Documentation of the Establishment and Evaluation of the Effectiveness of a Youth Crisis Hotline during the COVID-19 Pandemic
曾嫦嫦(Chang-Chang Tseng) ； 許文耀(Wen Yau Hsu) ； 湯素琴(Su-Chin Tang) ； 黃文怡(Wen-Yi Huang) ； 劉于涵(Yu-Han Liu) ； 姚幼玲(Yu-Lin Yao) ； 趙慧璇(Hui-Xuan Zhao) ； 林楷潔(Kai-Chieh Lin)
關鍵詞 Key words : COVID-19疫情 ； 兒童青少年熱線 ； 行動研究 ； COVID-19 pandemic ； youth hotline ； action research ； counseling
P.63 - 84
Purpose: Schools across Taiwan suspended classes during the level 3 alert of the COVID-19 pandemic and mental health services at health facilities were reduced. A group of 33 licensed clinical psychologists co-organized a toll-free counseling line for youth and their parents in cooperation with the Education Bureau of the Taipei city government to provide services to relieve students' stress and anxiety during the pandemic. The purpose of this article is to document the level of need for this service and its implementation process, and to investigate the impact of the service from a scientist-practitioner perspective as a reference for similar toll-free lines in the future. Methods: The 33 clinical psychologists counselled and interviewed callers using a questionnaire and entered the information into a google form. The questions concerned age, gender, chief complaint, parent-child interaction, characteristics of the child/youth, and the relationship between the child's emotional or behavioral disturbances and the pandemic. Before and after this conversation, they asked callers to indicate from 0 to 10 their level of stress with regard to their chief complaint. After the initial stage of hotline implementation, it became clear that the number of clinical psychologists providing services was more than needed for the number of callers. We explored the supply-demand imbalance using the action research technique of discussion through a cycle of reflection, correction, observation, evaluation, and re-correction. Results: The psychologists responded to 103 calls with complete consultation records. Of these, 33 were youth, 39 were parents, and the remainder were teachers or other adults. Forty-three were repeat callers; 18 had 2 conversations, and 25 had 3 or more conversations. According to mean difference tests, both initial and follow-up interviews showed a significant decrease in the stress evaluation rating provided before and after a given interview. Examination of changes in parent-related factors such as parenting distress, lack of confidence, and difficulty setting boundaries suggested that telephone consultation can promote parent-child communication and parenting skills. Three adolescents' had extended episodes requiring repeated follow-up care to stabilize them. They were eventually referred to a community psychotherapy center or their school's services. We addressed the supply-demand ratio for the hotline using action research techniques. Initially, the hotline used a landline that could not accept calls from cell phones. Lack of privacy prevented teens from using the hotline at home, and some parents resisted access to counseling resources. We added Skype access and invited teachers to consult the hotline before referring parents. We also reduced the number of psychologists on call to 1 per shift. The psychologists reported that they learned how to adapt their practice to the context of telephone consultation in which they have no visual cues to guide their responses; they learned to increase their attention to audio cues such as the caller's tone of voice, intonation, or delay in response in order to assess the caller's emotional state. Most of the psychologists (85%) expressed that this experience was helpful to their professional abilities. Conclusions: This project provided mental health services for teenage students and their families. It was effective in reducing perceived stress and improving parent-child communication, which can have a positive effect on children's emotional behavior, and may have prevented mental health crises for some adolescents. Participating psychologists also found the program to be professionally beneficial. Action research indicated ways to improve the service and balance supply and demand for this hotline.