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CHAPTER  6:  Telephone and Online Crisis CHAPTER  6:  Telephone and Online Crisis

CHAPTER 6: Telephone and Online Crisis - PowerPoint Presentation

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CHAPTER 6: Telephone and Online Crisis - PPT Presentation

Counseling Case Handling on Telephone Crisis Lines ConvenienceImmediacy of Access 24 hour hotlines Timelimited hotlines Hotlines vs warmlines Continuous national vs local c risis hotlines ID: 633485

telephone callers questions client callers telephone client questions cont handling caller counseling crisis severely problem worker hotlines time behavior disturbed terminate role

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Slide1

CHAPTER 6: Telephone and Online Crisis CounselingSlide2

Case Handling on Telephone Crisis Lines

Convenience/Immediacy of Access

24 hour hotlines

Time-limited hotlines

Hotlines vs.

warmlines

Continuous national

vs.

local

c

risis hotlines

Cell phones

Client/Worker

Anonymity

Control

Client can terminate the telephone call at any time

Cost Effectiveness

For both the client and the community

Therapeutic Effectiveness

Possibly as effective as traditional modes of therapySlide3

Case Handling Cont.

Access to Support Systems

Avoidance of Dependency Issues

Do not want to develop dependency on a crisis worker

Availability of Others for Consultation

More than one crisis worker on site

Availability of an Array of Services

The LINC

Service to Large and Isolated Geographic Areas

May have a

service area of 150 milesSlide4

Telephone Counseling Strategies

Making Psychological

Contact

Providing support is a priority

Defining the

Problem

Have a list of feeling words that describe emotions

Have a list of standard questions to review

Keep notes on the client

Ensuring Safety and Providing

Support

Ask questions that start with do, have, and areSlide5

Telephone Counseling Strategies Cont.

Looking at Alternatives and Making Plans

Alternatives should be simple and concrete

Use role play/verbal rehearsal techniques

Obtaining Commitment

Commitment should be concrete and time-limited

Errors and Fallacies

You are not perfect

If you feel you are being manipulated, you probably areSlide6

Regular, Severely Disturbed, and Abusive Callers

Paranoid

Schizoid

Schizotypal

Narcissistic

Histrionic

Obsessive-Compulsive

Bipolar

Dependent

Self-Defeating

Avoidant

Passive-Aggressive

BorderlineSlide7

the Severely Disturbed Caller

Important things to remember:

Behavior

is always purposeful and serves motives that may be either conscious or unconscious.

Behavior is comprehensible and has meaning even though the language used may not.

Behavior is characteristic and consistent with personality even though it is exaggerated.

Behavior is used to keep a person safe and free of anxiety.Slide8

Handling the Severely Disturbed Caller

Slow Emotions

Down

Focus on “here and now”

Refuse

to Share Hallucinations and

Delusions

Affirm

the paranoid delusion

are

real

but do not

agreeing to its

validity

Ask “when” questions rather than “why” questions

Determine

Medication

Usage

Changing, forgetting, or disregarding medication

Physician’s Desk ReferenceSlide9

Handling the Severely Disturbed Caller Cont.Keep Expectations Realistic

Maintain Professional Distance

Countertransference is not uncommon

Use owning statements

Seek supervision

Avoid Placating

Be empathetic not sympathetic

Assess LethalitySlide10

Other Problem Callers

Rappers

Calling just to talk

Covert Callers

Asking for help for someone else

Pranksters

or Nuisance Callers

Silent Callers

Be patient, acknowledge the difficulty in speaking, and let them know if you need to terminate the call. Slide11

Other Problem Callers Cont.

Manipulators

Questioning the worker’s ability, role reversal, and harassment

Sexually Explicit Callers

Transfer call to a same-sex worker

Callers With Legitimate Sexual Problems

Remember to Treat all Callers Respectfully and Seriously.Slide12

Handling the Problem Callers

Pose Open-Ended

Questions

Set

Time

Limits

Terminate Abuse

Switch Workers

Use Covert Modeling/Conditioning

Formulate

Administrative RulesSlide13

The Internet’s Growing Role in Crisis Intervention

Resistance by many professionals

Ethical concerns

Limited training

Lack of humanistic values

Many consumers are willing and eager to use a technologically-based form of therapy.

“Digital native” vs. “digital settler”Slide14

Behavioral Telehealth

The Appeal of Online Counseling

Feedback

Frequent emails or instant messaging

Disinhibition

Clients may open-up more quickly than in a traditional setting

Problems of Online Counseling

Confidentiality

HIPPA

Charlatans

Identity verification

Licensing

and Insurance

Learning

the

Language

Acronyms

“Text talk”

N

etizens”Slide15

Behavioral Telehealth Cont.

Netiquette

Civil and appropriate rules of discourse when operating on the internet

Some typos are okay, but not too many

Check with your client regarding emoticons

Be clear when using acronyms

Keep your text/font neutral

Be intentional when responding, do not engage in inflammatory remarks

Predispositioning

Can be very difficult on the telephone and even more so via the computer

Need

for Training

Virtual

Reality

May be used to treat panic

attacks, phobias, anxiety,

obsessive-compulsive disorder, etc. Slide16

Legal, Ethical, and Moral Issues More Research is Needed

Caller Identification/Tracker Features

Caller logs

Liability of volunteer hotline workers