Helping clients online and on the phone

Introduction

These guidelines are for the use of practitioners registered with the Dr Edward Bach Centre and relate to their work with the system of 38 flower remedies discovered by Dr Edward Bach. References to BFRPs (Bach Foundation Registered Practitioners) include BFRAPs (Bach Foundation Registered Animal Practitioners) unless otherwise indicated.

The pros and cons of personal consultations

In an ideal consultation we encourage clients to express their feelings naturally and in their own words. We use conscious techniques to do this – for example, the deliberate use of open questions (why, when, what, which etc.) that encourage clients to open up. More important still are those techniques we use unconsciously – the things that we have evolved to use when relating with other humans. Gesture, facial expression, the flash of an eye, build up real rapport.

Here are some of the things we do without thinking in a face-to-face meeting, which in other contexts become more difficult:

• Picking up visual clues that help us identify a client’s personality and mood
• Using visual and aural cues (head nods, small gestures, smiles, conversational noises) to encourage the client to open up
• Demonstrating with body language that we are listening and willing to hear what is being said
• Maintaining affinity by matching the client’s body posture, tone of voice etc.
• Signalling that we want to ask a question

In general, face-to-face consultations work best. But there are exceptions to the rule.

Some clients prefer the anonymity of working via email, phone or letter. Some are shy, or feel uneasy about sharing problems with a stranger. Others don’t have time to attend a formal consultation, or worry about the cost. Clients may feel more in control of what seems to be a lower-level intervention. They may prefer the convenience of getting help at once and without the need for making an appointment or travelling. Perhaps there are no BFRPs where they live.

BFRPs might also be constrained in how they work. Those of us balancing our Bach work with obligations as employees, partners, parents and carers may decide that offering a service by email or phone is the only way we can be active with the remedies. The advantages include:

• We can advertise to clients on a world-wide basis
• The amount of time spent per client can be reduced
• Contact with clients can be maintained more easily

We can offer a useful service on the phone; or online, via email or chat; or by letter. The important thing is to tailor the offering so that it replicates a normal face-to-face consultation where possible - and be aware of the limitations so that we don't take on inappropriate challenges. In what follows we look at some of the most common ways practitioners offer help at a distance and suggest ways to work effectively.

Help letters

At one time the Bach Centre received hundreds of letters every month asking for help with remedy selection. At the time of writing (2009) that flood has reduced to a trickle. Most requests for help come via phone and email.

This is a good thing. Despite being a common task on Bach Centre-approved courses, where it serves an educational purpose, answering a letter is arguably the least useful way to interact with clients. It doesn't allow us to use most of our interpersonal and practitioner skills.

If you receive letters from clients it’s fine to offer help with simple problems, especially where they concern matters of fact such as questions about your services, dosage, remedy indications etc. Any more complex query should be moved into another arena as quickly as possible. If a face-to-face consultation isn’t required or possible include your phone number or email address in your first reply. Encourage the client to move to one of these more interactive and immediate forms of communication.

Online help without advice

The simplest way to use a web site to help people is to list the remedy indications and allow browsers to make their own choices. As the person running the site you might offer to make up treatment bottles for a reasonable fee and send them through the post, but the actual selection of remedies is up to the client.

This approach is entirely in keeping with the principles of a self-help therapy. With care you can offer good, solid information on the remedies, including advice on telling apart similar remedies (Gentian / Gorse, Mimulus / Aspen etc.). People with simple problems and those with a good insight into their own emotions can select remedies for themselves without any direct BFRP intervention. The Bach Centre’s own web site uses this approach.

Clearly, though, this approach is less helpful for people who are stuck or whose problems have got beyond them.

Online questionnaires

The commonest kind of online questionnaire will have a series of 38 or more yes/no questions:

• Do you sometimes feel as if you are losing control?
• Do you feel afraid of something specific?
• Are you worried about the welfare of your family or friends?
• Do you feel panicky or full of terror?

Although this approach looks more sophisticated than a simple list of indications, it actually has significant drawbacks. Questions are closed, which discourages clients from opening out and thinking for themselves. There is usually no opportunity to explain subtle differences, so that clients may pick several remedies for something that actually only needs one. (A client in a severe Red Chestnut state could answer ‘yes’ to all four questions in our list.) The mix chosen will be less effective.

Perhaps the worst aspect to questionnaires lies in their very attractiveness. They look similar to 'a proper consultation with a practitioner' but don't reflect what a real consultation should be. If clients order the recommended mix from your site they may feel that you, not they, have made the choice. This would be unfortunate if the remedies chosen were not accurate.

Questionnaires have some value as an education tool, but the Bach Centre recommends that BFRPs do not use them to select remedies for clients. In some circumstances their use could be considered contrary to clause 5.2 of the Code of Practice.

Email consultations

Using email has the advantage of allowing the asking and answering of (open) questions relatively quickly. This means we can check our understanding of something a client has said, and lead the discussion in a way that is not really practical if we are communicating by letter.

The key to getting the most out of emails is to use open questions. A guide for new clients might say:

• Tell me a bit about yourself - your first name, age, what you do at work, your family and other relationships, health - anything you feel might be relevant
• What sort of person are you in general? - what are your likes, dislikes, hobbies? - is there anything about yourself you would change if you could?
• What's going on in your life right now? - what challenges are you facing? - how do you feel emotionally?
• What do you hope the remedies can do for you?

An alternative is to use an online form on the web site to ask the same questions, and revert to emails to ask further questions before the selection is made.

When you receive an email (or the data from an online form) it's a good idea to respond at once to say that you have recieved it, and that you will be in touch shortly. Say too that you might want to ask follow-up questions in order to make the selection more accurate.

When writing to clients follow a few simple rules to minimise the danger of being misread:

• Be polite and open and say what you mean - irony and ambiguity can be misunderstood
• If you do write something that is not to be taken seriously, use smilies :0)
• NEVER TYPE EVERYTHING IN BLOCK CAPITALS - it looks as if you are shouting and can be intimidating

We need to be conscious of the limitations of helping via email. Some clients do not express themselves well in writing. Others may hide behind the impersonal nature of email and - deliberately or unwittingly - give us a false impression.

In some situations - where there is an eating disorder, for example - the client's behaviour may be putting him or her at risk. It might be prudent here to limit your role and ensure that somebody sees the client face-to-face to make a more direct assessment. This might mean referring the client to another practitioner, or to a counsellor, doctor or other health professional.

Nevertheless in most cases email help can be effective if offered in a sensitive and non-directive way.

"One of my greatest pleasures was to help a 16 year old boy via an email consultation. He never spoke to anyone about anything before we 'spoke'. When we started he said very little but by the end he was sending me pages of thoughts. Afterwards he thanked me so much for 'listening' and reading between the lines."

- Julie Briggs BFRP

Chat and meeting rooms

Online chat and meeting rooms are good alternatives to email consultations. You can set up rooms so that you and the client are the only two people communicating, and if you use a reputable onine provider the service should be secure and confidential.

The obvious benefit to chat is the speed at which you can ask questions and receive answers - although this does depend on typing speeds. Meeting rooms often allow you to communicate using VOIP protocols similar to the Skype system, which removes this barrier. Add a webcam to your computer and you and your client can get pretty close to a face-to-face consultation.

Whatever way the first contact with a client comes you could consider moving to this kind of interaction, assuming you and your client both have the computer and broadband facilities necessary, and you are confident exploring the technology involved.

Phone consultations

Phone consultations can be a good way to mimic at least some of the interactivity and personal rapport that we expect to find in a face-to-face consultation.

As with all interventions by distance, the key to making this work is the use of open questions; and a keen sense of where your boundaries lie in terms of the kind of problem you feel qualified to help via phone.

Be careful about scheduling phone calls. Find a time where the client will be alone and undisturbed, and make a firm commitment to call at that specific time. It's a good idea to explain the duration and general content of a Bach consultation when the first call is booked - an online guide or an information sheet is one way to do this.

Some BFRPs feel more in control of timekeeping if they call the client themselves when the consultation is to start rather than wait for the client to call them. If the client doesn't answer you can leave a timed message to say you have called for your appointment. If you wait for the client to call you and she calls 15 minutes later than planned that might mean cutting the consultation short or being late for your next appointment.

When the caller isn’t the client

The difficulties involved in helping at a distance are magnified enormously when the person making the call is not the person who is going to take the remedies. The caller will usually have the best motives - but it is nearly impossible to be sure about our selections if we are not able to talk to the person concerned directly.

For this reason any advice we offer in these circumstances should be educational and general in nature. We need to be clear to the caller that we can't make personal selections for a third person without talking to them ourselves (or observing them, in the case of young children and animals). We can only ask about the situation and describe a few remedies that might be worth considering.

If the caller decides on this basis to select some remedies and wants you to confirm the choice, explain again that you can't do this without talking to the person yourself.

See also the separate guidelines on working with animals.

Disclaimer

The information here is provided in good faith but does not constitute legal advice or opinion. No responsibility will be taken by the Bach Centre or any of its agents or officers for any act or omission carried out by anybody who follows these guidelines. In line with clauses 8.1, 8.2 and 8.3 of the Bach Foundation Code of Practice BFRPs are responsible for their own actions at all times.