Supporting service users

Alcohol Concern: using Skype to deliver counselling

Over 10 million people in England drink over the recommended limit. Many people who think they might have a problem with the amount of alcohol they consume, however, would not consider visiting their GP or a local substance misuse centre because of the stigma they feel.

Charity Alcohol Concern realised that it needed to go online to talk to the growing number of ‘social drinkers’ – particularly women – who want advice on drinking, but were reluctant to consult traditional services. The Maudsley Charity provided funding worth over £48,000 to allow the organisation to develop a Skype-based counselling service. The aim was to target hard-to-reach drinkers in the London boroughs of Lambeth, Southwark, Lewisham and Croydon which the Maudsley serves.

Dry January is the starting point

For the past five years, Alcohol Concern has run a Dry January campaign, where people commit to give up drinking for the whole month. The success of that campaign, and the popular Dry January Facebook group, was the ideal starting point to launch the Skype service.

How is the service delivered?

Alcohol consultant Lauren Booker has been counselling since 2002. She says, ‘I wanted the Skype service to replicate a traditional therapy session. I use an external webcam so my client and I can maintain eye contact and I keep the environment neutral and calm.’

Privacy and confidentiality are essential too. Lauren adds, ‘We ask for minimal personal information. Even the email addresses and Skype handles used to communicate with clients are anonymised so that they don’t mention alcohol.’

Lauren asks all her clients to complete the Alcohol Concern audit tool (which is available on the charity’s website) to determine their problems with drinking. She also asks them to use an app to measure the amount they drink each week. She can then assess each individual’s alcohol intake, and work with the client to change his or her behaviour.

A client’s experience

Harry*, one of the service’s first clients, found out about the service on Google. He explains what prompted him to contact Alcohol Concern.

‘I have been suffering from mild mental illness for a while and had a fairly serious episode of mania which culminated in a lot of drinking which, of course, increased the symptoms. I decided that my drinking was perhaps a cause of other issues and that as I had been a fairly heavy drinker for a long time I made the decision to stop.

‘I contacted the service for more help, to understand theories behind drinking and abstinence, to learn coping mechanisms and to get expert advice. It’s clearly more complicated than the simple application of willpower.’

Five free 50-minute counselling sessions

The service comprises four 50-minute sessions over four successive weeks, which helps keep the client motivated. There is a follow-up three months later and all the sessions are free.

Alcohol counselling on the move

Clients appreciate the fact that there is a minimal wait time for the Skype counselling, and that they can organise the sessions to suit their lifestyle. They don’t have to travel, the service is available until 8pm during the week and on Saturday mornings, and they can even check in when they are travelling.

Harry has completed his sessions, and has not had a drink in 50 days. He says, ‘I have changed the way I approach alcohol and how I live socially so that the "alco-culture" that I was part of is avoided.’

Helping clients achieve their goals

He says Lauren’s extensive counselling experience and research-driven methodology was incredibly useful. ‘Lauren understood what I was trying to achieve and was instrumental in guiding me to put a plan in place to achieve my goal.’

Harry adds, ‘I learned how to decline the offer of alcohol, how to deal with situations where other people are drinking, and how to understand that what you are doing is something to be enjoyed and rewarded.’

Skype sessions avoid stigma and offer support

He would recommend the service to other users. ‘There is a stigma associated with not drinking and asking for perceived “help”. The Skype sessions helped me help myself and gave me support, coping tools and answers to my questions.

‘Importantly, they helped me congratulate myself for the achievements I made, and they have given me total confidence for the future. It’s easier to give up drinking when it’s seen as a positive action.’

Advice via Facebook Live

As well as individual counselling, Lauren has run Facebook Live Q&A sessions along with other alcohol consultants throughout Dry January. The popularity of the four sessions, which reached a total audience of nearly 60,000, demonstrated the interest in online advice on drinking. It also prompted some clients to get in touch for personal support.

Rolling out a nationwide service

The Alcohol Concern team and their clients are really pleased with the project’s progress. As well as serving the south east London area, Lauren says she would like to see other local services roll out similar programs, and she has developed training programs for other organisations to enable them to set up their own Skype alcohol counselling service.

*The client’s name has been changed to protect confidentiality.