Evaluating telephone and online psychological support and referral
| Date | 01 September 2020 |
| Author | Alicia McCoy,Andrew Hawkins,Amanda Reeves,Jasper Odgers |
| DOI | 10.1177/1035719X20927146 |
| Published date | 01 September 2020 |
| Subject Matter | Practice Articles |
https://doi.org/10.1177/1035719X20927146
Evaluation Journal of Australasia
2020, Vol. 20(3) 157 –175
© The Author(s) 2020
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DOI: 10.1177/1035719X20927146
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Evaluating telephone and
online psychological support
and referral
Andrew Hawkins and Jasper Odgers
ARTD Consultants, Australia
Amanda Reeves
Department of Education and Training Victoria, Australia
Alicia McCoy
Beyond Blue; University of Melbourne Australia
Abstract
Mental health counselling and support over the telephone or internet is increasingly
common. Evaluating effectiveness requires outcome measures and understanding
factors driving behaviour. This article describes a theory-driven evaluation of the
one-month outcomes of a short-term solution-focused support session for anxiety
or depression with a counsellor. The primary aim of the evaluation was to measure
the outcomes of this session on service users’ help-seeking behaviour. It also sought
to understand reasons for behaviour based on behaviour change theory. A secondary
aim was to measure changes in feelings of stress and coping before and after the
session, and collect evidence of the value of the service in terms of ‘consumer-defined
recovery’. The evaluation found the service was effective, with the overwhelming
majority taking some action, being more engaged with a health professional, having
reduced feelings of distress, increased confidence to cope and less hopelessness.
Improvements for service users included ‘reality testing’ the advice given and building
commitment or intent to follow the advice, and ‘rehearsing’ so service users can
demonstrate to themselves they have the skills required and can overcome any
obstacles to following the advice.
Corresponding author:
Jasper Odgers, ARTD Consultants, PO BOX 1167, Sydney, NSW 1230, Australia.
Email: jo@artd.com.au
927146EVJ0010.1177/1035719X20927146Evaluation Journal of AustralasiaHawkins et al.
research-article2020
Practice Article
158 Evaluation Journal of Australasia 20(3)
Keywords
behaviour change, mental health, online psychological support, support service,
theory-driven evaluation
Introduction
One in five Australians experience a mental health condition in a given year and almost
one in two will experience a mental health condition at some point in their lifetime
(Australian Bureau of Statistics [ABS], 2008). Emotional, mental and physical stress-
ors due to causes such as illness, job insecurity, financial concerns and relationship
difficulties can contribute to an individual developing mental health difficulties
(Australian Institute of Health and Welfare, 2014).
Telephone and online support services for individuals experiencing mental
health issues play a significant role in Australia’s mental health system (National
Mental Health Commission, 2014; Sands et al., 2016). Telephone support services,
as a more established medium than online services, have proven successful for
crisis intervention and treatment for conditions such as depression (King et al.,
2006). Potential advantages of such services are that they have wider geographic
reach including to those in rural and remote communities, that they offer anonymity
and confidentiality, that they provide an immediate response anytime during a
24-hr period, and they give the caller a sense of control that they can hang up at any
time (King et al., 2006; Urbis Keys Young, 2002). Telephone counsellors have been
described as being ‘available, empathic helpers who listened to callers and let them
talk, helped them to calm down, and provided options for addressing their con-
cerns’ (Kalafat et al., 2007, p. 334).
There are a myriad of supports available online and on the telephone in Australia.
These services vary in length (some services are intended to provide single session
support and others ongoing support) and in the type of service they offer, as well as the
population groups they target. A Contributing Lives Review in 2014 emphasised the
importance of telephone and online services that linked people directly to effective
interventions and local service systems (National Mental Health Commission, 2014).
Approximately 4% of Australians aged 16–85 years are believed to have used a tele-
phone counselling service for mental health issues at some point in their lifetime
(Bassilios et al., 2015). These support services provide a suitable and accessible path-
way for people to seek help and there is some limited research to demonstrate effec-
tiveness (Mishara et al., 2007). The most comprehensive known studies took place in
the United States in the 2000s with these showing some benefit for callers to crisis
hotlines. This included a reduction in confusion, depression, anger, anxiety, hopeless-
ness and feelings of being overwhelmed (Kalafat et al., 2007). Other research has
found that callers reported an increased sense of well-being and personal empower-
ment, and that their experience with the service had contributed to their personal
recovery process (Spirito, 2011).
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