HOTLINE CALLS
Crisis & Hotline Myths, Fantasies,
Delusions, or Everything you ever feared
about phone work, but were afraid to admit.
Omnipotence- “We have to do something”
You pick up the phone and suddenly you are
on the spot. There is a crisis and it seems up
to you to provide an instant, expert, final,
once and for all answer. Variations of this
delusion are:
“But all I’m doing is listening” - Until you
have listened, you have no business even
trying to be omnipotent. Many times all the
caller wants is someone to listen.
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“If I talk about it, it may happen.”- Callers are
not nearly as fragile as you think. If you think
the caller is suicidal, ask, don’t pussyfoot
around.
“ What if I’m being manipulated?” - When
dealing with desperate people, it may be all
right to be manipulated. This is not the time to
be confrontational.
“ If only I were a psychiatrist, psychologist,
social worker, medicine man-- then I could
help. If only I had read….or Why didn’t
someone tell me about…”- In reality, you most
therapeutic tool is you and the relationship you
establish over the phone.
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Thinking you need to have the “ultimate
answer” Will your referral be the “perfect
referral”? It may not work out for the caller;
they may have to call you back. Continue to
explore alternatives with them.
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Calls come into the hotline for:
An emergency
Referrals/information and/or
Emotional support
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Three stages of a crisis
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Rise in tension
Rise in anxiety/injury/shock, perhaps to the point of
being confused, overwhelmed, angry, feeling
helpless, and existing coping strategies are not
working
Resort to different coping strategies, one of which
may be calling the hotline
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What is the caller feeling?
Anxiety This is the feeling most often elicited
by the caller. Any substantial threat to wellbeing produces anxiety. A normal amount of
anxiety is expected and healthy when a person
feels alarmed about life circumstances.
However, severe anxiety produces confusion,
impaired judgment, distortion and very often
destructive behavior. Anxiety is the emotion
crisis line workers deal with most often.
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Helplessness When internal and external
events pile up, leaving the caller in a position
where the old familiar ways of coping no
longer work, the result is often an
overpowering feeling of helplessness. Many
times, feelings of guilt or shame overcome the
caller, along with a lessening of self-esteem.
The caller may not be able to see that there are
choices to be made, and becomes dependent
upon others to help with decision-making.
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Anger The caller may need to express feelings
of anger. The anger may be directed toward an
event in the life of the caller or toward another
person. It may be directed inward, or it may be
directed toward the hotline worker. Anger is a
legitimate emotion and must be expressed.
However, anger is seldom expressed
assertively and may manifest itself as hostility,
hurt feelings or by a denial of any feeling.
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Ambivalence The decision to make a first
crisis line call often comes out of desperation.
There is an inward struggle of dependence vs.
independence. Such feelings leave the caller
vulnerable. A caller in crisis often behaves
impulsively, letting emotions lead the way.
This is why some callers act demanding, or
manipulative. These are defense mechanisms,
which are used to protect them from feeling
anxiety, helplessness, guilt, and incompetence.
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By relieving some of the anxiety, helping the
caller to regain control and by reassuring the
caller that there are choices in any situation, the
worker can direct the caller to realistic problem
solving behaviors.
Hotline Advocate’s Role
Supporter Give empathetic but nonjudgmental support to the caller
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Listener Relieve the caller’s emotional
distress. Offer the caller an opportunity to
express feelings, explore fears or concerns, and
vent anger.
Clarifier Help the caller to identify the most
import issues first.
Information and Referrals Identify and
explain the many services that are available in
our community
Remember!! You cannot change others. Your
job is not to give advice, your role is to
delineate options for the caller to make their
own choices and regain control over his or her
own life.
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1.
Be yourself. “The right words” are
unimportant. If you are concerned, you voice
and manner will show it.
Speak in a calm voice. Control your breathing
to breathe slowly and evenly to remain calm.
Listen. Let the person unload despair,
ventilate anger. Draw out the caller’s emotions
and respond with empathy.
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Use the caller’s name.
Be empathetic, non-judgmental, patient,
accepting. Let the caller know that he/she has
done the right thing by calling.
Normalize the person’s situation; let him or
her know that they are not alone and not crazy.
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Assure the caller of confidentiality.
Avoid arguments, problem solving, advice
giving, quick referrals, belittling. It is not how
bad the problem is, it is how bad the caller
feels it is.
When the caller has expressed a thought,
pause for a few seconds before responding.
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Use open-ended questions. These are
questions that require more than a one-word
response. “Please tell me how you feel when
that happens?”
Speak to the caller’s feelings about the
situation (i.e. lonely, sad, angry, discouraged,
etc.)
Remain in control of your own feelings. You
have to be objective in order to be helpful.
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Relate the problem and feelings in a simple
way through paraphrasing. “ It sounds as if
you are feeling….” Active listening
Don’t give your solution! “If I were you…”
Find out what the caller has already done and
what he or she can do for themselves.
Support the effort. “Will you call back and let
us know how it worked out?”
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Close-ended questions are used to get a short
response.
They are used to:
Assess danger
Assess Safety Options
Gather basic identifying information (name,
address, phone number)
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If the caller is saying, “ I’m so depressed, I can’t
go on.” Ask the QUESTION: “Are you having
thoughts of suicide?” It is not putting ideas in
his or her head, it shows concern.
If yes, you can begin asking:
Get person’s name address and phone number.
Have you done anything already?
Do you have within sight, a weapon, pills, etc.?
Call 911 and keep the caller on the line until
help arrives Even if it is against the person’s
will!
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Get another person to call the number that the
caller gave you to make sure it is busy!
Would you unload the gun, flush the pills? (If
the caller will not, do not push) repeat the
question periodically.
Get the details of what the person took and
how much
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If the person has not already done anything,
ask questions like:
Do you have a plan?
Is the plan available
Will you agree to stay alive while we talk?
Have you thought about when you would do
it?
Would you like to talk about what is going on?
What made you call me today?
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Explore options (including feelings) Don’t lay
a guilt trip on the caller.
Explore reasons to live
Get the person to make specific plans for the
future.
What do you plan to do tomorrow?
What will you do if you feel like killing
yourself again?
Do you promise to call the hotline if you feel
suicidal again
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Warning signs
Using euphemisms (I’m going away, I can’t take it
anymore.)
 Getting affairs in order
 Making a will
 Giving away belongings
 Flat effect
 Sleeplessness or sleeping all of the time
 Loss of appetite or overeating
 Crying all of the time or inability to cry.
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Past suicide attempts
Telling of other family members who have
committed suicide
Latch on to the will to live. The caller wants to die
as evidenced by suicidal thinking. The caller wants
to live as evidenced by the fact that he or she called
you.
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Hotline Training Completed Click Here