Can we deliver harm reduction interventions in text mediated environments?

Two of the most important tools for anyone delivering harm reduction interventions is an ability to listen, balanced equally with the capacity to engage with people.  Effective engagement requires that we can demonstrate empathy.  In face to face interactions we demonstrate empathy through skilful use of listening, and the considered use of language.  Also essential to the building of rapport and engagement is the use of non verbal cues such as appropriate gestures, posture and facial responses.

This begs the question: Can we effectively engage people in harm reduction interventions in online text mediated environments?

The written word is not new technology

Keats series of letters in the 19th Century to Fanny Brawne ably demonstrates how the written word can express a vast range of emotions effectively.  Given this understanding we can presume that the building of rapport through expression of empathy is not only possible but may in fact be even more powerful in text mediated environments.

Text mediated interventions require skill

Just like face to face interactions, text mediated interventions require a degree of skill.   While these environments leave us without the use of many of the tools of interpersonal communication that we might rely upon in face to face interactions, there are a number of strategies that we can use in text mediated environments to aid communication.

3 communication strategies

  1. Emoticons: How many times have you read a text or instant message and been unsure whether the sender was having a go or just providing feedback? Without the context of facial cues and other non verbal prompts that aid in face to face communication, there is a capacity for misunderstanding.  The use of emoticons can help to add emotional context to a communication.
  2. Text Shorthand:  Text shorthand such as LOL (laugh out loud) is not as many would have us believe, the symptom of the declining ability of young people to read and write correctly.  This form of shorthand has become convention in text mediated environments, lending it self to a greater immediacy of communication which is important in the development of presence. Presence, the sense of closeness between communicators is particularly important in text mediated environments and crucial to rapport building.
  3. Use links:  Good harm reduction practice often requires us to provide practical demonstration of techniques and strategies.  This is often impossible in text based environments.  We can however utilise audio visual and pictorial resources to aid our intervention.  It is useful therefore to identify online resources such as websites, videos and downloadable pamphlets that can be of assistance to our work.  Bookmarking such resources allows us to quickly and easily provide links to relevant resources.


Just like face to face interactions, harm reduction interventions mediated by online text based environments requires a modicum of communication skills.  While there are definitely some barriers to communication when delivering harm reduction interventions in such environments, these obstacles are not insurmountable.  Perhaps more importantly, the use of online environments for the delivery of harm reduction interventions has the potential to reach people who may not otherwise access harm reduction services.

5 Responses to “Can we deliver harm reduction interventions in text mediated environments?”
  1. Great post, Matt.
    There is definitely a real skill to SMS, Twitter and the rest of it, ignored at your peril.
    I think your practical strategies are spot on…
    As always, if you know what you are trying to achieve, it’s much easier to get there

    • stonetreeaus says:

      Thanks for the comment Russell. Many counsellors that i have worked with in the past who have been asked to make the transition to text mediated counselling have been resistant to the idea based on the premise that you cannot engage appropriately with people online. All it takes really is some practice and adequate consideration of how we use more than just what we say to communicate.

  2. The answer is yes we can! Of course it’s not a simple translation from face-to-face to text-mediated online… but once you get used to it, netspeak is easy 🙂

    I see as an example of how text-mediated harm reduction can happen (although of course not everything on Bluelight could be categoried as harm reducing).

    • There was a discussion on a mailing list I’m part of about bluelight etc with a lot of negative talk about the sites. It seems many workers don’t get the idea that if there is bad info on a forum that maybe they should be using the forum as a place to bust myths and disinfo rather than moaning on closed lists

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