Familiar Callers: Changing Our Views and Interactions

Lisa Turbeville May 25, 2016 Helpline Best Practices, Helplines

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:

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.

Creating a Successful Volunteer Training Program

Lisa Turbeville March 10, 2016 Helpline Best Practices

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.

Facilitator

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.

Environment

Make sure the training environment is comfortable. Important features may include:

• Comfortable temperature
• Comfortable chairs
• Good lighting
• Enough space
• Windows
• Easily accessible bathrooms

Training Methods

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.

Role/Real Plays

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.

Additional Tips

• 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

Graduation