Research Discussion Paper
April 2011 number 7
Telebefriending and telephone support services for people with sight loss
Summary
This publication:
§ summarises the lessons learned from some services that offer telebefriending to people with sight loss
§ looks at the attitudes of service users, volunteers and staff towards telebefriending
§ describes the challenges and opportunities facing this kind of service
§ highlights issues relevant to commissioners and providers of services
§ suggests future research questions, including
─ can telebefriending reach people who do not currently use any support services?
─ what are the relative merits of individual telebefriending versus group phone calls? Do different circumstances suit different approaches?
─ how can services maximise the potential to use people with sight loss as volunteer telebefrienders?
─ how should telebefrienders and service users be matched?
─ how can telebefriending offer a culturally diverse service?
─ how do volunteers experience telebefriending? And how do those experiences differ from other volunteering opportunities?
Introduction
The term ‘telebefriending’ usually applies to one-to-one social telephone conversations between a person who may be socially isolated, for example because of sight loss or other concurrent health or care needs, such as limited mobility, and a trained caller – usually a volunteer. Some services also support group telephone calls where several people take part in a conversation at the same time.
Telebefriending was developed as a response to needs for social support and interaction among people who have difficulty getting around, or are unable to take advantage of social situations, or who are isolated from others with similar experiences. Telebefriending may be seen as an end in itself – providing social interaction and networks on the phone – or as a tool to enable access to other resources, or as a mix of both.
Background and context
The publication is informed by research on telebefriending conducted on behalf of Thomas Pocklington Trust by Annette Roebuck and Dr Guy Daly from the Faculty of Health and Life Sciences at Coventry University. This included a series of internal reports from a feasibility study, and planning and evaluation of a pilot telebefriending service.
It also draws on:
§ The report entitled ‘A Review of Home Care and Support for People with Sight Loss” carried out for Thomas Pocklington Trust by Andrew Gibson, Janet Read and Gillian Lewando Hundt of the University of Warwick
§ Thomas Pocklington Trust Research Discussion Paper 3: Volunteering with Visually Impaired People January 2007
§ RNIB Talk and Support – a service offering telephone social groups
§ Information from various national and local telebefriending services (not all for people with sight loss) and from the Mentoring and Befriending Foundation (MBF).
A range of telebefriending services exists for people with sight loss and other conditions. In some areas, local societies for people with sight loss offer such a service. Other organisations that also offer telebefriending include:
§ Deafblind UK, which provides a service for all members who can use a conventional telephone, and intends expanding the service to communication methods such as minicom. The service offers members a once-weekly chat, particularly in areas where home befriender volunteers are not available.
§ The Good Morning Project in Glasgow, which provides daily telephone befriending to over 300 vulnerable adults and alerts nominated contacts or the emergency services to potential health problems when the call remains unanswered. Many of the project’s clients have sight loss and a few are registered blind.
§ The Pocklington Resource Centre in Balham, South London, which piloted a telebefriending service for people with sight loss living in the London Borough of Wandsworth. The pilot was designed to offer short- and long-term as well as temporary services in response to individual needs. Trained volunteers made calls from the Resource Centre on one day each week. Examples of group telebefriending services include the following:
§ RNIB Talk and Support provides weekly telephone social groups to adults with sight loss across the UK. Volunteers offer a mixture of telebefriending and structured support sessions about welfare benefits and other relevant issues.
§ Independent Age runs a service called Live Wires, bringing together like-minded people to discuss books, radio plays and other topics of interest over the telephone. People with sight loss can take part as they are supplied with audio- or large print books.
§ The ‘UBS Telephone Buddy’ links volunteers and service users over the phone. Volunteers create a new pathway to services and to support that is often needed in an emergency.
§ Community Network supports telephone groups (and one-toone telebefriending) for people who are isolated. An example is Seafarers Link, a telephone friendship and support group linking retired seafarers across the UK.
As this list shows, telebefriending services may be aimed at particular groups of people, including people with sight loss, or to those in a particular area, age group, or with particular interests or experiences. All of them aim to enable service users to increase social contacts and reduce feelings of isolation. Telebefriending is appreciated by people who have some hearing loss, provided that they can use appropriate amplification aids and the telebefriender has good communication skills. For some organisations, telebefriending is a way to keep in touch with people they cannot visit: Friends of the Elderly provide such a service for the older people they support through their benevolent arm. Telebefriending is also used to support carers who find it difficult to leave their home, to provide support and mentoring to young people and to bring people together who have similar long-term conditions. Not only do telebefriending services vary in their aims and purposes, but individuals also vary in the ways in which they use them. While telebefriending is, above all, a means of enriching social life, it can also be used to provide information on services and facilities that people with sight loss might otherwise miss, particularly if they do not use the Internet or do not have regular contact with people who are likely to pass on information.
Experiences of telebefriending
Evaluation of Thomas Pocklington Trust’s pilot service in Balham showed that staff, service users and volunteers all welcomed the telebefriending service, though they had slightly different interpretations of its aims and purpose. Staff mainly saw it as a means of exchanging information, providing social chat, helping non-Internet users to find information, providing informal emotional support and giving news about local services. Service users and volunteers mainly saw it as a means of increasing people’s confidence, decreasing social isolation and offering informal emotional support. Such variation is likely to be common in other services.
Experiences of service users with sight loss
People with sight loss use telebefriending for different reasons and generally value the service. Pocklington research shows that people with sight loss report the specific benefits of telebefriending as follows:
§ Telebefriending reduces loneliness and isolation by putting people in touch with each other so they can enjoy conversation on subjects of common interest. For some people, this is their main or only social conversation. For others it is an additional pleasure and an added social contact.
§ Telebefriending increases social inclusion, helping people feel more connected to their community.
§ Telebefriending gives people with sight loss a social structure and something to look forward to; even a short call can make a real difference to their sense of well-being.
§ Telebefriending sometimes helps people feel safe, because they know someone is taking an interest in their physical and mental well-being.
§ Telebefriending can encourage people with sight loss to make use of other support/services, by providing information about these services, and through direct contact with people who have knowledge of local services and/or people who have used them.
The factors which may influence service users’ experience of telebefriending include:
§ Compatibility. Matching the interests of service users and volunteers makes shared interests more likely; but to some service users this matters less than a volunteer’s good sense of humour or other factors that enable people to get on.
§ The communication skills of callers. Apart from obvious skills such as friendliness, empathy and clear communication, service users want to be sure that callers will make it clear if they are unable to call at an agreed time and, in certain situations, to provide access to other, specialised, support.
§ The gender of callers. The Balham service users who indicated a preference for the gender of the telebefriender requested a female regardless of their own gender. The rationale for this included perceptions that females were generally better than men at communicating and understanding the views of other people.
Experiences of volunteers and staff
Lessons from services emphasise the importance of training and support for telebefrienders. Essential elements are identified as: role play or other practical exercises that reflect the reality of phone calls, and exercises to develop communication skills that include listening and techniques for conversations where there are no non-verbal clues. More specific training includes support to recognise and respect the boundaries of the telebefriending service.
It must be borne in mind that telebefriending is not a counselling service but that elements of emotional support such as non-judgemental, active listening skills may be required.
The boundaries of telebefriending may become particularly blurred where there is a clear need for emotional support, such as after a bereavement or in a deteriorating health condition. When friendships form beyond a friendly telephone service, callers must be trained to recognise the limits of what they may offer and know how to signpost service users to other sources of support where necessary.
Callers, and especially volunteer callers, often make the point that the benefits of telebefriending are not all one-way and that they enjoy the calls. For some, telebefriending develops their skills and confidence and reduces their own isolation.
There are clear opportunities for people with sight loss to volunteer as telebefrienders to other people with sight loss, and in some circumstances such peer support may be a particular strength of telebefriending.
Telebefriending services: challenges and opportunities
Recruiting service users
Reaching people with sight loss who are socially isolated and not in touch with other services is a key challenge for telebefriending services.
To some extent this may be addressed through promotion of services and good working relationships with GPs, eye clinics, hospitals, sensory needs teams, older people’s organisations and services, and others who may be in touch with people with sight loss.
Generally, recruitment is easiest when the telebefriending provider has a strong profile and where referrers and potential users have been fully involved in planning the service.
Meeting the needs of diverse communities
Telebefriending services will wish to be accessible to as many potential users as possible. This may mean offering the service in different languages and cultures. Robust relationships with organisations that can support access to the service are likely to be helpful in understanding needs and how best to meet them.
Telebefriending services may be able to involve volunteers who speak languages other than English that are widely spoken in the service area. Services can also work to ensure that service users’ language needs are met by making links with organisations that offer support to different communities and that may themselves offer telebefriending services.
Making telebefriending available to diverse populations is not just about language, however; for many black and minority ethnic communities in the UK, English is a first language or is widely spoken. Cultural preferences, personal and community experience of using services and attitudes to sight loss are all factors that need to be taken into account when developing appropriate services. There is no substitute for listening carefully and developing ongoing dialogues with communities in order to involve them in planning how best to meet needs.
Flexibility
Telebefriending services work best when they are offered flexibly in response to the needs of service users. When services operate at limited times or only on certain days they may exclude some people.
Location of callers
Telebefrienders make calls from different locations: the organisation’s base, their workplace or home. Making calls from the organisation means staff are available to support volunteers or monitor calls. A requirement to call from the organisation may exclude some volunteers and result in a less flexible service.
Opportunities for volunteers
Volunteer telebefrienders give their time to support people with sight loss. Telebefriending offers the volunteer opportunities to gain confidence, use and develop skills and experience, and to develop social networks. It can offer opportunities for volunteers with sight loss to support others, offering mutual benefits to volunteers and service users.
Issues for providers and commissioners
To make services effective and efficient, providers and commissioners should consider the following issues:
§ The referral pathway
Defining who can make referrals to a service is important. If partnerships with other organisations are needed, these take time to develop, particularly if partnership working around sight loss is new. Encouraging referrals will require the provider to have a reasonably high profile in the local area.
§ Time for service development
Funders of new telebefriending services should aim to support services long enough for the service to become established. Experience shows that telebefriending services are not fully used in their earliest stages; as local knowledge increases so does use. There is a risk that short-term and pilot projects may not have time to reach their full potential before funding ends.
§ Models of services
Different models exist and appear to be effective in different circumstances. Limited evaluation means that selection of an appropriate model should be based on clear definition of the aims of the service, who will be eligible to use it, the terms on which volunteers and / or paid staff are to be involved and the extent and frequency of the service that is sought or can be sustained. Achieving congruency between the aims of commissioners and service providers is essential.
§ Confidentiality
Service users, volunteers and staff all need a clear understanding of what confidentiality means within the telebefriending service. A written confidentiality policy should be in place from the outset to guide staff and volunteers.