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?
- To restate their crisis plan
- Who else can they call besides the crisis hotline?
When speaking with someone who has been contacting your center several times per day, it is okay to ask the individual:
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:
Systematic review of research into frequent callers to crisis helplines
An Autobiography in Five Chapters
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.Continue Reading