Interview with Tanuja Babre
Deepika: In our last episode we spoke to Aparna Joshi and Tanuja Babre from iCALL, a telephone and email based counselling service run by the School of Human Ecology, Tata Institute of Social Sciences in Mumbai. They spoke extensively on their observations on the nature of distress often seen within cities and how their initiative was strategising to understand and respond to it.
We also spoke to Tanuja, who is a professional counsellor, about the people behind the helpline. Who picks up the phone when any of us calls in distress and what does it take to be a good counsellor?
In our extra today, Tanuja explains the inner workings of iCALL and explains what goes into running a professional psycho-social helpline.
Tanuja: We do an interview, they have to apply through the positions. Then a basic screening happens where we only look at MA in Clinical or Counselling. Post that there is a telephonic interview that happens. If you clear the telephonic interview you have a face to face interview. If you clear that, there is a mock call that you have to go through. If you clear all of those, you get recruited.
To test skills… because people have not been trained at that point there is no specific skills we are looking at. We are only looking at process skills, use of basic validation, rapport building, normalising the client’s concern, not saying anything problematic. Say if it is a person who is saying so I think I like someone who is my gender but it is wrong and can you help me fix it. So no moralising, advising, or solution giving. So we keep a look out for that. And if the person is able to do that and contain the emotion the person is bringing up, then mostly the person is recruited.
There are two male persons and 12 female counsellors. When the counsellor is new, at that point of time all their calls have to be debriefed within the team. There is a two to four overlap where all their calls, emails and chats have to be debriefed. Over a period of time what happens is if any key cases are going on that are debriefed, the team discusses how to handle this, how to respond to this. Any challenging cases. Then there is one-to-one supervision which is available whereby each counsellor is expected to seek supervision from a person who is dedicatedly offering just supervision on a regular basis. On a weekly basis at least. Apart from that there are multiple other things in terms of there is a buddy assigned. Each person will have a buddy assigned. If I am a junior counsellor, a senior buddy counsellor is assigned. The senior counsellor also oversees my work, how I am documenting, how I am taking the calls.
So your day starts with; there are two shifts, 8-4 and 2-10. Your day starts with once you come in to the shift, you have look at the software to see what are the calls that have come in the last time you left office. Primarily if there are any key calls that we have identified as call backs which have been set with the client, which we identify as crisis cases whereby there might be harm to self or others; or a person who might have scheduled an appointment and is going to call back, so i’ll definitely go through their transcripts so that in case that call lands and I take up their call.
To be honest the service starts at 8. We have a… if you call between 10 in the night to 8 in the morning, a little before.. 7.59 you’ll get an auto recorded message. The minute it turns 8 the phones start blasting in. Sometimes there are people waiting for it to turn 8 o clock so they call. The days starts with responding to whatever that comes in. To be honest there is no way of predicting what the case might be. But a lot of the times, in the morning time, there are not a lot of crisis cases because the day is just starting. The number of crisis cases is higher in the evening.
As the day progresses I offer services for the day, depending what I’m doing – call, chat, email – till 2 o clock. Then there might be debrief from 2 to 4. As the phone rings people move to continue to take calls while others are still in the debrief. From 3 to 4 I am expected to document, do the documentation. A lot of our counsellors while on the call do make notes in terms of key words or phrases or any sort of timeline the client is providing. I fill those in at this time. And four o clock the shift ends. That is how ideally it is.
The morning shift is fairly less exhausting. The call flow is lesser. The afternoon shift, even in the afternoon shift 6-10 the call flow is much higher. Because people are leaving work at that time. Counsellors are also caught up.. counsellors they have staggered lunch breaks. Everyone cannot go on lunch breaks together which are very very interesting because these are simple things which you might have in any office place because of the format you work in, you don’t have the option to take a break with your friend. So counsellors try to take breaks and go when you have lunch etc. So all that is monitored. Which also means that you are working very closely, not just physically or professionally but emotionally with everyone around you. I think the team themselves are so kind, compassionate and supportive of each other that everybody will be really mindful of everyones limitations. Say I am not feeling okay, then ten people will come and ask me what is going on. You take a break and don’t take a call at this point. Everyones also mindful of each others mental health and the mental states they might be in. If there is an exhausting call, then they might say, why don’t you take a walk for ten minutes and come back. But ideally this is what you will see going on in iCALL office, if you step in.
The people who are calling are extremely diverse. The one thing I can say having worked as a counsellor in iCALL is that you can never predict what it might be. At the same time it is really satisfying because you are connected to so many peoples narratives and journeys and part of their own growth and their own recovery. But majority of the people who are calling are from the age group of 11-30 years old. At the same time there are people from other age groups but at present 40% of our usage is from this age group of adolescents and young people. The kind of concerns people bring in is really unpredictable. Sometimes, it is really distressing even for you as a therapist to hear those narratives and be a part of those narratives.. concerns related to violence, suicidality or discrimination. Problems which might make you as a therapist feel I will contribute little to those. But at the same time people also reaching out to say you know, you gave me this homework and this is what helped and this is how I am doing. So the day might be mixed with all of these narratives but I think what is most important is that every counsellor, tries to create a space for every client whereby they can contain their emotion, they can reflect upon it, they can offer inputs to help them process, recover or help them with the goal that they came to the helpline with.
The kinds of work, this is true for any helping profession, more so for helplines, the kind of workloads they are handling is much higher than what you will see in a face to face set up right. On an average they respond to 5-7 calls a day. At least. Which could be much higher. They are not just responding to contain their emotion, they are listening to them, listening to really understand what they are saying and contributing to whatever can be done to help this person. So burnout is a very real problem.
Burnout, fatigue, maybe having days when you can’t have it or days where you sometimes might not have the energy to contain what is happening inside you, so it barely leaves you with the energy to contain what someone else might be bringing. We encourage all of our counsellors to seek therapy. We offer a self care allowance, a certain amount of money is offered to everyone on a yearly basis which subsidises counselling to them and they can go to any counsellor. We are also thinking about opening up this amount to any activity that they think helps them feel better. This is offered to anybody on an annual basis. This is not just for counsellors but research staff, admin staff, everybody is offered this amount. This is also because we as an organisation believe that therapy helps in personal journey. Apart from that we constantly keep on working with people also to understand and unpack what is reasonable accommodation. So it might be related to doing a certain shift for a certain amount of time or some time off. Or being given a certain kind of work. Being given a break from this profile. So we work with all those things.
But as a counsellor, it is also important to understand your own capabilities of what you can and cannot do. Knowing when your own resources are feeling depleted and knowing that right now is the time that I need help. Not feeling any shame in terms of accessing help for yourself. Apart from that it is very important that you create spaces for yourself where you can open up without shame, without distress and despair and talk about what you are going through which is a non judgmental space. And not only just one but you create multiple spaces for yourself which are outside of your work. Because the work itself is exhausting. So it is important for you to create your own identity outside of these spaces which make you feel rejuvenated and make you feel more like your self. And at the same time having this ethical responsibility of knowing when I need to step out. And when I am in a mental space to be able to work with a client and when I am not. That is something any therapist for that matter needs to (take into account).
Listening to peoples journey and being part of their journey is such a privilege. And a helpline such as this, to be honest I have had times when I felt like I want to call someone like iCALL but the same time, in my capacity I cannot do that. And I feel that… I might be having a bad day or a difficult day at work to be honest. So we all sit in the same room and I hear people talk to clients and it is all in the same room. And sometimes it fills me with hope and so much warmth and just listening to a narrative whereby a counsellor might be saying that treat yourself with compassion because you reached out and despite of all of this that is such a huge courage. And can you identify that courage in yourself? And this is a voice that person may not be hearing in their life otherwise but at the same time I do understand that this is one voice among 50 other voices and it might get lost somewhere. And that itself is resistance to whatever larger dominant narratives which are there around you.
Over the years I have worked with people who have been feeling suicidal and i worked with them for two days and post that they have never called back but I know for a fact that is something that contributed to their life. I have worked with people to be honest and it is very very strange… sometimes I might be at a social event representing iCALL and someone comes to me and tells me that – I have been using iCALL services and to be honest, iCALL saved my life. And from that to just knowing that we are contributing to a narrative to someone’s life to say that you are important, what you are feeling is important, what you are feeling is valid and you and I can work on this together.
We feel and find ourselves being really fortunate in being able to contribute to peoples lives. And I am saying that the first narrative is as important as this one and that is what encourages and inspires you to do what we are doing, that is what inspires you despite the exhaustion and fatigue to keep coming back and be connected to people in this way.
Outro: If you’d like to learn more about iCALL visit the website icallhelpline.org. If you would like to access the helpline their number is 022-25521111, I repeat its 022-25521111. They are available from Mon to Sat from 8am to 10pm.
To read further and access resources related to iCALL and the conversations around mental health in Indian cities visit our website http://www.thecuriocitycollective.org.
And don’t forget to join us for our next TCC episode where we shift gears to another big topic in cities – garbage – and thats how we begin our four-part series called Trash Talk!