From April 26th through the 29th, members of our team will be in Phoenix for the 50th American Association of Suicidology Conference.
We’ll have a booth at the conference and you’ll see us at many of the events and sessions, too. It’s important to us to learn about and be aware of all the latest research and the expanding needs of helplines as they work to build suicide-safer communities.
We hope you’ll stop by our booth and let us know how things have been going for your organization, and tell us about the exciting initatives you’ve had going on. We’ll be available to answer any questions you may have about iCarol, and we’ll have some fun activities to check out that are brand new this year!
In particular we’d really enjoy hearing your feedback about the new iCarol Ideas Portal we recently released. We’re excited to hear from our users about how it’s going, what you like about it, and any other feedback you may have. So if you’ve used the Ideas Portal, we definitely want to see you!
With all the excitment and so much going on, the time at the conference goes by quickly, so please look us up at the conference, or
beforehand to schedule some time to chat so we’re sure not to miss the opportunity to see you!
We look forward to seeing you and learning about all the latest in the life-saving work being done by the helpline industry so that we can continue to build our systems to support you.
My former employer’s Executive Director used to always say that as long as people still used phones, our crisis lines would answer them, but if people used ESP to communicate, well, we’d use that too. While most humans haven’t yet figured out a way to use ESP for communication, our society is using different forms of communication and even non-communication to get information, assistance, and support.
Text and chat communication has grown exponentially across most age ranges within the past five years. On top of that, a growing trend has also arisen with the internet: self-service tools. There is a big opportunity for helplines of all kinds to use self-service tools to promote their services and increase partnership agreements.
Because we here at iCarol are committed to providing helplines and others the tools they need to reach people across multiple platforms, we created Online Forms. With Online Forms, website visitors can submit information which comes into your iCarol system as a completed report form. Since the forms are essentially a public facing version of an iCarol report form, you can view, edit, and report on the form in the same way as all of your other report forms.
Several possible applications exist for using iCarol’s Online Forms. Let’s explore two use cases:
Assessment and Program Intake
Elmdale Crisis Center (a fictitious organization) operates numerous crisis lines through various contracts with mental health authorities, public and private health providers, and local municipalities. Elmdale’s management team is looking at ways to increase contract amounts by providing additional services without adding too much burden on their staff. After reviewing their current service offerings, they found a few contract required assessments that could be offered through an additional avenue, Online Forms.
They designed the following workflow:
With this workflow, Elmdale Crisis Center can extend the service offerings of the contract with the goal of increasing the number of people who request an assessment and intake into the service provider’s programs.
Consumer Satisfaction Survey
Elmdale Crisis Center’s management team wants to capture a consumer’s satisfaction and risk levels after using their crisis services so that they can report on outcome achievements and demonstrate their social return on investment, necessary for future funding requests. They decided to use iCarol’s Online Forms so that the consumer’s responses and information comes into their system automatically and their front line staff is notified if the person submitting the form would like additional follow-up.
Elmdale placed the consumer satisfaction survey on their website and created an iCarol resource record containing the online survey link, so that their consumers can receive the link directly via a texted or emailed referral from the iCarol system. They instructed their workers to provide the survey link to consumers at the end of their conversations.
The management team designed the following online survey:
Pre-screening question – if answered “no”, visitor cannot complete the survey.
1. Have you contacted Elmdale’s crisis services? Yes/No
1. When did you last contact Elmdale’s crisis line?
- This week
- Last week
- Earlier this month
- Last month
- Longer than two months ago
2. How did you contact Elmdale?
- Other, please specify
3. On a scale of 1-10, how upset were you at the beginning of your conversation with an Elmdale crisis worker?
- 1-10 Scale
4. On a scale of 1-10, how would you rate the level of empathy and understanding the Elmdale crisis worker demonstrated during your conversation?
- 1-10 Scale
5. One a scale of 1-10, how upset were you at the end of your conversation with an Elmdale crisis worker?
- 1-10 Scale
6. Will you contact Elmdale’s crisis services again?
- Yes, definitely
- Yes, possibly
- No, probably not
- No, definitely not
7. Would you recommend Elmdale’s crisis services to a friend or family?
- Yes, definitely
- Yes, possibly
- No, probably not
- No, definitely not
8. Would you like an Elmdale crisis worker to contact you regarding this survey?
- Yes +
+ Contact Information
First Name ________________
Phone Number __ (____) ___________
Best time of day to call _______________
The versatility of iCarol’s Online Forms opens up entirely new methods for those in need to contact you. Using Online Forms provides additional opportunities to increase and improve service offerings, which can translate into more funding to support your helpline.
Do you have other ideas about how Online Forms can be used? Leave a comment below. Want to discuss some of these ideas with an iCarol staff member? Contact us.
Guest blogger Brenda Patterson is the Executive Director of CONTACT the Crisis Line in Jackson, Mississippi, and serves on the Board of Directors for CONTACT USA.
With all callers/chat visitors we practice active listening and unconditional acceptance. We try to use open ended questions when facilitating conversations and summarize the caller/chat visitor’s plan as we close the conversation. When talking to an individual with an intellectual/developmental disability there can be additional considerations. Let’s look at five:
- Person first language is a topic all by itself. Whether or not you know at the beginning of a call or chat if the individual has a disability using person first language in any conversation is important. Person first language emphasizes the person, not the disability. By placing the person first, the disability is no longer primary, but one of several aspects of the whole person. Examples include: “person with an intellectual disability,” “person who has autism,” “person who is blind,” rather than “the mentally retarded,” “the autistic,” or “the blind.” Also consider how you refer to their challenge and devices that help them adapt. Using phrases such as “person with an addiction/mental health concern” “one who uses a wheelchair” instead of “mental patient,” “drunk,” “druggie,” “invalid,” or “wheelchair bound” is preferable.
- Consider that people with intellectual/developmental disabilities often share the following thought processes:
- Difficulty with fluidity and flexibility of thinking
- A dislike of ambiguity (black and white thinking)
- Difficulty prioritizing and breaking down tasks into manageable projects
- A tendency for poor generalization skills (a person belongs in one and only one
environment and utilization of a skill in one situation but not others)
Recognize that individuals with an intellectual/developmental disability may think logically about concrete events, but have difficulty understanding abstract or hypothetical concepts. The use concrete examples when facilitating problem solving is helpful.
It’s important to dispel the myth that people with intellectual/developmental disabilities cannot benefit from therapy. In reality many different types of therapy have been found to be effective in treating people with developmental disabilities. Do not hesitate to mention therapy as an option. Although it generally takes longer for people with developmental challenges to make changes, those changes are stable once made.
Because there are higher incidents of abuse in people with any disability, the likelihood of trauma related symptoms occurring are greatly increased, which can be mistakenly attributed to the person’s developmental disability or pre-existing mental illness. Trauma responses generally represent a change from the person’s normal level of functioning.
While there are a number of additional tips to consider when talking to an individual with an intellectual/developmental disability, and there are tips which are specific to individuals with Autism Spectrum Disorder these are primary and apply to all individuals with a developmental disability.
With all callers we want to empower them to advocate for themselves and to generate their own solutions, as well as connecting them with services that can further assist them. Whether you are talking to the individual with an intellectual/developmental disability or their family, it’s important to ask if they are receiving Home and Community-Based Services (HCBS) as provided in the state they live in. HCBS provide opportunities for Medicaid beneficiaries to receive services in their own home and community. While waiting lists can be long, the services provided are invaluable and making application early in the individual’s life is important. It can mean they will have the support they need to be independent in adulthood and be happy and content in the life choices they have made.
This post was so popular, it’s found a new home on our site! Click here to read 10 Reasons to add Live Chat or Texting to your service.
Crisis Hotlines have been around for over 40 years, and so have individuals that call regularly. These types of repeat calls are often referred to as exhausting, challenging and frustrating. Viewing these calls as such can introduce the danger that someone in actual need may not receive the full benefit of the services offered. Though the caller may not be presenting a crisis at the moment, your support and empathic listening can aid in the prevention of escalating into a crisis. Often times, the callers are utilizing the same unsuccessful maladaptive coping skills to try to resolve their situation. They have most likely burned many bridges, have very little or no support from family and friends, and feel lonely and isolated. They are often turned away and told no or that nothing more can be done. It is important to remember that these callers can also experience crises.
As many centers are adopting a trauma informed care approach, the use of recovery oriented language and care is emerging. The term Frequent or Chronic caller is being replaced with Familiar or Experienced caller, to name a few.
Some centers or crisis workers struggle with setting limits and boundaries. Callers can benefit from the structure and learn to develop and rely on their own strengths. The callers are the experts on what helps them and it varies for every person.
Challenge yourself and your center to create a thoughtful approach to handling these calls, while maintaining boundaries, consistency, and setting limitations. Establish firm and consistent boundaries in a respectful manner. Some centers have time limits per call, others have limits on how many times an individual can call. Once you decide on a limit, it is important for all crisis workers to remain consistent. Create a clear guideline for crisis workers to follow. Example below:
Initial call of the day:
- Listen, reflect feelings
- Don’t dictate
- What has changed since your last call?
- What was your plan when your last call ended? Have you tried…?
- Have you followed through with your plan?
- What else can you try?
When speaking with someone who has been contacting your center several times per day, it is okay to ask the individual:
- To restate their crisis plan
- Who else can they call besides the crisis hotline?
Be cautious of providing the same intervention techniques each time, it can be beneficial to treat each call like a brand new call every time. Perhaps something has changed and what didn’t work yesterday may work today. Remember there is value in listening and acknowledging their reality. Consider what it must feel like to live with this every day.
1. Help the individual identify the precipitating event that caused them to call/chat/text. “What has happened/changed since your last call?”
2. Help the individual prioritize and stay focused. Acknowledge that it seems there has been a lot that has affected their lives. “I’m wondering, which situation is most important for you to resolve.” “What can I help you with today?” “From what you have shared, there seems to be a lot going on for you. Which one is the most worrisome for you today?”
3. It is better to interact than react. Validate that they are doing the best they can. “It sounds like you are doing the best you can. What can you try differently to cope with this?”
4. Identify coping skills. “What has helped you in the past? Have you tried that today?”
5. Help them explore new, healthy coping skills. “I’m wondering if you have thought of new ways of coping.”
6. Explore the importance of retelling their story repeatedly, “How is this helpful for you?” “What are you hoping to get from this conversation today?”
7. Empower them to work toward recovery.
8. Limit exploration of the situation and problem solving.
9. Help the caller focus on what he/she can do to help him or herself today.
10. Support the caller in developing a reasonable, specific and attainable plan. Provide additional resources, such as a warm line for support.
Other helpful statements:
“You really seem comfortable doing what you have always done, that’s more familiar to you. How would it be for you to try…”
“It sounds like you feel scared to make any changes.”
“It sounds like you have a sense of what it is going to take to change and you’re not sure you want to do that.”
“It seems discussing your past experiences are more comfortable for you than trying to make changes.”
For research on Familiar callers, please use link below for information:
Guest blogger Lisa Turbeville is Manager of the Resource and Crisis Helpline and Legal Services at Common Ground, and serves on the Board of Directors for CONTACT USA.
Mental Health America is participating in several free webinars this month.
Peer Supports for Transition-Aged Youth
Date: Wednesday April 6, 2016
Time: 2pm EDT
Transition-Aged Youth(TAY), including foster youth, youth who have been through the juvenile justice system, and youth with mental health diagnoses, have unique needs that are often unaddressed. At this crucial stage . . . Read more and register
Peer-Run Respite Programs
Date: Thursday, April 14, 2016
Time: 2pm EDT
Peer-Run Respite Programs serve as successful alternatives to hospitalization or other traditional crisis services with focuses on support, hope, and . . . Read more and register
Best Practices in the Use of Self-Directed Care to Support Recovery in Women
Date: Thursday, April 21, 2016
Time: 2pm EDT
Building relationships and support systems is an important part of recovery. Mental Health America’s highly innovative It’s My Life: Social Self-Directed Care program combined . . . Read more and register
During spring break and other common vacation periods, staff and volunteers may need to adjust the time they serve at your agency. You want to ensure that your calendar is up-to-date with all changes and the following iCarol features are there to assist.
Unregister from a shift
If a volunteer or staff member has already signed up for or been assigned to a shift, but realizes that they cannot serve the shift, they can un-register from the shift. To do so, the volunteer or staff member will use the shifts area of iCarol to navigate to the day of their shift, and will click on their name in the list of shifts. A pink box will appear to the right, and in that box, there is an “Unregister” button which they should click.
Clicking this button will remove the person’s name from the shift, and it will revert to an “Open” shift so someone else can sign up for it.
This feature is similar to the “Unregister a shift” feature, but goes an extra step and facilitates the coverage for shift assignment changes. If a volunteer or staff member has already signed up for or been assigned to a shift, but realizes that they cannot serve the shift, they can ask for a substitution. To do so, the volunteer or staff member will use the shifts area of iCarol to navigate to the day of their shift, and will click on their name in the list of shifts. A pink box will appear to the right, and in that box, there is an “Ask for Substitution” button which they should click.
Clicking this button will send an email to all users indicating that the volunteer or staff person is looking for a substitute, and will highlight the shift in yellow so it is easily spotted. If someone would like to substitute, they would navigate to this shift in the Shifts area of iCarol, and click the Accept button.
Whether or not you allow un-registration or shift substitutions, and how soon before the start of a shift a person can unregister or ask for a substitution, are settings Admin’s can control via the Shifts tab in Admin Tools.
Exceptions to Repeating Assignments
If you have members that are assigned to the same shift over a period of time, the repeating assignment is a great tool to use. This tool allows you to collectively schedule those repeating assignments and it also handles exceptions, such as to remove the person from the shift during a particular time span when they will be on vacation. To do so, use the shifts area of iCarol to navigate to the first shift within a repeating shift assignment that they would like to unregister for and click on their name. A pink box will appear to the right, and in that box, there is a link labelled “Repeating assignment” which they should click.
This will cause the following box to pop-up:
Firstly, the volunteer or staff person should click the radio button next to “Remove”. Next, using the drop-down boxes, they should indicate what time frame (every, every other, each month’s first, etc.) and what day of the week they would like to be removed from. The date next to “between” will be defaulted to the date of the shift the volunteer or staff person is adjusting. The volunteer or staff person should adjust the date next to “and”, or check the box next to “no end date” to remove themselves from every shift into the future. Finally, they should click the “Make these changes” button.
If you have any questions about these tools, please do not hesitate to submit a case to the support team via the online case management tool, found in the Help menu in iCarol.
When it comes to training our helpline volunteers we all seek the same result: success. How we achieve that success varies amongst centers. How can you improve your training while balancing the needs and limitations of your agency? Here are some key factors to consider when creating or transforming your training.
Selecting Prospective Volunteers
Volunteer selection is an important part of the process in order to determine if a prospective volunteer can be an effective crisis interventionist and is the right fit for your agency. Volunteer selection can be done individually or in a group setting. Identify the appropriate person/s to provide this, such as staff and/or current volunteers. Just because someone wants to volunteer on a crisis line, doesn’t always mean that they should. Protecting your agency, those we serve and the volunteer are all critical pieces to keep in mind. Identify individuals you feel believe in and can carry out your mission, possess the qualities and skills you find important and are trainable.
Choosing the right facilitator/s to provide the training is important. The facilitator/s should preferably have experience in crisis intervention, teaching, a strong knowledge of the material and familiarity with how the crisis room operates. You may want to consider offering opportunities to current volunteers to co-facilitate sessions.
Other important skills you may want to consider when selecting a facilitator:
- Ability to adapt and utilize different teaching and learning styles/techniques
- Ability to provide meaningful feedback
- Ability to identify individuals that need to discontinue the training
- Ability to debrief individuals, training can be intense and trigger individuals
- Possesses keen observation skills
- Professional, organized, punctual, represents the agency well
- Actively engages well with others
- Has a good sense of humor
Duration and Schedule
How long should training be? The duration of your training should reflect the amount of time needed to properly teach and prepare individuals. It may be tempting or more convenient to provide a shorter training, but that may not always be in your best interest. There are advantages to offering shorter and longer trainings. Shorter trainings may attract more volunteers because it is less of a time investment and they produce volunteers that are ready to take calls sooner. Longer trainings can provide more time to teach and develop volunteers and give you the opportunity to get to know each of them better. Invest the time; you are only as good as your training.
Give thought to the amount of time between trainings, to give your volunteers and instructor time to process what has been taught and keep them rejuvenated. Allowing a few days between training classes can be beneficial. As you are scheduling your training keep the calendar in mind, you may want to avoid scheduling your training too close to any holidays.
Make sure the training environment is comfortable. Important features may include:
- Comfortable temperature
- Comfortable chairs
- Good lighting
- Enough space
- Easily accessible bathrooms
Remember to cater to different learning styles and don’t be afraid to experiment. More agencies are offering courses on line, which can be convenient but may exclude those that are not computer savvy. However, don’t forget to offer some traditional courses in person because human contact is invaluable.
Asking volunteers to practice using their own past resolved crises instead of made up scenarios can be really beneficial. It offers them the opportunity to bond with the other trainees, see firsthand how the crisis intervention works and most importantly, demonstrates how hard it can be to be vulnerable and how brave our callers are to share their stories with us.
- Debrief your volunteers after every session
- Provide a balance of exercise, didactic and skill practice
- Ask volunteers to observe the crisis room and calls
- Provide opportunities for continuing education
- Send volunteers to workshops and conferences
- Keep the training and topics up to date
- Get their feedback and make changes accordingly
- Prepare them, but most importantly have fun
Once the volunteers complete the training, don’t forget to honor them with a graduation celebration. Certificates, awards, cake and small gifts are some nice ways to honor the graduates. You may also want to consider hosting a graduation party that includes crisis line workers and other agency staff, including the CEO.
On Friday March 11th from 12:00 – 1:00pm EST, the American Association of Suicidology will present a webinar titled “Harnessing the Presence of a Teachable Moment to Improve Care for Suicide Attempt Survivors.”
Description: The population of suicide attempt survivors treated in acute inpatient medical settings is heterogeneous in nature, ranging from those who made a near-lethal attempt with little intent to die to others treated for a serious premeditated suicide attempt meant to result in death. As such, discharge planning will vary based upon multiple factors, including medical coverage, resource allocation, and patient motivation to engage in mental health services. While patients stabilize physically, hospitals could . . . Read More
This webinar is offered free of charge to AAS members, and is just $35 for non-members.
AAS membership offers learning opportunities like this webinar, discounts on conferences, publications, and training, and more. Click here to learn more.
The success of your follow-up program hinges in part on how many contacts you can make and how much outcome data you can collect. And that is very dependent upon how many help-seekers will agree to take part in your program.
Asking a client to agree to a follow-up can be intimidating, and it takes skill and experience to ensure their participation. Here are some tips guaranteed to turn more of your inbound contacts into follow-up opportunities.
Build rapport – The success or failure of getting a caller to agree to a follow-up contact actually begins from the first moments of the call. Building rapport and trust between the specialist and help-seeker is a key component to the success of the call itself, but also impacts the chances of future contacts. If your specialist struggles to make a connection, or the client doesn’t feel heard or helped, they’re unlikely to welcome a call back. But, if your help-seeker feels connected to the call specialist and feels a sense of trust, they’re much more likely to agree to hear from your service again.
Don’t ask – One strategy that will help you get a “Yes” is to not ask them the question at all. Asking someone, “Can I call you back tomorrow?” gives them a choice of saying “Yes” or “No.” What if you make the assumption that they want to hear back from you? Instead of asking permission, try telling them you’re going to reach out to them again, and put them in position of having to refuse. Sound uncomfortable? It’s all about the delivery and can take some skill to pull off. Some example phrasing:
If done correctly, your client won’t feel pushed or pressured, they’ll feel cared for.
- “I’m so glad you reached out to us today. Hey, I’m going to call you back tomorrow just to see how things are going, what time is good for you?”
- “I want to check in and see how you’re feeling tomorrow, what’s the best number to reach you at?”
- “Just to be sure you got everything you needed, I’m going to call you back to make sure those referrals could help you. How’s Thursday afternoon?”
- “When we get back in touch to check in, what works better for you, should I text you or call you?”
- “We want to help you through this, I’ll check in again tomorrow to see how you’re feeling.”
Pick your moment – There’s no rule saying that you have to schedule the follow-up contact at the end of the interaction. If there’s a moment earlier in the call that feels right, take the opportunity then. Maybe it’s when you’re giving referral information, or at a moment when the person needs to be reassured that you truly care. If you find that moment at some point earlier in the conversation, schedule the follow-up then, or at a minimum, plant the seed, and continue your conversation. Then come back to the topic at the end of the call to remind them you’ll be following up and firm up the details.
Avoid the “S” Word – Surveys and feedback are important, no doubt, and there’s a great likelihood you’ll need to collect data from the client when you follow-up. But, there’s usually no reason the help-seeker needs to know this when scheduling the follow-up. The word “survey” can be a turn off to many people, so knowing this is expected of them may discourage the very thought of being called back. If you must give them notice of this, then the word “feedback” may be safer (e.g. We’d like to call you back and get your feedback”). If possible, don’t mention either when you’re scheduling the follow-up contact. Instead…
Make it about them – The client should feel like you’re following up because you care, because you want to know they’re okay, because you want to continue helping. This shouldn’t be hard, because of course you DO care and you DO want to keep helping! The more you make them feel like there’s nothing in it for you, and that it’s all about being there for them, the better your chances that they’ll want to hear from you again. And the more successfully you do this, the more eager they’ll be to give back to you by answering your survey questions when the time comes.
Continue helping – Speaking of what’s in it for them, don’t forget to let your callers know that they have something to gain from hearing from you again. Having the chance to talk about their situation again may be an attractive prospect. Maybe you can offer them additional referrals, or brainstorm more options with them dependent upon what’s transpired since you last spoke. If they feel like you’re an ally on this journey with them, they’ll welcome continued contact.
Give them options – Give your help-seekers options for how they can hear back from you, and consider how they reached you as a guide for how they may wish to be contacted again. Phone callers may wish to be called back, but make sure they know you can text them or email them, too, if those provisions are in place. Research conducted by Varolii Corporation in 2013 found that text messaging was quickly becoming the preferred channel of communication for most American consumers, and one in five consumers were equally likely to prefer a text message as they are receiving a voice call. Consider your client’s age as well – 36% of 18 to 24 year olds said a text message was their preferred form of communication with businesses. For help-seekers whose initial interaction happened via live chat or text, there’s a good chance they’ll reject a follow-up by phone. Convenience may be key for some clients; your ability to reach back out by alternative channels could improve the chances they’ll agree to future contacts from your service.