Read this article published on the Cercle Psy website.

Listen here to an extract from the MIDI 2 program : Vous avez dit Flops Technologiques? broadcast on Radio Le Mouv’ (Radio France), in which I’m interviewed about my experience as a telephone psychologist.

On some specialized hotlines, psychologists take many calls every day from troubled teenagers. How are these telephone interviews conducted? What are the most recurrent problems? To what extent does the telephone force psychologists to revisit their practice? A survey.

Some fifteen years ago, a helpline for teenagers aged 12 to 25 was set up by a non-profit association (1). Its mission is twofold: to listen, inform and guide young callers, and to monitor their health problems on a national scale. According to a summary of activity in 2010, the helpline handles over 600 calls a day, while the website to which it is affiliated receives almost 2,000 visits a day.

 

Psychologists with contrasting backgrounds

The uniqueness of this telephony solution lies in the team of professionals who run it. And with good reason. The team comprises no fewer than forty salaried psychologists with a wide range of experience and theoretical backgrounds, not forgetting the presence of a number of doctors who complement their fields of expertise. Some psychologists are psychoanalytically oriented, others are behaviorists, while still others prefer an integrative approach. During difficult calls, the team present at the time provides support and advice to the caller. Almost all of these practitioners have a parallel practice, either in an institution or in private practice. A true blend of clinical and theoretical practice.

 

Which callers for which problems?

According to the structure’s most experienced psychologists, the problems have not changed over the last ten years. The most recurrent? Sexuality. The youngest children’s questions revolve around their first kiss, their first sexual encounter. At times, a great deal of crudity, a sign of blossoming impulses, transpires through comments that can be clumsy, rude or even violent. Older boys ask about condoms and contraception. Young girls often worry about unwanted pregnancies. The second major problem is undeniably malaise: low self-esteem, anxiety, depression, addictions, self-mutilation, suicide attempts, etc. Dejected and disoriented, some young people contact the service without formulating any specific questions. They then pour out all their suffering, in a more or less structured way, as if to unburden themselves. Calls can last from five to forty minutes, depending on the problem being addressed.

 

An inevitable revisiting of the psychologist’s position

One thing is certain: whatever their theoretical background, training or experience, psychologists are forced to readjust their practice. We no longer speak of patients or shrinks, but of callers and listeners. The latter must develop an auditory and clinical sensitivity never seen before. What’s more, there’s no therapeutic follow-up. However, even if the relationship is only punctual, the bond can remain: the psychologists in the system sometimes remember certain callers with emotion, just as the callers must undoubtedly retain a memory of the encounter. The psychologist must also adopt the right distance from the caller. For example, he or she cannot allow himself or herself to go too deeply into the analysis and introspection of the young person, for fear of opening « wounds » that he or she will not be able to close.

 

What are the advantages of a telephone interview?

The main advantage of this kind of dialogue is that the caller’s inhibitions are reduced. Anonymity and distance depersonalize the caller, sparing him the embarrassment of traditional face-to-face contact. The distance conferred by the telephone gives him the opportunity to be abrupt, spontaneous and unrestrained. The teenager also becomes master of the relationship, in the sense that he or she can interrupt it whenever he or she wishes. This approach allows psychologists to go « further, faster ». Some even estimate that twenty minutes of telephone interviewing is equivalent to several months of exploratory interviewing in a traditional clinical approach.

 

What are the limits of such an encounter?

Beware, however: this type of relationship involves only one channel, the voice. The impossibility of observing certain elements such as gaze, gestures, body movements… can make the psychologist’s analysis more difficult. On the other hand, the absence of follow-up can be frustrating for callers and listeners alike.

Finally, a psychologist on the telephone cannot afford to remain silent on the other end of the line, waiting for the caller to confide in him or her. He or she may be asked to give his or her own opinion, advice and suggestions, a position that remains uncommon in a traditional clinical approach. Finally, the emergence of practical questions about the body or contraception requires precise answers. This places us in an ambiguous position between listening and taking action.

 

And on the Internet?

Alongside the telephone service, this system includes a triple interaction space: the question box, the forum and the virtual community. The question box is the most direct way of interacting with Internet users: they post questions by e-mail, which psychologists answer later. The forum, for its part, brings together exchanges between young people, which the psychologists moderate. Messages that are too extremist, bordering on incitement, or simply likely to offend the sensibilities of other young Internet users, are generally not validated. Finally, the third (and most astonishing) space occupied by the team of psychologists is a public virtual world in which young people can find, in pictures, a bus bearing the effigy of this helpline. Twice a week, two of the team’s psychologists lead discussions on themes specific to adolescence (first sexual encounter, onset of pubertal signs, relationship difficulties with peers, etc.). A sort of collective chat with a strikingly realistic replica. A few minutes before the animation, the young people, who have chosen an avatar (virtual image), line up in front of the bus. The vehicle itself contains ten seats, plus a fridge from which participants can help themselves to drinks. The aim of the event? To raise young people’s awareness of certain issues, and encourage them to discuss them with each other, via images. The exchange is particularly dynamic.

At the start of the 21st century, human relationships are becoming increasingly mediatized, creating a certain ambivalence between geographical distance and emotional closeness, the multiplication of social relationships and loneliness. In parallel with today’s social telephony systems, private psychologist services are being developed over the telephone or the Internet, by e-mail, chat or video chat. Their stated aim? To reach people who are reluctant to have face-to-face therapeutic contact, or who want occasional advice. Although strongly criticized by the profession, this practice is nonetheless appealing to some members of the general public… Telephone and Internet: the tools of tomorrow’s psychologists?

(1) Its managers did not want the name of the line, nor that of the association to which it belongs, to be quoted.