With the onset of the pandemic, the i4we schools’ program had to revamp and adapt to cater to the needs of the students through virtual and telephonic mediums. Phone calls were chosen as the mode of contact to reach the students as it was the most practical and accessible option.
Although data suggests that most adolescents have access to phones, their parents expressed concern about excessive use of mobile phones due to fear of addiction.
The first step towards reaching children in their households was to get their parents’ consent. This was also an important step that helped us address the concerns of parents. Their concerns included fear of mobile phone addiction, stigma about mental health and so on.
Thus, in order to get parental consent, we had discussions that consisted of psychoeducation, addressing parents’ queries and stigma about mental health, and encouraging them to offer private time and space to their child during counselling.
The Tele-counselling process put forth certain new challenges that we had to address. One of which was the shift from counselling in a therapeutic space that is created and controlled by the therapist to counselling in a domestic/personal space where the counsellor has little to no control.
Therapeutic space is a physical and psychologically safe space that is designed to enable individuals to feel comfortable enough to work through their emotional issues. Physical aspects such as lighting, access to the outside, seating, soundproofing, ventilation are important contributors to a successful counselling process . For example, the counsellor achieves this by using simple but effective techniques such as allowing natural light and ventilation into space, sitting in an L-shaped set-up, making sure the conversation isn’t heard from the outside etc. Similarly, psychological aspects such as confidentiality, absence of judgement and hierarchy are crucial in a therapeutic space. These components were relatively easier to fulfil in an academic institution.
Creating a safe therapeutic space was challenging as we had no control over the child’s environment. Private rooms or space is a rarity for adolescents in these communities. The lack of personal space also compromised confidentiality. Owing to these factors, the students themselves found the process uncomfortable and confusing which led them to be hesitant and unwilling to talk openly. Additionally, there were many instances where the parents listen in on the conversation, prompt answers or observe what their child is doing.
Furthermore, there were few logistical challenges. Technical barriers of connecting a phone call, poor network, fixing appointments with the students and most importantly sticking to those appointments were all key difficulties.
These challenges proved to be disruptive to the counselling process. The students found it very hard to shift from the casual nature of their daily life to a serious setup of talking about thoughts and feelings to a counsellor who is not physically present.
The most crucial challenge that I would like to highlight is those of the ‘Risk Clients’. These are the clients who have been known to have self-harmed in the past, experienced suicidal ideation, or are victims of abuse (physical and/or sexual) in the past or present. There were instances where the clients who opened up and shared a lot of personal information in the face-to-face sessions were completely against discussing these issues telephonically. Some of the students messaged us to not call them anymore and there were others who completely denied having gone through these incidents. In some cases, we were able to employ certain strategies to overcome this (such as using code words for people or incidents), but that has been possible only with clients having a good therapeutic relationship with the counsellor priorly in the face-to-face setup.
Upon reflection, the major learning from this situation is that the students at risk do not have the freedom to completely open up to a counsellor from their household. It could be due to a predator being present or due to other family members silencing the abused person from speaking up. This reiterates the importance of school and the security and resources it provides to children and adolescents. It is often emotionally and developmentally more enriching than home in a socioeconomically disadvantaged country .
Even with the steady challenges and disruptions, calling the students during a time when they barely have access to peers and the academic environment was beneficial to some of them. I remember a particular student Deepa (name changed) who came in with a lot of hopelessness and abandoned feelings but expressing eagerness to work on herself. Her primary concern was how she has repeatedly sought help from adults in her life but found none. She admitted feeling hopeful about her prospects after a long time because now she has an ‘akka’ to guide her. Similarly, Rahim (name changed) earnestly took down notes, fascinated to learn why he thinks and feels the way does. All Rahim needed was a trusted adult to accept him which led him to a journey of self-acceptance and personal growth.
I believe this holds true for the clients at risk who dropped out as well. The knowledge,that they now have, that there are people who care about their well-being and can help is extremely significant. While the students appeared confused and unsure why a counsellor is calling them, most of them were pleasantly surprised that someone wants to know how they are doing as opposed to the usual scrutiny that they face with their academic performance and behavioural conduct.
To sum up, although counselling adolescents during a pandemic over phone calls has been challenging, it has also created an impact among the students and has been a great learning experience for our team.