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.
More than a decade ago when iCarol was first created by two helpline volunteers, Neil and Jackie McKechnie, helpline work was very much based in serving people via the phone. And the phone remains a method of communication to this day for helplines all over the world.
Over the years though, as new technologies grew in popularity and availability, people increasingly turn to channels like chatting, texting, or connecting with services through websites. And helplines need to embrace these new channels to stay relevant and reach more people. The flexibility in iCarol enables helplines to capture important information regardless of the type of contact — our Call Report Forms are used to collect data on interactions, whether they happen over the phone, online, via text, or even at in-person visits from mobile crisis teams or walk-in clinics. But some of the verbiage inside iCarol still centers around calls as a primary service, like the main Calls page, Call reports, and Caller Profiles.
We know that many helplines have expanded services beyond the phone, and that iCarol plays an important role in your documentation of all channels. For that reason, we are considering a name change for the “Calls” section of iCarol to better describe what you do and how you use these features. Please take 2 minutes to give your input about this by taking a brief survey.
In the wake of Hurricane Matthew, many states in the southeastern United States faced destructive damage including massive flooding.
Here’s the latest from our friends at 2-1-1 in North Carolina:
NC 2-1-1 Provides Resources to NC Residents Affected by Hurricane Matthew NC residents in all 100 NC counties can dial 2-1-1 from any phone 24/7 for resources
Raleigh, NC – NC Emergency Management has asked NC residents affected by Hurricane Matthew or those wishing to help with disaster relief to dial 2-1-1 for storm related resources. Residents in all 100 counties can dial 2-1-1 from any phone to reach a trained call specialist who can help them find shelters, and learn about evacuation routes, find help with storm clean-up, locate food, water and ice, learn more about volunteer needs and more. The service is available 24/7 in any language and callers will always be connected to a live call specialist trained to assist during disasters.
NC 2-1-1 call specialists are in contact with emergency management personnel and have the most up-to-date information on storm related resources, both during the storm and after. Call specialists can provide evacuation and shelter information, help people find food, water and ice distribution points and storm clean-up information and help, and help people find storm related clean-up help. Call specialists also have information about volunteer and donation needs and can provide that information to callers wishing to help those affected by the storm. NC residents should dial 2-1-1 or 888-892-1162.
In addition to disaster related calls, NC 2-1-1 can help NC citizens find resources for other health and human service needs, such as food, housing, assistance with utilities, job training, information about health care providers, and more year round. All calls are confidential and the service is offered at no cost to North Carolina residents.
NC 2-1-1 is provided to residents in all 100 North Carolina counties by United Way. The service is free, confidential, and available 24/7/365 in any language.
NC 2-1-1 staff shared with us that amidst the challenges of the situation, their service is standing out and being recognized by leadership throughout the state for their availability and outstanding service to their community. The system has proven itself to be a great tool to help citizens in need, and the people reaching them are feeling comforted, and pleasantly surprised, when they reach a live person.
We received a nice note from them in the aftermath of the storm:
“iCarol has served us incredibly well and I am so pleased with how easily I can pull the statistics I need. A big thank you to Mary for helping me pull those saved chart templates together Friday afternoon. The leadership at emergency management has been so impressed with the kind of information we can provide to them with just a few key strokes.” – Heather, NC 2-1-1 Statewide Strategy Director
We’re honored to be NC 2-1-1′s choice of software providers and we’re glad that iCarol has been an instrument to help them help people and produce important data for emergency management personnel, while reducing stress on their staff. Our thoughts continue to be with them and with all the people in the southeast US affected by Hurricane Matthew.
According to Larry C. Johnson’s Eight Principles of Sustainable Fundraising, few non-profit organizations see their donors as investors. Often times a non-profit will focus on events where donors get some kind of premium for their one-time donation. Johnson ask us to re-imagine this — to move from a transactional construct to one that is more relational. When we ask people to give, we are inviting them to partner with us, to share in our vision and support our mission and programmatic goals. Before any event we should be asking: Does the event fit in with our mission? Is it worth the time, volunteer and staff effort, and upfront costs? How will we continue to engage our donors afterward? Regardless of the event, be it outreach or fundraising focused, it’s helpful to have a donor management system in place beforehand, to capture data and continue engagement post-event.
My center, the Idaho Suicide Prevention Hotline, has held multiple fundraising and outreach events — a concert with an out of town performer who’d played previous benefits for our local NAMI chapter; a semicolon tattoo event — almost 100 people got permanent ink of henna tattoos that evening; hosting the film “The Mask You Live In”, a documentary about the risks of toxic masculinity, at our local art house theater; and a golf tournament this summer.
We have learned that the best fundraisers are the ones with the lowest initial overhead and the least amount of logistical work!
We have learned to not be too attached to dollar amounts, but to see these events first and foremost as outreach and volunteer engagement/recruitment opportunities. The concert required the most work and capital outlay, and we just broke even financially. We saw it as an overall success as the press surrounding the event did a lot to raise awareness of our service, and bring more prospective volunteers through our doors. The tattoo and film fundraisers were fairly easy to stage, cost relatively little up front and raised decent money between them. Finally, our golf fundraiser was hosted and staged by a person who had lost a family member to suicide some years prior and approached us with the offer.
We also held an outreach event at a local arts festival where we created “listening stations” (booths with hard wired phones inside and out). One trained volunteer inside each booth played a caller with a thought provoking but non-suicidal/ on-super acute crisis story to tell. We asked participants to pick up the phone and simply listen, while our volunteers, in role, shared their stories. The volunteer then thanked the participant for listening.
With the exception of the concert, our goal with each of these events is to have them be, if possible, “The First Annual…” which lowers the logistical bar for us for next year, and starts to build culture, community and history around each event, both within our shop and in our larger community.
Get creative! Ask your volunteers, staff, and local community members for ideas that fit with your mission! Most of all, have fun with it. Treat your volunteers, staff, and participants well, make the most of community engagement opportunities presented, and keep up the dialogue with all of your new and existing partners/ investors! If you are considering a semicolon tattoo event, keep in mind that an organization called Project Semicolon has trademarked some of the associated imagery and verbiage. We reached out to them and got permission in writing before moving forward with the event.
Guest blogger John Reusser is Director of the Idaho Suicide Prevention Hotline, and serves on the Board of Directors for CONTACT USA. John is also a member of the Idaho Council on Suicide Prevention, a board member of the Livewilder Foundation, and Certified ASIST (Applied Suicide Intervention Skills Training) Trainer and a licensed Designated Examiner.
Ontario Online and Text Crisis Services program (ONTX) recently marked a year of service to their communities, and shared data with constituents in their latest newsletter. In the report they describe response to the program as “overwhelmingly positive” while allowing contact with many individuals who otherwise would not have reached out for help.
Some key findings:
Total chats and texts: 8,921
75% of visitors were under 24 years old, while that same demographic makes up a very small portion of their phone callers
Over 200 specialists trained to take chats and texts
They receive an average of 5 suicide-related contacts each time the service is open
More than half of visitors said that in the absence of an online emotional support service like ONTX, they would not have spoken to anyone about their problem
For a full look at the released findings click here, or read a summary here. Want future updates from ONTX and other services of DC Ontario? Be sure to sign up for Distress and Crisis Ontario’s newsletter by emailing your request to .
We’re thrilled by the success of our friends at ONTX, though it comes as no surprise to us that they’ve had this response. The caring people at the Distress and Crisis Ontario have been providing listening support and crisis intervention to Ontario for nearly 50 years. Their latest step to make their services available in a way that works for everyone in need demonstrates their commitment to helping people and saving lives.
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
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:
Peer Supports for Transition-Aged YouthDate: 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 ProgramsDate: 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 WomenDate: 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
Right now the information and referral industry is in the midst of transformation. In a time where there are varying challenges facing our communities, help-seekers need the expertise and hands-on guidance of information and referral specialists now more than ever. And, in an ever-evolving mobile and connected world, consumers are hanging up their phones in favor of the convenience of communication via texting, live chat, and simply finding the right resources on their own via the web. Meanwhile, stakeholders desire access to data about the needs of the clients served by helplines, the efficacy of the services, and the gaps between human needs and the availability of services to meet them. These changes, and the need to adapt to them in order to stay relevant, can understandably overwhelm members of the industry, from visionaries and leaders to helpline staff.
Coming from helpline backgrounds ourselves, we’ve always been passionate about creating tools that make helping people even easier. We want to share our insights with you, and that’s why this year we’re holding a special day long intensive training summit just before the AIRS conference in St. Louis. Whether you’re a long-term customer or are considering iCarol for use in your I&R center, please join us to focus on best practices using iCarol, led by our staff of Certified Resource Specialists. Focused on 2-1-1 Directors, Call Center Directors and Resource Managers, you’ll learn about:
Strategies for getting the most out of the software
Cases studies from our clients using iCarol for innovative solutions
Serving clients by phone, web, chat and text in one integrated system
Applying the AIRS Standards and using the taxonomy well
Advanced training on existing iCarol features and a peek at features coming soon
This day long event will be conveniently located at the same hotel as the AIRS conference, and lunch will be provided.
We’d like to introduce you to an extremely versatile new feature with tons of potential uses: Online Forms. Watch our short video for more information, and contact our support team with questions or to get started with a trial.
Interpersonal and mental health issues were the most common topics of discussion
Visitors are reporting a decrease in distress following their chat
55% of visitors said they wouldn’t contact someone else if they couldn’t reach ONTX
For a full look at the released findings click here, and for future updates be sure to sign up for Distress and Crisis Ontario’s newsletter by emailing your request to .
We thank them for sharing these findings — we are often asked by others looking to add online emotional support to their service what they can expect. Data like this is very helpful as other prepare to make the critical shift of bringing their services online.