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COUNSELLING IN CHINA: DR. STEPHEN PALMER INTERVIEWS WANG XINGJAUN & XIAO-MING JIA
Published in Counselling Psychology Review, 13, 2, 21-25, 1998.
Copyright, Palmer, Wang & Xiao, 1999
COUNSELLING IN CHINA: TELEPHONE 'HOTLINES' *
Stephen Palmer, Wang Xingjaun and Xiao-Ming Jia
Stephen Palmer interviews Ms Wang Xingjaun and Professor Xiao-Ming Jia of the Women's Hotline counselling service in Beijing, China.
During October 1997 I (SP) was invited out to Beijing, China to run a series of workshops and lectures on stress management/counselling and the multimodal theory of stress. Before leaving London I had read an article in a National newspaper which referred to the development of telephone counselling services in China. With my on-going interest in telephone counselling (see Palmer and Milner, 1997) I decided to make contact with Beijing's own telephone 'Hotline' as soon as I arrived in Beijing. I was hoping to interview key staff running the service. By a round about route I finally made contact with Ms Wang Xingjuan and Professor Xiao-Ming Jia from the Women's Hotline.
*Article based on an interview first published in Counselling Psychology Quarterly, Vol. 10, No. 4, 1997, pp. 473-479. Published with kind permission of the Editor.
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The Women's Hotline was started by the Women's Research Institute (WRI) which was founded by Ms Wang on her retirement. Previously she had a career in journalism working for the Xinhua Daily, Chinese Youth Daily, and the Beijing Press. After 'retirement' she has spent her second 'career' devoting herself to the cause of women's liberation in the Chinese People's Republic. Professor Xiao-Ming is also Director of the Mental Health Guidance Centre, Beijing Institute of Technology.
Initially, some commentators predicted that the Women's Hotline would not be warmly received as telephones were unpopular in the country and the Chinese, in particular the women, would not wish to talk to strangers on the telephone (see Maple Women's Psychological Counselling Centre, 1996). However, they were proved wrong and the Hotline has gone from strength to strength. In fact, between September, 1992 to April 1995, the Women's Hotline received nearly 15,000 calls. However, the service does have a number of limitations (see Appendix 1).
As my Mandarin is nonexistent this interview took a few hours. I have edited out sections where we spent time clarifying meanings of specific words or phases (Palmer, 1997).
Stephen Palmer (SP): Today, I would like to focus on a number of issues. I want to learn more about the Women's Hotline service you set up, the type of problems that your counsellors deal with, the therapeutic approach used by your counsellors, the training and supervision you offer the counsellors and finally how the West may be able to help.
When did you set up the Hotline?
Wang Xingjuan (WX): We set up the Women's Hotline on September 1st, 1992 - this was the first Women's Hotline in our country. In 1993 we opened a second Women's Hotline and Women's Expert Hotline. We are open everyday, Monday to Friday, for 11 hours for Chinese women.
SP: Why did you set up the Hotline?
WX: For the women of this country because when this country was opened to the outside world many Chinese women had to face new problems and challenges. Some lost their jobs, and the divorce rate is rising every year which means some losing their family and their marriage. They experienced many psychological problems and mental stress. We hoped to help these women. Our counsellors' slogan is:'Pour forth your troubles. We'll try our best to help you. The commitment of our Women's Hotline is to give our love, care and show our warm and sincere feelings to women of all circles'.
SP: Are the calls mainly from Beijing?
WX: Currently the ratio between calls from Beijing and the provinces is 54%:46% respectively for the Women's Hotline. The ratio of the Women's Experts Hotline is 50%:50%. This indicates that the hotline service is now being used by women all over the country. This is an encouraging development. Also, it probably reflects the rising rate of telephone installation all over China.
SP: Now that is has been running for some years what sort of problems are your callers bringing to you now?
WX: For many callers the main problem is marriage and family. The second problem is about love and the third their mental health and childcare problems. The fourth area of problems is sex and the fifth area is legal problems.
SP: In your analysis of issues raised by callers which is printed in your booklet there are three areas - domestic violence, interpersonal relationships, and family upbringing that you did not analyse early on (see Appendix 2). Why was that?
WX: Because in China we believe that men and women are equal, so we do not think that women will be beaten by their husbands. In China they do not recognise that domestic violence could be a problem.
SP: When did you start to recognise it as a problem on the Hotline?
WX: On the Hotline some callers began to discuss this problem. They said they were beaten by their husbands. We realised this was a new problem in our country so we decided to research this subject. Subsequently, over the last year we have analysed it and published our findings.
SP: Do men use the service?
WX: Yes. Generally men discuss issues about marriage, adjustment of relations with their family members, and the harmonization of sexual life between husband and wife.
SP: What problems do you have running the Hotline as a manager and supervisor of the service?
Xiao-Ming Jia (XJ): I think first of all the callers have many different problems. We talk about how these problems are common and we ask them what they want to do in the future. There are many ways to solve their problems and we talk to them about choosing the best way. We want them to choose the most helpful option so we don't tell them precisely which is the best. However, the caller wants us to solve their problem but because they only see one way to solve it they want us to give them another way.
SP: So essentially you've got conflict here because the caller wants you to give them an answer whereas the telephone counsellor does not want to provide them with a direct answer to their problem.
XJ: Yes.
SP: So the volunteer counsellors have problems too!
XJ: Yes (laughter). The volunteer wants to help the callers but sometimes the counsellor doesn't know how to help the caller. The counsellor then feels unhappy and sometimes anxious. Another problem is that sometimes the caller's problem is similar to the counsellor's own problem. This is a very big problem. So the counsellor wants help and so does the caller!
SP: So do you discuss this kind of problem in supervision?
XJ: Yes.
SP: How many of these volunteers do you have?
WX: We have trained about 150 volunteers and at the moment we have about 70 volunteers working on the Hotline.
SP: With how many supervisors?
WX: Seven.
SP: I think I'll return to the issue of supervision a little later once I've understood the approach your counsellors use. What training do you give the volunteers?
XJ: Sometimes we have a lecture. An expert counsellor helps to train the other counsellors on how to deal with the many problems. The experts come from foreign countries such as Britain, Australia, Hong Kong and Malaysia. We also have workshops to talk about the main topics such as divorce and marriage. In addition we have seminars once a month to discuss difficult cases.
SP: So they don't necessarily have intensive training but regular lectures and seminars.
WX: Yes.
SP: What theoretical approach to you teach the volunteers?
WX: Our volunteers need the skill to answer questions. For example our volunteers will answer any question about maternal health, legal matters, marriage, some about HIV, they ask a whole range of questions so our volunteers must know everything.
SP: So it's a very practical approach providing information on a range of topics.
WX: Yes.
SP: If someone rings up who is feeling suicidal how do your volunteers help them?
WX: This is a very difficult problem. But the number of callers like this is not very big.
SP: I would like to clarify this issue. If a caller telephones in with a marriage problem or a work related problem they don't say my big problem is depression or anxiety. They would say that they have a practical problem.
WX: Yes.
SP: It might be an idea if we take a specific example. Let's say a woman has rung in and told the counsellor that her husband abuses her or beats her and asks what she should do - How would you help?
XJ: First we ask the caller what they are feeling. We give the caller a long time to talk about their problem. We think this is very important. Usually the caller hasn't spoken to anyone else about this problem.
SP: They don't share it with anybody not even their family.
XJ: No. They are very ashamed about their problem. They don't like other people to know about their problem. So they have many pressures and they keep them inside. They don't have a chance to speak about their feelings so we give them a chance to do this. If a woman rings in and says that her husband beats her we ask her what has happened. Sometimes they explain they have fought with their husband and they can't resolve the problem and they want to know what to do. So we tell them that if they want to do something have they thought about the consequences - what would be the result? For example if a woman leaves her husband she may lose her home and may face a very difficult future. We would ask the caller lots of questions about her social support and resources. On the other hand, inner resources are also important. As the caller discusses her problem we hope she will gain inner strength too.
SP: It sounds as if you are taking a problem focused or solving approach to counselling once you have explored how they feel.
XJ: Yes. That's it.
SP: Is the counselling on-going?
XJ. Yes. Sometimes the caller rings back when she knows the counsellor will be staffing the hotline and continues the conversation.
SP: Are there any long term training courses for counsellors in Beijing at for example Certificate, Diploma or Masters levels at Beijing University?
WX: Some. At Beijing University on psychology but only a few.
SP: Are they taught counselling and therapy on the psychology
courses?
XJ: Yes.
SP: Do they get any counselling skills practice on the courses?
XJ: Very little. Lots of theory but they don't learn how to do it.
SP: I think I now have a better understanding of the hotlines' approach and the training available in Beijing.
I would like to return to our earlier conversation about supervision. Your literature suggests that the supervision focuses on monthly seminars and lectures. What else do you discuss in supervision?
WX: In some cases we discuss how to answer the questions asked by the callers. Also we look at particular case studies in more depth.
SP: Is it one-to-one supervision or is it in a group?
XJ: A group of about thirty to forty counsellors with one supervisor.
SP: I would imagine that there are lots of questions and problems to deal with in the supervision session. How much time is devoted to the session?
XJ: Three to four hours.
SJP: Is this sufficient time?
XJ: Not always.
SP: Apart from the supervision process, how do you monitor the standard and quality of work of the volunteers?
WX: The supervisor listens in to the call and writes down her answer and response. It wouldn't be good if the volunteer was heard to speak to the supervisor while on line to the caller.
SP: I would agree.
XJ: Two counsellors may also work together - one answers and the other writes down the case notes. Sometimes in supervision we role play too. This helps us to learn from each other's experience.
SP: What sort of resources do you have to run the Hotline?
WX: We have to rent the house, we have to employ managers, we need to have computers to analyse all our calls. Our big problem is getting money.
SP: Do you receive any government funding?
WX: No. We have to rely on foundations both in this country and abroad. For example, the Ford Foundation has helped us. We hope to do many things but of course without money we cannot.
SP: What other things would you like to do?
WX: We would like to help the battered women in the countryside. They need to learn how to protect themselves legally. We need to train the police and government officers to protect and help battered women.
SP: This would need a fair amount of funding. In what way can the West help you?
WX: I hope the West will be able to help train our volunteers and our supervisors to improve the quality of counselling. Secondly an exchange of experience because in our country right now we have over a billion people so I would like to ensure that every province in China has a Women's Hotline. We have 31 provinces and there are local women's hotlines in Shaanxi, Shenyang and Shanghai. In 1996 we trained counsellors from nine cities and provinces and achieved great success. With our existing number of hotlines callers sometimes ring for two weeks and can't get through so we need more lines. More funds would mean more lines. Although the caller pays for the call we have to rent the house and telephones.
SP: There have been many changes in China during the 1990s. How have they affected the demands upon your organisation.
WX: Before the reforms and opening up to the outside world all women had jobs but now many people have lost their jobs and they are old. Women face many new problems now, as their economic position changes. We hope the Hotline will help women become more confident.
SP: I would like to thank both of you for taking part in this interview and for being so patient with my poor Mandarin.
Additional Facts: China has a population of around 1.237 billion of which women make up 592 million or 49.1% of the total.
References
Palmer, S. (1997). Telephone counselling in China. Counselling Psychology Quarterly, 10, 4, 473-479.
Palmer, S. and Milner, P. (1997). Help on The Line: essential skills for listening and communicating by telephone. Cambridge: National Extension College.
The Maple Women's Psychological Counseling Centre, (1996). Women's Hotline, Expert's Women Hotline: An Introduction. Beijing: The Maple Women's Psychological Counseling Centre.
Acknowledgement: We would like to thank Maggie Palmer for her assistance in facilitating this interview and working on the manuscript.
Correspondence:
Dr. Stephen Palmer, Centre for Stress Management, 156 Westcombe Hill, Blackheath, London, SE3 7DH.
Ms Wang Xingjuan and Professor Xiao-Ming Jia,
The Maple Women's Psychological Counselling Center, The Women's Hotline, No. 127, Di An Men Dong Da Jie, Beijing, China.
APPENDIX 1
Limitations of the service
The Hotline service recognises that it has five key limitations (adapted The Maple Women's Psychological Counselling Centre, 1996:6):
1. Time limitation: The Women's Hotline has two lines in operation, yet many telephone callers complain that it is difficult to get through. As the Women's Hotline serves women nationwide and there are so many advice-seekers, they are unable to service their needs.
2. The Hotline can only offer a general service of 'psycho-counselling' to those who have general psychological problems, but it can do nothing for advice seekers who have a psychological disorder.
3. The Hotline is unable to undertake follow-up activities or give continuous guidance. As the principle of secrecy is advocated, the counsellor does not ask the name and address of the caller, therefore no further contact can be made after the caller hangs up.
4. Limitations of area: As telephones have not reached every part of China's rural areas, there are few calls from 'peasant women'. The Hotline mainly provides a service to urban women, and 80% of calls come from large and medium sized cities.
5. Limitations of the abilities to help: They are unable to give assistance to a women wishing to be transferred to another post or helping those made redundant to become employed.
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