Receiving phone calls from an individual in crisis presents a challenge. The caller may be an anxious friend, desperate family member, suicidal stranger, or an angry customer. Despite Ma Bell's promise of being able to "reach out and touch someone," crisis line workers are at a definite disadvantage. Without visual contact or close physical proximity, staff are expected to respond, having only the verbal messages coming over the receiver to provide them with information upon which to act.
Prior to becoming an instructor with CPI, I was involved in just such a venture. I was director of a non-profit agency which, in addition to many other services, provided a 24-hour, 7-day a week phone line to individuals in crisis. The phone lines were often staffed by trained community volunteers and because it was the only crisis line available in a four county area, aside from local law enforcement offices, we received a diversity of calls.
While challenging, providing an appropriate response to the individual crisis caller was not impossible once listening and intervention tools were implemented. Crisis line workers are taught to decipher, evaluate, and intervene. These same tools may be utilized by anyone who receives a call from someone who is upset - someone who may be in a state of crisis.
As soon as you pick up the phone, assume the caller is in some stage of crisis, whether or not he seems to be. The balance of his life has been upset, otherwise he would not have made the call. The caller will present the problem. You, then, need to deal with it. To simplify this process, we categorized the most commonly received calls. For each category, we supplied various verbal intervention strategies that might be most appropriate. The categories provided a basis for initially dealing with any crisis call.
One of the most crucial and demanding crisis calls received is the life-threatening calls, where individuals may be in immediate danger, or in need of emergency services. The caller may be characterized as displaying frantic speech, short, shallow breathing patterns, and an inability to listen and speak rationally. They may be panicky, crying, explosive, or expressing helplessness.
Here are some steps to take when receiving a life-threatening call:
- Remain calm, even if you don't feel calm. A crisis can be contagious. You won't be able to effectively help the caller if you are upset. Breathe evenly and slowly.
- Identify yourself by your first name. The caller may be more apt to share information when speaking to a name rather than speaking to an anonymous party. Get the caller's name, and if appropriate, address and phone number. The caller may be crying and/or talking rapidly and excitedly. By asking simple, concrete questions, you may be able to break the pattern and begin to calm the person down, at least to a point where they can give information and begin to retain some rationality.
- Find out if the person is in immediate danger. If so, has the police, paramedics, or other appropriate service been contacted? If they haven't, call them, with the caller's permission, if possible.
- If the situation involves a possible abuser or self-abuse, find out if there are any weapons (guns, knives,...) in the house. Where are they located? Who and how many people are in the house? Do they have a pet (dog...)? This information should be forwarded to the police if they are coming to the scene.
- If the call is suicidal in nature, remember that the caller is usually calling because they want help. Your responsibility is to the caller, not for the caller. It is extremely important that you be an active listener and supportive. Often this is the best aid that can be offered to suicidal individuals. Emergency services may need immediate, direct contact with the caller. If you can, get the caller to promise not to harm themselves and to accept assistance from emergency services.
- If the caller is extremely upset, show him that you can understand it. "I hear that you are upset. Let's talk about what happened." Ask him to "calm down and take a few deep breaths."
- Get the details. "Tell me more about it," "When did this occur?" If the caller seems reluctant to talk, get him to talk more with a statement such as "Tell me more about it, so I can better understand the situation."
A type of call that can be very frustrating to deal with is a ventilation call. This is when an individual just wants to talk about his problem. The caller seems to go on and on venting his feelings and brings up many unrelated items or issues. At times, you may find that the caller is not ready to listen, for he might not be looking for a solution to his conflict. The caller can be frustrated, feeling helpless, confused, or tense. These calls may cause the crisis line workers to feel ineffectual in that attempts to suggest concrete options or viable solutions may be rejected by the caller who is not ready to engage in problem-solving. Remember that helping the caller to clarify his feelings could be the first step. The caller must move at his own pace.
These ideas might help your attempts to deal with ventilation calls:
- The two most important things you can do is be supportive and be an active listener.
- If the caller is venting, let him go on for awhile. Perhaps he needs a safe place to "dump his feelings." Use supportive statements to acknowledge your understanding and empathy: "Oh, I see;" "That sounds like it upset you."
- Acknowledge the caller's feelings. Help him clarify his feelings - "How did that make you feel?"
- If the caller continues to vent for long periods of time and/or is a repeat caller, his use of the crisis line may be self-defeating, nonproductive and inhibits him from taking action. If you determine this to be so, offer the possibility of problem-solving. Ask him what would make the situation better: "What do you think would make you feel better?" "What have you tried?"
- Use restatements and paraphrasing: "You said that it would all be O.K. if he just got a job. Are you saying that the problem would be solved?" Using restatements is not just parroting what the caller just said to you; it is a way of providing some feedback which takes the essence of the caller's statements and reflects it back to him. Then he can hear what he's saying which may help to clarify his feelings. It also establishes whether you are properly understanding the caller.
- Avoid making assumptions. If you do not fully understand the caller, ask him to explain further. "Tell me more about how this affected you." "Let me make sure I understand you correctly..." If he uses terminology that you don't understand, ask him to explain. "What do you mean when you say 'snuffed them out'?" "Can you tell me what you mean by 'he did a job on her'?"
- If the caller is angry and abusive during his venting and begins to direct his anger onto you, you must decide if it is helpful or abusive to let it continue. You can make him aware of his behavior or you may choose to let him vent a bit. Give supportive statements during the lulls in his ventilation... "You sound angry," "That really upset you;" "I hear you." You are more apt to be heard during the lulls and the caller may gradually calm down because constant venting involves a great expenditure of energy which tires most people. If he is very abusive, you may choose to set some limits. "I would like to help you, but I can't unless you calm down." "I understand you are upset. If you can't calm down, call me back when you are and then we can talk."
- You might get a caller who wishes to talk about his situation but initially has difficulty discussing it. Use open-ended questions to start conversation. They are more effective than closed questions. "Do you have children?" vs. "Who is in your family?" "Do you like your job?" vs. "Could you tell me a little about your job?"
- In all cases, avoid making judgment. The caller is telling you how he feels. Based on reality or not, it is how he perceives the situation and his feelings are real. Avoid making statements that are negative and judgmental. "It's stupid to get a divorce if you have two kids and no job skills." "That's not going to work." "You should be more understanding."
- If an individual requests your opinion on an issue, avoid giving it. Try to turn it back to him. "Well, what do you think?" Taking sides on an issue may prevent objectivity. Assist the caller in making up his own mind. Avoid taking over. Bring up possible actions and discuss them with the caller. Let him decide. Don't make decisions for him.
- Often you will get a caller who feels helpless and may demonstrate low self-esteem and self-doubt. Emphasize his strengths and positive behaviors. "It takes a lot of courage to call someone for help." "You sound like a concerned father to care enough to call."
Many people contact a human service agency for basic information and referrals. In this common type of call, the person may be expressing worry, anxiety, general uneasiness, and concern. They often have identified what they feel is a problem and have chosen a direction. They want a referral or helpful information.
- When providing a referral, it is important to help the caller think what using the resource may mean to him. It is not just giving a name and a phone number. Help the caller think through which type of resource might be the best for him.
- Attempt to become familiar with all the resources you might use. When making a referral, you must be confident that the agency will provide the services requested.
- Do not hesitate to take the time to find a resource that is most appropriate to the caller's situation. Explain to him that you are taking your time to be careful and find the best information that you can.
- In giving a referral, you should describe only two or three choices. Supplying the caller with too much information or too many referrals may overwhelm him. Although limiting the number, do provide the caller with a choice. Give him the name, phone number of the referral, operating hours, and a brief description of the services offered.
- Try to answer any questions that the caller may have about the service and encourage him to contact the service directly.
- Do not give out answers for the sake of giving out answers. If you do not know, say that you don't know but that you are willing to find out more information if he would call back, or have him get the information directly through the referral service.
To be effective as an intervener, you must be yourself. Inauthenticity will be easily realized. Be aware of your emotional responses to the caller's situation. Remain empathetic, but you must be detached and objective to be effective.
Be warm and attentive as well as calm and confident. The tone of your voice should be moderate and the pace of your voice consistent. If you feel that you are losing your ability to listen and feel tired on the phone lines, realize your limits. Perhaps it would be wise to take a break for awhile and collect yourself.
Answering crisis calls is a great challenge. You will not know what type of call you are receiving until the caller begins to speak. As an intervener, the best you have to offer is yourself - your care, objectivity and concern. By being able to identify the nature of the call you receive, you may be able to initiate some responses and solutions to the caller's concerns. With your assistance, the caller may be able to initiate some responses and solutions to the caller's concerns. With your assistance, the caller may be able to resolve the conflict which has upset his life in a healthy, effective and safe manner.
Acknowledgements to Ramona DeSmith and Milwaukee Family Services.
National Report -- Winter 1986 -- Volume 5, Number 3