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"Are you a robot?" A discourse analysis of rapport-building in online crisis chats from a suicide prevention centre Timm, Maria

Abstract

Despite an increase in the use of online crisis counselling services, little research has been conducted on how the therapeutic relationship is negotiated online. The prevalence of suicide in Canada as well the established importance of the therapeutic relationship when working with suicidal individuals led to the development of this study. The current study consisted of a discourse analysis of client-counsellor interactions in online crisis chats with individuals who reported thoughts of suicide. Data sources consisted of 24 transcripts obtained from two online crisis services: one for youth, one for adults. Of these, 16 were considered rapport-containing; eight were considered non-rapport-containing. Chats were separated into three phases: Initial Contact, Suicide Assessment, and Termination. Content analysis followed by discourse analysis found that, in the first two phases of the rapport-containing chats, the client tended to express a dialectic of wanting help and simultaneously feeling hopeless and of a person with a story to tell, and the counsellor positioned themselves as an empathic witness to the client’s narrative. The client-counsellor relationship in Phase 1 was characterized by themes of informality and equality/mutual respect. Main relational themes in the Suicide Assessment phase were client/counsellor collaboration and counsellor authenticity. In the Termination phase, main relational themes included shared humour, counsellor self-disclosure, and client trust. In the non-rapport-containing chats, in the Initial Contact phase, the client positioned themselves as a consumer of services and the counsellor positioned themselves as a service provider. The client-counsellor relationship in this phase was characterized by client frustration and counsellor helplessness with respect to the client’s unmet needs for counsellor directiveness, authenticity, and self-disclosure. In the Suicide Assessment phase, three main relational themes were found: client-perceived circularity of the conversation, feeling misunderstood, and feeling unheard. In the Termination phase, chats were frequently ended abruptly by the client, and the predominant theme was one of client rejection of the counsellor. Across all chats, client-perceived mattering (or lack thereof) was an observed theme. The results have important clinical implications for those working with suicidal individuals online.

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Attribution-NonCommercial-NoDerivatives 4.0 International