Making ‘Online Counsellings’ Through Policy and Practice: Multiplicity, Friction and the Potential for Advocacy

• In Event: ‘Evidence-making Intervention’: Transforming Implementation Science 2

Abstract

Online counselling services for a range of health conditions have proliferated in recent years. However, there is ambiguity and tension around their role and function. In line with recent critical analyses of policy and interventions, in this paper we take an evidence-making intervention approach to examine how online counselling is made in policy and through processes of local implementation. Specifically, we analyse how online alcohol and other drug counselling interventions and knowledges are enacted in Australia’s drug policy, and compare these enactments with an analysis of information about, and data from, Australia’s national online alcohol and other drug counselling service, Counselling Online. We suggest that while the policy enacts online counselling as a brief intervention targeting alcohol and other drug use, and as an avenue to facilitate referral to face-to-face treatment services, in its implementation in practice online counselling is enacted in more varied ways. These include online counselling as attending to alcohol and other drug use and interconnected psychosocial concerns, as a potential form of treatment in its own right, and as supplementing face-to-face treatment services. Rather than viewing online counselling as a singular and stable intervention object, we suggest that multiple ‘online counsellings’ emerge in practice through local implementation practices and knowledges. While it is important that policy makers, clinicians and researchers acknowledge the emergence of, and frictions between, multiple intervention objects in policy and practice, we also reflect on the potential for ‘evidence’ of this multiplicity to be used by services to advocate for greater funding.

Authors

• Michael Savic, Monash University

• Ella Dilkes-Frayne, The Australian National University

• Adrian Carter, Monash University

• Renata Kokanovic, RMIT University

• Victoria Manning, Monash University

• Simone N Rodda, University of Auckland

• Dan I Lubman, Monash University