This professional development presentation provides guidelines and best practices information for Employee Assistance and other mental health professionals when conducting brief counselling via telephone.

1. Bernie McCann, MS, CEAP
Brandeis University
Waltham, MA

2.  The purpose of this training is to assist
Employee Assistance professionals to take
the best advantage of new approaches to
deliver more user-friendly and accessible
services, specifically telecounseling.
 It is important to note telecounselling is NOT
intended as replacement for traditional face-
to-face setting, but rather as a separate
modality, another option for client services.

3.  Telehealth
 Telemedicine
 Telepsychiatry
 Videoconferencing
 PC-based video transmission
 Email applications
 Telecounselling

4. Providing effective telecounselling in
the EAP setting does require:
 Modification of some procedures;
 Reconsideration of several aspects of
the client/counsellor interaction;
 Revision of certain service protocols; and
 Specialty training of staff.

5.  Enhanced access for certain client groups
 May encourage engagement of ambivalent clients
 Telephonic modality may reduce distractions
 Less impact on productive work time & leisure time
 Increases opportunities for follow-up contacts
 Reduces migration to inappropriate sources of help

6.  Loss of personal intimacy from shared space
 Can be experienced as impersonal; mechanistic
 Counselor loses visual cues to assist in assessment
 May encourage obfuscation of critical information or
misleading responses
 Telephonic connection can be lost, inadvertently or
deliberately

7.  Effective telecounselling requires at minimum an
environment which is free from distractions, and
provides for both privacy and client safety.
 Conducting telecounselling with individuals who
are multi-tasking is rarely safe or effective.
 Conducting telecounselling with individuals who
are at work in an open office environment is
fraught with difficulties.

8.  Use of telecounselling requires careful screening
of clients. Examples of clients which are not
appropriate for telephone counselling include:
 Active threats of violence, suicide, or homicide;
 Mandatory alcohol and drug abuse referrals;
 Children and adolescents;
 Any others…?
Note: When in doubt of the suitability of clients for telephone
counselling, counsellors should immediately review case with a
clinical or administrative supervisor.

9.  Clinical profile: Clients appropriate for
telecounselling
 Unique confidentiality and privacy issues
 Use of active listening and other related
therapeutic communication skills
 Advanced telecounselling techniques:
Brief therapies – i.e., solution focused,
cognitive-behavioral, etc. as appropriate

10.  Clinical license: Jurisdictional issues when telephone
lines and services cross state/provincial borders
 Confidentiality and privacy issues: Mobile and
satellite phones in particular, are not secure
 Transmission issues: Poor transmission and service
interruptions have potential for faulty assessments,
misunderstandings, and safety lapses.
 Legal: In the US, certain statutory requirements for
secure transmission and storage of personal health
information (HIPPA, etc.) may impact use of
telecounseling and other electronic transmissions.

11.  Active Listening
 Paraphrasing, Clarifying and Agreeing
 Effectual Questioning
 Providing Clear Information
 Reflecting & Validating Feelings

12.  At initial session, counsellors should administer
a telecounselling statement of understanding
and explain the unique nature of service.
 Counsellors should request client telephone
number and ask permission to callback if
disconnected.
 Counsellors should identify a nearby source for
assistance if a crisis or emergency occurs
during the session.

13.  Telephonic assessments should be consistent
with EAP in-person clinical guidelines.
 Utilize a scale of global client functioning at
onset and closure of each case, consistent with
current procedures.
 Request permission from telecounselling clients
for subsequent customer satisfaction interview
and verify callback telephone number.

14. Telephonic case records should be consistent with
those used for EAP in-person clients. These
include proper and complete documentation of the
following:
 Telecounselling statement of understanding
 Standard screening and assessment tools
 Service utilization
 Case notes

15. Clinical supervision of telecounselling cases
should be consistent with established practice
guidelines, acknowledging critical differences and
additional considerations, including:
 Confirming client appropriateness for telecounselling
format;
 Adequate procedural safeguards to ensure client
privacy, confidentiality and safety; and
 Provisions for moving client from telecounselling
format if necessary or requested.

16.  Reaching a comfort level with telecounselling
cases is likely related to understanding the
differences and nuances of this delivery
approach as well as gaining some experience.
Questions, or comments?