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Five Tips for Working With Callers or Chat Visitors Who Have an Intellectual/Developmental Disability


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.

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Discounts for NASCOD/CUSA conference are ending soon – Register Now!

iCarol Webinars

Join iCarol at the National Crisis Center Conference in Arizona on October 20th: “Inspiring Hope” – presented by NASCOD and CONTACT USA. Attendance is essential for crisis organization managers and invaluable for all who work in crisis organizations and call centers. This conference is all about sharing knowledge and camaraderie; you are not alone!

NASCOD CUSA 2016 crisis helpline Conference

Please come and check out the amazing and definitely hope-inspiring presentation and workshop line-up they have in store for you this year by visiting http://www.nascod.org/conference/

But you must act quickly! Hotel conference discounts end after September 27th and conference registration closes October 7th.

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lgbt pride month gay lesbian bisexual transgender

Like so many others throughout the US and the rest of the world, we’re heartbroken over the events that played out early Sunday morning in Orlando. Yet another city’s name has become synonymous with tragedy.

Violence inflicted upon any person or group of people is horrific regardless of the circumstances, location in the world, or nature of the attack. The shooting in Orlando left us saddened because for many who identify as LGBTQIA, clubs and bars like Pulse make up part of the fabric of the LGBT community along with outreach centers and other friendly gathering places. For those who don’t find acceptance at home, these spaces are sanctuaries and the people in them become like family. This act of violence was carried out during Pride Month when members of the LGBT community and their allies are celebrating together.

These events are a sobering reminder that even in times of sweeping progress for LGBT causes and more visibility than ever, danger still exists and for some communities it is an epidemic. The threat of violence makes a huge impact on the mental health and well-being of LGBT people, and losses to suicide and suicide attempt rates continue to be higher among LGBT populations than those of non-LGBT counterparts.

Let us not allow intolerance and violence towards one group spawn persecution of another. Let us all try every day to bring education and awareness to those who may fear the unfamiliar and unknown. Whether that is fear of a sexuality, gender, religion, culture, race, ethnicity, nationality, or other qualities they may find foreign to their own experience. Ignorance, fear, or intolerance can morph and grow into hatred and violence when fed and nurtured. Knowledge and education can bolster tolerance and acceptance. Most importantly, let’s all love and support one another and recognize that when we all stand together in peace and solidarity, we stand stronger.

Darkness cannot drive out darkness; only light can do that.
Hate cannot drive out hate; only love can do that.
– Martin Luther King, Jr.

To the LGBT and other helplines around the world, thank you for being the light that drives out darkness for so many people.

For emotional support, information and referral, educational materials, and other ways you can support and help the LGBTQIA community, please explore the resources below.
The Trevor Project
LGBT Youthline
Switchboard LGBT Helpline
Nottingham & Nottinghamshire Lesbian & Gay Switchboard
Gay Switchboard Ireland
Trans Lifeline
It Gets Better Project
Human Rights Campaign
Have a resource to add to this list? Leave us a comment below!

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Familiar Callers: Changing Our Views and Interactions


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
  • De-escalate

  • Subsequent calls:
  • 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.

Thoughtful Suggestions:

    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.

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A dark, empty room with no escape

MHM 2016 Social Media Images-Twitter Profile

Depressive disorders are extremely common — 15.7 million American adults experienced a major depressive episode in 2014. It’s much more than simply feeling sad, it’s a medical condition with physical symptoms. Check out the infographic by Mental Health America to learn more as we continue our recognition of Mental Health Month, and be sure to visit their website for lots of great materials to help you spread the word to your community.

Depression Mental Health America infographic

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It’s described as “being powerless against your own mind”

MHM 2016 Social Media Images-Twitter Profile

May is Mental Health Month, and there’s no better time to beef up your knowledge of mental health facts and information. There are a number of great materials available via Mental Health America, Canadian Mental Health Association, and NAMI.

We’ll be bringing you some of these resources on the blog throughout the month. Starting with Mental Health America’s Infographic about Anxiety. Anxiety disorders are some of the most common mental health conditions — experienced by an estimated 21% of American adults. People living with anxiety describe it as, “Being so scared you’re paralyzed” and “Being powerless against your own mind.” Check out the infographic below for more information on what anxiety is, how it feels to those who experience it, and tips for tackling it.


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Get your Mental Health Month Toolkit

MHM 2016 Social Media Images-Twitter Profile

Since 1949, May is recognized as Mental Health Month, thanks to efforts spearheaded by Mental Health America. In preparation for this year’s Mental Health Month, MHA has released its 2016 Mental Health Toolkit for download. It includes things like:

  • Media Materials including key messages, drop-in article, sample press release, and MHM Sample Proclamation
  • Infographic Fact Sheets that incorporate plain language explanations of diagnostic criteria for mental illnesses, first person accounts about how it feels, a breakdown of common myths and misperceptions, screening data from mhascreening.org and coping skills on the topics of Depression, Anxiety, Bipolar Disorder, Psychosis and Recovery
  • Worksheets that individuals can use to make a mental health plan to help them work through symptoms and challenge intrusive thoughts
  • Social media materials including sample posts and images
  • Banner images for your website or Facebook and Twitter accounts
  • Mental Health tips for each day of the month

Download your toolkit here.

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New features recently released

New Features copy

Being a web-based software means we make regular updates to iCarol with each of our ongoing releases. In these releases we do some general maintenance and apply updates or fixes, but most exciting of all we add new tools and features.

In recent weeks we’ve added three new features that I’d like to tell you about. If you’re an iCarol user you may have already read about these in the release notes available on your dashboard, but in case you haven’t, here’s some information for you:

Laptop in useReceive feedback from Public Resource Directory visitors

You can now enable a setting on your Public Resource Directory (PRD) that allows visitors to submit comments. This will empower the public to alert you of errors in your record, or other troubles they may encounter with a resource. In order to submit their comment, they will need to enter their name, email address, and captcha code. This is not a comment for public view that will be there for all to see, but rather once submitted, the resulting comment goes directly to your resource staff as a resource flagged for review. Your resource manager will simply open and edit the record to view the comment. When they are satisfied that any reported issues are resolved, they can clear the comment to remove it from the record, thus removing it from the “flagged for review” list as well.

You simply need to follow a few steps to turn on this setting:

  • Click the Resources button on the left hand menu
  • Click ‘Manage Resources’ and then on the next page click ‘Public Resource Directory’
  • Scroll to “Page to show for details view” and ensure that “Combined view (blends Agency, Program, Sites and ProgramAtSite)” is selected (this feature will not work if the setting is “Simple view”)
  • Check the setting for “Allow people in the public to provide comments on resource records”
  • Scroll to the bottom of the page and click the “Save” button

PRD comments setting

Then, users will be able to submit their comments when they view a record on your PRD.

PRD public comment

Resulting comments will be similar to when resources are flagged internally within your organization, appearing on the main Manage Resources page and within the record itself.

PRD comment in iCarol

Remove a user’s ability to post to the chatboard

Security and Reliability

Depending on the practices at your individual helpline, you may wish to restrict volunteer and staff access to the Chatboard. Previously you could restrict a user’s ability to see or use the Chatboard at all. Now you can more specifically allow your users to see and read Chatboard posts, but then decide whether or not any non-Admin user can post messages or replies to the Chatboard via a separate setting. This is available in the Advanced Security Settings of each volunteer or staff member’s profile.

Advanced Security Settings chatboard posts

Customize the list of resources marked as “Flagged for review.”


You can now choose to have a single, drop-down style Custom Field appear with a record that is Flagged for Review. When you enable this setting you additionally will see the date it was flagged along with the reason when you first go to the Manage Resources page.

To use this new tool you’ll first need to make sure you have at least one drop-down style Custom Field set up in your system, with choices assigned to the drop-down. Custom Field creation and editing can be found by clicking on Resources, then clicking Manage Resources, and then clicking Custom fields from the leftmost column.

custom field

Once a Custom Field is set up, you’d take the following steps to enable this field choice as visible within the list of flagged resources:

  • Click Admin Tools and click the Resources tab
  • Scroll down to Other settings, and click the drop down box for “On the Flagged for review list on the Manage Resources page, include a column for this single-select custom resource field”
  • Select the custom field that you would like to display in the list of resources that have been flagged for review
  • Scroll back to the top of the page and click “Save all settings”

Custom Field flagged for review

Now flagged resources will appear on the Manage Resources page, along with the flagged date, reason, and the information contained in that chosen Custom Field as it exists in the record.

Verification priority

This has multiple potential uses that could help streamline processing of your flagged records. You could use this Custom Field to assign a priority level to your records, so that Higher priority records could be investigated and cleared more quickly. Another potential use would be to identify which staff person or position, or center if managing resources across a network, is responsible for management of the resource and thus should be the one to investigate the flagged record.

We hope that you’ll try out these new features if you think they may be helpful to you in your daily work. Set up and other information can also be found via the Help Articles posted within the Help section of iCarol, but please contact our support team if you have questions or need additional assistance.

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Upcoming webinars via Mental Health America


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

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Karma Nirvana helpline receives grant

karma nirvana logo

We’d like to congratulate our friends at Karma Nirvana as they recently announced that they are the recipients of a grant award.

This funding will go to assist the Honour Network helpline, the first national line of its kind, which serves victims and others concerned about forced marriages and honour-based abuse, as well as professionals who need guidance on these issues. Helpline counselors have experience in risk assessing situations of honour based abuse or forced marriage, and some can provide peer-based support from their unique perspective as survivors.

According to the organization, they currently serve a volume of approximately 700 calls per month from within the UK. They state that over 200 additional calls per month go unanswered, the majority of which ring to the center during evenings or weekends when the call center is closed. Thanks to this grant, Karma Nirvana will be able to extend their service hours, so they can help more people in need and fewer calls will go unanswered.

We’re so pleased by this wonderful news and wish all the best to Karma Nirvana as they extend their service offerings and save even more lives. To find out more about their service, please visit their website.

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