SPAN TRAINING PROGRAM LAUNCHED ON 25.9.2016 FROM 0930 HRS TO 1830 HRS : Theory Session Over
Coordinated by : 1. Dr.P.K.N Choudhary 2. Dr.Bhavani 3. John 4 Balaji 5.Ashwin and SPAN Admin Team with Chetana Staff Support .
Coordinated by : 1. Dr.P.K.N Choudhary 2. Dr.Bhavani 3. John 4 Balaji 5.Ashwin and SPAN Admin Team with Chetana Staff Support .
SPAN BATCH II TRAINING ON 6.11.2016
PRACTICAL TRAINING TO BATCH 1 ON 9.10.2016 BY JOHN HEMANT KUMAR OF NEURONS
Training conducted by Balaji of Darshika on 16.10.2016 Below
SPAN BATCH TWO FACILITATORS TRAINING 27.11.2016 BELOW
TRAINING OBJECTIVES
By the end of training, each volunteer trainee should be able to demonstrate knowledge, concepts, attitudes and skills as follows:
1.Knowledge and Concepts
1.The helping process (including what constitutes an effective helper, an active listener and the stages in that process).
2.Basic concepts of crisis theory, assessment and intervention.
3.Community resources.
4.Record keeping system and program policies.
5.Basic suicidology (including lethality assessment and legal issues).
6.Ethical issues.
7.The facilitation process and follow up procedures.
8.Voluntary and involuntary hospitalization criteria and procedure. Escalation process
9.Signs of “burn out” and/or over involvement and ways of dealing with it.
2.Attitudes
1.Acceptance of and non judgmental responses to, persons different from self and toward sensitive issues, e.g. abortion, religion, sexual preference, etc.
2.Balanced and realistic attitude toward self in general and, in particular, toward self in helper role.
3.Realistic and humane approach to death,dying,self destructive behavior and other human issues.
4.Awareness and appreciation of one’s own feelings and values as these may impact upon the intervention process.
5.Openness toward feedback and learning.
6.Enthusiasm and support for SPAN aims and objectives
7.Perception of people in crisis as basically normal (not crazy), capable of helping themselves and capable of further growth given the necessary resources.
3. Skills
1. Rapport or relationship building.
2.Clarification & Information gathering.
3.Crisis assessment.
4.Suicide assessment (long term risk and emergency potential).
5.Problem solving or formation of an action plan.
6.Efficient mobilization of appropriate community resources.
7.Accurate, comprehensive record keeping.
8.Implementation of SPAN policy and procedures (including handling of Rape Response calls).
9.Use of the consultation process.
10.Termination of a call (when and how).
The trainee’s possession of the foregoing knowledge, concepts, attitudes and skills shall be assessed through role play, written instruments, small group interaction, verbal exercises and supervised handling of actual calls. Evaluation and feedback will be on going through out the training period. A written record of progress will be maintained in the volunteer file. The foregoing also constitutes minimum performance standards for telephone Facilitators after completion of training.
BEING A GOOD VOLUNTEER
Ten Guidelines for being a Good Volunteer
- The three core conditions of counseling are UNCONDITIONAL POSITIVE REGARD, GENUINENESS, AND EMPATHY.
- No call, or case, is unimportant. ALL CALLS AND CASES ARE EQUALLY IMPORTANT, no matter what the severity of the problem. Every caller is equally special as the last - no more, no less. Even difficult calls have a special or wounded person at the en of the line.
- Counseling is empathetic, reflective listening in which the caller is helped in developing his or her own solutions. COUNSELING IS NOT ADVICE GIVING. Advice giving is better left to buddies, mothers-in-law, uncles, neighbors, etc.
- COUNSELING IS DIFFERENT THAN “CHIT-CHAT.” It is also not done in a “formula or “cookbook” manner, although there are important guidelines for doing it well.
- BOUNDARIES ARE IMPORTANT. Role and function clarification is very important. SPFs and advocates are facilitative listeners, not friends, lawyers, mind readers, dates, ministers, advice givers or experts.
- SELF-DISCLOSURE IS NOT COUNSELING. A counselor, or advocate, NEVER shares personal information about him or herself, even if the caller, or client, asks for personal information about you.
- COMMUNICATION IS NOT WHAT THE SENDER SAYS; IT’S WHAT THE RECEIVER RECEIVES. Check it out with the caller or client...is he or she hearing you as you had intended? And are you hearing him or her as intended?
- PAIN IS VERY PERSONALLY DEFINED. The idea that every person’s perspective is valid can be stated with the phrase “Same courtyard, different windows.” We all can be looking at the same situation, but from slightly different viewing points, each perspective is very real and possibly very different. What is the perspective of your caller or survivor?
- CARE FOR THE CAREGIVER IS IMPORTANT. Talking with your Shift Manager, a Program Coordinator or fellow volunteer is encouraged especially after challenging calls. Feedback, both to and from you, is very important to our success. Also, it is important to attend several in- services that the center offers to stay up to date with the counseling field, and rejuvenated.
Who Is At Risk For Suicide?
People of all genders, ages, communities and ethnicities can be at risk for suicide. Men are more likely to die by suicide even though more women attempt suicide. Men use deadlier means. Older adults and youngsters in the 15-24 year age bracket are also more prone for suicde. But people most at risk tend to share certain characteristics and they are:
- Depression, other mental Disorders, or substance abuse disorders
- A prior Suicide attempt
- Family history of a mental disorder or substance abuse
- Family history of suicide
- Family violence, including physical (domestic violence and ragging at schools and colleges) or sexual abuse (rape).
- Having easy access to harmful substances like pesticides or weapons like guns
- Being in prison or jail
- Being exposed to others' suicidal behaviour, such as that of family members, peers, or media figures.
About the Suicide Paradigm
Some thoughts on changing our conception of suicide
Suicide is the outcome of neurobiological breakdown. The process begins in severe stress and pain generated by a serious life crisis. These increase as the crisis, or the individual's perception of it, worsens. Feelings of control and self-esteem deteriorate.
Suicidality occurs when the stress induces pain so unbearable that death is seen as the only relief.
Suicidality entails changes in brain chemistry and physiology. Suicidal individuals manifest various chemical imbalances. As one becomes suicidal he or she is no longer capable of choice. Suicidality is a state of total pain which, coupled with neurological impairment, limits the perceived options to either enduring or ending utter agony. Quite a few of the suicide attempters do so as an act of impule and they are not to be classified under this and may choose so due to poor frustration tolerance and coping skills.
New insights are laying the groundwork for a new paradigm, which entails a change in how we see suicide.
Old Paradigm New Paradigm
Suicide - Killing of oneself Penacide - Killing the pain
Goal: End Life Goal: End Pain/suffering
Event or behavior Process of debilitation
Decision and a personal choice Disease outcome; no choice involved beyond crisis point in the process of debilitation A means of control or manipulation
The result of severe stress and psychological pain Voluntary action involuntary response Individual is a decision-maker Individual is a victim A psychological phenomenon A physiological or neurobiological phenomenon involving the mind involving the brain
HOW CAN SUICIDE BE PREVENTED?
The risk for suicidal behaviour is complex and it is crucial that we understand the role of both long term factors - such as experiences in childhood and personality of the individual – and more immediate factors like mental health and recent life events. Suicide is not a normal response to stress.
Effective Suicide prevention programmes need to take into account people's risk factors and promote interventions that are appropriate to the specific underlying factors.
Psychotherapy or “talk therapy” can effectively reduce suicide risk.
- Cognitive Behaviour Therapy (CBT) is the talk therapy of choice as it can help the individual learn new ways of dealing with stressful expreriences by training them to consider alternative actions when thoughts of sucide arise.
- Dialectical Behaviour Therapy (DBT) that has been shown to reduce the rate of suicide among people with borderline personality disorder: a serious disorder characterised by a chronic feeling of emptiness, unstable moods, relationships, self-image and behaviour. DBT helps the person recognise when his or her feeligns or actions are disruptive or unhealthy and teaches the skills needed to deal better with upsetting situations.
Medications especially to treat the underlying mental health issues go a long way in preventing suicides. For example a person who hears voices that are not there but that keep disturbing or commanding could respond well to medication and hence overcome the thought to end it all. Or even the person who is depressed recovers from depression in a matter of few weeks. Its a myth that medications necessarily cause drowsiness and are to be used for life. Nowadays medications have limited side effects and if not one the other medicine would suit the person.
If you are in a crisis call: 720 730 8383
MYTHS AND FACTS ABOUT SUICIDE
MYTH 1 A person who talks about completing suicide won’t actually do it.
MYTH 2 Suicide usually occurs without warning.
MYTH 3 A suicidal person fully intends to dies.
MYTH 4 If a person attempts suicide once, he or she remains at constant risk for suicide throughout life.
MYTH 5 If a person shows improvement after a suicidal crisis, the risk has passed.
MYTH 6 Suicide occurs most often among the very rich and the very poor.
MYTH 7 Families can pass on a predisposition to suicidal behavior.
MYTH 8 All suicidal persons are mentally ill, and only a psychotic person will complete suicide.
FACT 1 About 80% of persons who complete suicide express their intentions to one and often more than one person.
FACT 2 A person planning suicide usually gives clues about his or her intentions, although in some cases, suicidal intent is carefully concealed.
FACT 3 Most suicidal people feel ambivalent toward death and arrange an attempted suicide in the hope that someone will intervene.
FACT 4 Suicidal intentions are often limited to a specific period of time, especially if help is sought and received. Help can be effective.
FACT 5 Most suicides occur within three months or so after the onset of improvement, when the person has the energy to act on intentions.
FACT 6 Suicide occurs in equal proportions among persons of all socioeconomic levels.
FACT 7 Suicide is not an inherited trait, but an individual characteristic resulting from a combination of variables. One variable may be that another family member has died by suicide.
FACT 8 Studies of hundreds of suicide notes indicate that suicidal persons are not necessarily mentally ill
F.A.C.T.
Suicide Warning Signs
F for Feelings
• Hopelessness “It will never get any better.” “There’s nothing anyone can do.”
• Fear of losing control, fear of going crazy, fear of harming oneself or others.
• Helplessness, a feeling that “no one cares,” “everyone would be better off without me.”
• Overwhelming guilt, shame, self-hatred.
• Pervasive sadness
A for Actions or Events
• Drug or alcohol abuse
• Themes of death or destruction in talk or written materials (letters, notes)
• Nightmares
• Recent loss through death, divorce, end of relationship, separation, loss of job, money, status, pride, self-esteem.
• Loss of religious faith or spirituality
• Agitation, restlessness
• Aggression, recklessness
C for Change
• In personality - more withdrawn, tired, apathetic, indecisive or more boisterous, talkative, outgoing. Different temperament than usual.
• In thoughts - can’t concentrate on schoolwork, routine tasks, etc.
• In sleep patterns - oversleeping, excessive sleeping, insomnia
• In eating habits - loss of appetite, weight gain/loss, overeating, change in eating rituals
• In activities - loss of interest in friends, hobbies, personal grooming, or other activities
• Sudden improvement after a period of being down or withdrawn, “too euphoric”
T for Threats
• Statements, e.g., “How long does it take to bleed to death?”
• Threats, e.g., “I won’t be around much longer.”
• Plans, e.g., putting affairs in order, giving away favorite things, obtaining a weapon.
• Gestures, or attempts, e.g., overdose, wrist cutting.
Of course, aside from the more overt gestures or threats, none of these signs are a definite indication that the person is going to complete suicide. Many people are depressed and never end their lives by suicide. Many experience losses or evidence changes in behavior or demeanor with not indication of suicidal tendencies. However, If a number of these signs occur, they may be important clues that help is needed. Act immediately and get resources.
Rights of Suicidal Individuals
For those who are at risk of completing suicide
In an era of strong advocacy for consumer, client, and patient rights, one group has been forgotten. Those who are suicidal or at risk of becoming so are accorded little protection in professional ethics codes and similar instruments. This deficiency has been amplified by the debate about assisted suicide and the “right to suicide.” Most suicides are “unassisted” and those at risk are entitled to more than the right to die.
- Suicidal individuals have the right to have any expression of intent taken very seriously by those to whom they have communicated. Those at risk often make a “cry for help.” This should be regarded as a sincere request for aid.
- Suicidal individuals have the right to have their suicidal risk viewed as their most serious problem. There is no problem more serious. Those at risk may have other problems, which may be related to their suicidality. However, once the potential for suicide is determined it must take precedence until it is abated.
- Suicidal individuals have the right to be seen as wanting to be helped. They want their pain to end. They do not want to die. Those at risk are often ambivalent about living or dying because they may equate living with pain and dying with freedom from pain. Intervene on the side of life.
- Suicidal individuals have the right to have their condition brought to the attention of someone in their life who cares for them. Family members and friends are available and easily mobilized. Moreover they stand to be irrevocably harmed if a suicide occurs. Let them help.
- Suicidal individuals have the right to know that they are experiencing a chemical deficiency in their bodies brought on by stress and/or mental illness. Those at risk have a deteriorating sense of self-esteem and control. They must know that they are not causing what is happening in their bodies.
- Suicidal individuals have the right to know that medications are available which present viable means for stabilizing their situation. Those at risk must have early access to antidepressants and other drugs, which may take time to reach clinical effectiveness.
- Suicidal individuals have a right to acknowledgment of their pain, which may be physical, psychological, or emotional in origin. Those at risk have severe stress and psychological pain. Ask about their pain, and help to ameliorate it.
- Suicidal individuals have a right to meaningful intervention by those responsible for their care when they are manifesting critical symptoms. Those at risk cannot help themselves because of the process of debilitation that they are experiencing. At some point they can only be helped by others.
Common Errors Of Suicide Interventionists
Superficial Reassurance
Caregiver is . . .Too optimistic, emphasizes positive aspects of situational risks thus alienating the distressed person, rejects and contradicts the client’s anguish or hopelessness, Prematurely offers prepackaged meaning for expressed difficulties (such as religious or secular philosophy), discounts the depth of pain.
Inappropriate responses: “You have so much to live for.” “God works in mysterious ways.” “Things can’t be all that bad.”
Avoidance Of Strong Feelings
Caregiver . . .Retreats into intellectualization or premature advice giving, while avoiding empathic understanding. Models the containment of strong emotions, thus failing to allow the client free expression of angst.
Inappropriate responses: “Your tears suggest that you’re depressed. Maybe we should consider some medication.”
Professionalism
Caregiver . . . Insulates or protects oneself from complicated pairings with by seeking refuge in the boundaries afforded by one’s professional role. Overly distances and detaches, conveying disinterest. Fails to build upon the relationship qualities of the therapeutic alliance.
Inappropriate responses: You can tell me, I’m a professional and have been trained to be objective about these things.” “I never have clients who are suicidal.” “If you become suicidal, I’ll have to refer you to another therapist.”
Inadequate Assessment Of Suicidal Intent
Communications of suicidal intent (even veiled or indirect signals) may be met with reassurance, and even more direct statements of intent are ignored or contradicted.
Inappropriate response: “You sound as if you’re suicidal, but what is really bothering you?”
Failure To Identify The Precipitating Event
Caregiver . . .Fails to recognize and acknowledge key triggers of suicidal behaviors. Underappreciates the context and precipitating events which, when considered fully, could guide the development of actions within intervention. Fails to grasp that clients need their pain.
Inappropriate response: “What do you think your deceased wife would want from you? Don’t you think she’d want you to be more productive, to get on with your life?”
Passivity
Caregiver . . .Fails to be active, engaging, focused, and structuring. Passivity misses connecting/joining with the client, misses collaborative alliance.
Inappropriate responses: “I’m here to listen...” “It must be very hard to talk about what’s
bothering you.”
Insufficient Directiveness
Caregiver . . .Fails to negotiate safe structures. Misses the point that crises need more directive management, such as, “Would you put the gun down?” as contrasted with--
Inappropriate response: “It seems as if holding the gun makes you feel more in control.”
ADVICE GIVING
Caregiver . . .Fails to facilitate within the client the development of problem-solving skills and the opportunity to participate in his/her own solution/rescue.
Inappropriate responses: “You’re not thinking rationally. We need to identify an alternative way to interpret what happened.”
Stereotypical Responses
Caregiver . . .Takes shortcuts in the form of unwarranted, stereotypical assumptions based on demographic profiles, typologies, etc. Treats client as a statistic rather than as a unique individual.
Inappropriate responses: “Most men in your age group have this difficulty.”
Defensiveness
Distressed individuals in crisis may become more difficult with which to work, focusing on, displacing upon and perhaps attacking the caregiver. Fails to respond nondefensively.
Inappropriate responses: “Well, no, I have never been suicidal myself, but I can still help you.” “Sure, I’ve had suicidal thoughts myself, but I’ve always found better solutions to my problems.”
TEST YOUR KNOWLEDGE?
1. What services does SPAN provide and how is it different from other crisis intervention services?
2. What is your role as a volunteer? (name at least 4)
3. What the Caller can expect when they call the SPAN HelpLine?
4. How do you document your work?
5. When must you break confidentiality?
6. Under what circumstances must you report to the law enforcement agencies?
WHAT IS EXPECTED OF A VOLUNTEER?
WHAT THE CALLER OR SERVICE USER CAN EXPECT WHEN THEY CALL IN A CRISIS?
Survivors of Suicide Support Group
SOS offers a group setting for those people who have lost a loved one to suicide. This bi-monthly support group allows individuals to openly express feelings associated with death by suicide.
Issues unique to suicide survivors are discussed and explored within this group. Facilitated by professionals, the SOS group provides an open, non-judgmental atmosphere of support without the stigma often associated with suicide. Group members share their stories as well as various coping skills they have found to be helpful in the healing process.
The Survivors of Suicide group meets on ____________
TAKE 5 STEPS TO SAVE LIVES
- LEARN THE SIGNS
- Emergency Warning Signs:
- Someone threatening to hurt or kill shim/herself or talking of wanting to hurt or kill him / herself
- Someone looking for ways to kill self by seeking access to pills or others means.
- Someone talking or writing about death, dying or suicide, when these actions are out of character for the person.
- Contact a mental Health professional or helpline if you hear or see someone exhibiting one or more of these behaviours
- Hopelessness, Helplessness, feeling trapped / like theres no way out
- Sad
- Rage, uncontgrolled anger, seeking revenge
- Acting reckless or engaging in risky activities, seemingly without thinking
- Increased alcohol or drug use
- Withdrawing from friends, family and society and activities of interest
- Anxiety, agitation, unable to sleep or sleeping all the time.
- JOIN THE MOVEMENT (Connect Communicate Care or Reach out and save lives)
- Join the count down to World Suicide Prevention Day and
- Like our facebook page if you haven't yet or share it with your friends if you have
- Tweet or retweet
- Join the spantrust16 Facebook page.
- SPREAD THE WORD
- Make a personal pledge to tell 20 friends and their family members about World Suicide Prevention day and how they too can bring about an awareness and may be save lives by taking 5 min to register at http//go.gl/bit todo/ZeroSuicide
- Keep some activity ongoing to keep the awarenss alive in and around your area.
- SUPPORT A FRIEND
- Just by asking “R U OK?” Ask if he / she is thinking about suicide. Be direct. Talking openly and freely about suicide is known to decrease the chance of suicide.
- Be willing to listen. Allow them to talk openly about their feelings.
- Be non-judgmental. Don't debate whether suicide is right or wrong, or if feelings are good or bad. Don't lecture on the value of life
- Get help by reaching out to someone you trust. Another adult, a school teacher, a counsellor, a close friend or family member.
- REACH OUT
- Do you know where to turn for help if you or your friend or your near and dear one is having suicidal thoughts.Keep yourself abreast of the resources that are available in your area by registering yourself with Facebook/spantrust16
- Talk to a friend
- Call a hotline 7207308383 and talk to a trained helper
- Schedule an appointment with a professional therapist or psychiatrist...you can do so online without actually going to a hospital or centre.
- Read others stories of hope and recovery. Sometimes reading how others have gotten through a difficult time can help you navigate your own tough situation.
Types Of Callers
Third Party Suicide Calls
In general, people who are suicidal but don’t call the hotline are likely even more at-risk than someone who calls. In many cases those at-risk individuals come to our attention because someone who cares about them calls us – a third party call.
Many times we can make the third-party caller an ally and use their contact with the person atrisk to help us keep them safe. We can train the caller about suicidal intervention and risk assessment. It is unfair, however, to give third-party callers the responsibility for actually providing the suicide intervention. They are personally and psychologically too close to the person at risk to be objective and effective as interventionists.
It is also unfair to expect that the third-party caller will welcome being identified to the person at-risk as the one who called about them. That is expecting too much of the caller. Sometimes they will agree but more often not. Active intervention suggests that what the caller does or what they permit is not important. What is important is that the crisis worker talk directly to the person at risk.
As noted above, these persons at–risk may, in fact, be the most suicidal callers we talk to. It is not appropriate to call the at-risk person directly without their permission. Encourage the caller to give the person our contact information or participate in a 3-way call. Calling without permission may damage the relationship between the at-risk person and the third party caller, it may violate confidentiality, and it may agitate or anger the at-risk person.
Suggestions for Third-Party Callers
• Educate the caller to ask the person directly “are you feeling suicidal”. They cannot put the
idea in the person’s head if it is not already there.
• Take the threat seriously; don’t interpret it as a phase. Manipulative people do kill themselves.
• Educate the caller about suicide risk factors and warning signs.
• If there is an immediate risk/emergency (i.e. attempt in progress), have the caller take action by
calling 104
• Encourage the caller to call the SPAN Help Line as needed.
• Without putting themselves in danger, have the caller remove guns or other suicide tools from the
household.
• Keep as much contact as possible with the suicidal person. Use more than one person if
necessary.
• Notify safe significant people in the client’s life, and inform them of the risk. Don’t keep it a
secret.
What can the caller talk about?
ANYTHING!! You don’t even have to have a problem to call us. You can just call to talk. We also love happy calls and good news, so share with us!! If it’s important to you, it’s important to us! We may not have all the answers or solutions, but we are here to listen. Some examples of things to call about are:
- School Problems
- Exam fears
- Peer Pressure
- Sad Things
- Pets
- Bullies
- Friends
- Scary Things
- Hobbies
- A N Y T H I N G ! !
First Aid Kit for Suicide Survivors
Some Information That May Help You and Your Family
- Why did my loved one or friend complete suicide?
The majority of suicides (80% or more) are the result of untreated depression or other mental illness. Many survivors mistake a “triggering event” such as a relational breakup or personal failure as a “cause.” Despite what survivors may read in a seemingly “rational” and explicit suicide note, suicidal acts are desperate attempts to escape extreme and often enduring mental anguish, pain, and/or stress.
This is more related to a person’s ability to cope than a rational response to actual life events. Depression and other illnesses contribute to low self-esteem and undermine one’s confidence and ability to accurately perceive and deal effectively with stresses that a healthy person takes in stride or adjusts to more quickly and successfully.
- Why didn’t my loved one or friend tell me how he felt and why didn’t I know?
The vast majority of suicides are unexpected and unanticipated. Even those whose loved one was under “suicide watch” are shocked and dismayed at the ingenuity and determination of a suicide. Suicides are “masters of deception” because they fear they will be labeled crazy or that their pain will not be taken seriously or that help will be ineffective.
Again, it is all part of their lack of coping skills and skewed perception of themselves and those around them.
One of the heaviest burdens for survivors is guilt that they didn’t know their loved one was in danger. Typically, “warning signs” exist only in hindsight. Our society is poorly educated about suicide and mental illness, and what we think we know is often wrong. Also, family histories of suicidal behavior and other mental illnesses have traditionally been kept “in the closet.”
Parents are especially prone to blaming themselves for not knowing something so fundamental as the state of their child’s mental health. But if parents are taught anything at all about depression and suicide (and they are not), it is typically a “laundry list” of signs which closely mimic “typical” teenage behavior! Most cases of depression are diagnosed only in the wake of a failed attempt or some other serious behavioral problem or disorder such as ADHD or drug and acohol abuse. And even then, people are not well informed about how closely these other conditions are correlated with suicide.
- Does this mean that my family and I are at risk of completing suicide too?
1) Depression and some other mental illnesses run in families, and
2) because psychological trauma is related to brain chemical imbalances and because suicide grief is the most powerful and debilitating, survivors are one of the high-risk groups for suicide ideation/behavior.
- What happens now? What kind of feelings or emotions can I expect?
The best description of suicide grief is a jagged and jarring roller coaster ride that tends to spiral in endless loops.
- What can I do to help me and my family deal with these feelings?
- Will it ever get better, will we ever feel differently?
Straight Talk about Suicide Survivor Risk Insight and Advice for Them and Their Family
Suicide is often the beginning of a number of serious and even life threatening problems for the survivors. Among these are:
Complicated Grief Reactions:
Suicides are traumatic because they are sudden, unexpected, and often violent. They involve lengthy bereavements, feelings of guilt and anger, and loss of trust. If a survivor is unable to mourn normally, grief may become “hidden” or “delayed” for years. In the interim depression and/or other physical and mental problems may arise. The grief of young children, teens, unmarried partners, and the parents of adult victims may be especially challenging if it is not recognized or seen as justified by others.
Post Traumatic Stress Disorder (PTSD):
Suicide loss is one of the most abnormal and traumatic of life experiences. Those who see the act or discover the body may be especially affected by the more serious symptoms of PTSD. PTSD involves strong feelings of powerlessness and helplessness. Sufferers may have “flash-backs” to the event and relive the horror and the shock. These elements may lead to depression and other problems. PTSD breaks down one’s normal coping ability, and scientists are finding a physical component in the brain chemistry of sufferers as well. Those affected can benefit from counseling and new therapies such as EMDR. Depressive and Affective Disorders: Survivors may face “double jeopardy” in regard to these conditions. All survivors are at risk of emotional disorders because of the overwhelming nature of their loss. Family members may be physiologically predisposed to depression and related disorders by genetically determined factors that they share with their lost loved one. Grief reactions and PTSD may “trigger” depression. These same stressors may also create chemical imbalances, most notably of the neurotransmitter serotonin, which are linked to depression.
Suicidality:
This is the state of being suicidal and ranges from thoughts of suicide (suicidal ideation) to suicide attempts. The saddest and greatest concern is that suicide survivors are themselves at high risk of suicide. This is because the experience of the suicide can create the same state of mind among survivors that led to the loss of their loved one. Suicidality is not normal or automatic among survivors, but it may be linked to any of the serious problems that survivor’s face.
What You Can Do:
1. Be alert to signs of these problems in yourself and in others close to your loved one.
2. Don’t wait for them to happen. Find help or support as soon as possible.
3. See your family doctor and share your concerns.
4. Consider grief counseling or similar help on an individual or family basis.
5. Consider attending the Survivors of Suicide Support (SOS) Group at the Crisis Center.
6. SPF Training may be useful because of the impact on beliefs and values
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Helpful Skills for Building Relationships
When a (crisis call facilitator) is able to feel and communicate caring, understanding and acceptance for a caller, s/he enhances his/her capacity to be of help to that person. A relationship is an experience between two individuals; the relationship you are asked to build with the caller is unique in many ways. It may come at a time when the caller is particularly vulnerable and sensitive. The conversation may focus on painful feelings, losses, confusing situations, situations where the caller feels inadequate, unsolvable problems, etc. and will take place without the benefit of eye contact and physical presence. As a telephone counselor, you will put your understanding and caring into your verbal exchange and will have only a limited time with this person. In spite of those obstacles, building a strong relationship will be an essential tool for working with this caller.
Attending Skills: (paying attention physically)
Attending is giving your physical attention to another person - listening with the whole body. Attending is nonverbal communication that indicates that you are paying careful attention to the person who is talking.
This may seem rather difficult to do while on the telephone, but it is important to practice these skills whether or not the person can see you. In the phone room there can be numerous distractions (other volunteers, television, solitaire, homework, etc.) Give the caller your undivided attention. When the phone rings minimize environment distractions and utilize these skills.
SOLER SKILLS
S Sit Squarely
O Sit Openly
L Lean forward
E Eye / Ear contact
R Relax
Reflecting Skills: (paying attention mentally)
Feeling understood, accepted, and cared about is important to each of us, especially at a time of crisis. Reflection is the process of identifying, making clear and expressing back feelings and thoughts. This process involves grasping what the other feels and means, and then stating this meaning so that the person feels understood and accepted.
While reflecting may seem contrived in our everyday ordinary conversation, it is an essential skill in counseling. People rarely report that it feels contrived. Rather, they seem to appreciate the degree of concern and focus. Except in extreme emergencies, you can never reflect enough.
• Reflecting is nonjudgmental and accepting. It conveys the desire to understand what the caller is feeling and saying by trying to understand the feeling behind the message and then reflecting that feeling back to the caller (e.g. “Sounds like you were really angry about that” or “It seems you were very scared when that happened.”) This is also called “active listening.” Active listening helps clients clarify their thoughts and helps them ventilate and better understand their feelings.
• Don’t pretend you understand if you don’t. Ask the client for more information instead (“Can you tell me more about that?”).
• Don’t ever tell the caller that you know exactly how she or he feels.
• Vary your responses and monitor your tone of voice. A great deal of empathy and warmth can be conveyed through your tone of voice.
• If the caller begins to ask personal questions or for your opinions, reflect the feeling behind the question back to the caller (e.g. “What do you think I should do?” – “Sounds like it’s confusing figuring out what to do. I can’t give you answers, but we can talk about what you see as your options.”). Self-disclosure will be discussed more later in this section.
Name what you hear
“You’re confused about her feelings toward you”.
“You’re afraid to be alone”.
“You’re really upset about your daughter”.
Clearly state these feelings and facts. If you use a question format (“Do you feel sad?”), you will sound unsure, unbelieving and perhaps patronizing. Questions also force a response from the client and may cause defensiveness.
Name what you hear as long as you hear it
The caller will introduce new feelings only when ready to deal with them; it may be necessary to reflect some feelings many times. View these reflections as a gradual release of pressure: some people can let it all out at once, while others need a series of little releases. Multiple reflections may be a way of looking at something from different angles until the whole picture is seen.
Reflect verbalized and non-verbalized material
While some feelings are mentioned, others are perceived by tone, content and word choice. It is preferable to reflect the feeling that the caller has started. Sometimes, however, we may reflect feelings that we perceive beneath the flow of conversation. For example, the caller may be discussing the death of her husband. While she may not state anger, the listener may perceive it because of her angry tone. By mentioning our perception of the tone, the caller may feel freer to discuss this feeling. If the listener misinterprets, then she will almost always correct the impression, perhaps disclosing more valid feelings in the process. Don’t let fear of being wrong silence you!
Be aware of incorrect uses of the word “feel”
In general conversation, the word feel is used to express thoughts, as well as feelings. Generally, anytime “feel” is followed with “that” (“I feel that…”) it has been used in a factual, not an emotional way. Avoid this usage when you are reflecting an emotion.
It can be used to express
an indefinite thought (“I feel like having a drink”.);
as a statement of opinion (“I feel that Roger’s brashness is…”);
or as a statement of belief (“I feel that all men are created equal”.).
Reflective listening is active
Reflective listening may seem to be a passive process. To be successful, however, it relies on intense concentration. We hear more than just the words of the caller; we also hear the feelings, values, and attitudes of an individual. To do this requires empathy and acceptance of the importance of the caller’s concern.
Experiencing and expressing feelings are major ways of interacting with others. Effective communication occurs when people take responsibility for their thoughts, feelings, and behavior—when individuals own who they are and what they do. Many of us have conditioned ourselves to screen awareness of our feelings, blocking effective communication and selfunderstanding.
Empathy is necessary
Empathy literally means “to feel in”, to stand in another’s shoes, to get inside his or her feelings. Empathy is a learned skill and can be improved through attention and practice. To improve your empathy…
• Pay attention to your own feelings
• Listen with genuine concern, interest, and full attention
• Listen first, then speak
• Understand and accept what another is experiencing; do not judge
Pity, sympathy, projection and transference sometimes masquerade as empathy. Pity is feeling sorry for another, and tends to patronize the client.
Sympathy is feeling for another (becoming emotional involved), and tends to cause one to be less objective and neutral. Projection attributes our feelings to another. (“I would feel this way in that situation, so you must also”.) Transference is when we react to a client because he or she reminds us of someone else. All of these situations interfere with and detract from our ability to empathize with another individual.
Why Reflection Is Effective
It is respectful. When you mirror emotions and thoughts, you help the speaker see his/her image. The speaker can decide whether it needs alteration.
It helps the speaker feel deeply understood; often getting at unverbalized feelings of which the speaker is sometimes unaware.
It serves a supportive function by communicating to the speaker that you are in tune with him/her.
It shows that you are paying attention. You cannot give an interchangeable response unless you are really listening. Careful listening is not an accident!
Concentrating on how the other person feels eliminates the need for personal judgement. All feelings are legitimate even if you can’t accept the person’s behavior.
Feelings can sometimes be the causes of behavior. If you can help someone with his/her feelings, it may help him/her to examine his/her motives as well.
It provides the opportunity for emotional catharsis, i.e. a feeling of relief from tension and pressure.
Since the speaker is free from having to defend his/her feelings, the speaker can face his/her problems more directly.
Ways to Reflect VERBATIM
Repeat back to the caller word-for-word exactly what he or she has just said.
Client: “I just don’t know what I’m going to do. I feel trapped.”
Counselor: “You just don’t know what to do…. you feel trapped.”
PARAPHRASING
Reflect the words that the caller has just stated, but change the wording a little bit.
Client: “I just don’t know what I’m going to do. I feel trapped.”
Counselor: “You sound like you’re at a loss as to what to do because no options seem like the right
one.”
REFLECTION FORMULAS
This is a lot like paraphrasing, but the counselor leads with a frequently used “formula.”
1. When _______________________happens, you feel ________________________________.
Client: “I just don’t know what I’m going to do. I feel trapped.”
Counselor: “When you don’t know what to do, you feel stuck.”
2. It sounds like _______________________________________________________________.
Client: “I just don’t know what I’m going to do. I feel trapped.”
Counselor: “It sounds like you feel trapped because you don’t know what to do.”
3. What I’m hearing you say is ___________________________________________________.
Client: “I just don’t know what I’m going to do. I feel trapped.”
Counselor: “What I’m hearing you say is that you feel stuck because you’re not sure what you can do.”
REFLECTION OF FEELING
It’s debatable, but many mental health counselors believe that addressing feelings is the priority before any thoughts or actions can be had in problem solving. As a SPAN volunteer you should place a lot of importance on feelings as a way of affirming and empathizing. Reflect feelings often.
Instead of using the Reflection Formula, you go immediately to reflecting feeling. Remember, all feelings can be traced back to the primary feelings: SAD, MAD, GLAD and SCARED.
Client: “I just don’t know what I’m going to do. I feel trapped.”
Counselor: “You feel trapped.” OR “You sound scared.”
REFLECTION OF THOUGHTS
If the caller sounds as if he or she is working from a cognitive approach, reflect thoughts or if it is difficult to connect with him or her around feelings, then reflect thoughts.
Client: “I just don’t know what I’m going to do. I feel trapped.” Counselor: “It sounds like you really want to know what to do, and when you don’t, you’re uncomfortable.
REFLECTION OF EVENTS, ACTIONS, BEHAVIORS
When you need to reflect facts, so as to make sure that you’re hearing the story correctly, reflect the facts, events, actions or behaviors as you have heard them.
Counselor: “Let me see if I’m hearing you correctly . . . your doctor told you that ____.” Or Counselor: “Let me see if I’m hearing you correctly . . . you were in a car accident and you have not been working for three weeks.” Or
Counselor: “Let me see if I’m hearing you correctly . . . you’re saying that you have not slept or eaten in three days.”
List of Feeling Words
AFRAID ANGRY HURT EMBARRASSED
scared irritated in pain Demoralised
alarmed mad aching disconcerted
frightened enraged alone humiliated
terrified hostile injured ashamed
anxious furious wounded degraded
panicky announced in agony lose face
terror-stricken exasperated anguish
fearful inflamed broken-hearted LONELY
apprehensive provoked solitary incensed SAD alone
CONFUSED infuriated sorrowful lonesome
perplexed downcast desolate
confounded AMBIVALENT dejected
distracted ambiguous unhappy HATE
disconcerted vague melancholy abhor
flustered undecided gloomy loathe
bewildered unsure dismal resent
mixed-up uncertain heavy-hearted dislike
puzzled detest
DISGUSTED TIRED despise
FRUSTRATED nauseated weary
defeated sickened fatigued HELPLESS
thwarted revolted exhausted powerless
exasperated repelled beat defenseless
baffled aversion vulnerable
hindered LONELY resouceless
fighting a losing battle WORRIED solitary crippled
anxious alone dependent
GUILTY uneasy lonesome
bad fearful desolate HOPELESS
at fault apprehensive futile
to blame concerned WORTHLESS desperate
sinful disturbed useless desolate
culpable fretting no good despondent
reprehensible upset valueless dejected
tormented miserable pessimistic
SHOCKED trouble lousy disappointed
appaled; horrified good for-nothing forlorn
revolted; surprised LOVE give up
disgusted like;fondness; affection; idolize; care; attached; admire
Reflective Response Exercise
Feelings and content are two components of communication. An important skill in counseling is the ability to discriminate between feelings and content in a caller’s statements. A simple formula for reflection that includes feelings and content is:
“You feel ___________________________ because ____________________________” However, it would be unnatural to continue using only this formula; as the counselor becomes more skilled and relaxed, he/she will find a number of ways to say the same information.
In this exercise, please read each statement from a supposed caller. The first set of blanks asks you to fill in a response using the formula “You feel __________ because __________.” In the next set of blanks you are asked to re-write the reply in your own words, making sure that you include feelings and content in your response.
1.Girl, age 14. “I really don’t want to lose him. We have been going out for seven
weeks. And I don’t want to just throw that away, ‘cause I know if I don’t have sex
with him, he’ll break up with me. I don’t know what to do.”
Formula: __________________________________________________________________
Your own words: ____________________________________________________________ _________________________________________________________________________
2.Businessman, 38: “I really don’t know what my boss wants. I don’t know what he thinks of me. He tells me I’m doing fine even though I don’t think that I’m doing anything special. Then he blows up over nothing at all. I keep asking myself if there’s something wrong with me. I mean that I don’t see what’s getting him to act the way he does. I’m beginning to wonder if this is the right job for me.”
Formula: _________________________________________________________________________ Your own words:___________________________________________________________ _________________________________________________________________________
3.Woman, 73, in the hospital with a broken hip: “When you get old, you have to expect things like this to happen. It could have been much worse. I’m not a complainer. Oh, I’m not saying that this is fun or that the people in this place give you the best service— who does these days? But it’s a good thing that these hospitals exist.”
Formula: _________________________________________________________________ Your own words: ___________________________________________________________ _________________________________________________________________________
4.Girl, age 9. “My little sister is such a pest! She follows me everywhere I go. She even wants to come in my room when I have friends over.” Formula:____________________________________________________________
Your own words:______________________________________________________ ______________________________________________________
5. Man, 35, who has not been feeling well: “I’m going into the hospital tomorrow for some tests. I think they suspect an ulcer. But nobody has told me exactly what kind of tests. I’ve heard rumors about these kinds of tests but I’m not really sure what they’re like.”
Formula: __________________________________________________________
Your own words: ______________________________________________________ __________________________________________________________
6.Boy, age 16. “I mean, everything I do, my mom’s on my back. She’s always telling me to do something, and whatever I do it’s wrong. If she doesn’t stop pretty soon, I might just get pushed too far.”
Formula: ____________________________________________________________ Your own words: ______________________________________________________ ______________________________________________________
7.Woman, 43: “It was all I could do to call here. A friend told me to call the police. And then I’d become one of those stories you read in the paper everyday! Or they’d be asking me all sorts of questions. I just want to forget it. I don’t want to keep reliving it over and over again.”
Formula: _______________________________________________________________ Your own words:________________________________________________________ _________________________________________________________
8.Female high school student, 17, talking to a male counselor about an unexpected pregnancy: “I, well, I don’t think I can talk about it. (Pause). You being a man and all that. (Pause). What happens between my boyfriend and me and my family—well, that’s all very personal. I don’t talk to strangers about personal things.”
Formula: _______________________________________________________________ Your own words:_________________________________________________________
_________________________________________________________
Open-Ended Question Skills
With an expressive caller attentive listening and reflection may be all the communication skills you need. Some callers will not communicate as easily because they are not used to putting their feelings into words. Open-ended questions may help a reluctant person to talk more freely. By definition, an open-ended question is a question that cannot be answered by “yes” and “no”. The question requires the caller to answer in sentences and encourages him/her to reveal something about him/herself, his/her feelings and his/her situation. It serves as an invitation to talk and avoids the sharpness that can be contained in “why” questions. At times, the question may actually be a statement, though serving the same purpose. Some examples of open-ended questions are:
“What do you think might happen when you talk to your husband?” “How is living on your own different than living at home?” “Who would you most like to talk to about this?” “How would you like her to respond when you talk with her?”
Some examples of statements used as questions are:
“Tell me about your relationship with your boyfriend” “Tell me when you first began to feel uncomfortable”
“I wonder what would be comforting to you right now”
“I’m curious about what you were thinking at that moment”
A series of open-ended questions and reflections can help a caller to share his/her inner experience. The questions help him/her to explore the situation more thoroughly and perhaps express for the first time what s/he thinks or feels. The reflection acknowledges and accepts the point of view. If you find yourself asking a series of questions and sounding like you are taking a survey, check yourself out. Your questions are probably close-ended and need to be rephrased.
Open-ended questions are designed to:
• Get the caller/client talking, telling the story
• Give definition in the caller’s/client’s terms about what “it” means to them
• Give the counselor information about what language to use in mirroring
• Reduces the counselor’s temptation to do mind reading, which does not work.
• Give the caller/client a chance to give expansive information, rather than narrow yes/no responses. The more expansive the better.
Closed-ended questions are designed to:
• Limit how much a caller/client can say.
• Reduces the information to Yes/No responses.
• Assists when assessing for an emergency risk. (Do you have a gun? Is the gun loaded?)
Roadblocks to Effective Listening
Over time most of us have developed a series of bad listening habits. In our efforts to become effective crisis interventionists, we have to discover and unlearn them. If you are free of the following ten blocks to good listening, you are well on your way to mastering the art of crisis intervention.
1.There is our almost universal tendency to judge or evaluate everything we hear. A person speaks and, before she/he has hardly started to express their idea, we, in our infinite wisdom, have decided either that she/he is preparing our own verification or rebuttal. From that point on, we simply are not listening to what the person is saying.
2.Another bad listening habit is our tendency to jump to conclusions to supply our own details and ramifications – to fill the black spaces, so to speak. The psychologists call this the “non-critical inference” syndrome. We put words in each other’s mouths. We jump to our own conclusions as though our lives depended on it.
3.Still another bad listening habit is what the psychologist call the “plural inference” syndrome—our tendency to assume that everyone else thinks as we do. We have certain beliefs and convictions, and we are so firmly fixed in these that we make the assumption that others have the same beliefs.
4.One of the most serious bad listening habits is the closed mind. We KNOW the answer— we are happy in our belief that we know the answer—and no one can get through to us.
5.Unfortunately, most of us have an extremely short attention span. We are inclined to let our thoughts wander after a fairly short period of attention. We “listen” with our eyes, our ears, all of our senses—and it takes a real effort to concentrate our attention on the speaker over an extended period of time.
6.How about wishful thinking, or in this case “wishful hearing”? Aren’t we just a bit inclined to hear what we want to hear? Ever have someone try to put words into your mouth? Ever leave a meeting and find that there are a dozen different versions of what took place? Ever made a statement, “He hears what he wants to hear?”
7.Semantics. The meaning of words, phrases, and terms is often very subtle and evasive. Professions, vocations, even avocations, have a language all their own. This matter of semantics is not only a personal and industrial problem; it is also a word problem. In any language, there are words that simply cannot be translated into another language.
8.Probably one of the most common bad listening habits is our infatuation with the sound of our own words. We’re often not quiet long enough to listen to anyone else. The talker is NOT a listener! Benjamin Franklin considered silence high on his list of virtues.
9.We must overcome our own arrogance—the idea that WE, the listener, are superior to whoever is doing the talking. We must listen to accept thoughts, ideas, and concepts from others. The teacher invariably learns more than his or her students do. We can learn from every single person with whom we come in contact.
10.Fear! Fear of being changed. Fear of having our ideas, our convictions, upset. We tend to seek out a black and white world—a world that simply does not exist. We are happy and comfortable in our ideas, and we resist anything that might change them.
The following ways of responding to a person are further roadblocks or barriers to communication. These responses have a negative impact on communication because they get in the way of an equal and open exchange. These responses imply that the listener is uncomfortable with the topic and that the listener is judging, feeling superior to, or condescending to the client’s feelings and the flow of the conversation. There may be some situations where these roadblocks are appropriate, but the listener should be aware of the effects of using them.
Ordering, Directing, Commanding
• Telling the client to do something, giving her or him an order or command: “You have to stop thinking about all the bad things that could happen!” or “You should call the police.”
Warning, Threatening, Promising
• Telling the client what consequences will occur if she or he does something: “If you do that, you’ll be sorry” or “If you calm down, I’ll listen to you.”
Moralizing, Preaching, “Should” And “Ought”
• Invoking outside authority as accepted truth: “You shouldn’t act like that” or “You ought to tell her what you’re feeling”; “Think of all the women you will let down if you don’t report".
Name calling, labeling, stereotyping
• Making the client feel foolish, shaming or categorizing her or him: “That’s a typical male way of thinking” or “You’re smarter than that” or “Police tend to be …”
Interpreting, analyzing, diagnosing
• Telling the client what his or her motives are or analyzing motives, communicating that you have the client figured out: “You’re just jealous of your friend” or “You only feel that way because he won’t give you what you want.”
Offering praise, reassurances
• Trying to make her or his feelings go away, denying the strength of the feelings: “You’ll feel better tomorrow” or “Don’t worry, things will work out.”
Guidelines to Being a Better Listener Really want to listen.
Almost all listening problems can be overcome by deciding to really hear and be interested in people.
Act like a good listener.Be alert, sit straight, lean forward if appropriate, and let your face show interest.
Listen to understand.Don’t just listen to be listening; try to really understand what is being said.
React!Be generous with applause, nods, comments, questions, and encouragement as appropriate.
Stop talking.You can’t listen while you are talking. In a conversation, let the other person finish and hear what he or she is saying before you go in.
Empathize with the speaker.Put yourself in the speaker’s place and try to clearly see that point of view.
Ask questions.When you don’t understand, when you need further clarification, ask questions. However, don’t ask questions that will embarrass or put down the other person.
Concentrate on what the other person is saying.Focus on the words, the ideas, the feelings being expressed, and the body language.
Look at the other person.Facial expressions and body language will all help the other person communicate with you.
React to ideas, not to the person.Don’t allow your personal attitudes to influence your interpretation of words. Good ideas can come from anyone.
Don’t argue mentally.If you are trying to understand the other person, arguments will set up barriers.
The Temptation to Self-Disclose All counselors, professional and volunteer alike, must grapple with the concept of selfdisclosure. Where does self-disclosure fit into counseling? What kind of self-disclosure is helpful? What kind of self-disclosure is harmful? Is there ever a time when it would be helpful to someone?
It is tempting to self-disclose as a counselor and even to convince oneself very earnestly that it is helpful. A caller may even encourage and thank you for self-disclosing. But let’s think through the possible reasons why self-disclosure is tempting and potentially harmful to callers. Our volunteers would never intentionally hurt a caller, but the subtle temptations of resorting to selfdisclosure might be found in the following.
“If it worked for me, it could work for you” When a counselor has had personal experience with a specific problem and has achieved resolution with it, it is tempting to say, “Hey, this worked for me.... it could work for you too! I want you to be happy (or in recovery) just like I am.” In other words, the counselor is perhaps over-eager to facilitate towards the most expedient and solution based on personal experience. The counselor intends to help, but we all know about the road paved with good intentions…
“I feel your pain” We have as our core conditions of counseling unconditional positive regard, empathy, and genuineness. Some textbooks liken genuineness to authenticity. It seems reasonable that one way a counselor can join with a caller is by stating a similarity, a shared point of view, or a history of similar suffering. This is not exactly what is meant by authenticity. The skilled helper must be aware of the thin between self-disclosure and authenticity. It is not synonymous with self-disclosure.
Rather, it is more in the realm of “use of self,” not self-disclosure. Use of Self would be comments that suggest to the caller that “I am really here for you,” “I am really trying to understand how it feels for you.” Examples might include comments such as “I am really feeling scared for you right now” or “If I were in your shoes, I would be so sad” or “I’m worried for you as I hear you describe this situation.”
“Bait and Switch” Even though our mission statement is to give a person in need a helping response, it is not uncommon for callers to turn the tables, to role reverse, to begin to interview you, the counselor, instead of the other way around. Callers often ask questions like, “Do you have this problem?” or “Do you have children?” or “Are you married?” or “What do you think?” Some callers use this as a distraction. Other people’s problems are easier to examine than one’s own. The caller may just want to see if you can connect with you, as if the questions are really about “Can you empathize with me?” Another possible reason may be the caller begins to see you as a friend. Friendship development is much more comfortable than facing one’s problems.
“What was I thinking?” Sometimes I have heard volunteers after the fact exclaim, “I don’t know what came over me! I know I should not self-disclose, but I totally lost my sensibilities about it during the call!” This might be an occasion to examine how you are doing in your own life. What stressors, difficulties, or “issues” are going on currently that would make you vulnerable to forgetting who the caller is. We hope that volunteers and staff alike are helping each other on our shifts when our own “issues get stirred up.” Counselors are often accused of being ‘wounded healers.’ This is a very real phenomenon for all counselors and so it is not abnormal; that’s why being in counseling oneself is a routine for many counselors. Self-awareness, self-monitoring, selfcontainment and intentional awareness are better substitutes for self-disclosure.
Alternatives To Self-Disclosure If callers or clients tempt one into self-disclosing, there are four strategies to immunize oneself from doing so. Try these methods and review the grid below and the sample questions.
REFLECT
The counselor mirrors what the caller is saying, reflecting back to him or her what seems important, without answering the question directly.
DEFLECT & CLARIFY
The counselor puts emphasis back on the caller while asking the caller for more information about his or her needs.
OBLIQUELY CONFIRM
One way to avoid self-disclosing is to offer a very broad and expansive confirmation that what the caller is asking for is something that you can understand. It is a truth that you can honestly confirm without revealing your personal story.
BECOME AN ALLY
I find that many want to know about their counselor so as to determine if he or she is safe, trustworthy or a potential ally or advocate. Encouragement is a way to affirm your interest in your caller’s situation without self-disclosing.
The following table is a synthesis of the many responses we might offer when callers ask us to self-disclose. I invite counselors to review and practice these, while putting them into your own words. Also, it is possible that we might employ more than one type of response to a caller and more than once during a call.
SOME COMMONLY USEFUL ALTERNATIVES TO SELF-DISCLOSURE REFLECT
DEFLECT & CLARIFY
OBLIQUELY CONFIRM
BECOME AN ALLY
Are you married (coupled, single, divorced, widowed)?
It sounds like you have a problem with an important relationship?
Tell me about your relationship. What is it that you need help with?
Relationships are very important to me.
I try to be very supportive of people in significant relationships.
Do you have children?
It sounds like you have a problem that involves children.
Tell me about your children. What is it that is bothering you about children?
Children are important to me and I also understand that they can be challenging.
I am an advocate for parents and for children.
Have you ever had this problem? Or Are you a recovering alcoholic, (or ______ problem)?
It sounds like you want to know if I can understand your problem.
I’d like to hear more about you. Help me to know more about what you’re struggling with.
It is true that I, just like everyone else, have had to face difficult times before.
I’m very aware of how people with this problem struggle.
How old are you?
You want to know if I can relate to someone your age.
Tell me what matters to you about age. How is age important to you?
I’m aware of how important it can be to feel as if someone close in age can relate to our problems.
People of all ages are really important to me. I try to relate to all age groups as well as I can.
Will you call me sometime?
No, but it sounds like you wish that we could maintain contact.
No, I can’t call you back, but let’s focus on what we can talk about right now. What would you need from someone who could talk with you on a more regular basis?
No, I can’t call you back, but I can relate to the feeling of wanting a comforting and supportive person in life.
It’s really important to me for every person to have a good support system. While I can’t call you back, I want to help you expand your support
Are you a Christian (Jewish, Muslim, etc.)? Or where do you go to church?
It sounds like your faith is very important to you and you want for me to be able to understand.
I’m really interested in your faith. Tell me about how your spirituality is important to you.
A guiding belief system or a set of values is important to me.
I know how important a belief system is to all people and I really want to understand yours.
Will you pray with me?
I’m hearing you really needing my support.
What would your prayer be for yourself?
I believe in the importance of prayer, contemplation, and reflection.
Many people find comfort in prayer, contemplation, and reflection and I really support that.
Are you gay, lesbian, straight?
Am I hearing that if you knew my sexual orientation, you might feel I could understand?
Help me to know how I can be supportive with you related to your sexuality.
Being able to be free to be oneself is very important to me.
I want to be available to you and to all callers so that you do not fear judgment.
Where do you live?
You’re curious about where I live.
What is important to you about knowing that?
Having a sense of community and belonging to a neighborhood is important to me.
I really believe in the concept of community for all people. Help me to know about yours.
What do you think about this issue?
You want to focus on my thoughts about this.
What are your thoughts about this issue?
I have some thoughts about this issue, but the most important thing to me right now is your thoughts.
Everyone has thoughts and feelings about life’s challenges, and I really want to help you find your way through your thoughts.
What would you do if you had this problem?
You wish I could give you some advice about this.
If you had advice for a friend about the same problem, what would it be?
With problems, I find that I have to come to my own decisions through a process of reflecting. I’d like to help you to do that.
I believe that the best solution for most people is the one that they come up with for themselves. Let me try to help you.
SPAN OFFICIALLY LAUNCHED ON 10.9.2016 BETWEEN 1300 HRS-1400 HRS AT BASHEERBAGH PRESS CLUB
People Present :
1.Dr.PKN Choudhary
2.Dr.Phani
3.Dr.George Reddy
4.Dr.Naresh
5.Mrs.Ananda Diwakar - Roshni NGO
6.Mr.John Hemant Kumar - Neurons
7.Mr.Karthik
8.Mrs.Mary Sebastian
9.Mrs.Padmaja
10.Ms.Covi
11.Ms.Padmini
12.Mr.Niranjan Reddy
13.Mrs.Aaliya
14. Mr.Balaji &Team -Darshika NGO
15 Mr.Madhu
16.Mr.Vishwanath
17.Mr.Ashwin Naidu of UFERWAS & S9 CONSULTING
Word of Thanks to Mr.Karthik for coordinating on the admin work
Details :
Mrs.Mary Invited the guests onto the dais .Later Dr.PKN Choudhary officially launched SPAN and shared the vision of SPAN
Later all the guests shared their experiences on Suicide Prevention Awareness and the unified effort by various organisations is the first of its kind in the world in the domain of Suicide Prevention Networking .Later Darshika Team joined late due to their impending activities elsewhere and later Vote of Thanks was proposed by Mrs.Mary and session was closed
Compiled by
Ashwin Nallari Naidu
for SPAN
10.9.2016@1715 Hrs
People Present :
1.Dr.PKN Choudhary
2.Dr.Phani
3.Dr.George Reddy
4.Dr.Naresh
5.Mrs.Ananda Diwakar - Roshni NGO
6.Mr.John Hemant Kumar - Neurons
7.Mr.Karthik
8.Mrs.Mary Sebastian
9.Mrs.Padmaja
10.Ms.Covi
11.Ms.Padmini
12.Mr.Niranjan Reddy
13.Mrs.Aaliya
14. Mr.Balaji &Team -Darshika NGO
15 Mr.Madhu
16.Mr.Vishwanath
17.Mr.Ashwin Naidu of UFERWAS & S9 CONSULTING
Word of Thanks to Mr.Karthik for coordinating on the admin work
Details :
Mrs.Mary Invited the guests onto the dais .Later Dr.PKN Choudhary officially launched SPAN and shared the vision of SPAN
Later all the guests shared their experiences on Suicide Prevention Awareness and the unified effort by various organisations is the first of its kind in the world in the domain of Suicide Prevention Networking .Later Darshika Team joined late due to their impending activities elsewhere and later Vote of Thanks was proposed by Mrs.Mary and session was closed
Compiled by
Ashwin Nallari Naidu
for SPAN
10.9.2016@1715 Hrs
This is an initiative for and by the residents of the Twin Cities of Hyderabad and Secunderabad, in collaboration with organizations already working in the field, Psychiatrists and Psychologists.
Register only if above 18 years.Inform your Family -This is a must.
An initiative for Suicide Prevention in the Twin Cities-
Just by filling in the form you can show your support to the cause.
Click on the link below:
http://goo.gl/forms/xefQ1P314Y5Jedu82
Register only if above 18 years.Inform your Family -This is a must.
An initiative for Suicide Prevention in the Twin Cities-
Just by filling in the form you can show your support to the cause.
Click on the link below:
http://goo.gl/forms/xefQ1P314Y5Jedu82
Suicide Causes
Suicide Causes- by Kevin Caruso
Over 90 percent of people who die by suicide have a mental illness at the time of their death.
And the most common mental illness is depression.
Untreated depression is the number one cause for suicide.
Untreated mental illness (including depression, bipolar disorder, schizophrenia, and others) is the cause for the vast majority of suicides.
Also, some people are genetically predisposed to depression, and thus they may not appear to be undergoing any negative life experiences, yet still become depressed, and may die by suicide.
So, some people die by suicide because of a depression that was caused by genetics. You probably have heard about some indivuduals who died by suicide and did not exhibit any symptoms or appear to have any serious problems. In these cases, it is possible that the person had depression that occured because of this genetic factor.
It is very rare that someone dies by suicide because of one cause. Thus, there are usually several causes, and not just one, for suicide.
Many people die by suicide because depression is triggered by several negative life experiences, and the person does not receive treatment – or does not receive effective treatment – for the depression. (Some people need to go through several treatments until they find one that works for them.)
Some of the negative life experiences that may cause depression, and some other causes for depression, include:
Know what the symptoms of depression are – you should review the information on the depression and suicide page of this website – and if you or someone you know is depressed, get help immediately.
And remember that any untreated mental illness, including depression, bipolar disorder, schizophrenia, and others, may cause suicide.
If you or someone you know is suicidal, please read the information on the home page of this website and take immediate action.
Thank you,
Kevin Caruso
http://www.suicide.org/suicide-causes.html
Suicide Causes- by Kevin Caruso
Over 90 percent of people who die by suicide have a mental illness at the time of their death.
And the most common mental illness is depression.
Untreated depression is the number one cause for suicide.
Untreated mental illness (including depression, bipolar disorder, schizophrenia, and others) is the cause for the vast majority of suicides.
Also, some people are genetically predisposed to depression, and thus they may not appear to be undergoing any negative life experiences, yet still become depressed, and may die by suicide.
So, some people die by suicide because of a depression that was caused by genetics. You probably have heard about some indivuduals who died by suicide and did not exhibit any symptoms or appear to have any serious problems. In these cases, it is possible that the person had depression that occured because of this genetic factor.
It is very rare that someone dies by suicide because of one cause. Thus, there are usually several causes, and not just one, for suicide.
Many people die by suicide because depression is triggered by several negative life experiences, and the person does not receive treatment – or does not receive effective treatment – for the depression. (Some people need to go through several treatments until they find one that works for them.)
Some of the negative life experiences that may cause depression, and some other causes for depression, include:
- The death of a loved one.
- A divorce, separation, or breakup of a relationship.
- Losing custody of children, or feeling that a child custody decision is not fair.
- A serious loss, such as a loss of a job, house, or money.
- A serious illness.
- A terminal illness.
- A serious accident.
- Chronic physical pain.
- Intense emotional pain.
- Loss of hope.
- Being victimized (domestic violence, rape, assault, etc).
- A loved one being victimized (child murder, child molestation, kidnapping, murder, rape, assault, etc.).
- Physical abuse.
- Verbal abuse.
- Sexual abuse.
- Unresolved abuse (of any kind) from the past.
- Feeling "trapped" in a situation perceived as negative.
- Feeling that things will never "get better."
- Feeling helpless.
- Serious legal problems, such as criminal prosecution or incarceration.
- Feeling "taken advantage of."
- Inability to deal with a perceived "humiliating" situation.
- Inability to deal with a perceived "failure."
- Alcohol abuse.
- Drug abuse.
- A feeling of not being accepted by family, friends, or society.
- A horrible disappointment.
- Feeling like one has not lived up to his or her high expectations or those of another.
- Bullying. (Adults, as well as children, can be bullied.)
- Low self-esteem.
Know what the symptoms of depression are – you should review the information on the depression and suicide page of this website – and if you or someone you know is depressed, get help immediately.
And remember that any untreated mental illness, including depression, bipolar disorder, schizophrenia, and others, may cause suicide.
If you or someone you know is suicidal, please read the information on the home page of this website and take immediate action.
Thank you,
Kevin Caruso
http://www.suicide.org/suicide-causes.html