre for Addiction and Mental Health (CAMH)<br />Housed at the AIDS Committee of Toronto<br />
    22. 22. Thanks<br />Jessica Cattaneo, Manager of Program Development at ACT<br />Program Advisory Committee & Funders<br />Community partners and Bathhouse Staff.<br />AIDS Committee of Toronto.<br />

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