Kathleen,

I offer telephone consultations, but this is an option that seldom happens. 
Occasional interstate clients will opt for telephone, instead of Skype, and 
I have had local clients who have asked for telephone consults after the 
initial one. My process is to set a time and have them telephone me. The 
appointment is so that I can be prepared, as for any consultation, and not 
caught with my mind on some other intensive task. Having the mother 
telephone me is for the obvious reason of not wanting to be caught with 
telephone charges.

During the telephone consultation I use a client record sheet, adapted from 
my regular one, and in addition take notes to keep me focused.  One of the 
lines is for email contact details.  Storage of client records is the same 
as for my other consultations.  Telephone clients don't get a printed pen, 
which I normally give clients, but they receive relevant handout information 
by email.  I charge less for a telephone consultation, but I may reconsider 
this. It is an advantage for me that I had previous experience as an ABA 
counsellor, including telephone and email counselling, and I've presented on 
telephone counselling at conferences. This experience isn't essential and 
some tips follow.

Telephone consulting requires reiteration of questions and descriptions, so 
that the image in the mother's mind of what you are saying is the same as 
what you meant. Never be afraid to ask for clarification to be sure of what 
the mother means. Choose wording that helps build a visual picture. For 
instance, if asking about nipple damage, carefully define regions of the 
nipple, such as shaft, tip, base. The 0-10 pain scale, though not visual, is 
useful where it is relevant. Ask the mother to be your eyes if she has her 
baby at breast during the call, by asking, "Do you notice if...?" or "Tell 
me what you see your baby's jaw doing?" and other questions.

The above information is about actual consultations by telephone. I also - 
like most of you - do telephone follow-ups, and some follow-ups are by text 
message or email, when the client chooses to contact me that way. I add 
notes from the text message to the client's record, before deleting. 
Booking calls are sometimes made by text - especially when I am out-of-town! 
Clients who have moved back overseas or to other distant places can - and 
do - have follow-ups by email, text or telephone.

One of the texts for my graduate degree in counselling had a section on 
electronic counselling, and particularly the privacy issues of email, etc.

Virginia

Virginia Thorley, OAM, PhD, IBCLC, FILCA
Lactation Consultant (original cohort of 1985).
Cultural Historian of the History of Medicine.
Brisbane, Queensland, Australia.
Website: www.virginiathorley.com
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On Tuesday, October 08, 2013 4:36 AM, Kathleen Huggins wrote:
> Hello!  I am looking to find IBCLC's who have telephone practices.
>
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