Hello, We Have a Problem: Crisis Hotline

crisis hotline, crisis intervention
Photo credit/Wikipedia

Would YOU be capable of handling a real crisis on the phone? I’m not so sure, with all of my education, experience in dealing with patients, clients and victims/survivors, whether my knowledge and common sense would effectively apply in all situations.

Could I do it? Could you??
According to the (Albert R Robert’s, Ph.D.) Seven Stage Crisis Intervention Model, one must:

1) Plan and conduct crisis and biopsychosocial assessment (including lethality measures);

2) Establish rapport and rapidly establish collaborative relationship;

3) Identify dimensions presenting problems(including the “last straw” or crisis precipitants;

4) Explore feelings and emotions (including active listening and validation);

5) Generate and explore alternatives (untapped resources and coping skills);

6) Develop and formulate an action plan;

7) Follow-up plan and agreement (Point of crisis resolution). It appears that these assessment steps must be completed relatively quickly and skillfully.

Psychologist, Barry Greenwald, PhD of Oak Park, Illinois describes a crisis as: “Any event can be a crisis if it wipes out our ability to make sense out of what is happening. We become bereft of means for exercising some form of control on our lives. We feel helpless; the victim of events beyond reason and certainly beyond our control. It is only after we regain some sense of understanding and some sense of control that the crisis is reduced to something manageable.”
Caller Characteristics:

  • The caller is likely to be very upset and disorganized in his/her presentation. Occasionally, a caller will present in a wooden, robot-like manner, devoid of any feelings whatsoever;
  • The caller cannot make sense of or understand what has happened;
  • The caller complains of not knowing what to do and expresses a loss of ability to do anything about the acute problem;
  • The listener intensely experiences the caller’s sense of helplessness and feels a very real pull to intervene actively to take control of the situation.

The Response:

  • The listener can provide organization to the caller by asking questions;
  • Help the caller to just describe the events that have taken place without emphasizing the feelings. There will be opportunity to come back to them;
  • Try to get a feeling for the person’s coping style and what is still working. Sometimes, it is just necessary to encourage and reinforce coping styles that are very wobbly.
  • Questions such as: “What do you feel you’ll be able to do?” “Is there something you want to do about this?” Their responses can provide clues as to how well a person is coping and where you might need to lend your skills to theirs;
  • Gently educate the person as to what they might expect for the next couple of days during the acute phase of the crisis (A roller coaster effect and that this is very normal)
  • In any crisis call, you should listen for and be alert to suicidal potential. If you sense that possibility, do not hesitate to bring it up for discussion. You may have to actively encourage the person to seek a safer situation, and arrange for people to be with her or him, or even suggest hospitalization;
  • Make concrete plans with them in a step-by-step fashion and only for the next couple of days. And…encourage the caller to call back after a few days in order to see how things are going;
  • Be aware that, a crisis can be the tip of an emotional iceberg…. that further professional intervention may be needed…

Do you feel re-assured yet? If not, how much training is really needed?

An internet search revealed a range of 55 to 200 minimum hours. One resource offering accreditation, training conferences etc. is Contact USA, (a network of crisis intervention centers across the nation.) Conceived in 1967 as a response to the growing social issues of a changing nation, CONTACT has grown and evolved into a network of over 50 centers in 20 states, exploring new ways in which to serve their individual communities.
Anyone who volunteers in a crisis situation is a VERY SPECIAL PERSON in my book!

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