Artificial Intelligence and Social Work

Introduction

Social Work and related professions have the potential to experience rapid change and growth in the future as technology advances and the population changes. This is especially true with artificial intelligence.

Artificial Intelligence (AI) describes a range of technologies that allow machines or computers to make decisions that are normally made by human beings.

Emotional Support Technology

Perhaps the first attempt at emotional support using a computer was the ELIZA software created by Joseph Weizenbaum in 1964. Through pattern matching the software was able to respond with empathy statements and open-ended questions to keep the conversation going.

Modern options include XiaoIce (Zhao, et. al., 2018). As the authors describe,

The primary design goal of XiaoIce is to be an AI companion with which users form long-term, emotional connections. Being able to establish such long-term relationships with human users as an open-domain social chatbot distinguishes XiaoIce from not only early social chatbots but also other recently developed conversational AI personal assistants such as Apple Siri, Amazon Alexa, Google Assistant and Microsoft Cortana.

Another example includes Replika, which recently released its source code as open-source. As these technologies get more advanced they may play a more important role in our emotional support options for people who are struggling with loneliness.

Digital Psychotherapy

Digital psychotherapy options include online and electronic therapy options. One example is Electronic CBT for Insomnia (Espie, et. al., 2018) which was a rich-media web application that participants used to receive cognitive behavioral therapy via the internet, and Whiteside et. al. (2014) which studied the program Thrive:

Thrive is similar to programs used in successful trials of Internet-delivered CBT; the Thrive interface is interactive and its curriculum is adaptive to patient input. […] Thrive includes three CBT-based modules that are based on behavioral activation, cognitive restructuring, and social skills training techniques

While these programs are currently not utilizing much artificial intelligence, in the future we may see them adapting to the client’s progress and altering the curriculum in ways that will increase efficacy or completion rates.

As CBT programs become more researched and advance we should see more of these appearing. As Whiteside notes, these programs are significantly cheaper to deliver (using a fully automated or a paraprofessional “coach” model rather than delivering full therapy) and so may represent an increasingly common option for therapists.

Decision-Making Tools

Decision-making tools are potentially the most exciting use of technology and artificial intelligence. An example of where this technology has been helpful is in child protection work in England. (Pegg & McIntyre, 2018)

We may see AI being used in the future to help us integrate the hundreds of variables found in child protection assessments and files to increase our success rates and improve risk assessments. Certainly, we can’t replace humans in this incredibly careful work (just like in suicide risk assessment) but we can use these tools to augment our understanding of child protection and decrease the lag between learning things in research and applying them in practice.

Conclusion

Artificial intelligence has the potential to improve our lives by providing more emotional support to those who are lonely, providing digital psychotherapy and decision-support tools to improve child protection and other social work fields.

References

Espie, C.A., Kyle, S.D., Williams, C., Ong, J.C., Douglas, N.J., Hames, P., Brown, J.S.L. (2012) JAMA Psychiatry. Retrieved from https://www.jwatch.org/na47591/2018/09/28/electronic-cbt-insomnia

Pegg, D. & McIntyre, N. (2018) Child abuse algorithms: from science fiction to cost-cutting reality. Retrieved from https://www.theguardian.com/society/2018/sep/16/child-abuse-algorithms-from-science-fiction-to-cost-cutting-reality

Weizenbaum, Joseph (1976). Computer Power and Human Reason: From Judgment to Calculation. New York: W.H. Freeman and Company. pp. 2, 3, 6, 182, 189. ISBN 0-7167-0464-1.

Whiteside, U., Richards, J., Steinfeld, B., Simon, G., Caka, S., Tachibana, C., Stuckey, S., … Ludman, E. (2014). Online cognitive behavioral therapy for depressed primary care patients: a pilot feasibility project. The Permanente journal18(2), 21-7.

Zhou, L., Gao, J., Li, D. & Heung-Yeung, S. (2018) The Design and Implementation of XiaoIce, an Empathetic Social Chatbot. Journal of Human and Computer Interaction.

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Introduction to Employee Assistance Programs (EAP)

Introduction

Does your organization have an Employee Assistance Programs (EAP)? Have you ever considered being part of one or using the one available at your organization? Read on to learn more about these common workplace benefits and how they can be helpful to you as a social services worker or a practicing counsellor.

EAP are fairly common in larger organizations, according to the International Employee Assistance Professionals Association (EAPA, n.d.):

In the US, over 97% of companies with more than 5,000 employees have EAPs. 80% of companies with 1,001 – 5,000 employees have EAPs. 75% of companies with 251 – 1,000 employees have EAPs

Despite their commonness, there are a number of articles out there discussing the notion that many employees actually fail to take advantage of the services provided by these supports. For example, Barrett (n.d.) says that only 3-5% of UK employees with access to an EAP actually use one. A Psychology Today article discussing the US landscape (Albrecht, 2014) titled “Why Don’t Employees Use EAP Services?” the author notes four barriers to employees utilizing EAP supports:

  1. They (mistakenly) don’t think it’s confidential
  2. They feel there is a stigma for accessing supports
  3. They think (mistakenly) that they need permission
  4. They don’t know the EAP exists

These barriers will need to be overcome if an organization is to see their EAP become a successful part of their benefits program.

Services Offered by EAP

There are numerous services offered by different EAP providers. For example, some of the services offered by LifeWorks by Morneau Shepell include:

  • Counselling
  • Financial Consultation
  • Legal Consultation
  • Life Coaching
  • Research

I’ll discuss some of these benefits below.

Counselling

Counselling is the resource we think of most commonly when we think of an EAP. Telephone counselling is the most popular model of delivery for this support but some EAP providers have moved to video counselling or even providing in-person counselling at a contracted rate.

This counselling support is short-term and solution-focused so that clients are given a handful of sessions in order to work on a defined goal with that counsellor. This can be especially helpful for situational events (grief, trauma, life transitions) where some extra support can help you bridge the gap.

This can be one of the most useful benefits offered by an EAP given that there is often no charge for those sessions when compared to health insurance – if your needs fit within the short-term model.

Financial Consultation

Financial consultation can be very useful for employees who are struggling with debt, bankruptcy, credit issues or even seeking investment advice. While a financial counsellor or financial planner can’t tell you what to do with your money they can help you understand the range of options available to you and give you some knowledge to help you make decisions more effectively.

Legal Consultation

Lawyers can be expensive, and although some offer free consultation you often don’t even know where to begin to locate one. Some EAPs offer legal consultation services that help you understand the gist of a legal issue and give you some awareness of things to keep in mind.

Because of conflict of interest rules, legal supports may not be able to help you with employment-related matters or if you’ve already retained an attorney – but it’s worth a shot.

Life Coaching

Life coaching is a service to help you make a plan for handling a future event. It’s a forward-looking, goal-oriented process that focuses more on behavior and less on the emotional content of a situation like in counselling.

Health Coaching is an example of specialized Life Coaching that might help you deal with weight management, stress management or quitting smoking by acting as a “cheerleader” and helping you on your road to accomplishing these goals.

Research

Research is a benefit offered by some EAPs where if you’re looking for resources like childcare they can help you locate providers in your community that are able to provide this support to you. This can help you navigate the web of services around you and better prepare yourself.

Advantages of Using an EAP

EAP services are designed to help reduce absenteeism and improve employee performance by helping you deal with personal problems (or sometimes work-related problems) through a confidential service separate from your employer.

By receiving some short-term counselling or other support you can improve your productivity and prevent yourself from needing leave or other time off. This helps both you and the company save money, save time and better enjoy your work.

A literature review discussing the benefits of EAP services in the burgeoning Indian corporate world noted “It is seen that such programs offer benefits in preventing distress among employees and also help them become more resilient to adverse situations.” (Betti, Jutta & Gujral, 2018)

Another study exploring the changes experienced by employees in South Africa who received substance abuse treatment through the EAP found that they appreciated it as a “vehicle for change.” (Soeker, et. al., 2016)

The participants shared a sense of accomplishment and they also valued the tools they acquired in the program and how it positively changed their lives. EAP changed the participants’ lives. EAP improved their work performance as well as behavior at the workplace. Participants felt empowered after attending the EAP. The different categories expressed how EAP brought about a positive change in the participants’ lives.

 

Working for an EAP

If you’re a social worker, counsellor or therapist you may have considered working for an EAP as well. Generally counselling provided by an EAP is provided over the phone. The pace is fast but the work is exciting and varied and you can learn a lot about different clients. This is especially useful if you’re in the early part of your career and would like to get your licensure.

Conclusion

The EAP Industry continues to expand. There is an opportunity for researchers to learn more about EAPs and how to make them effective. There are opportunities for individuals to access EAPs in order to improve their wellness and of helping professionals of all stripes to consider joining an EAP as a counsellor in order to increase their skills in providing crisis intervention, telephone support and brief solution-focused counselling.

Bibliography

Albrecht, S. (2014) Why Don’t Employees Use EAP Services? Psychology Today.

Barrett, P. (n.d.) The EAP gap. The Wellbeing Pulse. Retrieved on Feb 6 2019 from https://thewellbeingpulse.com/the-eap-gap/

International Employee Assistance Professionals Association. (n.d.) “International Employee Assistance Professionals Association Publications / Resources > FAQs” Retrieved on Feb 6 2019 from http://www.eapassn.org/FAQs

Soeker, S., Matimba, T., Machingura, L., Msimango, H., Moswaane, B., & Tom, S. (2016). The challenges that employees who abuse substances experience when returning to work after completion of employee assistance programme (EAP). Work53(3), 569–584. https://0-doi-org.aupac.lib.athabascau.ca/10.3233/WOR-152230

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How to be an Effective Board Member

Introduction

Becoming a Board Member is a big responsibility and a big accomplishment. This is doubly so if you are young, given that less than 2% of Board Members are under 30 in the United States! The benefits of Board Membership are numerous, including giving you new professional and personal networking opportunities, professional skill development and spiritually – knowing that you are supporting an organization’s growth and development, especially if you are a nonprofit Board Member.

On the other hand, the skills that make someone an effective Board Member do not come naturally. While some organizations have formal Board of Directors training programs, not all do. Read on to learn about the skills required of effective Board Members.

Understand the Role of the Board

The role of the Board of Directors is to set the organization’s strategic direction, assess risks and threats to the organization, plan for the future and to make corrections in order to keep the organization on track. Additionally, the Board of Directors hires the Chief Executive (either the CEO or the Executive Director, occasionally the President) and sets the metrics that are used to evaluate that individual.

The Board is responsible for governance and leadership, but not for the day-to-day operational activities of the organization. This is something new Board Members sometimes struggle with. Your role is to make sure that the Executive Director has the tools they need to achieve the metrics, but they will ultimately decide how best to carry out these goals.

For instance, your strategic plan might include increasing your revenue by 10%. The Executive will be responsible for carrying this out (though the Board is an important contributor to fundraising and finance.) So, you might help by setting up meetings with people in your network or by participating in fundraising events but it would be inappropriate to tell the Executive Director to plan a certain event or direct the way in which they raise the revenue by 10%.

The organizational flow is from customers or clients, to the staff, to the Executive Director or CEO, and finally the Board. If this chain of command gets disrupted, you will have issues. It is important to strike a balance between minimizing risks and maximizing opportunities – because these concepts are in constant conflict.

Perform Strategic Planning

Strategic planning is the process of setting the strategic priorities of the organization. This involves figuring out where you want the organization to go and then to set in place concrete strategies, goals, and ideas in order to decide the future of the organization.

Strategic planning models can be used to help you identify where the organization is right now and where you would like to be. One example is the model presented by OnStrategy, that includes 4 phases:

  1. Determine Position
  2. Develop Strategy
  3. Build the Plan
  4. Manage Performance

You can see my article on Basic Strategic Planning for Nonprofits to help you learn more about the nuts-and-bolts of strategic planning.

 

Hire and Evaluate the Executive Director

Hiring the Executive Director is one of the most challenging aspects of a Board of Directors. The Executive makes a huge impact on the overall success of the organization and choosing the wrong Executive can seriously impede progress to your goals.

One barrier that makes choosing Executives difficult is that many Board Members are mid-level or senior members of their own organizations but have not held that role themselves. This makes sense, given the number of organizations out there – only one Executive can exist at each one. If you’re hiring for a role you’ve never held yourself, the possibility exists that you will select someone based on the wrong criteria.

To avoid this, make sure that you ask behaviorally-based questions that get at the heart of the activities you need your Executive to do, and captures the essence of the job. For example,

  • Tell me about a time when you had to manage a large fundraising project
  • What would you change about our organization over the next 12 months?
  • What is your approach to handling conflict?

You should also share the Key Performance Indicators and the Strategic Plan (if it is public) with potential Executive Directors because these are the metrics you will be evaluating your Executive Director on. Their goals should align with your Board’s goals.

Manage Organizational Risks

Risk management means identifying the potential threats to the organization and then taking steps in order to mitigate their risks. This will be different depending on what your organization does, but some common threads will run through all nonprofit organizations.

For example:

  • Your funding comes from one primary funder. What happens if the funder winds up or stops funding you?
  • One staff member has critical competencies that if you lost, would affect the missing. How do you respond?
  • One of your most important programs has no competitors. What happens if a competing organization starts working in the same space as you?

Identifying these risks on a regular basis will help your organization to respond to them. As the Board, you will not direct the Executive Director how to respond to these risks, but together a collaborative plan can be put in place to make sure an effective response is developed.

Board Members are legally responsible, with a fiduciary duty, for the success of the organization. This means that if the organization gets sued, the Board Members (if they don’t have Errors & Omissions insurance) could be held personally liable for the debts of the organization.

Approve the Budget

Determining the budget of the organization is one of the most important jobs the Board has. In addition to creating the budget (usually based on the previous year’s budget, expected revenues and other data), the Board must also ensure the organization is staying within the budget.

Each meeting, you will review the financial statements in order to discuss where you are above or below the budget. This will help avoid a sudden cash crisis.

Participate in Fundraising

Board Members should be participating in fundraising to help the organization succeed. This can include helping to run fundraising events, providing access to a network of contacts (especially if you are a mid-level or senior-level member of your industry) or otherwise helping the organization to bring in some revenue.

Perform Effective Governance

Governance is the “command and control” or “checks and balances” part of the Board Member role. Good governance includes both the role of the Board of Directors and the organization at large. You’ll perform good governance by making sure the strategic plan is up to date and being reviewed regularly, approving and discussing the budget, and also by creating and enforcing policies and procedures.

Policies and procedures are the rules that set the conduct of both the Board Members themselves, but also of the volunteers, staff, and others in the organization. Examples of policies and procedures that are important for good governance include:

Meeting Attendance. Your Board Members should be required to regularly attend meetings. If they are unable to meet this requirement, they should resign from the Board in order to allow that spot to be filled by someone who is more available to commit to the Board’s requirements.

Term Limits. Most Boards have one or two-year terms, which ensures regular turnover and assessment of who is an effective and high-performer on the Board and who is not. This helps keep the organization fresh and energetic, while also benefiting from the experience and expertise of long-term Board Members.

  • Budget Approval. There should be a formal policy about how often and when the budget is approved. It should be approved at least on a yearly basis, and then reviewed more regularly than that to ensure that the organization is staying within their financial means.
  • Conflict of Interest. A Conflict of Interest policy helps ensure that Board Members do not let their personal interests interfere with those of the organization. For example, if a nonprofit is seeking a facilities management contract, a Board Member who owns a facilities management company should not vote on (or potentially even be present during the session) where the picking of a company is decided on.
  • Auditing. It’s important that organizations receive regular audits, and a policy may be written to ensure the organization seeks regular audits based on the size of the organization. Larger organizations may be required to receive an audit yearly, while smaller organizations may want to get one in order to ensure they are eligible to apply for grants and other forms of fundraising.
  • Board Evaluation. A self-assessment of the Board can help Board Members identify their strengths and weaknesses so they can make changes in the future. Every year or two may be a good frequency for this activity.
  • Board Orientation. Like a Board Evaluation policy, a Board Orientation policy should set out the procedure for orienting new Board Members to the organization so that they can hit the ground running.
  • Review and Writing of Bylaws. Bylaws are the policies and procedures that govern the organization, including things like what are the names, terms, and appointment process for the Officers (President, Vice President, Secretary and Treasurer) and other elements. These bylaws should be reviewed regularly.
  • Personal Giving. Finally, some organizations choose to have a Personal Giving policy that expresses the organization’s wish that nonprofit Board Members participate in fundraising for the organization or make their own annual gift to the organization.

Conclusion

These are a few of the many elements that go into an effective Board Member. Are there elements you think I’ve missed? Do you weigh technical skills or interpersonal skills more strongly in an effective Board Member? Let me know in the comments.

Cite this article as: MacDonald, D.K., (2019), "How to be an Effective Board Member," retrieved on July 23, 2019 from http://dustinkmacdonald.com/effective-board-member/.
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Scales of Measurement

Introduction

This post is part of a series I’ve been chipping away at, where I teach basic statistics and probability. The other posts in the series include:

Variables are the outcomes of a psychological measurement. As the Australian Bureau of Statistics notes, a variable is “any characteristics, number, or quantity that can be measured or counted.” Also called data items, they are called variables because the “value may vary” and may change over time.

There are four scales of measurement used to distinguish variables:

  • Nominal/Categorical
  • Ordinal
  • Interval
  • Ratio

Nominal Variables

Nominal variables are those that separate a value into different categories. Examples of nominal variables are gender (male, female, other) or type of transportation (car, bus, train). These are categories and have no intrinsic value that allows them to be compared on their own.

Ordinal Variables

Ordinal variables are similar to nominal variables but they are ranked. These are like nominal variables but they are ranked. One example of an ordinal variable is educational achievement. A scale might look like this:

  • Less than a high school diploma
  • High school or GED
  • Bachelor’s degree
  • Graduate or first professional degree
  • Doctorate degree

These can be ranked from least education to most education, but there is no way to tell necessarily how much “more” education a Bachelor’s degree is when compared to a graduate or professional degree.

Interval Variables

An interval variable is an ordinal variable where the different items are evenly spaced. For example, income level:

  • $0-4,999
  • $5,000-9,999
  • 10,000-14,999
  • 15,000-20,000

Each one of these is evenly spaced. There must be a continuum to measure an interval variable.

Ratio Variables

Ratio variables are like interval variables but with the notable exception that “0” indicates an absence of the value. For example, in our previous example income level happens to mean no money. If we look at temperature however, 0 degrees Celsius does not mean there is no temperature. This makes Celsius an Interval Variable.

On the other hand, Kelvin is a ratio variable because 0 Kelvin really means no heat or temperature at all (as we say, absolute zero.)

Continuous vs. Discrete Variables

One more distinction is the difference between continuous and discrete variables. Continuous variables are those that can take on any value. For example, a variable that can have any number between 10 and 11 (10.48938, 10.74982, 10.9999) is continuous.

If the survey only has two values with with nothing in between (like 10 or 11) then this is a discrete variable, also known as an integer.

Why Separate Variables into Categories

It’s important to understand whether the variables we are working with are nominal, ordinal, interval, ratio, because we’ll use different statistical tests when working with different data. Coding, and other manipulations and processing of the data may also differ depending on the variable.

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Advanced Crisis Line Training

Introduction

A few years ago when I was working for Distress Centre Durham (DCD), I undertook a project to develop a new advanced training curriculum for telephone responder. Currently the Basic Training is 16 hours of in-class, plus another 16 hours of supervised phone shifts where a responder demonstrates that they have the active listening, empathy, suicide and crisis intervention skills we need for them to be on the phones independently.

After about 3 months or 50 hours they are required to undertake an Advanced Training session. This session helps consolidate some of the learning, revisit some of the classroom skills and then to build some additional skills going forward.

This training was turned into a PowerPoint that I won’t share because it contains some copyrighted Distress Centre Durham material – but you can read below for information that you could use as the foundation of your own advanced crisis line training. I’ve since made some updates so this training goes beyond the original that I developed for DCD.

Session Information

The length of the session was usually about 3 hours. The content covered was as follows:

  • Introduction
  • Burnout and Stress Management
  • Handling Difficult Calls
  • Advanced Suicide Intervention
  • Advanced Crisis Intervention
  • Discussion of Difficult Situations
  • Conclusion

Five Step Limit Setting Process

For more information on this limit-setting process, you can see my article Setting Limits and Boundaries with Callers. Briefly, the five steps are:

  1. Identify the inappropriate behaviour
  2. Identify what correct behaviour is
  3. Indicate the consequences for failing to change behaviour
  4. Give the caller an opportunity to change their behaviour
  5. Follow through on consequences (e.g. hanging up) if behaviour does not change

Active Listening Process (ALP)

For more information on the active listening process, you can see my article Active Listening Process on Crisis Lines. As a quick reminder, the different skills in the ALP include:

  • Voice Tone
  • Pace
  • Setting the Climate
  • Open Ended Questions
  • Close Ended Questions
  • Empathy Statements
  • Clarifying
  • Paraphrasing
  • Summarizing
  • Referrals
  • Winding Up

Burnout and Stress Management

What is Burnout?

Burnout is a “state of physical, emotional, or spiritual exhaustion.” It occurs when we give too much of ourselves for too long and don’t take appropriate steps to recover. Symptoms of burnout can include:

  • Becoming cynical or critical of callers
  • Being irritable or impatient
  • Feeling responsible for the outcome of calls
  • Having unexplained headaches or other physical complaints

An example of a situation I knew a responder was feeling burned out was when they took a 20 minute call with a regular caller who was dealing with relationship issues. While their on-the-phone work was good, when the call was over, they were very upset that the caller was not in crisis and just wanted to bounce ideas off the responder.

This responder felt like their time was being wasted by this caller, when we could be taking crisis calls instead. It’s clear that responder cared a lot for our callers – but they were not treating all of our callers like they were important to us. For this reason, we had a discussion about how our service is preventative and designed to both provide emotional support and crisis intervention. The responder took a leave of absence and when they returned several weeks later they were recharged and ready to support all of our callers.

Emotions on the Helpline

We can experience a range of emotions on the helpline. Some of these are positive and some of these are negative.

Positive Helpline Emotions

  • Excited
  • Grateful
  • Happiness
  • Hopeful
  • Meaningful
  • Optimistic

Negative Helpline Emotions

  • Anger
  • Frustration
  • Guilt
  • Confusion
  • Physical fatigue
  • Nightmares
  • Intrusive thoughts

What Causes Burnout?

There are a number of causes of burnout. These include working too many hours on the helpline – feeling like you’re a martyr or you always have to be there. Having your expectations set too high and expecting clients to change or improve (they call us because we’re a source of support that don’t ask them to change.)

Being isolated or having a lack of social support can increase burnout, as can a failure to debrief either with peers or supervisors after your calls. Feeling disconnected from the day-to-day events and other things happening at the crisis line can also cause increase your fatigue and burnout.

Overall, if you feel ineffective in your work you’ll be at greater risk for burnout.

Preventing Burnout

To prevent burnout, it’s important that you always debrief after tough calls. You can talk to your peer in the call room, you can talk to your supervisor. You can work fewer shifts or even take a Leave of Absence away from the Centre for a while, to recharge. Adjusting your personal life so you have a better work/life balance, and coming to Team Meetings and other social events can help you.

Finally, stress management techniques and having a strong support network will help you prevent burnout.

Relaxation and Stress Management Techniques

  • Bubble Bath
  • Hot Shower
  • Meditation
  • Physical Exercise
  • Sleep
  • Yoga
  • Others…?

Handling Difficult Calls

There are a range of difficult callers that responders can be confronted with. These include individuals with significant mental health issues, “chronic” or repeat callers who are calling for social maintenance reasons and sexual fantasizers or abusive callers who are trying to misuse the service.

Seriously Mentally Ill Callers

These individuals have significant struggles or may be actively in a mental health crisis. They might speak very quickly and not let you get a word in edge-wise, or they may be very impatient. Winding up the call be difficult and these calls can make you feel ineffective or frustrated.

Remember to keep an open mind, and remember why we support these callers. They often have few resources other than us that are non-judgemental and empathic. Let the caller vent their fears, anxieties and frustrations, but always remember the Active Listening Process (ALP).

If a caller is having delusions, we must not feed into those delusions but instead empathize with the underlying emotion. Rather than saying “Yes, there could be vans outside your house monitoring your thoughts”, say something like, “That would be really scary if it were happening.”

Social Maintenance Callers

These individuals are calling because they’re lonely. While our service provides support to them we must make sure that they do not monopolize the lines, or push boundaries in trying to collect personal information on our callers.

We will use our 5-Step Limit Setting Process if the caller wants identifying information, and try to engage the caller openly in things that they can do, or that you and them can talk about, to reduce their loneliness. When the call starts going in circles (they’re repeating themselves and not moving on to anything new), we can begin to wind up the call.

They should call us back tomorrow if they’d like to speak again, and you can discuss with staff the setting of a time limit or other restrictions.

Sexual Fantasizer Callers

These can be some of the most frustrating calls for us to deal with, because they make us question what we’re doing on the helpline. These callers are often difficult to determine as sexual fantasizers at first – they drag it out as long as possible.

When we begin to suspect that we’re speaking with a sexual fantasizer, we must remind them to stick to the discussion of the emotions of their problem. For example, sometimes we get legitimate callers who want to talk about cross-dressing, sexual orientation, or sexual fetishes. If these callers are genuine, they will prefer to speak about the emotions of those elements and how they impact those around them, rather than discussing the specific activities of cross-dressing, having sex with men, or engaging in a sexual fetish.

You might feel angry or used when the call ends if you don’t figure it out early enough. You’ll need to make sure that you debrief and put your stress management techniques into practice.

Angry or Abusive Callers

These callers are those who are calling to take emotions out on you. This can be challenging and is not an appropriate use of our service. Using your Five Step Limit Setting Process, you’ll need to let the caller know that you are here to listen if they are upset but that they cannot direct language at you.

If they would like to make a complaint, they should call the office line. Set the boundary, and if they continue then you’ll end the call. And make sure you follow through!

Suicide/Crisis Intervention

Suicide intervention is the process of assessing and intervening with someone who is at high-risk of suicide. Once you’ve done some risk assessments on the phone you’ll have a better sense of how to weave these questions into your exploration of the caller’s issues.

By starting each suicide assessment with “Have you done anything tonight to kill yourself or end your life?” you’ll be able to move smoothly into the safety planning questions. Your goal is to make sure that you have a sense of whether the caller will be safe tonight. If they will, you don’t have to worry. If they won’t, you can begin building a safety plan or support network collaboratively with the caller to make sure they will be safe.

You’ll want to conduct a suicide risk assessment:

  • Any time you suspect a caller is suicidal
  • When they tell you they’re having suicidal thoughts
  • Even if the person denies current suicidal thoughts

In an emergency, when the caller has already taken steps to end their life, you must:

  1. Change your voice tone. Become assertive, to let that caller know that they need to cooperate with you so you can get them help
  2. Collect their location, and other identifying information
  3. Tell them to unlock their door, open the door if they can, so that emergency personnel can reach them
  4. Debrief after the call with your supervisor

Example of Suicide Intervention

  • Caller explains they have self-injured today
  • Responder assesses suicide risk, they come up medium on the CPR or DCIB Suicide Risk Assessment
  • Responder explores coping strategies but they say there’s nothing they can do, they’ve tried it all and they can’t guarantee their own safety
  • Responder arranges for a taxi to take them to hospital or mental health crisis bed

Discussion of Difficult Situations

During the discussion of difficult situations, responders would talk about situations that they personally found challenging – whether or not they were covered on the above. A group discussion would help responders get a better sense of how their peers would handle those situations, and the facilitators would share their own thoughts. This helped to increase the confidence of the responders in dealing with those situations in the future.

Conclusion

We would wrap the session by thanking everyone for coming out and presenting them with an Advanced Training certificate. Completion of both Basic and Advanced Training was required for a responder to be considered a Certified Volunteer Helpline Worker.

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