Tips for telephone work

This section is for discussion relating to the Layard report, and subsequent schemes like Improving Access to Psychological Therapies where lower intensity inteventions are offered in primary care
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Molly
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Joined: Fri Sep 03, 2010 1:27 pm

Tips for telephone work

Post by Molly » Thu Apr 05, 2012 12:00 pm

I'm wondering if any of the PWP's on here who conduct guided self help via telephone would be able to give me some tips on how to deliver it most effectively? I have searched the forum but discussions tend to be more about whether PWP like doing telephone appointments.

I've been a PWP for two and a half years but have only ever delivered guided self help face to face. I think I've been quite resistant about doing telephone appointments, but I think that has been more my issue of wanting to have more face to face client contact rather. I am hoping to start incorporating telephone work into my week though as I have heard from PWP's in other services that it can have really good outcomes and also I have been finding recently that people are less able to take time off work for appointments.

The questions I have are

Do you complete the assessment face to face and then have follow up appointments as telephone contacts or is both the assessment and treatment sessions telephone based?

What materials do you find work best with telephone contacts? For face to face appointments I tend to use Reach Out, in-house booklets on BA, CR and graded exposure and occasionally Chris Williams and wondering if it will be ok to continue using the same?

How easy is it to link everything back to the 3 systems/5 areas formulation over the phone and is there anything you do to facilitate this?

How do you organise your telephone contacts? Do you send all the materials out at the start or after each session? Do you post out a summary of what they need to do as homework after each session?

Lots of questions! I'm sure the more I do them I'll pick up what works best for me, but any tips in the initial stages would be great!

Molly

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fledgling
Posts: 202
Joined: Sat Jan 15, 2011 11:42 am

Re: Tips for telephone work

Post by fledgling » Thu Apr 05, 2012 2:18 pm

Hi Molly,

In the service I worked for, we had limited clinical space so it was mostly telephone work with the odd face-to face available- each PWP was left to decide how/when they wanted to use their face-to-face slots.

What I found worked well was to do assessments by telephone (as I often might be signposting/stepping up anyway), then offer the first guided self-help session face-to-face to those I was definitely keeping on my caseload. I would explain from the outset that there would be further telephone work after this, but often patients come in with an expectation they will see someone face-to-face at some point, so giving them that option can help with engagement. This also means you can introduce the 5-Areas in person, which I think is easier done visually! I wouldn't send all the guided-self-help literature in one go as that can be daunting- I'd usually post them some basic psycho-ed stuff before the first appointment, then go to the appointment armed with different bits of literature to give them depending on how the session goes.

Follow-ups would then be by telephone, possibly with the option of another face-to-face midway if I was introducing a new intervention that might be easier face-to-face, like doing a though record. At the end of each telephone session we would agree homework as usual (I think you can trust people to make a note of this rather than sending them a letter every time!), and we would provisionally agree what we might look at next time so I could send them any new literature in readiness.

I think you do get used to telephone working, patients are more accepting of it than you might expect, and there are a lot of advantages in terms of time etc. One thing I think you do tend to find however is that you get more DNAs, as people can see a telephone appointment as less formal than face-to-face. So it's important to make clear from the start that telephone sessions are appointments (you won't be able to just 'ring back later' if they're busy!), and what the service's DNA/cancellation policy is.

I'm sure others will have different experiences- IAPT services seem to vary so much! But I hope that's helpful and good luck with it :) .

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Will
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Re: Tips for telephone work

Post by Will » Thu Apr 05, 2012 4:51 pm

Flora makes a lot of good points! Every service is set up differently, with some offering just telephone appointments and some mixing them with face to face. Some staff get the choice, some don't. Ultimately, it can be a useful option and it's something that has been avoided for a long time, largely due to staff anxiety - it's all about practice at the end of the day.

I wrote a wiki entry on the topic that might be a good starting point - viewtopic.php?f=30&t=13462
Ponderings and wonderings in 140 characters - @willcurvis

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fledgling
Posts: 202
Joined: Sat Jan 15, 2011 11:42 am

Re: Tips for telephone work

Post by fledgling » Thu Apr 05, 2012 5:09 pm

Ah, didn't know there was a wiki! Looks really thorough- good stuff, Will :wink: .

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Will
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Location: North-West England

Re: Tips for telephone work

Post by Will » Thu Apr 05, 2012 10:46 pm

flora84 wrote:Ah, didn't know there was a wiki! Looks really thorough- good stuff, Will :wink: .
8)
Ponderings and wonderings in 140 characters - @willcurvis

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