Mld CriSIS 455 20 The Use of the Telephone I.. SUicide preventioN. The telephone has been the maJOI' treatw in Counseling and Crisis ment rnedjum of stllClde prevention centers, In many centers, Intervention 1S offered, 2. CrtStS mtcJ'trCnttoH. Many sUlcJde preventlOn centers soon Davld Lester found they were aske(j to help 111 all kmds Of cnses, not Just 5UJcidal cneE'S, SO som:e centers changed their onentahons i toward more general enSlS mterventlon. I1 3. Teen hoflitlt's. Telephone counseling serVices soon becflme directed toward partiCUlar groups of the popuiaUon, most com- teenagers. The teen hottine functions sllniIarlv to a cnSlS mtcrventton center, except that the problems It handles differ. In U1(~ last decade, there has Lle-en a tremendons merease In the Many teen hotlines do nol attempt to proVIde twenty~four~ use of the teiephone for counseling peopjc, This development hour service but are open tor counseling bte dHemoons and has two mam SOurces. Pirsc th~ suicide preventIOn movement, ~vemng&, ,I i following the opening of the sUicide prevention cent er In Los 4. SerVIces for the elderly. Another popuIiltwn setect(>d tor spe­ t\ngeics In th(~ 19505, adopted the telephone as the primary m­ cwl con.cern IS the elderly. Bostoo·s Rescue, Inc" nInS a serVl.ce strument because of its accessibility, Any mdividual In ens}!) for senior CItIzens where a call is piaced every dav to each mem­ CQuld USU(l.!]Y get to a telephone to call for help. The teiephone ber. 11115 protects the memb~rs m case of iHncs$ Or emergencv, offers a number of other advantages over traditionai modes If the eaU 15 unanswered:, lil volunteer VtSlts tht~ pE'rsor(s home. of CQUHseJing, particuiar!y the relative anonymity afforded the The calls are made sent or cthzens, so soctai contacts are lrutI- distressed individual, " atcd and renewed in the process of mamtalrll ng the serVH.:c. In i The second stimulus to teiephone couJ1seling came from the Boston the serVIce IS .free. N(:\\' York Cit(s'servlCc, financed by ct€'veiopment of POl son m formation (enters, Here, the telephone fees from pa.rtIcIpating semor citizens, differs from the Boston has the assets of lmmedjacy and If it person iKC1- servIce because It restncts the socIalizmg aspects, New York dentallv (or mtenhonaIly) mgests some chemlcat Immediate linuts calls to roughly a mmute an.d serVE'S d ma.miy protec­ counseHng about antidotes and treatment can be obtamed, The tIve fUllctlon 111 case of illness. telephone sel\-'es to transmit lnformatlOl1 qUICkly to people. 5. Servrces tor mtiividuais Iuith parhcUfar needs ana problems. For These two mOdels of immediate counseling, twentYFfour exampJe t Boston·s Rescue, Inc., started a speClai telephone cOun" htlurs a day from it trained staff, have been applied to numbers :>ervjce fol' homosexuals, \vJth supportmg cliniC $CTVtCe. of other areas, The number of centers now operatm.g lS easily Services now eX.1st tor abortJon counscling, Victims of rape, par~ over 1,000. ents who have a hIstOry of abusmg their cl1Udren, and so on. 6, Scrotas of 11 more nature. Buffalo·s Smcicte Preven~ THE USE OF THE TELEPHONE IN COMMUNITY SERVICES tlOn and Cns1s ServJCc opened a "problem In living" servIce to encourage people to call with anv kmct of problern. It 1$ useful to reVlew, bnefly, some uses to Whi.ch the telephone 7. frotlines, These provide mformatlOrt about ctrugs and has been put as an Instrument of counselinl1 and advlsmg. theIr effects, plus cQul1selil1g to those mvotvcd with not only prOVIde counseling but also help mdivluuais Tbis paper contams elaborated and \lpciate,,; ideas. discussed bv the currently on "bad tnps" or in stMes of acute panIc. aut)10r In prevIous publicatIons (Lester, 1974a, 1974b: Lester and Rr(Wkrn1n 1973}. S. Potson Cfnters. POison control centers provide tmmediate CO'ltnseiing on treatment procedures, AiU10Uu:t., these centers I David Lester 456 Counsehng and CriSl S 457 I many unlicensed, Ulunspected serVices eXIst? One central agen­ were generally oTlgmated by pediatncwns to aid In treating cy, wtth l'rmned and $up(~rvlSed staff, would provide b!2tter p01sons, the focus h{iS shifted~ It has become mcreasmgly Ol)vJ()us that m many cases of "accidentaJ" quality counseling. Y€'t wOll,id victIms of rape, for example, call 8tfJ(~destructJve work, As resujt a general counseling serVice? Doesn't the prOVISIon of a SPf!CHli , pOlsonmg, tenctencles are at Cl the smcide preventwn centers anci <1rug hotHne serVIces must SerV1C€'r directet1 toward those victims and manned bv svmpa~ work closely watt the P01S0fl conuoi centers to facilitate the tu: counselOrs, who art' themselves perhaps Vlctlms of nlpe, treatment, fadIi tilte use of the service? One sojutlOn 15 to have separate telephone numbers 9 f\uwor confrol (f;nli'J's < These SerVl(CS: were pnmarlly m()ti~ vated bv tile nots of the 196Gs and the need to quiet the Tumors and mdivldual advel'hsHH!' Camn~11I2'nf;. tHJt <::lhufin the lines In ;1ccompanymg such socIal upheavals, Now they have extended the same agencv. The SUlc1cte Prevention And Cri:Hs Scrv1Cc 111 then mforlTIatlO!1wglvmg serVice to other areas of commumt.v Buffa!o, at one POint, had its counseJors answer tour different ,I concern serVlCCS, each with Its own telephone number ,and Zldvertlsmg 10. Contl11lJJ1!i1j . A recent d£'velopment has been coop- program (it SUIcide preventlOfl serva::e, teen hotline, problems V1 S(!fVtce, caSt~, it e~ratJOn betwt;:(:n radiQ statIons and commumty groups. In CaU and drug hotJine), in this however, For Act-ton, OT1RInilted bv \VMCA In New York City, tr.:uned proved difficult to have counseJol'S 5Wlh:h from serVICe" to ser~ Vlce CouHsclors tned to listeners with sp(~citk problems: gar- turrllng from a senousiv depressed cittzcn renlOvill, rat and pest controL i()W~8tandard housmg, voter consideTmg SUIcide to a Shy teenager who did not know how to , ~1S.k Out the who SIts nC,(Jr hIm In dass, Perhaps. It )5 most ;,1 consumer fraud, traHk safety, poUutiOl1 f taxes, etc. StatIOns have occ3sHmaHv focused upon specific problems; sensible to coordinate serVices (and if possH,le, locate thcrn to­ 'rVMCA m Nt'\v York focused on h<HISlng, WVVDC in lVashing:­ Vf"fhf'rl but have separat-e groups ot counseJors for C'ZI(1l servlC(\ ton, D, C ' on garbage removal, A second Issue regMding the proliferatwn ot {elcphant' caun~ '11. Last yeaL Or, Lloyd Mogicn, a psvchiatnst, serVIces IS whetller any counseior can counsel any caBer, started a program on radio statJon KQED lfl San Frannsco Must a cDunselOf be homoSexuitl to counsel hCllHosexud!s, a rape where listeners can 'In with problems, DL tv1'oglen counsels them vJchm or female to counsel rape vlctmlsl i;1 teenager to counsel to.onagers? Or can any competent. tramcd counseior handle any :1 \'vhile thE' conversations are broadcast, His program differs from most radio call-m programs because hJS .;31111 1$ counseling, client and any problem? There are no pertment empmcaJ data 12. ,Mimmaf ;;arICCfJ, Finally; there IS a grow1ng number of here and oJ.:nr\lOn5 differ, Usually, however, when community mln1mal services which are nonetheless related to the abOve: the needs ans€', specific mterest groups InItlate the serVIce, wl1ich Djaj"A~Pr;iver serVIce, Wake~Up SerVlCE'S, etc rt?suHs In like counselimz: like, The t(jjephone phlYs a central and Important part 1ft a iarge range or services and has proven particularly SUl table to the THE TELEPHONE IN PSYCHOTHERAPY goals of these serVIces, If there IS a commuruty need, it The wlept1one, in Jncreasmg ways, IS used by Ctt<'.:1P telephone couft8ellng set'VIce can be set up tu a sHort pe~ slOnaIs engaged 111 mdivtdual face-m-face psychotherapjf, For flod at time. The st?rvlCC provIded. once advertised, JS available to everyone, hecause mosl' people have a telephone or easy ac­ exampie, RoberheUo (1972) reported two cases of pSychDanalJf51 10 which a pattent wHO was temporarily unable to VitHt the psy~ cess to one. vVhen the community no longer nee(ls the sen'feCi tt can be easily dismantled. c!10analysts'g office (due to travel and illness) continued the , The proliferation of such servIces t'lIlsCS some serIOUS Issues. seSSiOns by telephone. He reported that the telephone made no difference m one Cl):$f? (where much of the con~ Is It better to I'wve many separate sCrvlc('~L Or are they better lo­ sJsted of discuS~HQn of the patient's dreams) and (lctthlUV hp!t"lf'ti calized 1rt one ilgencv? Can qualitv C'ontro! be assttred when i i " David testpr 458 Counseling and CriSIS Usagt" 459 In the second, In the latter case, transference had been so dis­ haVlOr modificatlOn program and reinforcmg the patient's self­ ruptIve that the p,atient could not stand beIng 1n the same room tnlage f facilitates continmng the behavlOr modificatton regImen, with the analyst. Her emotIOns mterfered w1th integration of in­ Miller (1973) surveyed a number of psvchtatnsts and found Sights mIo her ego, The telephone seSSIOns enabled her to ex ~ out that 97 percent used the teJephone for handHng emergen~ penence the emotions and also reflect upon the transference, el€'S, 45 perc(mt used It ilS an adjund to tuce~towfa('e pSYChother­ SeeDe (1968) reporteet on use of tM telephone to begin the apy, and 19 percent used It as the pnmary mode or tredtt11cnt. Scil1Z0phremc patIent's lt1tegratIOn mto hIS family. He n",ar'dE'd The psychlatnst$ differed In how easy they found the tele-phOl the first goal to be the patient's return to involvement m diffi~ to be as a mode of communIcatwn, It is ImportanL Miller noted, cult family sItuations! rather than temporary IlIDiation from fOf psycilotheI'aplsts to know their own reaction to the mode of I them, PhVSlcally returning him to his family maY l,e too stre5S~ the reactton of patients, and th(~ Sllitill1Ulty of pafw I but the telephone often provides the nght amount of dig» hCUlar problems to the mode.