Case handling on telephone crisis lines/telehealth
- Convenience
- client anonymity
- control
- immediacy
- cost effectiveness
- therapeutic effectiveness
- access to support systems
- avoidance of dependency issues
- worker anonymity
- availability of others for consultation
- availability of array of services
- service to large and isolated and populations
Telephone counseling strategies
- Making psychological contact (very quickly make them feel safe and comfortable)
- Defining the problem (seek to understand events, focus on reflecting clients feelings)
- ensure safety and support
- consider alternatives and make plans
- obtaining commitment
Handling the extremely distressed caller (delusional)
- Extremely distressed callers often have mental illnesses and may demonstrate behaviors from delusional thinking to emotional volatility.
- Counselors must not indulge in callers’ delusions but focus on re-establishing reality and control through directed questioning.
- Understanding medication usage and keeping expectations realistic are key in managing calls with severely disturbed individuals.
Rules with dealing with callers who are disturbed
Slow emotions down: slow down emotional responses and focus on here and now issues, avoiding more feelings
- refuse to share hallucination s and delusions: acknowledge but not affirm callers delusions
- determine medication usage
- keep expectations realistic
- maintain professional distance
- avoid placating
- assess for lethality
Silent callers rappers and pranksters
Dont hang up but get curious and wonder aloud whether or not they have a problem that is making them call
- do not berate them or joke
Handling problem callers
- Pose open-ended questions: Open-ended questions refocus frustrated callers toward problem-solving, moving away from negative criticism.
- Set time limits: Setting time limits on calls can help manage conversations with callers who resist refocusing on their issues.
- Terminate abuse: Abusive calls should be terminated firmly and clearly to maintain a respectful and safe communication environment.
- Switch workers: Switching workers, especially with sexually explicit callers, disrupts their goal and can effectively manage inappropriate behavior.
- Use covert modeling: Covert modeling techniques can be used to extinguish repeated problematic calls, guiding callers to seek appropriate help.
Tele-behavioral healths growing role in crisis intervention
- From 1988 to now, crisis intervention has evolved from landline telephones to advanced internet technologies.
- The COVID-19 pandemic accelerated the shift to tele-behavioral health, overcoming initial skepticism.
- Modern crisis intervention incorporates video conferencing, texting, mobile apps, email, chat rooms, and social media.
- Emerging technologies like artificial intelligence and virtual reality are being explored for future crisis services.
