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Telephone technology in sexuality counselling (TARSHI), 2007


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Telephone technology in sexuality counselling ICTs and Sexual Issues covering the case study of TARSHI from 2007

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Telephone technology in sexuality counselling (TARSHI), 2007

  1. 1. Telephone technology in sexuality counselling ICTs and Sexual Issues Upasna Kakroo Senior Research Associate csdms TARSHI (Talking About Reproductive and Sexual Health Issues) was founded in 1996 and is guided by the vision that all people have the right to sexual well-being and to an enjoyable and self-affirming sexuality. TARSHI works towards expanding sexual and reproductive choices in people’s lives. Its programmes address people of all ages, genders, communities, classes and sexual preferences and disability status, with a focus on women and young people and their sexual and reproductive health and rights. TARSHI began as an individual fellowship project supported by MacArthur Foundation and later was also supported by the Ford Foundation and Packard Foundation. It has expanded its activities beyond the helpline and is recognised as one of the organisations in India that addresses issues of sexuality from a rights’ perspective. TARSHI’s work currently includes two broad programmatic strands: enhancing the quality of helpline services on issues relating to sexuality and making a larger positive impact in the realm of sexuality. The Helpline • The TARSHI helpline has received over 57,000 calls in its eleven years of operation, since February 1996. • The callers are from diverse socioecono-mic backgrounds and are in an age group from 7 to 70 years, though the majority is between 18 and 35 years of age. Over one-third of callers call back. The majority are Hindi speakers. As the helpline is run in Delhi, most callers are from in and around the city, but there are also many callers who have migrated from rural areas to the city, and still may have their roots in rural India. • The helpline provides information, counselling, and referrals on sexuality and sexual and reproductive health issues. The helpline service is free, though the calls to it are not toll-free. • It is supervised by a qualified clinical psychologist and has trained counsellors who speak with callers about concerns as wide ranging as body image, masturbation, homosexuality, relationship issues, contraception, abortion, HIV/AIDS/STIs and sexual abuse. • The amount of time devoted to each is flexible and can range from one minute to an hour. • Approximately 80% of helpline callers are men, despite the fact that the line is meant to be especially for women. Women bear the greater burden in terms of sexual and reproductive health problems and are doubly disadvantaged because of lack of access to accurate information. Devising ways to increase the number of women callers has been an ongoing challenge. • Designed to be interactive, non-judgemental and non-threatening, the helpline offers information that is relevant to the contexts of people’s lives, and counselling that explores with callers the pros and cons of particular choices (while never taking from them their own right of choice), as well as referrals to appropriate agencies. • The referral network includes private practitioners, government hospitals, therapists and lawyers, as well as HIV counselling, testing, care and support services, etc. The service organisations are researched to the best of TARSHI’s abilities, and site visits are made in an attempt to ensure good-quality service – or at least to know
  2. 2. first hand what callers will encounter at a facility. In the case of private doctors and therapists, the organisation tries to select gender-sensitive, gay sensitive, sex-affirming and non-judgemental professionals. Helpline counsellor training • New helpline counsellors undergo 10 – 12 weeks of intensive training that focuses on information, perspective and building counselling skills. Counsellors are trained on basic sexual and reproductive anatomy and physiology, pubertal changes, conception, contraception, sexual practices, sexual problems, infertility, STIs, HIV/AIDS and other topics. • As a part of their ongoing work, and continuing even after the formal training period ends, counsellors are encouraged to read about, and analytically discuss, different perspectives on these issues. Because people engage in a wide range of diverse sexual acts, the counsellors must also be familiar with the repertoire of human sexual behaviour and know the terms (including slang) that people use to refer to sexual practices. • The counsellor training is done through experiential and interactive role-plays and mock counselling sessions. Making a larger positive impact in the realm of sexuality • TARSHI has used a variety of information dissemination strategies to increase awareness about sexuality. These have ranged from producing and distributing written material on sexuality in the form of pamphlets, booklets, and books in English and Hindi on sexuality and related issues at public events and bazaars, to professional presentations and writings. TARSHI has especially focussed on producing material that is gender- sensitive, non-heterosexist and affirming respect for all people and their right to sexual well-being. Raising awareness of sexuality and rights issues are undertaken • TARSHI has conducted various public education and advocacy activities through publications, websites, campaigns, public events like organising theatrical performances, poster competition, film screenings and talks, and sessions in schools and colleges. It has also worked in partnership with other NGOs to create a broader public understanding about women’s rights, sexuality, gender and violence. • The Sexuality and Rights Institute: This is an annual two-week long residential course that focuses on a conceptual study of sexuality. The Institute is organised in collaboration with CREA. It examines the interface between sexuality and rights and its links with the related fields of gender and health. The faculty comprises of national and international resource persons who use a range of pedagogical techniques including lectures, group work, films, reading assignments and exercises. Participants examine sexual and reproductive health programs as well as various legal and socio-cultural issues and incorporate their learning into planning and working on programmes. Six such Institutes have been held since 2002. • The South and Southeast Asia Resource Centre on Sexuality is hosted by TARSHI with the aim to develop and build on the scholarship and capacity in the field of sexuality in the South and Southeast Asian region The Resource Centre specifically focuses on sexuality related work in China, India, Indonesia, Nepal, Sri Lanka, Thailand, The Philippines, and Vietnam. The Resource Centre Library provides access to books and journals on sexuality, an online listing of available material, and regular updates for activists, advocates, practitioners, and researchers. The online library can be viewed through Advantages and disadvantages of telephone technology in sexuality counselling The advantages of using a helpline to access services, especially on sensitive issues such as sexuality and reproductive health, are: • The telephone is an easy, accessible and inexpensive mode of communication • Callers do not need appointments or have to travel long distances. They can call at their convenience • Callers can decide to make and end the call. This enables them to feel more in control and hence more comfortable and willing to access the service
  3. 3. • Anonymity makes it easier for callers to discuss intimate concerns • When provided by a not-for-profit organisation, the service usually charges no fee The disadvantages of using a helpline as a medium of intervention are: • The helpline worker has to rely solely on auditory cues and does not have access to other signals such as body language and facial expressions that might help in understanding clients better • Counsellors are unaware of the physical environment (home/office/public call booth/shop) the caller is in and so unable to anticipate when they may be interrupted. • Callers may become frustrated if telephone lines are busy for long durations • There is little or no possibility to follow-up with callers if the helpline guarantees anonymity • Anonymity makes it easier for callers to make crank calls Over the past few years, the number of callers who seem to have access to the Internet has been growing. Callers report getting the helpline number through the web (either through search engines or through the TARSHI websites). They also report reading up on information from the Internet. However, just the Internet is not enough – many callers call to clarify or check if they have understood correctly – they still prefer to speak to someone about their concerns at the end of the day. The Internet has made sexuality related information more accessible and is a definite aid in awareness-raising and proves to be very effective when coupled with a service like the TARSHI helpline. The TARSHI helpline is based on a sound understanding of ethical principles, and it places a premium on confidentiality and anonymity. The counsellors are trained in ethics and the ethical challenges that they might face in the course of the work. Counsellors maintain clear professional boundaries in their relationships with the callers. Telephone technology can well be harnessed in sexuality and HIV/AIDS education and prevention efforts, and the information gathered from a helpline can become a tool for research and advocacy and can spin off into creating other means of public education. The issues of context, sustainability and ethics are considered before setting up a service that has the potential to change the lives of the people who use it and TARSHI in all respects does just that!