50 Stories Part 42: Face-to-Face for 50 years
Image: Distress Centre counsellors in 2017.
The professional qualifications for Distress Centre counsellors have increased over 50 years, as has the complexity and number of clients they see. Less than 300 sessions in 1970 became 1,650 in 2010 and 2,900 in 2019. The majority of referrals now come from an online web form which was created to speed up the intake process, followed by crisis line referrals.
David Kirby, Clinical Services Manager notes: “Depression and anxiety are reported as the big presentations now, and some people who were otherwise doing well are now in a place they have never been, where they are situated to lose everything because of finances.”
Distress Centre’s counselling process
Counsellor Lynda Gardiner describes the process:
“Usually our counselling referrals come from the intake worker. We offer up to 6 sessions of crisis counselling with the same counsellor. However, if they really need additional help right now, there is the odd client we will extend and continue supporting.”
David Kirby, Clinical Services Manager, one of the longest serving staff members, talks about the counselling service, including the recent changes caused by COVID:
“Right now, we have a full-time intake worker and 4 full-time counsellors with Masters Degrees. The immediate availability of counselling through the 24/7 crisis line has been consistent through the years, and for the most part, the counselling program has always existed as a core program. The biggest thing that has changed is the increased support we provide to the volunteers. We recognize that volunteers are doing some really difficult work and they need on-site support from staff, especially after hours.
“Clients are mostly adults, but not by policy. We have to attend to the legal stuff around minors, case law, statutes, professional practices, etc. Things that did not matter as much in 1970. The youth program (ConnecTeen) has grown proportionally more than any other program of DC. The use of technology has really boomed, and we are staying current with the way that people prefer to reach out for help. Over the years public education has grown and waned, but if it makes sense, we are involved in that too.”
Counselling during COVID-19
“With the arrival of COVID, the initial stress was getting counsellors technology-competent and set up at home,” David said. “Really, we had no precedent for being technically minded as social workers and psychologists. For the most part everybody on the counselling team has had some pretty exhaustive experience on the crisis lines, providing on-call support, or taking part in coaching shifts.
''With the arrival of COVID, the initial stress was getting counsellors technology-competent and set up at home. Really, we had no precedent for being technically minded as social workers and psychologists.'' - David Kirby
“The real learning has been around video counselling, to replace the in-person counseling sessions. We had to develop some informed consent around that, identify who had responsibility if the signal drops, if it gets patchy, we lose audio, who does what and how do we restart?
“We are just as busy. On a monthly basis, we are seeing more clients in terms of intakes, probably 10-20% more than last year. During COVID-19, the clients’ presenting concerns are more complex for sure. People thrown together in the household, or maybe relationships that were already kind of not working well, but now everyone is at home, with more substance abuse, more conflict.
“Remote counselling is not going to be a good fit for every client. Probably half of our clients have the technical resources, the other half have no interest or no access. It is helpful if clients have some experience previously with counselling, then they kind of know what the steps are and the sequence in the session. We always start with phone counselling just to see it if fits for people, before we would suggest remote video counselling.
“Video tends to be more exhausting for sure, for the counsellor. You would never in a normal session be really looking face-to-face directly at someone the entire time. The attentional demands can be quite tiring. At the end of the day there is a huge deficit of energy, compared to the same number of in-person or phone sessions.
“One of the things that is on my agenda in terms of supervising is just really underscoring the importance of self-care. Compassion fatigue, vicarious trauma, burn out and recognizing you have to really be careful and unplug at the end of the day. Having some separation at home is critical, and fortunately, the six of us do.
“We have made some adjustments for the manager-on-call. They are the go-to person for any kind of risk issues that come up, 24 hours a day. We have reduced that from 7-day rotations, to 3 days, and we all take turns. I think we will take this system forward. Some of the people on my team are pretty much set in their remote work. I have one staff who had a total commute of 3 hours, so it might be hard to get him back into the office!
“We have a really cool opportunity, all of us in the team, to really think creatively about how we do the work and to maybe let go of things that we have realized were not working that well in the first place.”
''We have a really cool opportunity, all of us in the team, to really think creatively about how we do the work and to maybe let go of things that we have realized were not working that well in the first place.'' - David Kirby
Judy Wilkie, former client, summarizes the vital service the Distress Centre counselling provides the community:
“Counsellors offer a safe place in a crisis moment. It is much worse out there today, because of the economics of Calgary and because of COVID-19. If I hadn’t had that safe place when I needed it, who knows what would have happened?”