Interviews with young people

Meke

Youth Ambassador Meke, provides useful tips for integrating technology into a clinical setting from her personal experience with healthcare professionals.

What does technology mean to you?

Technology is the way I stay connected with people in my life (except my grandparents, lol). It means freedom and connection in the sense that I can be connected from anywhere, anytime to anyone. It also makes life so much easier and means I have access to an answer to any question I might ever want to know (except big questions like the meaning of life!!), at my fingertips.


What types of technology do you use in your day to day life?

I use my laptop with wireless internet or a desktop computer. I use my phone for pretty much everything (GPS, internet, calls, music, videos, calendar etc.). Sometimes I use an ipod if I want to go jogging.


Have you sought treatment for any type of mental health difficulties?

I have had a lot of help over the past nine years to deal with various mental health difficulties - from some really amazing people!

Would you tell me a little about them?

Most of the help I have received has been to assist me to deal with the consequences of childhood trauma. I have had help to deal with PTSD, anxiety, depression and eating issues as well as self-harm and suicidal ideation. Sounds kind of depressing when you say it like that, but I think I am pretty lucky to have had support for so many things when I was still an adolescent - before life went along too far!


What were your experiences with health care professionals like?

I have had an overwhelmingly positive experience in my contact with mental health professional like counsellors and psychologists. I have had a number of people support me long-term along the journey (due to accessing different services for different issues etc.). My experience with GPs and with a Psychiatrist has been less helpful - not negative but just very medical, removed, clinical etc. I have recently found a GP though, who is really amazing!


What types of technology were used in your sessions?

I actually first used technology to seek help when I was 14, by contacting Kids Helpline - it was the first time I ever spoke to a counsellor or anyone else for that matter about my childhood experiences. For a number of years I used the phone, email and wed based counselling services through Kids Helpline to access support. This was free and I didn't have to get permission from my parents. With my face-to-face services the only real use of technology has been to schedule appointments (phone or texting) but occasionally I have sent an email to my counsellor as she has invited me to do so if I want to.


How do you think it would have/or did make a difference to your treatment?

I think it really changed my experience in the sense that I reached out for help a lot sooner (it was less daunting and overwhelming). I was able to seek help in a way that felt comfortable for me and met me where I was at. I was able to 'say' things I could not say aloud by writing them down in an email. Often I would write an email when I was having a tough time and just the process of doing that helped me to feel better. I also found that using web based counselling (like instant messaging) really helped me to work on my relationship with my counsellor. It was instant interaction but a little bit more removed so I could say things that were really hard to say (e.g. if I had felt hurt by her) and then she would respond right away and we could resolve it. I wasn't at a place to do this out loud until further into the process of therapy. It helped me to verbalise my deeper beliefs about myself (not just surface stuff) to be able to write it down.
I have to admit though, that I really needed face-to-face support for some issues, particularly my eating issues - so technology can have its limitations.


What advice would you give a health care professional wanting to use technology in their practice, including some practical examples?

I don't think the use of technology should replace face to face contact but I think it is a great asset and can really enhance it! I also think it is possible to 'do' therapy via the internet or phone if someone is unable to attend standard services for whatever reason. In my opinion, a combination of as many media as possible is the best and most helpful! I feel like I have lost something working with counsellors face to face without email - I often can't sort my thoughts out fast enough to really communicate what I need to say in session.

One way to use emails in practice is to invite people to send the emails between sessions, knowing that you will not read them until the actual session (so it's not cutting into your time - but is part of the session). The email can highlight patterns and be a starting point for conversations that otherwise may never have happened (due to shame, difficulty verbalising or just simply forgetting what it is really like in those times when one is really in a bad, or a good place).

Another idea is to get the young person (YP) to do homework online or via email. For example if you are doing mood diaries or ABCs - or wanting them to monitor certain behaviours, then you could have them complete this online (if you have this set up) or to email it through the updated form each night, for example. Makes it a bit more fun! Also if you wanted YP to try mindfulness practice or progressive muscle relaxation you could have the recordings for these on your website for them to download and try at home - rather than giving them a CD. Or if this isn't possible then even just email MP3 files to the YP so that they can put them onto their ipod straight away!  You need to have both options though, because there are some YP who can't afford all the latest technology (and I was definitely one of them when I was younger).

If you want to get really keen, you could try using an instant messaging service to facilitate conversations with individuals who may have some sort of reason why they can't or don't want to talk on the phone or be seen face-to-face (some obvious examples being severe anxiety or hearing impairment). You can set it up so that there is a planned session time where you are both online from wherever you are and can have a session. Emotion can be introduced by being creative - for example using emoticons (:-), :-P, :-( etc) or by putting up a shared drawing board where you can scribble things to demonstrate what you are talking about. It is slower this way though, so sessions might need to be an extra half hour longer to cover the same ground (depending on typing speed!).

If you are working with young people who are geographically isolated, or might have difficulty getting out of the house (e.g. some YP with disabilities, terminal illness or chronic pain or young carers) use of technology such as a combination or phone, email and web counselling might be possible. It depends on the phone if they are worried about someone listening in, which is why the internet is a good option.

I think texting is a great way to confirm appointments or even to remind young people about homework (if they are ok with this!). I even got a text one time from a counsellor right before she knew I had to face a really anxiety provoking experience - it came out of the blue and was a once off thing to remind me of what we had talked about and let me know she was thinking of me and believed in me. It made SUCH a difference!

Another simple idea would be to have an ipod dock in your room so that YP can share music that is meaningful to them in the sessions, and then tell you why! Not to mention this would be fun and funky!

One really important thing as well, is to make sure you have a decent website. It's pretty likely that YP who are looking for services are going to check them out online first…so this is a really important first impression. I remember I nearly got scared off a service that had a really alternative and full-on website - but has turned out to be a really awesome place when you actually get there!

What would you say to a health care professional to convince them or to sway them into including technologies in their treatment of young people?

I think health care professionals worry that if they introduce the use of technology they might find themselves flooded with crisis emails, texts or generally having difficulty managing the services. When it comes down to it though, like anything else there just needs to be clear communication to the young person the boundaries around the service (the same as face to face support). You can even have them sign a contract if that is what is needed.

I think health care professionals working with young people should try to embrace the use of technology as a way of making help seeking more relevant and accessible to young people. Like, when I went and saw a Psychiatrist, and sat on her floral couch in her medical room - I felt like I was stepping back in time and it made me automatically awkward. When I chatted online or wrote an email to a counsellor I felt like I was in my own world and could be myself and I think that really helped me!

Technology plays such a huge role in the lives of young people - and I don't think it's about the health care professional even being a pro at using technology because it's constantly changing. I used to help my counsellors learn chat lingo and it made me feel like I had something to offer and communicated to me that they were interested in my world (not just my problems).