FESAT Conference

1
FESAT Conference Taking a Call on Cannabis- Drug
Helplines Response Monday 1 October 2007 Will
zeroes and ones take us there? E-counselling
and cannabis Tom Evenepoel, co-ordinator De
DrugLijn
2
Across the world the message fliesInformation,
truth and liesIt's all yours and it's all
mineYou just have to find the timeWe're all the
same, we share the blame, we play the gamesIf
it's yes or no the decision is easy, it's
easyZeroes and ones will take us there.
3

• De DrugLijn
• 2. A new way of communicating
• 3. Results
• 4. E-counselling and cannabis
• 5. E-counselling in practice
• 6. Conclusion

4
1. De DrugLijn

• Started as a telephone helpline in 1994
• For the Dutch speaking community in Belgium
  (approx. 6 mil.)
• Since 1996 flyers and brochures
• Since 1999 website, elaborated site since 2003
  ( 200 webpages)
• Pilot project e-mailcounselling in 2004

5
2. A new way of communicating

• A change of hearts
• Occasionaly answering e-mails since approx. 2001
• No policy or strategy often simply asking people
  to call our helpline
• Reluctance amongst staff about answering
  questions online

6
2. A new way of communicating

• Five stages of a telephone conversation
• 1. opening/welcome
• 2. exploring the question
• 3. defining the problem
• finding a strategy
• round-up

support advice insight counseling referal
7
2. A new way of communicating
   I think Im addicted please tell me what to
do! How on earth can you answer such a
question? The reply would be a tenfold of
questions! Arent we missing some enormous
opportunities?
8
2. A new way of communicating

• And a change of minds
• What kind of questions could we answer
  information - advice - help
• How to deal with the limitations
• Decontextualisation
• Channel reduction

9
2. A new way of communicating

• Possible advantages become clear
• Writing takes more time and effort (motivation)
• Writing involves structuring ones own thoughts
• - Writing allows to let of steam in a safe way
• - Distance in time allows consideration of what
  to write and how to formulate it
• Written messages can be saved or stored
• Writing allows to define ones own tempo

10
2. A new way of communicating

• Policy guidelines
• All kind of questions (information, advice and
  help)
• Only answering mails via the web application
  (safety follow-up)
• Answer within 5 working days (no emergencies)
• Maximum 3 inquiries on the same topic
• Always a personal and tailored answer

11
2. A new way of communicating

• Script
• Receiving and categorising the e-mail
• Printing and reading the e-mail
• Formulating an answer
• Check proofreading by a colleague
• Sending the answer

12
3. Results

13
3. Results online evaluation

• Why did you prefer to mail?
• 48  it suits me better 
• 28  I find it more practical 
• How did you feel about the answer?
• 94 finds personal enough
• 98 is satisfied with its length
• 93 is satisfied with the tone of voice
• 91 is pleased with the content
• 84 found it helped them out
• Overall score 8.8/10

14
3. Results online evaluation
Im very glad I had a try and e-mailed you. I
didnt dare to call, because its so much easier
to write things than to say them.
This e-mailservice is a very good idea! Young
people are far more familiar with the computer
than with the telephone. All went very well.
Its wonderful that I can talk about drugs via
the internet. I know that using drugs can be
risky, but talking about it in this society with
all its prejudice and ignorance isnt easy.
Thank you very much !
I got a very clear and very quick answer. Thanks
a lot.
Thank you for your understanding and sincere
concern.
15
4. E-counselling and cannabis
Who ? Gender More men compared to calls and to
e-mails in general  Age 30 from 15 till 20
years old 27 from 20 till 25 years old 13
from 25 till 30 years old
Telephone 17 40 till 45 years old 24 45 till 50
years old 10 50 till 55 years old
16
4. E-counselling and cannabis
Who ?
(
parent 13 52
(ex-)user 53 25
partner 7 5
friend 5 3
17
4. E-counselling and cannabis
Which topics ? (
General effects and dangers 34 39
Urine and blood testing 26 19
Signs/indications of cannabis use 6 12
Legal information 17 9
Withdrawal symptoms 9 6
Ways of using cannabis 3 7
What cannabis looks like 0 3
18
4. E-counselling and cannabis
Which problems ? (
Impact on parent-child relation 17 58
Ones own cannabis use 54 17
Impact on partner relation 8 5
Impact on relation with a friend 7 3
Other personal psychological problems 2 5
19
5. E-counselling in practice

Hugo, 30 y. Subject getting of cannabis Ive
been smoking cannabis since I was 18. Some
episodes a lot (5 till 7 joints a day) sometimes
no cannabis at all. Im 30 now and want to quit.
Ive tried cutting down with the help of a
psychologist, but with little results. How can I
quit? Can you help me?
20
Tom, 17 y. Subject stopped for a week, feeling
strange Im a 17 year old boy and Ive been
blowing for about a year. In the beginning about
once every other week. During summer holidays I
started using a lot (about 3 joints a day). The
last week I blowed, I felt bad (anxious)
afterwards. Now that school started, I havent
smoked weed in the last 8 days. But I still feel
a bit strange, sometimes I start to sweat and
feel anxious or start panicking. How come and
will it go away?

21
Jeff, 18 y. Subject my mums panicking I used
to occasionaly smoke a joint at festivals. My mum
found some of my weed. I immediatly addressed her
about it myself and started an honoust
conversation. In the end I agreed to quit
completely. Still, my mum thinks Im a junkie
and wants to check my urine. She constantly
accuses me of getting addicted, even when Im
simply drinking a beer or behind my computer (Im
an ICT student). Im getting tired of those
false accusations. Im really getting desperite
and hope that you can help.

22
Jorgo, 18 y. Subject cannabis and child Im
going to be father in 3 months time, but I
occasionally smoke cannabis (about 4 joints a
week). I dont smoke near my pregnant girlfriend
and wont do so once the babys born. I always go
and smoke outside. I wondered if they can take
our baby from me if they find out I use cannabis.
Im 18 years old, my girlfriend is 16. Thanks in
advance.

23
Sara, 24 y. Subject cannabis addiction I was
planning to call you but Im afraid it will be
too expensive with my mobile phone. Im addicted
to cannabis, just like my boyfriend. Ive been
using it for a year now, and Im starting to get
some financial problems. I would like to stop,
but simply cant Ive set a new date but doubt
if Ill manage. My friend should quit as well,
but hes only just starting to realise that hes
got a problem. I dont think we can get enough
support from each other and Im scared of
approaching someone else for help. Im planning
to talk to my doctor about it. Have you got
further advice or tips?
24
5. E-counselling in practice

• Answering strategy
•  Thank you for contacting our helpline 
• Short summary of the e-mail and the main
  questions
• structure the questions and thoughts
• avoid misunderstandings
• 3. Positive feedback supporting
• gaining confidence and motivating
• showing recognition for the effort and concerns

25
5. E-counselling in practice

• Answering specific questions or topics adding
  explorative questions
• showing involvement and commitment
• Getting the dialogue going
• between mailer and helpline
•  dialogue of the mailer with himself 
• Offering alternatives and considerations
• giving perspective for change showing recognition
  for the effort and concerns
• Supporting, inviting to mail back and round-up

26
3. Results

• Evaluation by the helpline staff
• The e-service has clearly given a boost to the
  dynamics in our service
• Very challenging for your own skills and
  expertise as a helpline worker
• That same fact makes it also very motivating
• The script we follow (writing and reading
  answers) stimulates exchange of ideas, knowledge
• Very time-consuming

27
6. Conclusion

• - even more anonimity than the telephone
• - distance in space and time makes it even more
  low-threshold
• it can appeal to some that might find it
  difficult calling
• modern day communication extra appealing for
  young people
• it especially manages to reach young males (most
  important group of cannabis users)

28
6. Conclusion

• Topics addressed are often more sensitive (re.
  taboes on cannabis problems, legislation,)
• The sense of control on the communication seems
  to be of huge importance
• E-mailers want personal contact, but want to keep
  a distance as well trust is a key element
• E-mailcounseling seems extra demanding, but
  expectations are different as well
• Figures show that telephone and e-mail are very
  complementary

29
6. Conclusion
The future? Telephone helplines have always
been a gateway In recent years they have become
crossroads different groups with different kind
of questions contact a helpline line via
different channels E-mailcounselling as an onset
to further online early interventions for
problematic users
zeroes and ones can help us get there
30
Contact details
www.druglijn.be tom.evenepoel_at_druglijn.be
( 0032 2 423 03 44