THE TALK LINE
THE TALK LINE
(Telephone Aid in Living with Kids)
441-KIDS
[pic]
VOLUNTEER TRAINING MANUAL
The Talk Line Family Support Center
1757 Waller Street
San Francisco, CA 94117
415-387-3684
TABLE OF CONTENTS
Orientation and the Dynamics of Child Abuse
I. Orientation
A. History of the TALK Line 6
B. The Volunteer's Role 8
II. The Dynamics of Child Abuse
C. History 10
D. Definition 10
E. Dynamics - who abuses and why 11
F. Treatment and Prevention 13
G. Protective Factors 14
III. Summary 15
Crisis Intervention Techniques
I. Listening for Feelings
• Active/Reflective Listening 18
• Decoding the Message 18
• Common Difficulties with Reflection 19
II. Effective Responses 20
III. Ineffective Responses 20
IV. Mentalizing & Mindfulness 21
V. Summary 22
Working the Call
I. Opening Statements 24
II. Evaluating the Caller 24
III. Evaluating High-Risk Parents 25
IV. Asking Questions 26
V. Closure 27
VI. Confidentiality and Self-Disclosure 27
• Confidentiality of Client 27
• Volunteer Confidentiality 28
• Personal Disclosure 28
VII. Summary 30
Parent Focused Calls
I. Needs and Feelings That All Parents Have 32
II. Cultural Awareness 32
TABLE OF CONTENTS
(continued)
III. Parents with Special Needs
• The Addicted Parent and the Co-Dependent parent 33
• Spousal Abuse 36
• The Recently Separated/Divorced 37
• Single Parents 38
• Step-Parents 39
• Adolescents Parents 39
• Foster Parents & Relative Caretakers 40
IV. Summary 42
V. Hints for Parents 43
Child-Focused Concerns
I. Parent's Concerns About Child's Behavior 45
II. Discipline 46
III. Child Development 47
IV. Common Concerns Regarding Children 53
V. Overall Guidelines 56
Other Types of Calls & Procedures
I. Sexual Abuse and Incest 58
II. Procedures for Handling Incest and Sexual Abuse Calls 61
III. Frequent Callers 62
IV. Third Party Callers 63
V. Follow-Ups 64
VI. Terminations 65
VII. Referrals 66
VIII. High Risk Calls 68
• Suicide 68
• Hurt Child 68
Office Procedures/Protocols
I. Office Procedures
• TALK Line Guidelines 70
• Phones 70
• Calls 70
• Follow-Up Calls 70
• Filing 71
• Undiverting 71
• Diverting 71
• Back Up 71
• Volunteer Shifts 72
TABLE OF CONTENTS
(continued)
• Resources 72
• Shredding 72
II. Closing Up Procedure 73
III. On- Call Supervisor 73
IV. Power Failure Procedures 73
V. Parking 73
VI. Respite Care Procedures 74
\\Server\data\People\Becca-From Admin Computer\TALK Line\Manual-Volunteer\TALK LINE Training Manual - Current.doc
ORIENTATION AND THE DYNAMICS OF CHILD ABUSE
I. ORIENTATION
A. History of the TALK Line
B. The Volunteer’s Role
II. THE DYNAMICS OF CHILD ABUSE AND NEGLECT
C. History
D. Definition
E. Dynamics—who abuses and why
F. Treatment and Prevention
III. SUMMARY
ORIENTATION AND THE DYNAMICS OF CHILD ABUSE
I. ORIENTATION
Welcome and thanks for being here!
A. History of TALK Line (Telephone Aid in Living with Kids)
December 1974 – Established by the San Francisco Child Abuse Council with the hope that parents under stress would call us, rather than take their pain and frustration out on their children. In addition to crisis counseling, we offer short and long term follow-up, advocacy, and referrals to community agencies when appropriate.
September 1976 – Moved to the Family Service Agency of San Francisco, as the Line was a direct service, and the Child Abuse Council elected to continue with an emphasis on coordination and education.
1987 – The TALK Line and the Child Abuse Council moved into the current site at 1757 Waller Street (an historic building that by turns was a fire station and a furniture showroom) in order to accommodate the growing demand for parent-child-related services.
August 1997 – The TALK Line separated from the Family Service Agency and joined the Child Abuse Council to become the San Francisco Child Abuse Prevention Center.
The needs of the parents calling the Line led us to establish the following services to augment those provided by the Line:
1977 – Respite Care Program – First established to provide emergency voluntary shelter for children whose parents were in crisis, to prevent abuse and neglect and keep children out of foster care. Now operates to give stressed parents a periodic break on an emergency basis and is limited. SFCAPC contracts with Family Support Services of the Bay Area agency to help provide respite care.
1979 – Single Parent Network – Established due to the high number of single parents we are serving. An evening group meets weekly.
1988 – Parent & Children’s Drop-In Center – Established to provide parents with an opportunity to connect with other parents, relax, or see a counselor while their children are being cared for in the Playroom.
1989 – Homelessness Prevention Program for Families – Established to prevent homelessness among families with children who are threatened with eviction or who have recently housed after being homeless—to help stabilize families economically, socially, and emotionally. The program ended in 1994.
1990 – M.A.M.A. (Moving Addicted Mothers Ahead) Program – Established to provide parenting skills and counseling services for mothers with infants who have been doing drug and alcohol treatment with the Haight-Ashbury Detox Clinic. Program ended in 1994.
1991 – F.I.R.S.T. (Family Intervention and Recovery Services Team) Program – Established to provide a varied support network for parents as they enter treatment and assist in finding post-treatment services. Program ended in 1995. Substance abuse counseling is still available.
1992 – Weekly NA and AA meetings with childcare provided.
1997 – E.S.S.P. (Economic Self-Sufficiency Program) – Established to assist low-income and welfare recipient parents to become job ready. Provides emotional and logistical supports around finding employment, job retention, childcare, and family adjustments. This program has ended.
2014- Kids Turn – A child focused program to help children express emotions and help parents co-parent while going through separation or divorce.
In addition, San Francisco Child Abuse Prevention Center (SFCAPC) offers various support groups for parents. See bulletin board for flyers.
Our Child Abuse Prevention Program, with the TALK Line at its core, is the only service in San Francisco aimed at the prevention of abuse and neglect. Other agencies work with families after a report of abuse or neglect is made and substantiated, but cannot help a family prior to formal intervention. When appropriate, we do work closely with Child Protective Services (CPS) and other agencies to better help our clients, but there is much that we can do prior to such involvement, and your role as a volunteer is key in that process.
B. The Volunteer’s Role
Without you, the volunteer, we would have no program—or a markedly less effective one.
• You provide the equivalent of $300,000 worth of staff time per year.
• You are a volunteer, and therefore apt to be trusted by the parent because you are not “paid to care”.
You are:
• An empathic, non-judgmental listener who will validate feelings, whether angry, painful, or fearful. You let callers know it is okay to feel; that they are okay as people. You will help them change their behavior over which they do have control, not their feelings, which are okay as they are.
• An educator who will help parents understand the changing feelings and developmental needs of their children, as well as their own feelings and needs, and who will help them develop realistic expectations of their children.
• A role model who will communicate clearly and follow through as promised. Most of our clients have a long history of being “let down” by people in their lives. We need to help them learn to trust that someone does care. Only people who feel worthy themselves can be good parents. Your follow-ups are crucial.
An Observation of Your Role
You volunteered, no doubt in part because you are concerned about the prevalence [problem?] of child abuse and neglect. You will work with one parent, one child, one family…a drop in the bucket…but do not let yourself lose perspective. Four out of five violent criminals were abused as children. You will thus be helping to alleviate not only the suffering of a specific family, but contributing to the decrease of violence in our society. It all starts with one individual, one child.
You will experience frustration, anxiety, disappointment. You will work with angry, difficult, slow-to-change parents and wonder if life will ever change for their children. You will also experience real highs, elation, and renewed faith in the ability of people to care and persevere and change.
You will be asked to acknowledge your own feelings as they arise—and there will be many. Without an acceptance and understanding of these, you will find it difficult to accept and understand those of our clients. We ask you to talk about your angry feelings, your fears as well as your positive feelings, as they come up during the training and on the Line. We hope, in return, that this will help you to learn something about yourself, learn how to use yourself—above all, reinforce the importance of caring, human connection.
You need to keep your expectations low. Do remember that change is a gradual and a slow process. The fact that you can “hang in” and not give up is very important in the work you do on the Line.
II. THE DYNAMICS OF CHILD ABUSE AND NEGLECT (CA/N)
C. HISTORY
Child abuse is an age-old phenomenon that spans human history. In the United States, the first acknowledged “battered child” was Mary Ellen, who in 1871 was taken to the Society for the Prevention of Cruelty to Animals! It was not until the 1960’s that Dr. C. Henry Kempe, a pediatrician at the University of Colorado Medical Center, coined the phrase, “the battered child syndrome,” and was able to convince the medical community, as well as others, that child abuse was a reality and that children needed protection.
Since then, reporting laws have been written; funds have become available to study the problem of CA/N; preventive and supportive strategies have been developed to attempt to keep parent and child together whenever possible.
D. DEFINITION
It is important not to get “stuck” in concerns about the “correct” definition of CA/N. Many definitions have been set forth over the years, but basically one must consider not only the child’s safety but his or her well-being, both physical and emotional. Thus in our preventive framework we see as abuse “any family crisis which threatens the physical or emotional survival or well-being of the child” (Gil). 90% of our calls would qualify as potentially abusive situations under this definition.
Types of abuse include:
• Physical
• Emotional
• Neglect
• Sexual
Emotional abuse can often be more damaging than physical abuse, although the two often go hand in hand. Emotional abuse may intensify when a parent stops physically abusing. All forms of abuse can contribute to developmental difficulties in children, both physically and psychologically. The later treatment is initiated, the less likely the chance of repairing psychic and developmental damage to the child. This is why early intervention is critical.
Child Protective Services, CPS, the mandated investigative agency, will always intervene when:
• There are definitive physical manifestations of abuse (bruises, broken bones, etc.)
• The child’s life is in danger
E. DYNAMICS—WHO ABUSES AND WHY
Abuse occurs on all socio-economic levels of society. We see all parents on a continuum:
ABUSIVE NORMAL
|Perceives kids’ needs as attacks |On a good day, perceives kids’ needs as |On a good day, perceives kids’ needs as |
| |demands. On a bad day, perceives kids’ |needs. On a bad day, sees kids’ needs as |
| |needs as attacks. |demands. |
WHAT MAKES ONE PARENT FEEL/THINK ABOUT LETTING THE CHILD “HAVE IT” AND ANOTHER PARENT ACT ON THOSE FEELINGS AND THOUGHTS—SOME PARENTS TO AN EXTREME?
There are usually four factors present when abuse occurs (Kempe & Helfer):
• A parent with the potential to abuse (i.e., any parent);
• A “special” child, singled out for abuse;
• A precipitating crisis;
• A society geared neither to the needs of parents nor children, and in which violence is sanctioned in many forms.
It is important to have a thorough understanding of what factors contribute to a “high risk” situation so that you can identify these callers. Together with the staff, you can then determine how best to help these parents. Remember, though, that high-risk parents are, at times, distrustful, angry, and frightened. Your empathy and warmth, not referrals to other resources, are the key to helping callers regain their equilibrium.
FACTORS IN CHILD ABUSE
Physical and emotional
(Kempe’s Model)
1. Society
a. Historically abuse prevalent.
b. Child-rearing patterns—child seen as possession.
c. Good parent = good child.
d. Economic stresses—no childcare, housing, etc.
e. Lack of parent preparation for rearing child.
f. Violence in society is made prevalent and accepted—TV, etc.
2. Individual Parent
a. Way parent raised—physically abused, highly criticized, dependency needs not met, or denied—will raise child(ren) similarly unless intervention made.
b. Isolation (no support system—friends, family, resources). Can’t reach out for help.
c. Little knowledge of child development—can handle some stages (e.g. infancy, latency) but not others (e.g. two-year-old “no” stage).
d. Low self-esteem—has few supports, social or family. Reads child’s behavior as being about self.
3. Individual Child
a. Seen as “different” by parent: smart, ill, reminds parent of…self, other, more demanding.
b. Seen as extension of parent, not a separate human being with own needs, etc.
c. Parent needs to be “loved.” Unrealistic expectations of child. Child does not respond to expectations—or—role reversal: child expected to take care of and understand parent’s needs and he does. Abused children are often “model children” when around parent—may be withdrawn or act out at school. Abused child can be very loyal to parent. Needs to believe in her/him. Child may fear being abandoned if he/she acts out.
4. Precipitating Crisis
a. A relationship deteriorating.
b. Dependency needs of child—no space from child.
c. Constant demands from child.
d. Whatever parent perceives as a crisis (e.g. spilled milk, washing machine breaking down, minor incident in chronic stress situation, or acute/major change).
FACTORS IN SEXUAL ABUSE OF CHILDREN
Definitions:
“Sexual Abuse”: Sexual abuse, also referred to as molestation, is forcing undesired sexual behavior by one person upon another.
“Incest”: A type of sexual abuse in which sexual molestation of a minor by a parental figure (including boyfriend or stepparent) or other family members.
Contrary to popular belief, the predominance of sexual abuse incidents occurs in the home—approximately 93% of abusers are known to the child or family. Like physical and emotional abuse, it is also cyclical in nature and inhibits a child’s subsequent development and ability to form healthy, mature, and intimate relationships.
FACTORS IN NEGLECT
Neglect of children can be seen on a continuum as well. In its mildest form, an overwhelmed, depressed parent in crisis may find it temporarily impossible to respond to a child’s normal demands for attention, as well as difficult to perform the everyday basic routines of feeding and clothing the child. In this case, help and support for the parent as well as temporary separation of parent and child (i.e., use of respite care) can relieve the situation.
In its more severe form—chronic neglect—inability to provide minimum housing, food, and clothing as well as protection or supervision—a report must be made, in order to assess the need to remove the child.
Alcohol, drugs, or psychological impairment on the part of parents make it impossible for parents to respond to the basic physical and psychological needs of their children.
TREATMENT AND PREVENTION
The process of any treatment and prevention program includes:
1. Increasing the parent’s sense of self-worth by validating feelings and supporting appropriate behaviors, and helping the parent make connections between his/her present difficulties (i.e., “There is nothing inherently ‘wrong’ with you”) and past experience. You, the volunteer, will be doing this to a great extent, sometimes in preparation for helping the parent accept a referral for therapy (either individual, group, marital, or family) to work more in depth. Many of us are afraid of change and the “unknown”—and see therapy as being for “crazy” people. So a positive experience with you can greatly enhance the possibility of a parent’s entering therapy.
2. Helping the parent distinguish between his/her feelings and behavior. This involves appropriate ways of coping with stress and ways of communicating constructively with children and spouses. Gaining control over one’s own behavior also gives one a sense of power and increases self-esteem.
3. Helping the parent to secure adequate food, housing, child care, and a dependable support system.
4. Increasing trust so the parent can avail him/herself of help.
Several programs have been shown to be effective in working with high risk/abusive parents, in addition to therapy:
• Parental stress crisis lines
• Parenting groups
• In-home visits
• Respite care
• Parent education
Not all parents can benefit from or are open to seeking help from these services. Your task is to be aware of their availability and to support your client in seeking services that s/he is open to and can benefit from.
If a parent is resistant to seeking help, it is important for you to stay in touch and support whatever steps the parent can take. If a parent is open to seeking help for a specific child, but not for him or herself, encourage this as it is often less threatening to see the child as in need of help. Above all, we need to let parents know we will stay with them—that we are not just trying to get them “off our backs,” by referring them to another agency. High-risk parents are highly sensitive to any kind of rejection.
PROTECTIVE FACTORS
SFCAPC’s mission is to prevent child abuse and we do that by strengthening families. We do this by providing families with all the support they need so we don’t get to a point where a child is hurt. There are 5 critical components that keep children safe. We call these protective factors. Protective factors are attributes of families that help them to succeed and thrive, even in the face of risk and challenges. Research studies support the common-sense notion that when these Protective Factors are well established in the family, the likelihood of child abuse and neglect diminishes. The TALK Line focuses on Parental Resilience and Knowledge of Parenting & Child Development.
1. Parental Resilience: Recognize & support families to develop inner strengths and increase flexibility so they can be there for their children.
2. Social Connections: Helping families decrease isolation and know who to go to for support; helping build support systems
3. Social and Emotional Competence of Children: Giving children words to express how they feel; helping them learn healthy relationships and regulate feelings and behavior
4. Knowledge of Parenting and Child Development: helping parents really understand how to support their children through various stages of life.
5. Concrete support in times of need: meeting needs through community support and resources; making sure basic needs are met (ex. Food, shelter)
III. SUMMARY
• The TALK Line and its services were established to PREVENT child abuse and neglect. Without you, the volunteer, there would be no program.
• Though child abuse is an age-old concept, it was not until the 1960’s when Dr. C. Henry Kempe coined the term “Battered Child Syndrome” that social service agencies, law enforcement, and the legislature began to address the problem seriously.
• Within our preventive framework, we see child abuse as any family crisis which threatens the physical or emotional survival or well-being of a child.
• All parents have the potential to abuse, some obviously much more than others.
• Three factors are present when abuse occurs…the parent, the child, and the crisis. The fourth pervasive factor is the social context within which the abuse occurs.
• It is important to understand all these factors to help identify high-risk parents.
• Most parents who abuse were victims of abuse themselves. They often have low self-esteem; expect a lot from their children; don’t know about child development and what to expect from children at different ages; are strongly impacted by stress; find it hard to reach out for help, and may have learned that violence “solves” problems.
• Children can be singled out for abuse if they are perceived as “different” by the parent; don’t meet the parent’s expectations; are seen by the parent as an extension of themselves; or they remind them of the other parent.
• A crisis may be anything the parent perceives as a crisis, from a minor incident in a chronic stress situation to an acute or major change. The needs of the child can exacerbate any stress situation.
• Sexual abuse and neglect are forms of child abuse which have their own separate dynamics.
• We can help at-risk parents by increasing their sense of self-worth; by helping the parent distinguish between feelings and behavior; and by helping to provide for basic survival needs and support systems.
• We help prevent child abuse through the use of the five critical protective factors
• TALK Line focuses on 2 of the five protective factors: Parental Resilience & Knowledge of parenting & child development.
CRISIS INTERVENTION TECHNIQUES
I. LISTENING FOR FEELINGS
• Active/Reflective Listening
• Decoding the Message
• Common Difficulties with Reflection
II. EFFECTIVE RESPONSES
III. INEFFECTIVE RESPONSES
IV. SUMMARY
A crisis is a critical point, stage, or event which can be a turning point in an individual’s life. People in crisis can be, and often are, open to change.
Parents often call the TALK Line when they are having a problem or problems which may be, or they may perceive, as a crisis.
When in crisis, a person feels helpless, overwhelmed, and unable to cope.
A parent might abuse a child in times of crisis—that is, take his or her negative feelings out on a child.
Through telephone counseling, you can help parents explore their feelings and work through their crises.
I. LISTENING FOR FEELINGS
When parents call, your primary task is to listen and respond to their feelings. You may not be used to talking about feelings; content is easier. However, it is your listening for and responding to feelings that reduces the caller’s tension and helps them explore their situation. The callers can then start solving their own problems
Most people grow up learning that their feelings are not okay, thus they are not okay. They confuse behavior, over which they have control, with feelings, over which they have less control. Therefore, they don’t allow themselves to feel…or express their feelings…for fear of being seen as bad or of losing control.
But feelings don’t go away. They may be repressed. They may be turned inward (i.e., anger ( depression). They may be misdirected, or manifest themselves in passive/aggressive behavior, anxiety; psychosomatic complaints build up and become explosive and dangerous to the self and others.
Feelings are universal. People need to know it’s okay to feel. The technique known as active/reflective listening teaches you to validate feelings. When feelings are heard, accurately reflected, and validated, one is apt to conclude, “My feelings are okay—I’m okay—I can solve my problem.”
Many times parents don’t tell you how they feel. Some of them are not in touch with their feelings. They feel numb. Others are in touch, but can’t acknowledge or label their feelings. They feel confused. Some can label, but don’t know where their feelings are coming from.
ACTIVE/REFLECTIVE LISTENING
It is up to you to listen, decode the message from the feelings and, stating them in your own words, reflect the feelings back to the caller.
Empathy: Your most important tool, it allows you to think of how you would feel in their situation. What if it was you who called the TALK Line—would you be feeling guilty, hurt, confused, scared? By reflecting feelings, you capture the emotional meaning of the message. You give the caller the experience of being heard and understood.
Your voice: If it is warm and empathetic, it conveys how good it is that “you” called.
DECODING THE MESSAGE
• Listen.
• Restate the feeling content of what you hear in your own words.
E.g., “You sound really angry…”
“You must be frustrated…”
“That’s very scary…”
• Use questions only to clarify feelings—draw the caller out.
E.g., “I’m not really clear…”
“Do you mean…?”
“I’m wondering if…”
Avoid asking “How do you feel?” It can be experienced by a caller as threatening. Tentative reflections phrased as a question can seem to ask for approval from the caller and tend to water down the message. The best reflections are declarative statements.
ACTIVE LISTENING
EXAMPLE
In active/reflective listening you feed back the feelings you hear. You do not offer an evaluation, opinion, interpretation, analysis, logic, or advice. Remember, parents are often calling in crisis. They need to fully vent their feelings before they can go on to problem-solving. And all people appreciate having their feelings heard.
IT IS NOT YOUR RESPONSIBILITY TO SOLVE THE CALLER’S PROBLEMS.
HINTS:
• Give the caller space to explore their situation.
• Tolerate silence.
• Stay separate—your feelings and problems are yours, and the client’s belong to them.
• It’s not so much what you say, as how you say it.
COMMON DIFFICULTIES WITH REFLECTION
1. You feel self-conscious, awkward—an unfamiliar response.
Try to play with it in situations where your awkwardness won’t bother anyone. Or reflect under your breath in ordinary circumstances.
2. It’s hard to remember all the words, particularly in a long, fast, or complicated message.
Allow yourself a 3-5 second silence; in this way you can give yourself time to think and get in touch with the caller’s world. You can repeat key words, use metaphors, or visual images.
3. You don’t know which part to reflect, especially if the caller sounds confused or describes several problems and feelings.
Reflect contradictions (e.g., “You say this and also this…”)
4. You fear dreadful consequences if you ask about something or help someone feel more deeply.
You’re afraid that asking if a parent is feeling suicidal will cause him/her to commit suicide. It won’t—talking about feelings alleviates the necessity of acting them out.
5. You fear reflecting the wrong feeling.
People will let you know if you’re wrong and will often go on to define it themselves. What they get from you is the feeling that you are indeed trying to understand.
6. You need to solve problems.
It is often tempting to offer advice or solutions, especially in situations that appear desperate or that make us anxious. A more helpful (and more respectful) stance involves joining a caller in sorting out his or her situation rather than imposing our views and values. In this way callers can be helped and empowered to seek their own solutions.
II. EFFECTIVE RESPONSES
• A listener must be able and willing to listen calmly and patiently.
• A listener must be able to express warmth and empathy.
• A listener must have a non-judgmental approach, though we all may feel judgmental at times.
• A listener must be able to accept that people have a right to feel, or verbalize feelings, about anything. (Acting on destructive feelings is always discouraged.)
• A listener must have a basic acceptance of her/his feelings and others’.
• A listener must respect the caller’s capacity to make decisions and solve his/her own problems.
• A listener must be dependable and reliable in keeping agreements and following up with the caller.
• A listener must be able to tolerate silences. This gives the caller time to think and feel in response to your comments.
III. INEFFECTIVE RESPONSES
• Ordering, threatening, warning…this can elicit resistance, or feelings of rejection or “badness.”
• Preaching, moralizing…the caller may feel you are trying to manipulate their lives, and can be left feeling unworthy or inferior.
• Arguing, persuading…the caller can be left feeling bad about themselves, and helpless to solve their problems.
• Providing “the” solution…the caller is not always looking for advice, even if they ask for it. It can strengthen their feelings of helplessness and encourages a dependence on you for answers. If your advice fails, the caller may blame you to avoid facing their own confusion or feelings of inadequacy.
• Blaming, criticizing…many parents have had their share of this, and don’t need a repetition of this response from a helpful person.
• Praising…in its extreme, this can produce the opposite of the desired effects, especially when the caller does not believe in him/herself. If you praise callers, they may worry that you will also criticize them.
• Reassuring…do not overdo the reassuring, and keep in mind that sometimes we reassure when we are very uncomfortable or concerned. The caller may also feel that you are saying their problem is not that bad, and feel rejected, or may feel misunderstood.
• Labeling…it’s important not to pigeonhole people by giving them psychological labels such as passive/aggressive; resistant; experiencing separation anxiety, etc. These labels tend to make people feel less than human, and depersonalize the contact.
If the listener has been effective, the parent will probably feel accepted and heard; they will have been able to express many of their feelings. This will help them get some focus and clarification about their specific concerns; they have likely explored options for dealing with their concerns, and feel more in control and less panicky.
MENTALIZING & MINDFULNESS:
Mentalizing and Mindfulness are integrated into the ways that we work with families.
Mentalizing is the ability to understand the mental state of oneself or others that underlies overt behavior. It is a relational skill that utilizes psychological mindedness (thinking of self and others and being aware of needs, motivations, intentions, and desires), affect consciousness (being aware of your own and how others are feeling), mindfulness (see below), and empathy (being able to place yourself in the position of another). Mentalization is thought to be the primary skill that is used by parents and caregivers to bond with and attune to their infants and children.
How Mentalizing relates to work on the TALK Line
-Fostering an attachment relationship
-Attentiveness to distress (empathy, attunement, responsiveness)
- “Marked” emotional responsiveness: representing the caller’s emotion back to the caller rather than becoming fully immersed in it (ex: reflecting feelings)
-Emotional self-awareness and self-regulation
-Providing support, encouragement (when appropriate) and help while appraising and respecting the caller’s competence and autonomy
How Mindfulness relates to work on the TALK Line
Mindfulness is defined by: a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations.
It is related to the work on the Line in the following ways:
-Focusing one’s awareness on the present moment (volunteers are encouraged to practice self-care that will allow you to be as present as possible while on the line. Practices of past and present volunteers include: getting tea, having a moment to close your eyes and become present at the beginning of your shift, taking short breaks as needed to walk around, get fresh air, etc.)
-Accepting and acknowledging one’s thoughts and feelings without being reactive towards callers. Paying attention to our thoughts and feelings without judging them. This allows us to be less judgmental towards others too. Your thoughts and feelings experienced with different callers can be discussed with supervisors for support, as well as allowing us to gain a better understanding of the needs/experiences of the caller.
IV. SUMMARY
• Parents often call the TALK Line when they perceive a crisis.
• Through telephone counseling, you can help parents explore their feelings and work through the crisis in ways that are most appropriate for them.
• Listening for and responding to feelings facilitates problem-solving by giving parents the message “My feelings are okay—I’m okay—I can solve my problem.”
• Active/reflective listening is decoding the caller’s message into feelings and repeating the feelings back to the caller in your own words.
• Active/reflective listening lets the caller know he/she has been heard and understood.
• It is not your responsibility to solve the caller’s problem. By active/reflective listening you allow the caller to find his/her own solutions.
• A good listener is warm, empathic, non-judgmental, and generally accepting of his/her own and others’ feelings. It is important that a volunteer be dependable and follow through with callers.
• A volunteer may miss the opportunity to be helpful by preaching, blaming, rescuing, labeling, judging, jumping to solutions or conclusions or arguing with the callers about how they feel.
• Mentalizing and Mindfulness are integrated into the ways that we work with families.
WORKING THE CALL
I. OPENING STATEMENTS
II. EVALUATING THE CALLER
III. EVALUATING HIGH-RISK PARENTS
IV. ASKING QUESTIONS
V. CLOSURE
VI. CONFIDENTIALITY AND SELF-DISCLOSURE
• CLIENT CONFIDENTIALITY
• VOLUNTEER CONFIDENTIALITY
• PERSONAL DISCLOSURE
VII. SUMMARY
Telephone counseling involves striking a balance between listening and reflecting the caller’s feelings, as described in “Crisis Intervention Techniques” and gathering information to evaluate the caller’s status, as we shall discuss in this section.
I. OPENING STATEMENTS
“TALK Line, may I help you?” or a similar statement is said to indicate your willingness to listen and be of assistance. Your tone of voice is the key—not too flat, not too cheery.
Reaching out for help is scary. Parents may feel cautious as they begin to speak. You need to reassure them that you are there for them, you know it’s hard to talk, and it’s okay for them to take their time.
A parent may ask, “Who are you?”, “What do you do?”, or “Is this just for child abusers?” Simply respond: “We are a parental stress line for parents who want help coping with their children or need to talk about their own problems and feelings.” This lets them know that it’s okay to talk about themselves as well as their children.
Keep in mind that a call for information, or resources, may evolve into a stress call. Ask questions to draw the caller out, i.e., “It would be helpful to know a little more about the situation.”
II. EVALUATING THE CALLER
Using your listening techniques, try to determine the following in the course of the call.
1. What is the parent asking for?
Normalize that all parents need help.
2. What is the real issue?
Is there something bothering the parent that he/she isn’t talking about because it is too scary or painful?
3. Why is the parent calling now?
Is there a precipitating crisis or a build-up of stress?
4. What is the degree of isolation?
Do they have friends, family?
5. Does the parent have any space from the child?
Any resources?
Does she/he feel guilty for wanting it?
You may have to tell the caller that all parents need space.
6. What are the parent’s expectations of the child?
Realistic, or does s/he expect too much from a child of that age?
Does s/he expect the child to meet her/his needs?
Can s/he understand and empathize with the child’s needs?
7. Are there external stresses such as problems with housing, welfare, food?
If so, what has the parent tried so far?
8. What are the family relationships like, especially the marital or partner relationship?
9. Is there any significant information regarding the parent’s history?
10. What specific behavior of the child is causing difficulty or concern?
11. What has specifically been tried in dealing with the child’s behavior?
III. EVALUATING HIGH RISK PARENTS
It is critical that you know the “signals” that indicate the potential for child abuse. Parents who are high risk for abuse are in need of very specific interventions to help them regain control, or to keep them from enacting behavior which is detrimental to the physical or emotional well-being of the child.
INDEX FOR HIGH RISK
• A young child under three. A child of this age is at greater risk for injury.
• The parent’s level of maturity, emotional stability or mental health.
• The parent’s history of child abuse—physical, emotional, or sexual—and neglect.
• The parent’s high expectations of themselves as parents.
• Parent’s behavior:
□ Discrepancy between what the parent says and what parent does.
□ Mainly negative attention to child, finding no positives.
□ Destructive ways of expressing anger (e.g., history of fights, beatings).
□ Denies fear of losing control.
□ Past abuse to child; or previous removal of child to foster care.
□ Unrealistic expectations of child, or total ignorance of child developmental ages and stages.
• Child’s behavior:
□ Difficult baby (e.g., cries a lot, hard to comfort, ill, disabled).
□ Perceived “defect” of child (learning disabled, temperamentally difficult, etc.).
□ Difficult child or adolescent (rebellious, in trouble with the law, missing curfews, out of parental control).
□ Defiant, child lies and/or steals or acts out in other ways.
• Negative statements made by parents about the child, for example:
□ “I wish the child hadn’t been born.”
□ “He/She does that or acts like that to just piss me off or embarrass me”
□ “I thought my baby would love me.”
□ “He’s plotting to get me.”
□ “He’s fine with everyone else except me.”
□ “He’s just like his rotten father.”
□ “I get nothing from this kid but trouble.”
□ “Ungrateful for all I do for him/her”
• No visible support systems, including lack of friends, family, husband, partner.
• Extreme marital problems which cannot be resolved (domestic violence, alcoholism, drug addiction of partner, etc.)
• Alcoholism or drug addiction of parent.
It is important to remember in evaluating high risk calls, that the presence of certain characteristics does not prove that a parent is at risk for abuse. These are indicators & clues, that there might be a problem, and further contact is indicated.
Also, once a parent calls and you determine them to be at risk, you should consult with the TALK Line staff, to ascertain what type of protective action might be necessary. The bottom line is protection of the child by providing services to the parents. Not all parents see themselves as having serious problems, and may not be motivated to seek needed services.
IV. ASKING QUESTIONS
During the course of a typical call you need to ask questions to determine the degree of crisis and how high risk the parent is, as well as to explore the caller’s situation. You can avoid “interrogation” by combining a question with a validation or reflection. Unfortunately, if you are afraid of being intrusive, you may not be very helpful.
“Open-ended” questioning is most effective. This type of questioning starts with who, what, when, where, or how. (Close-ended questions elicit “yes” or “no” answers.) Questions can also be speculative—e.g., “I wonder if…”, “I’d guess that…”, etc. “Why?” questions are best used sparingly since people often feel obligated to defend something in response to “Why?
V. CLOSURE
By the time you come to the end of a call you will have:
• Reflected the caller’s feelings.
• Explored the caller’s situation.
• Summarized the major issues and concerns.
• Get caller’s name and phone number
Ending the call:
• If you have not gotten a name during the call you can do so now by saying, “By the way my name is ___, what’s yours?”
• Convey that you’re glad s/he called—it’s good to ask for help.
• Let the caller know that you’d like to call her/him back, to see how things have worked out, or if a referral worked.
Example: “I’d like to call you back next week, to see how you’re doing. Is this time good? May I have your phone number?” “If someone else answers, may I say I’m calling from the TALK Line?” (DO NOT SAY “Would you like me to call you back next week?”)
Let callers know that the TALK Line is available 24 hours a day when deemed appropriate. They can call and talk to whoever is on, or they can leave a message with them for you and you will get back to her/him during your next shift. If a caller refuses to leave a number, let them know when you will be in next, and invite them to call you back.
Always end the call by saying “I’m really glad you called.” This validates their courage in reaching out for help and conveys your caring.
Remember—DON’T PROMISE ANYTHING YOU CAN’T DELIVER. You are a role model for the caller. Be reliable in calling back when you say you will. If you are unable or unwilling to follow a caller, please get their phone number, but let them know that someone else will call them back.
Helpful Hint: If there is a reason you can ask for an address (e.g., an offer to send a flyer or some reading material) and if it feels comfortable—please do it. It is helpful to write a note to a client if they become unavailable by phone.
VI. CONFIDENTIALITY AND SELF-DISCLOSURE
CONFIDENTIALITY OF CLIENT
Like all other therapeutic services, the TALK Line has clear rules about client confidentiality. The guidelines are:
• The content of any call as well as the fact that a caller uses the TALK Line is strictly confidential. No references to calls or callers may be discussed with anyone outside the confines of the TALK Line without a signed release from the caller. Feelings and questions regarding callers often arise and we ask that volunteers direct these to their supervisors.
• All files must stay within the building. All write-ups completed at the center or at home on shifts which have been diverted should be entered into the computer system, Efforts towards Outcome (ETO).
• When arranging a follow-up call, it is important to ask the caller whether, if they are not home, you may leave a message saying you are from the TALK Line. Without a caller’s consent you may not leave a message “from the TALK Line.” This is especially important in situations where there may be domestic violence, since family knowledge that a caller has asked for help may jeopardize his/her safety.
Confidentiality: Sticky Questions
1. If a client asks, “Is this call confidential?”, it is important that volunteers give an accurate, honest and complete response.
The following should be learned well enough to be stated with ease if, and only if, a client asks.
“Everything we talk about is confidential and you should know that I talk to my supervisor about all the parents I’m talking with so that I can be as helpful to them as possible.”
2. If a client asks “Do you keep files?”, here’s what we’d like you to say…
“I keep some notes so I can keep track of things you tell me. These notes also help me remember questions I might want to ask my supervisor.”
VOLUNTEER CONFIDENTIALITY
Because it is important that boundaries be maintained between volunteer’s work at the TALK Line and their personal lives, we ask that volunteers never give their home phone numbers (or any other staff or volunteer home numbers) to callers. In addition, to insure that home phone numbers do not become accidentally available to callers, we require that you take the following measures:
• Make sure that you have complete blocking for Caller ID on you home phone. (If your phone is not blocked and you make an outgoing call from home to a client with Caller ID, your home phone number will appear on their screen.)
• If you call a client from home who has Caller ID, do not dial *82 to unblock your phone (a voice prompt will direct you to do this). Instead, have the operator dial the client’s number. This will bypass Caller ID without disclosing you number.
• Do not have your phone number included in the outgoing message on your home phone. (If a client uses Call Return (*69), after you’ve called them from home, reaching your message machine would disclose your home number.)
PERSONAL DISCLOSURE
During the course of your outgoing contacts with clients you may occasionally be asked personal questions. Callers may feel uncomfortable focusing on themselves, wish to create a “friend” relationship with you, or just be naturally curious about some aspect of your life. Since the purpose of the time is to assist callers in working on their problems, the relationship between volunteer and caller is not one that involves mutual exchange of personal information. For this reason, we discourage volunteers from offering information about themselves. This can feel awkward when you are asked a direct question and offering one answer can easily lead to more questions. The following are some helpful guidelines:
• The most reasonable question a caller might ask is “Are you a parent?” This is really a way of asking “Can you understand my situation?” It is important not to try to sidestep this (or any) question, but to address what is really being asked—e.g., 1. (If you are a parent) “Yes—and I know how hard it is to bring up kids”—then refocus on caller’s situation. 2. (If you are not a parent) “No—and I’m continually impressed with how hard it must be to bring up kids”—then refocus on caller’s situation.
Note: It can easily feel that your competence or credibility is being challenged and the temptation to try and convince callers that you do understand them is strong. It’s helpful to remember that, parent or not, none of us can completely understand another’s situation; everyone’s life is unique. In listening attentively and attempting to understand, we offer callers a valuable gift.
• Any other questions can be answered by acknowledging the feeling (curiosity, interest) and explaining why you don’t want to respond.
Example: “Of course you’re pretty curious about some things about me, we’ve been talking for quite a while. But what we’re doing here has to do with you and the things you’re dealing with, so it’s not really useful to talk about me.”
Avoiding or ignoring questions generally doesn’t work. A straightforward response sets clear boundaries as well as respect for caller’s feelings.
VII. SUMMARY
• In order to establish a successful helping relationship, you need to strike a balance between listening, reflecting the caller’s feelings, and gathering information to evaluate the caller’s needs, as well as how high risk they are.
• It’s not what you say, but how you say it. That’s the key.
• In order to evaluate the caller’s needs, you need to use your listening techniques to draw the caller out.
• It is critical that you know the “signals” which indicate a high potential for abuse.
• You need to become comfortable with sometimes feeling intrusive. Convey that you want to know because you want to get to know this person in an effort to be helpful.
• Combining questions with validation of feelings will avoid the chance of your being seen as intrusive.
• You are ready to end a call when you have reflected the caller’s feelings, explored the caller’s situation, summarized the major issues and concerns, and have the caller’s name and phone number.
• Always try to get a phone number for following up, even if you can’t follow.
• Remind callers that the TALK Line is available 24 hours a day, and validate their having called.
PARENT FOCUSED CALLS
I. RESPONDING TO THE NEEDS ALL PARENTS HAVE
II. CULTURAL AWARENESS
III. PARENTS WITH SPECIAL NEEDS
A. THE ADDICTED PARENT AND THE CO-DEPENDENT PARENT
B. SPOUSAL ABUSE
C. THE RECENTLY SEPARATED/DIVORCED
D. SINGLE PARENTS
E. STEP-PARENTS
F. ADOLESCENT PARENTS
G. FOSTER PARENTS & RELATIVE CARETAKERS
IV. SUMMARY
V. HINTS FOR PARENTS
I. NEEDS AND FEELINGS THAT ALL PARENTS HAVE
Whether or not they are able to acknowledge them, all parents have the following basic needs:
• Breaks from their Kids: Everyone who cares for kids needs a periodic break—time to relax, have fun, and restore themselves. Parenting is hard work.
• Information: Raising children isn’t instructive in our complex society. Every parent occasionally has questions about her/his child’s behavior and how to respond to it.
• Support Systems: The ongoing demands of raising children are too hard to manage alone. Friends, relatives, and a community are vitally important in assisting with hands-on care, emotional support, and back-up in times of crisis.
• A Non-Judgmental Sounding Board: All parents need people who can hear their feelings, thoughts, and questions without judging or dismissing them.
• Validation: All parents need to hear positive feedback about the things they have accomplished or are trying to accomplish. The challenges of child-rearing make it hard to maintain a sense of competence and self-worth unless there’s some outside reinforcement.
Being a parent stimulates many intense, sometimes uncomfortable feelings, such as:
• Confusion: Sooner or later every parent runs into a situation that baffles him or her. Kids’ behaviors are often hard to understand or interpret without help.
• Frustration: Lots of things that kids do, which are not only normal but developmentally necessary, are annoying or frustrating to adults. It’s nobody’s fault; it’s just a fact.
• Overwhelm: Parenting is a full-time job. Add anything else, like a career, economic or relationship stress, or an illness, and anyone would be overwhelmed.
• Anger: The parent-child relationship is unique, complex, and intense. Parents are often surprised and frightened by the angry feelings they sometimes experience toward their kids.
• Guilt: Every parent has made choices or behaved in ways that may appear to have negatively impacted his/her children. Parents tend to berate themselves for their perceived failures; guilt seems to come with the territory in raising children.
• Helplessness: Parents often feel powerless to assist their children through hard times or to find ways to deal with their children’s behavior. This is especially true of parents of teenagers.
II. CULTURAL AWARENESS
We use the very broad term, “culture,” to cover many aspects of identity. This notion of culture is very complex and, often times, dynamic. It can include ethnicity, socio-economic level, religion, geographic region, sexual preference, and more.
As the volunteer, you have the responsibility of holding the paradox of always remembering that there are many other versions of living besides your own, while constantly staying in tune with the many similarities that exist between us (i.e., all of our lives are stressful, we all want our lives to work, we all want to be respected, and heard.)
The goal is not for you to attempt to be an expert on people who are “culturally” different from you. It’s easy to get into assumptions and/or judgments about people when we think that they’re different from us (not to mention when they seem similar to us!). The goal is for you to listen and join your caller where s/he is.
Accept the fact that you have biases. We all have them. It’s important for you to be aware of what your biases (prejudices) are so that they don’t get between you and your caller. In this culture we all have been taught to feel separate from (and often, above or beneath) various people. In our desire to understand and to feel competent, sometimes we’re tempted to compartmentalize people and, to objectify them.
Slow down and make a space for your caller to tell you who they are.
If you don’t understand something about your caller’s story, ask her/him. S/he is the expert on her/his life. Ultimately, it comes down to the individual on the other end of the line, not an ethnic group or a religious affiliation, etc.
More than anything else, fully attend to the human on the other end of the line. That is primary—regardless of perceived differences. Respecting the caller on the phone will take you a long way.
…knowing less, learning more… Be Curious
III. PARENTS WITH SPECIAL NEEDS
A. THE ADDICTED PARENT AND THE CO-DEPENDENT PARENT
During the course of a call you may suspect that a caller has a problem with chemical dependency. The caller may sound drunk or may casually mention drinking or drugs. More frequently, if mentioned at all, it’s because the caller is concerned about a spouse or child. It is up to you to assess if there is a problem by asking directly.
• Don’t minimize or deny the problem or collude with the caller about this. It is a major—if not the major—problem in any family. Things are unlikely to improve unless the substance use goes away.
• It is a “disease” not a failure of will power or moral inferiority.
• Most addicts need help to get and stay sober—that “help” can be a treatment program or self-help 12-step programs.
• Addiction affects the entire family not just the user and/or their partner. Children are profoundly impacted by parental substance abuse even if there is no other kind of abuse co-occurring. The addict and co-addict may vigorously deny the impact because the kids don’t see the using parent “high”.
• Addicts most often come from families where addiction was present in their formative years.
• There are four adaptive styles used by children to deal with parental addiction:
The “Hero” – perfect child, mother’s helper, well-behaved, does well in school, generally successful and appearing to be non-problematic.
The “Scapegoat” – the hero’s opposite, in trouble at home and at school, has difficulty relating to peers, often defiant and oppositional with authority figures.
The “Lost Child” – this child withdraws in the face of conflict or unpleasantness, they are quiet and work hard not to be seen.
The “Clown” or “Mascot” – the child who is funny and amuses everyone but teachers in the middle of a lesson. Makes the family feel good and forget problems.
• The partner of an addict is often addicted to the addict and acts in ways to sustain the addict’s using. The co-addict may enable—e.g., buy alcohol or drugs, deny or minimize the problems, take over responsibilities for the addict and/or rescue the addict from the negative consequences of his or her using.
• Addiction follows a fairly predictable pattern (thought the time span over which it develops can vary):
1st is experimental use usually starting in adolescence (or sometimes at puberty).
2nd is social use—use is at parties and social occasions.
3rd is increasingly frequent use less tied to social occasions and increasing tolerance (needing more of the substance used to obtain the intoxication at a satisfactorily level).
4th is solitary use—finding opportunities to use regardless of surroundings with increasing preoccupation on getting high.
• Somewhere in this progression, blackouts will be experienced (with alcohol) and tolerance developed.
• There is an inability to control use and repeated attempts to do so with increasingly negative consequences related to using (work, family, legal problems); there are often attempts to stop using that fail, and if left untreated the progression can lead to death.
• Alcoholic families often operate in a destructive triangle into which you, as a counselor, might become embroiled. The triangle’s three points are Victim, Rescuer, and Persecutor. A Victim says “Help me. I can’t do this.” The Rescuer leaps in to say “I’ll save you.” When the Rescuer’s efforts become too burdensome and intrusive the Victim then begins to blame the Rescuer and tell them they are now among the Persecutors who created the Problem in the first place. The Rescuer now becomes a Victim in search of their own Rescuer because they feel persecuted by the former Victim.
• Detecting substance problems:
Listen for chronic money problems.
Listen for victims or “poor me” statements.
Listen for denial and minimization of problems.
Listen for restricted range of affect.
Listen for generalized mistrust of others.
Listen for families who cannot talk about problems without shame (belief that family problems should be kept inside the family).
Listen for signs that the suspected addict is disengaged from the family but the family is over-engaged with him or her.
Listen for changes of mood that follow predictable cycles.
Find out if caller came from a family where substances were abused or were a “problem” at times.
One or more kids are being labeled as troublemakers at home and/or at school and another child as presented as being perfect or nearly so.
Listen for low self-esteem and preoccupation with another’s problems and few self-care skills.
PROCEDURES
Call from a parent who is drugged or drunk and
1. There are young (under 3) children in the home, you need to determine if there is someone else sober present in the home or nearby and accessible who can take care of the children. If not, after getting the caller’s name and number call your supervisor or other staff person to help assess and decide on a plan of action.
2. There are older children in the home, you need to talk long enough to engage the parent so that you can get a name and telephone number. Validate the pain and difficulty in their lives but also say that “There is little we can do for you right now but we’d very much like to have someone follow up with you when you are sober.”
The focus of follow-up will be to deal with the substance abuse and your supervisor will talk with you about how to keep your work focused and not become involved in a collusion process with the caller.
Calls with substance abusers who are not loaded when calling but reveal there is a problem in the course of conversation:
• Determine the degree of the problem.
• Remember the focus becomes getting help.
• Five questions for assessment:
1. Have you ever felt you should cut down?
2. Have you been upset by others’ comments about your use?
3. Have you ever felt bad or guilty about your use?
4. Have you ever needed to use to steady yourself from previous use?
5. Did you come from a family where alcohol or drugs were a problem?
These questions should not be asked directly but subtly woven into your discussion with the client.
RELAPSE
Relapse is part of the disease of addiction.
Relapse can be a one-time “slip” or a period of using but repeated short periods of sobriety followed by use is not relapse—it is using.
Persons who have relapsed feel a lot of shame and need support to pursue recovery again.
Signs of relapse:
• Stop attending recovery programs or 12-step meetings.
• Getting really busy about things like work or other people’s problems and losing recovery focus.
• Associating with place or people with whom they’ve used, or associating with users in general.
• Cross addiction—no longer using original addictive substance but uses some other mind-altering substance, e.g., no longer smokes marijuana, or engages in other addictive behavioral patterns, e.g., work.
• Getting too hungry, too angry, too lonely, or too tired (H.A.L.T.).
B. SPOUSAL ABUSE
Spousal abuse comes in several forms—emotional, verbal, physical, or sexual. It follows a pattern of increasing intensity and frequency over time. The shoving will sooner or later escalate to slapping, and the slapping to beating. Though men are abused too, the most likely victims of domestic abuse are women.
The Cycle of Violence
• First phase – Tension Building. Disagreements, criticisms, threats, “minor” violent acts that are ignored and where the abused person often placates to avoid an abusive incident. There are times when the abused party may provoke a violent incident to advance the cycle and end the tension building phase to get to the third phase.
• Second phase – Acute Violence. Control is lost and violence occurs. This is a point where the victim frequently calls us for help. How much help she will take, however, may decrease rapidly after the violence has occurred and denial sets in.
• Third phase – Honeymoon Phase. The batterer is remorseful and promises not to repeat the behavior. The victim is often blamed, however, for provoking the violence that was directed toward her.
As noted above, the woman may call just after a battering incident. One of the most important things you can tell the caller is that no woman deserves to be beaten, whatever else she is told!
Crisis Intervention
• Make sure she and her children are safe. Give her referrals to shelter and other battered women’s resources. Help her make calls if necessary.
• Focus on the incident—do not blame the partner. The woman does not, necessarily, want to leave the relationship. She does want the abuse to stop.
• Offer support. She does not deserve to be attacked.
• Respect her love for her partner.
• Encourage her to protect herself and at least think about leaving the relationship. Leaving may be the only way her partner will get help.
• If she is unwilling to leave at this time, help her devise a safety plan and an exit plan for emergencies. This means keeping some emergency money and clothes stashed some place safe where she can get them quickly. Help her plan a safe place to go where her partner will not be able to get her—a friend not known to him, a battered women’s shelter, a relative, etc.
• Mostly, you are holding ambivalence
• Encourage her to develop a support network. Often battered spouses have been systematically isolated from others so they need support from others.
• Talk about the damage to the children who are exposed to repeated incidents of domestic violence. Batterers are often raised in families where they witnessed spousal abuse. Spousal abuse is traumatic to kids because it fosters feelings of helplessness and disempowerment.
C. THE RECENTLY SEPARATED/DIVORCED
Becoming a single parent is a crisis that is painful, no matter how” bad” the relationship was. During this crisis, parents work at uncoupling, grieving, and experimenting with new roles. There will be much fear, anger, sadness, and confusion. They will need to talk about these feelings even if they don’t raise them themselves. Our role is to validate these feelings, to facilitate their talking about them.
Even if the separation was expected and planned for, the parent usually experiences great swings in mood (relief ( depression) which may be accompanied by a fear of going crazy (great loneliness). There is usually a drop in socio-economic status. Financial problems, housing, and loss of friendships must be dealt with. In addition, their ability to parent decreases at this time. Contact with the other parent, whether ongoing, inconsistent, or non-existent, will be difficult. Yet the child does have a right and need to see the other parent.
PROCEDURE
1. Help the parent talk about his/her feelings.
2. If a parent seems very depressed or “stuck” suggest counseling to work through the grief.
3. Stress that the parent talk to the child about her/his feelings; that the child will be experiencing the same feelings as the parent even if she/he is not expressing them.
4. It is important that parents let their children know that a) the separation is not the child’s fault, and b) that they will not abandon the child.
5. Help the parent understand that a child’s difficult behavior is the child’s response to the separation and it would help if they could talk about it.
6. Help the parent build as much structure into the child’s life as possible and to be available to the child’s feelings as much as possible.
7. Help the parent get space from the child at least once in a while to do things that feel good.
8. Help the parent ask for help.
9. Encourage the parent to build the support systems so vital for their successful adjustment.
Non-custodial parents will also need your support in adjusting to the loss of both their spouses and their children. Non-custodial parents have the added burdens of feeling powerless, and of having “lost” their whole family.
D. SINGLE PARENTS
Over half the parents who call the TALK Line are single parents, that is, they have all or most of the responsibility for raising their children. People became single parents by choice or by circumstances beyond their control. They differ in their resources and motivations, but all single parents have special needs and problems.
Economic stresses are often particularly severe for the single parent. The costs of housing and childcare, combined with low salaries, and inadequate or no child support make for strict-budget existences. A sick child or a repair bill can precipitate a crisis.
Feelings of failure and guilt may overwhelm the single parent. Trying to overcompensate for the loss of a parent, s/he may try to do the impossible job of being both parents and feel guilty for failing. If both parents are involved with the child, unresolved conflicts can threaten the family’s stability. Societal and/or family rejection of divorce or having a child “out of wedlock” can increase pressure on single parents. Anger at having all the responsibility can increase the potential for child abuse and neglect. Alcohol or drugs may be used to block out feelings.
PROCEDURE
Validate his/her feelings.
Help him/her to balance the needs to work, spend time with their children, and have a social life.
Encourage her/him to join a support group, especially if s/he is isolated.
Custody Issues
Often parents call angrily, stating some kind of custody issue between themselves and the previous mate. The callers may simply want to ventilate his/her anger. Some of this anger may be related to problems which were present in their marriage. For example, if the child is picked up late for a visit, this may remind the parent of all the time she waited to be picked up on time. Some of the anger will be current, some will be summoned from the past. It’s important to encourage the parent to communicate with the ex-partner in a calm state, and figure out how s/he can negotiate specific wants or needs.
Do not take sides. Simply explore with the parent the full range of feelings they are experiencing and try to help him/her arrive at conclusions, so further upsetting experiences can be avoided or prevented.
Stress the importance of not criticizing the other parent. Children who are told a parent is “bad” will feel that one half of them is “bad” too.
E. STEP-PARENTS
The introduction of a new mate will invariably create difficulties for the single parent and her/his children. The children will usually feel jealous and act in ways which threaten the natural parent. (“I’ll never find anyone because of my rotten child.”)
Discipline can become a major problem if the natural parent wants the stepparent to take over (It won’t work.), or the stepparent disagrees with the natural parent’s methods of discipline.
There is a myth of “instant love” which will create one big happy family. When this doesn’t happen, feelings of rejection and anger can surface.
A stepparent cannot replace the natural parent and a child inevitably feels conflicting loyalties between the same-sexed parent and stepparent.
Help the stepparent form a friendship with the child and refrain from disciplining the child. Help the caller understand that it takes a long time for this new family to come together and much patience must be required.
F. ADOLESCENT PARENTS
Young parents have needs for much support and reassurance, which they may not be able to have met by parents and friends who are upset at their decision to have children at such a young age or who no longer share interests.
These parents may have unrealistic expectations about having children. A child is not just someone who will love them or a toy to play with. When they eventually realize all there is to parenting, they may resent the child for taking over their lives. They may be reluctant to ask for help.
These parents need help to find the balance between meeting their own needs as teenagers for fun, affection, and understanding and meeting their children’s needs—a very difficult situation.
It is important to provide them with as much structure as possible, so they don’t feel overwhelmed. Hooking them up to some of the resources specifically for teenage parents is vital.
G. FOSTER PARENTS & RELATIVE CARETAKERS
There are thousands of children in California's foster care system who require temporary out-of-home care because of neglect, abuse or exploitation. The preferred placement of children who require out-of-home care is with relatives. If a home with relatives is not a possibility, foster parents and other caretakers provide a supportive and stable environment for children who cannot live with their birth parents until family problems are resolved. In most cases, the foster parents and care providers work with social services staff to reunite the child with birth parents. Foster parents often provide care to many different children. Children who require out-of-home care generally come under the jurisdiction of the juvenile court. The juvenile dependency process involves a series of hearings and case reviews which may result in foster care placement, including placement with relatives.
Foster parents frequently have the same stresses and strains (as well as the joys) that natural parents have. The only difference is that they are often expected to be “super parents.” Most people feel, “they asked for it, they must love it.” Even though these types of parents have actively sought out the parenting experience, they can come face-to-face with their expectations not being met, or difficulties around parenting.
Foster parents have an additional burden: They have little privacy as their lives are constantly interrupted by therapists, school appointments, social workers, monitoring visits with birth families, maintaining medical appointments for the children placed in their home all the while continuing their own busy lives. Social Workers are often completing home visits in which they do safety checks of the home and are allowed to go through their personal drawers and closets. Foster parents have different children come in and out of their lives and it can be hard to experience that loss constantly. This can also affect the foster parent’s birth children as well and the foster parent is left having to hold their own feelings and their birth child’s feelings.
Foster parents also can receive children in their care who have had life experiences which make it more difficult for them to care for the children. The children may exhibit difficult behavior, or may have emotional problems that cause them to “act out.” Explore how they feel about sharing their feelings and problems with their social worker.
Relative caretakers deal with many of the same issues as foster parents. In addition, they may feel obligated to care for the children of relatives while struggling with feelings of overwhelm or anger at the children’s parents.
General thoughts about parent callers:
Parents will not necessarily call and identify any of the previously mentioned problems as the reason for calling. Often they will begin by talking about a child-related concern, and eventually feel comfortable enough to share other concerns. It is sometimes easier to talk about problems with the child than problems with self or mate. It is our job to encourage parents to talk about their own needs and feelings, as well as about any problems they may be having with their children.
Parental needs are similar to children’s needs, and to be useful to callers, keep these in mind:
Parents need help to feel good about themselves;
Parents need to be comforted when they are hurt, supported when they feel weak, and liked for their likeable qualities;
Parents need someone they can trust and lean on;
Parents need someone who will tolerate their crankiness and complaining;
Parents need someone who will not be tricked into accepting their sense of low self-worth;
Parents need someone who is there in times of crisis;
Parents need someone who will not criticize them, even when they ask for it, and who will not tell them what to do, or how to manage their lives;
Parents need someone who will help them understand their children without making them feel stupid for not having understood in the first place;
Parents need someone who can make them feel valuable and not someone of less value because they asked for help;
Parents need someone who understands how hard it is for them to have dependents when they have not been allowed to be dependent themselves.
IV. SUMMARY
• When parents call the Line, it’s important that you relate to them first as people with needs and feelings. Validate feelings consistently and reflect them attentively.
• There is a broad array of problems that are specifically adult-related and can affect parents directly. While it is important to be familiar with the dynamics of certain problems, the basic principles of active listening, evaluating high risk factors and support will be vital.
• Problems such as alcoholism or spousal abuse may place the child in danger. Action may need to be taken to make sure the child, as well as the parent, is safe.
• Recently separated/divorced parents, single parents, stepparents, and adolescent parents all have added stresses to cope with. Helping parents explore the full range of their feelings; providing support and empathy, as well as specific information, will go a long way to helping the parent feel their lives are more manageable.
• Parents may find it easier to talk about their children than their own problems. Help them talk about themselves by attending to how they feel about the child’s behavior. You can then explore other areas of their lives by asking judicious questions.
V. HINTS FOR PARENTS[1]
Special Tips
Here are some questions to ask yourself when you begin to feel the stress of being upset with your children:
1. Is it so important that the children always do things my way?
2. Can I let the children have it their own way sometimes?
3. Do I really take enough time to try to understand what the children are saying to me?
4. Do I really know what the children want and need from me?
5. Is what I say or tell them to do really clear to them?
6. How often do I stop and listen--letting the children tell me what they think and feel--simply because they need to talk to me?
7. After I’ve lost control, how do I really feel about myself?
8. Can I apologize to my child when I’ve lost control?
9. Am I really taking my problems out on them?
10. How would I feel if someone said or did the same thing to me?
Some Stress and Tension Relievers
1. Count to 10, put the child in a safe area (crib, playpen, childproof room) and go to another room or outside for a few minutes.
2. Go into another room, and cry or scream. Then take 10 minutes to read, knit, or do whatever relaxes you best.
3. Lie on the floor with your feet up on a chair; place a cool washcloth on your face; and think of the most peaceful scene you can imagine. Stay there for 5 minutes.
4. Tell your child exactly what is making you feel angry. Be really specific about what behavior needs to be changed in order to reduce your anger level.
5. After you’ve put the children down for a nap, forget what you “should” be doing. Take some time for yourself to relax—sleep, read, listen to music, take a bath—whatever makes you feel fresh again.
6. Designate a corner, chair, or some quiet spot as a “time-out” place where you can go when you feel like losing your temper. Designate a separate one for your child. It gives both of you a few minutes to calm down, and it tells the other person that you are getting angry.
7. Save a special, quiet plaything to be used only at certain times. It will be a treat for your child, and will provide some quiet time for you.
Bonus Points
When things are going well, pass out rewards.
1. Compliment and reward the children for the good things, such as being quiet, not fighting, not whining, cleaning up.
2. Let the children know when their behavior is making you happy.
3. Hug the children and say “I love you.”
4. Say “thanks” for small favors.
5. Treat the children and yourself for doing so well.
CHILD-FOCUSED CONCERNS
I. PARENT’S CONCERNS ABOUT CHILD’S BEHAVIOR
II. DISCIPLINE
III. CHILD DEVELOPMENT
IV. COMMON CONCERNS REGARDING CHILDREN
V. OVERALL GUIDELINES
I. PARENT’S CONCERNS ABOUT CHILD’S BEHAVIOR
Often parents will call expressing concern about their child’s behavior and wondering if it is normal and/or how to cope with it. There are several factors which may be involved in a child’s behavior.
His/her behavior is a function of:
A. Temperament
B. Developmental stage
C. Situation (home, school, peers)
How a parent reacts to a child is due to the parent’s:
A. Emotional makeup
B. Knowledge and understanding of the child
C. Knowledge of parenting skills
Therefore, you’ll need to check:
A. Stage and development of child
B. What precipitated behavior
C. Parent’s response
D. What else is going on in the child’s or parent’s life
The volunteer will want to help parents understand what this child’s needs are—that indeed their child is a separate person with feelings, needs, and wants of his or her own. This is important in helping parents develop/have empathy for their child. You must, however, continue to validate the parent’s feelings of frustration, anger, concern as you point out what the child is expressing, so as not to convey the impression that you are siding with the child. It is very difficult to absorb much information when one is in a rage!
It is important that the volunteer have a general knowledge of the psychological needs of a child at different developmental stages.
In this section you will find an outline of the landmarks of development and the ages at which they generally occur and the psychosocial development generated by Erickson. This outline will give you a general feeling for child development.
Remember that you do not need to be a child development expert. You can always tell the parent that “I’m not sure…let me check and get back to you.”
Generally, you want to help the parent to:
A. Verbalize his/her own feelings
B. Learn to actively listen to the child’s feelings while setting age-appropriate limits (we all have angry feelings we need help expressing)
C. Use “I” messages in communicating with the child, rather than blaming or preaching—e.g., “I feel, I need, I want…”
D. Encourage independence (choices, changes, etc.) age-appropriately while validating dependence (doing for, protecting, meeting child’s needs to “fall apart” at times, etc.)
It is important that we try to assess when a child’s behavior is disturbed enough to warrant referral for evaluation and possible psychotherapy. The older the child, the greater the number of areas in which he or she is having difficulty (e.g., home, school, with peers), and the severity of symptoms are all indicators that the child may need professional help.
Parents are usually very threatened (although sometimes relieved) by this suggestion. It is important to point out that children are often very confused themselves about why they are “misbehaving” and an objective, outside person can usually help to sort it out.
II. DISCIPLINE
Discipline is not synonymous with abuse. Over-disciplining can become abusive, but every child needs constant and reasonable discipline, i.e., limit-setting, as a guideline in developing self controls.
Discipline, then = providing child with:
A. Structure
B. Guidance
C. Limits
A child needs to know
A. what’s expected;
B. what the consequences are if s/he doesn’t follow through.
If the parents are inconsistent, or unable to give a clear message about what they want, the child may become confused and be unable to adjust his/her behavior.
Parents usually spank when they’ve tried everything else they can think of and it has failed, or when they don’t know what else to do. Other parents may feel it’s desirable and necessary to spank a child. Remind parents that the purpose of discipline is to teach, and unfortunately, what most children learn from spanking is that hitting is okay. You can question with them whether spanking is working or not (e.g., child’s persisting in unacceptable behavior) and ask them is they would like to work on finding another, more effective way to set limits.
If parents have been abusive in the past, it is critical to help them find other ways of coping with their children, rather than hitting. Offering alternatives, and exploring if the parent feels able to carry through on a technique is important. Don’t set up the parent to fail, by giving a technique beyond the parent’s ability to carry it out.
Always encourage the parent to call the Line before getting out of control.
Note: We have several booklets which are available to be mailed to parents who need help with appropriate limit-setting.
III. CHILD DEVELOPMENT
| | | | |
|Age |Child’s Needs |Common Problems |Volunteer’s Guide/Response |
|Stage I | | | |
|0-6 months |Needs to be held a lot—this will |Nursing |Check mother’s feeding pattern—e.g.|
| |not spoil child. | |every four hours—give support how |
| | | |hard it is. |
| |Physical discipline is dangerous. |Teething |Help parent explore cause of |
| | | |crying, i.e., wet diapers, baby |
| | | |hungry, etc. Reassure that it’s |
| | | |okay to let child cry for a while. |
|6-8 mos. |Recognizes family versus strangers.|Crying |Reflect feelings; explore cause of |
| | | |crying; give support how hard it is|
| |Very attached to mother. | | |
|8 mos. |Crawls. |Separation anxiety |Support parent to reassure child |
| | | |that when mother goes away, she |
| | | |will also come back. |
|12 mos. |Begins to walk. | |Reflect feelings; explore situation|
| |
|Stage II | | | |
|18 mos. – 3 yrs. |Shows increasing signs of |Can’t share possessions. |Encourage parent to avoid conflict |
| |individuality—begins to get | |and to substitute objects or remove|
| |separate sense of self. | |them instead of arguing. |
|2 yrs. |Begins to explore and learn how to |Begins to have temper tantrums if |Reassure parent of the difficulties|
| |do things alone. |thwarted. |of handling the “Terrible Twos.” |
| |Develops sense of mastery. |Begins to control bowel movements. |Develop parent’s empathy for |
| | | |child’s growth needs to get into |
| | | |things. |
| | |Favorite word is “NO.” | |
| |
|Stage III | | | |
|3-6 yrs. |Love identification with parent of |Sibling rivalry—much competitive |Help parent vocalize with the child|
| |the same sex—suppression of Oedipal|drive. |different feelings s/he may have |
| |feelings. | |re: sharing the parent. |
| |Sexually explorative. |Masturbation |Help parent verbalize that this is |
| | | |a private thing and set appropriate|
| | | |limits to not making it a large |
| | | |issue. Encourage much verbal |
| | | |communication from parent re |
| | | |movement and exploration. |
|4 yrs. | |Separation problems. | |
| | |Sleep disturbances. |Explore possible reasons. |
| | | |Reassurance and firmness re: |
| | | |staying in bed. |
| |
| | | | |
|Age |Child’s Needs |Common Problems |Volunteer’s Guide/Response |
|Stage IV | | | |
|6-12 yrs. |Determination for mastery, | |Encourage verbal communication |
| |eagerness to do and experiment |School problems. |between parent and child. |
| |alternates with reluctance to | | |
| |compete. | | |
| |Same sex closeness. |Possibly problems with peers. |Help parent validate difficulty re:|
| | | |child’s struggle with friend and |
| |Will measure skills and worth to | |importance of school. |
| |peers. | | |
| |Trying to figure out where they fit| | |
| |in society. | | |
| |
|Stage V | | | |
|12-18 yrs. |Development of identity. |Separation from parent. |Difficult both for parent and teen.|
| |Sense of self. |Ambivalence between |Explore with parents re: |
| | |dependence/independence. |ambivalence. |
| | | |Encourage parent to negotiate with |
| | | |teen re limit-setting. Use “I” |
| | | |messages. |
Developmental Guidelines: Children’s Reactions to Trauma (Infancy to Two & a Half years)
|General Trauma Reactions |Memory for Trauma |Parental Support |
|- Disruption of sleeping & toileting |- Memory of trauma may be evident in behavior or|- Maintain child’s routines around sleeping & |
|- Startle response to loud/ unusual noises |play |eating |
|- “freezing” (sudden immobility of body) |- Snatches of incomplete memory or visual images|- Avoid unnecessary separations from important |
|- fussiness, uncharacteristic crying, and |may remain in memory and be given verbal |caretakers |
|neediness |description by toddlers |- provide additional soothing activities |
|- Loss of acquired speech & motor skills | |- maintain a calm atmosphere in child’s presence|
|- Separation fears and clinging to caretakers | |- avoid exposing to reminders of trauma |
|- withdrawal; lack of usual responsiveness | |- expect child’s temporary regression; don’t |
|- Avoidance of an alarm response to specific | |panic |
|trauma-related reminders involving sights & | |- help verbal child to give simple names to big |
|physical sensations | |feelings; talk about event in simple terms |
| | |during brief chats |
| | |-give simple play props related to actual trauma|
| | |if child is trying to play out the frightening |
| | |situation (a doctor’s kit, a toy ambulance, toy |
| | |dog, etc.) |
Developmental Guidelines: Children’s Reactions to Trauma (Two & half years to Six years)
|General Trauma Reactions |Memory for Trauma |Parental Support |
|- Repeated retelling of traumatic event |- Memory of at least some visual images from |- Listen to and tolerate child’s retelling of |
|- Behavioral, mood, & personality changes |traumatic event is likely for youngest children;|event |
|- obvious anxiety & fearfulness |many demonstrate recall in words and play |- respect child’s fears; give child time to cope|
|-withdrawal & quieting |- at the older end of this age range, children |with fears |
|- specific, trauma-related fears; general |are more likely to have lasting, accurate verbal|-protect child from re-exposure to frightening |
|fearfulness |and pictorial memory for central events of |situation and reminders of trauma, including |
|- post- traumatic play often obvious |trauma |scary TV programs, movies, stories, and physical|
|- involvement of playmates in trauma-related | |or locational reminders of trauma |
|play at school & day care | |- accept and help the child to name strong |
|-regression to behavior of younger child | |feelings during brief conversations (the child |
|- loss of recently acquired skills (language, | |CANNOT talk about these feeling or the |
|toileting, eating, self-care) | |experience for long |
|- separation anxiety with primary caretakers | |- expect and understand child’s regression while|
|- loss of interest in activities | |maintaining basic household rules |
|- sleep disturbances: nightmares, night terrors,| |-expect some difficult or uncharacteristic |
|sleepwalking, fearfulness of going to sleep and | |behavior |
|being alone at night | |- set firm limits on hurtful or scary play and |
|- confusion and inadequate understanding of | |behavior |
|traumatic events most evident in play rather | |- avoid nonessential separations from important |
|than discussion | |caretakers with fearful children |
|- unclear understanding of death & the causes of| |-Maintain household and family routines that |
|“bad” events | |comfort child |
|- Magical explanations to fill in gaps in | |-avoid introducing new & challenging experiences|
|understanding | |for child |
|- complaints about bodily aches, pains, or | |- provide additional night-time comforts when |
|illness with no medical explanation | |possible: night lights, stuffed animals, |
|- visual images of unpleasant memories of trauma| |physical comfort after nightmares |
|that intrude in child’s mind but will seldom be | |- explain to child that nightmares come from the|
|discussed spontaneously | |fears a child has inside and that they will |
|- loss of energy & concentration at school | |occur less and less over time |
|- fear of trauma recurring | |Provide opportunities and props for |
|- increased need for control | |trauma-related play |
|-vulnerable to anniversary reactions set off by | |- discuss & discover triggers for sudden |
|seasonal reminders, holidays, and other events | |fearfulness or regression |
| | |- monitor child’s coping in school and day care |
| | |by communication with teaching staff & |
| | |expressing concerns |
| | |- listen for child’s misunderstanding of a |
| | |traumatic event, particulary those that involve |
| | |self-blame and magical thinking |
| | |- gently help child develop a realistic |
| | |understanding of event |
| | |- remain aware of your own reactions to the |
| | |child’s trauma |
| | |-provide reassurance for child that feelings |
| | |will diminish over time |
| | |- provide opportunities for child to experience |
| | |control and make choices in daily activities |
| | |- be mindful of possibility of anniversary |
| | |reactions |
Developmental Guidelines: Children’s reactions to trauma (Six years to Eleven Years)
|General Trauma Reactions |Memory for Trauma |Parental Support |
|- Repeated retelling of traumatic event |- Child is likely to have detailed, long-term |- listen to & tolerate child’s retelling of event |
|- Obvious anxiety and fearfulness |memory for traumatic event |- respect child’s fears; give child time to cope |
|- specific post-traumatic fears |- factually accurate memory may be embellished |with fears |
|- post- traumatic re-enactments of traumatic |by elements of fear or wish; perception of |- increase monitoring and awareness of child’s play,|
|event that may occur secretly and involve |duration may be distorted |which may involve secretive re-enactments of trauma |
|siblings or playmates | |with peers & siblings, set limits on scary or |
|- fear of traumas recurring | |hurtful play |
|-Intrusion of unwanted visual images and | |- Permit child to try out new ideas to cope with |
|traumatic memory that disrupt concentration & | |fearfulness at bedtime |
|create anxiety, often without parents’ | |- Reassure the older child that feelings of fear or |
|awareness | |behaviors that feel out of control or babyish (e.g.,|
|- loss of ability to concentrate and attend at | |bed wetting) are normal after a frightening |
|school, with lowering of performance | |experience and that the child will feel more like |
|- Spacey or distractible behaviors | |him/herself with time |
|- behavior, mood, or personality changes | |-Encourage child to talk about confusing feelings, |
|- Regression to behavior of younger child | |worries, daydreams, mental review of traumatic |
|- toileting accidents | |images, and disruptions of concentration by |
|- withdrawal and quieting of excesses of | |accepting the feelings, listening carefully, and |
|aggression & limit testing | |reminding child that these are normal but hard |
|- loss of interest in previously pleasurable | |reactions following very scary event |
|activities | |- Maintain communication with school staff and |
|- sleep disturbances: nightmares, sleepwalking,| |monitor child’s coping and help with demands at |
|night terrors (rare for this age), difficulties| |school or in community activities |
|falling or staying asleep | |- Expect some time- limited decrease in child’s |
|-Complaints about bodily aches, pains, or | |school performance and help the child to accept this|
|illness with no medical explanation | |as a temporary result of the trauma |
|- concern about personal responsibility for | |- Protect child from re-exposure to frightening |
|trauma | |situations and reminders of trauma, including scary |
|- acute awareness of parental reactions; wish | |television programs, movies, stories, and physical |
|to protect parents from their own distress | |or locational reminders of trauma |
|- frightened by intensity of own feelings | |-Expect and understand child’s regression while |
|- vulnerability to anniversary reactions set | |maintaining basic household rules |
|off by seasonal reminders, holidays, or other | |-expect some difficult or uncharacteristic behavior |
|events | |- listen for a child’s misunderstanding of a |
| | |traumatic event, particularly those that involve |
| | |self- blame & magical thinking |
| | |-Gently help child develop a realistic understanding|
| | |of event |
| | |- remain aware of your own reactions to the child’s |
| | |trauma |
| | |- provide reassurance to child that feelings will |
| | |diminish over time |
| | |- provide opportunities for child to experience |
| | |control & make choices in daily activities |
| | |-be mindful of the possibility of anniversary |
| | |reactions |
Developmental Guidelines: Children’s Reactions to Trauma (Eleven to Eighteen Years)
|General Trauma Reactions |Memory for Trauma |Parental Support |
|- trauma- driven acting out behavior; sexual |- acute awareness of and distress with |- encourage younger & older adolescents to talk|
|acting out or reckless, risk taking behavior |intrusive imagery & memories of trauma |about traumatic event with family members |
|-efforts to distance from feelings of shame, |- vulnerability to flashback episodes of recall|- provide opportunities for young person to |
|guild, & humiliation |- may experience acute distress encountering |spend time with friends who are supportive and |
|- increased impulsivity |any reminder of trauma |meaningful |
|- accident proneness | |-reassure young person that strong feelings- |
|- wish for revenge and action oriented | |whether of guilt, shame, embarrassment, or wish|
|responses to trauma | |for revenge- are normal following a trauma |
|- increased self- focus & withdrawal | |-help young person find activities that offer |
|- sleep & eating disturbances; nightmares | |opportunities to experience mastery, control, |
|- acute awareness of & distress with intrusive | |and self-esteem |
|imagery & memories of trauma | |- encourage pleasurable physical activities |
|- vulnerability of depression, withdrawal, and | |such as sport & dancing |
|pessimistic worldview | |- address acting out behavior involving |
|- personality changes & changes in imp | |aggression or self-destructive aspects quickly |
|relationships | |and firmly with limit setting and professional |
|- flight into adulthood seen as a way to | |help |
|escaping impact & memory of trauma (early | |- monitor young person’s coping at home, |
|marriage, pregnancy, dropping out of school, | |school, and in peer group |
|abandoning peer groups for older friends) | |-take signs of depression, accident proneness, |
|-fear of growing up and need to stay connected | |recklessness, and persistent personality change|
|to family | |seriously by seeking help |
| | |- help young person develop a sense of |
| | |perspective on the impact of the traumatic |
| | |event and that it takes time to heal |
| | |-encourage delaying big decisions |
IV. COMMON CONCERNS REGARDING CHILDREN
Spoiling Babies
Parents sometimes feel that by giving in to their infant’s cries they are setting themselves up to “spoil” their child. They need to hear that babies cry because they have a need (even if it is difficult to ascertain what that need is). Babies need touching, talking to, attention, stimulation, and to have their cries responded to in order to form a sense of the world that is safe and secure. And parents may need permission to “spoil” their babies (by responding to their cries) while bearing in mind that allowing a child to cry occasionally will not have a negative effect on the child as long as his needs are met fairly consistently.
Note: It is always better for a child to be left in a safe place to cry than to be dealt with by a parent who may lose control.
Sleep Problems
Occasionally parents call with complaints that they can’t get their baby or small child to sleep, or that the child wakes up during the night and will only go back to sleep in the parents’ bed.
Getting a child to go to bed can become a nightly struggle for some parents. Assurance that children are well served by having a fairly regular bedtime (as are the exhausted parents) is a good first step. Nightly rituals, soft, cuddly toys as transitional objects, and a clear, consistent approach are all helpful in aiding a small child in the process of “letting go” of the day and falling asleep.
Generally speaking, for children over six months, middle of the night sleep disturbances results from separation anxiety. This often occurs after some disruptive circumstance—e.g., family trip, illness, absence of a parent. Help explore any recent changes with the parents, then encourage them to sit with their children during periods of wakefulness, rather than taking them to their beds. If this can be done calmly and consistently, children often resume sleeping through the night within several nights.
Toilet Training
This area is one that often creates tension between parents and their children. For a variety of reasons, parents sometimes feel pressured to try to toilet train their child before s/he is developmentally ready (usually not before 2½). This results in frustration and escalating conflict. It is helpful for a parent to know that there is a wide age range that is “normal” for toilet training to be accomplished, and that waiting until a child is developmentally ready makes things a lot easier. This is an area where a child begins to develop some sense of control and may resist a parent’s attempts to train.
Helpful Tips
a) Introduce the child to the “potty” around age 1½ - 2 and let them play and familiarize them themselves with it.
b) Use positive reinforcement and praise when the child shows interest (or success) in using the “potty.”
c) Avoid punishing “accidents” and avoid any negative attention when the child resists training.
d) Allow the child to proceed at his own pace; remind, encourage, praise—don’t force, threaten, or punish.
e) Look for signs of "readiness" e.g. waking up from naps dry.
Tantrums
During the 18-month to 3½-year period, children will occasionally vent their frustration or release tension by having a tantrum. It is helpful for the parent to view this behavior as the child’s internal struggle with himself around individuation issues, rather than a conflict with the parent. Tantrums are generally very frustrating to parents and they usually require a lot of support to avoid overreacting to them. Withholding attention, either positive or negative (i.e., ignoring the tantrum) usually works best in the long run, as long as the child is safe and not hurting him or herself. This is often very difficult for parents to do, and they need lots of validation and understanding of their rage, frustration, and embarrassment about the child’s behavior.
Note: Very frequent tantrums or tantrums in an older child may indicate problems and high stress for the child. This needs to be explored.
Power Struggles and Oppositional Behavior
Often we hear parents who talk about how their child “won’t do what he’s told,” argues, "talks back", or "wants his own way". The age of the child is most important since negativity is more expected at some ages than others. Children are usually most prone to engage in power struggles with their parents between the ages of 2 and 5. For this age group, stubborn or non-compliant behavior represents an important function: an assertion of autonomy from adult control. Refusing to bend to the parents’ wills helps the child to separate, i.e., to gradually see herself/himself as an independent person. For parents to be able to handle this frustrating period it is helpful for them to understand that this behavior is not only normal, but developmentally important.
Helpful Tips in Dealing with Negativity
a) For the under-3-year-old it is advisable not to offer choices since each option appears equally attractive. Too much choice leads to frustration and tantrums or to offer self-limiting choices (e.g., “Walk with me holding your hand, or be carried.”)
b) For 3 years old and older, offer options when possible and eliminate non-essential power struggles.
c) Use suggestions rather than commands whenever possible and appropriate.
d) Verbally and physically reinforce cooperative behavior.
e) Be as flexible as possible—using knowledge of the individual child’s temperament and strengths in trying to set limits.
f) Use “time-outs” (short periods only—1 minute per year of age—a kitchen timer is an essential tool) with parent leaving the room or child put in another room. This serves two purposes:
#1. Parent and child get “cool down” space from one another.
#2. Child loses parent’s presence and attention as a reinforcer for negative behavior.
g) When children are oppositional beyond the developmentally expected age, other issues may be intruding. Please get the whole story and consult with staff about ways to proceed.
Nightmares
Between the ages of 3 and 6 children often begin to have nightmares. Parents can best help their children through these times by leaving on lights, sitting with them, and empowering them to “chase away” monsters, etc. Whatever works in a family to comfort and support the child rather than expecting him or her to “just tough it out” is indicated. It’s very difficult to avoid being resentful after several nights of interrupted sleep, so it is most important to deal with the parent’s feelings first.
School Phobia
Though any child may try to avoid going to school occasionally, a consistent pattern of resistance to school may indicate a deeper problem. Please explore the entire situation—what’s going on at home as well as at school, and what methods the parent is using to deal with the situation. Staff will help on how to proceed.
Stealing
Many children take something from a store, a friend, or a parent sometime during their childhood. This is considered fairly normal behavior and is of little concern. Parents need to be clear in their position on stealing and neither minimize nor overreact to it. (By the way, it is very hard for a child under five or six to even have a concept of “stealing.”) Any consequences around this behavior need to be age-appropriate and geared toward learning, rather than punishment, e.g., returning or making compensation for the stolen article.
If, however, a child or adolescent has exhibited a pattern of chronic stealing or is stealing exclusively from a parent, more concern is warranted and counseling may be appropriate. Please consult staff about ways to proceed.
Lying
Parents frequently overestimate their child’s ability to distinguish reality from fantasy when the subject of lying comes up. Parents feel that very young children should “know what really happened”—especially if the child in question uses language well. In fact, children younger than seven are usually seen as developmentally incapable of lying. Recognizing this fact can help parents see their child’s behavior as developmentally understandable rather than purposefully “bad” or malicious. Any child older than seven or eight who lies frequently enough to concern his or her parents may be struggling with one of a number of issues. Get as full a picture of the child’s behavior, parent’s response, and the family’s situation and consult with staff.
Helpful Hints in Dealing with Younger Children Regarding “Lying”
1) Help parents understand that when a young child disagrees with the parent’s “truth,” s/he is not lying but generally just perceives things differently.
2) Suggest that the parent minimize asking the child questions to get them to “own up” when the answer is obvious (e.g., “Who wrote your name on the kitchen cabinets?”). Instead, it is better for them to simply state what they know to be true—to avoid getting caught up in trying to force the child to change his or her story.
Dealing with Adolescents
For many parents, dealing with their adolescent can be quite difficult. The rapid body changes, moodiness, and experimentation with different styles and value systems can leave a parent feeling bewildered and overwhelmed. In addition to dealing with their adolescent’s increasing independence, parents must deal with their own ambivalent feelings about the impending separation from him/her. Parents need to explore these feelings while being helped to set appropriate limits within the context of their child’s growing independence. Also, it is sometimes necessary to encourage parents to develop their own lives as individuals to avoid prolonged dependence on their child as a total source of fulfillment.
Helpful Tips in Dealing with Parents of Adolescents
a) “Save the big guns for the big issues.” Although teenagers require a gradual loosening of parental regulations, they still need clear and consistent guidelines around important issues—e.g., health and safety. Find out what are the “big issues” for your caller and help him/her establish clear and appropriate limits which s/he can follow through on.
b) On all the smallest issues, work with parents on developing dialogues with their teenager, expressing and hearing feelings, and negotiating rules. Find out how they talk to each other—use modeling and role playing to optimize communication, when appropriate.
Overall Guidelines
1) Remember—no one expects you to know all the answers. Empathize, reflect feelings and get as much specific information about a child-focused problem as you can. Staff will help you sort it out. It’s okay, sometimes preferable in fact, to say “I don’t know…let me find out and get back to you.”
2) It is very hard for parents to empathize with their children unless they feel that they are being dealt with empathetically. Therefore, avoid offering suggestions until you feel that the parent has worked through his/her own feelings enough to be able to consider alternatives.
OTHER TYPES OF CALLS & PROCEDURES
I. SEXUAL ABUSE AND INCEST
II. PROCEDURES FOR INCEST AND SEX ABUSE CALLS
III. FREQUENT CALLS
IV. THIRD PARTY CALLS
V. FOLLOW-UPS
VI. TERMINATIONS
VII. REFERRALS
VI. HIGH RISK CALLS
• SUICIDE
• HURT CHILD
I. SEXUAL ABUSE & INCEST
Child sexual abuse is a form of child abuse in which a child is abused for the sexual gratification of an adult or older adolescent. Child sexual abuse does not need to include physical contact between a perpetrator and a child. Some forms of child sexual abuse include:
• Obscene phone calls, text messages
• Fondling, Exhibitionism, or exposing oneself to a minor
• Masturbation in the presence of a minor or forcing the minor to masturbate
• Intercourse
• Sex of any kind with a minor, including vaginal, oral, or anal
• Producing, owning, or sharing pornographic images or movies of children
• Sex trafficking
• Any other sexual conduct that is harmful to a child's mental, emotional, or physical welfare
Effects of child sexual abuse include shame and self-blame, depression, anxiety, post-traumatic stress disorder, self-esteem issues, sexual dysfunction, chronic pelvic pain, addiction, self-injury, suicidal ideation, and propensity to re-victimization in adulthood. Child sexual abuse is a risk factor for attempting suicide. Much of the harm caused to victims becomes apparent years after the abuse happens.
Sexual abuse by a family member is a form of incest, and results in serious and long-term psychological trauma, especially in the case of parental incest.
Approximately 18–19% of women and 8% of men disclose being sexually abused when they were children. The gender gap may be caused by higher victimization of girls, lower willingness of men to disclose abuse, or both. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often fathers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of child sexual abuse cases. Most child sexual abuse is committed by men; women commit approximately 14% of offenses reported against boys and 6% of offenses reported against girls. Child sexual abuse offenders are not pedophiles unless they have a primary or exclusive sexual interest in prepubescent children. ()
A pedophile is a person who has a sustained sexual orientation toward children, generally aged 13 or younger. Not all pedophiles are child molesters (or vice versa). Child molesters are defined by their acts; pedophiles are defined by their desires. Some pedophiles refrain from sexually approaching any child for their entire lives. But it's not clear how common that is. Pedophiles do not usually call the line.
There are also Juvenile sex offenders: Sexual abuse is widely recognized as a significant problem in society, and the scope of the problem may be underestimated because juvenile sex offenders who are known to the system may represent only a small proportion of juveniles who have committed such offenses. Studies of adult sex offenders suggest another dimension of the problem: many of these offenders began their sexually abusive behavior in their youth.
|Characteristics of Juveniles Who Have Committed Sex Offenses |
|Juveniles who have committed sex offenses are diverse and differ according to victim and offense characteristics and a wide range of other|
|variables such as sexual offenses ranging from noncontact offenses to penetrative acts or non-sexual aggravated assault; history of |
|childhood experiences of being physically abused, being neglected and witnessing family violence; and history of mental health concerns |
|such as conduct disorder diagnoses and antisocial traits. |
INCEST
Incest is legally defined as the crime of sexual relations or marriage taking place between a male and female who are so closely linked by blood or affinity that such activity is prohibited by law.
For the purpose of our training we will look at incest as sexual molestation of a minor by a parental figure.
Why is it difficult to tell someone about sexual abuse by a family member?
It can be difficult for an individual to disclose sexual assault or abuse when they know the perpetrator. It can be especially difficult if the perpetrator is a family member.
What can keep a victim of sexual abuse by a family member from telling someone?
• They may care about the abuser and be afraid of what will happen to the abuser if they tell.
• They may also be concerned about other family members' reactions, fearing they won’t be believed or will be accused of doing something wrong.
• They may have already tried to tell someone what happened, but the abuse was ignored or minimized.
• They have been told by the perpetrator that what is happening is normal or happens in every family, and they don’t realize that it is a form of abuse.
• They may not know that help is available, or they don’t know who to trust.
• They may be afraid of getting in trouble for telling, or that the abuser will follow through with threats.
Intervention and Treatment
As in physical abuse, the family will require long-term therapeutic intervention. In addition, the criminal justice system needs to be involved (as does CPS) to remove the offender from the home.
Child Sexual Abuse (CSA) & Incest Statistics:
• 1 in 4 girls and 1 in 6 boys will be sexually abused before they turn 18 years of age
• A Bureau of Justice Statistics report shows 1.6 % (sixteen out of one thousand) of children between the ages of 12-17 were victims of rape/sexual assault
• Children who do not live with both parents as well as children living in homes marked by parental discord, divorce, or domestic violence, have a higher risk of being sexually abused
• According to a 2003 National Institute of Justice report, 3 out of 4 adolescents who have been sexually assaulted were victimized by someone they knew well
• Children are most vulnerable to CSA between the ages of 7 and 13.
• 15 % of sexual assault and rape victims are under the age of 12; an astounding 29 percent of all forcible rapes occurred when the victim was between the age of 12-17 years old. 93% of victims of child sexual abuse know their attacker; 34.2% of attackers are family members and 58.7% were acquaintances.
• 96% of people who sexually abuse children are male, and 76.8% of people who sexually abuse children are adults
• 325,000 children are at risk of becoming victims of commercial child sexual exploitation each year
• The average age of which girls first become victims of prostitution is 12 to 14 years old, and the average age for boys is 11 to 13 years’ old
• Every 8 minutes, CPS responds to a report of sexual abuse
Statistics from the National Sexual Violence Resource Center and updated in 2015
TALK LINE PROCEDURES IN HANDLING INCEST AND SEXUAL ABUSE CALLS
FROM A PARENT
• Listen—draw out his/her feelings (guilt, anger, etc.)
• Support him/her having called, how difficult it must have been for him/her.
• Point out that protection of the child is important—how s/he needs to keep the child away from the perpetrator.
• Explore the helpfulness of sorting out his/her feelings and what s/he wants to do. Please set up another time to continue talking. (“This must be a difficult time for you—it’s important to be able to talk about it.”) Suggest that counseling will be important for all of them—you can get names of places for him/her.
FROM A PERPETRATOR
• Treat this as you would any caller with a sexual agenda. You would say, after determining that the caller wishes to talk about some kind of sexual issue, "I know that this is an important issue to you, but I am not trained in ways to help you with this. I would like to get your name and number and have my supervisor, call you back.
• Do not engage in conversation but continue to repeat your lack of expertise and the wish to provide help via your supervisor.
• If the caller persists in trying to talk to you, you may end the call. Say, "I'm sorry I can't help you and I am going to hang up now." Then do it!
• The key to this is to communicate compassion and a genuine interest in helping the client. A person who is actually looking for help will respond to your authenticity, and someone who is interested only in recounting a sexual story (for their own gratification) will usually hang up after being asked for a name and phone number.
FROM A CHILD
• Find out where the child is now.
• Explore possible safe places for the child to go.
a) Sexual Abuse Center at SF General Hospital (CASARC: Child & Adolescent Support Advocacy Resource Center located in SF and Phone # is: (415) 206-8386)
b) Huckleberry House (for adolescents who feel less threatened by going here.)
• If an adolescent who will not leave home, make sure you stress not being alone with the perpetrator if possible.
• Support his/her having called.
FROM A THIRD PARTY
• Encourage the caller to call CPS or CASARC.
• Offer to have your supervisor call CPS/CASARC if caller seems reluctant. Make sure you get all pertinent information.
RESOURCE FOR SEXUAL ABUSE AND INCEST
Child and Adolescent Sexual Abuse Resource Center (CASARC), at San Francisco General Hospital:
• Medical treatment and crisis counseling for children up to 18 years of age—no charge for services.
• Children over 12 years do not need parental consent for treatment.
• Any questions regarding the legal implications of sexual abuse and incest, or counseling referral, should be referred to CASARC. Caller can call anonymously if he/she wishes.
III. FREQUENT CALLERS
The term “frequent callers” refers to individuals who call to talk on a consistent basis, but rarely seem to make any progress or improvement. Many frequent callers are isolated with very few emotional or social outlets which compounds their problems and leads them to call frequently.
PARENT FREQUENT CALLERS
We try to alert you to “frequent callers” who are parents so that we might respond to them in a consistent and helpful way. Please check the protocols file for instructions and ways to handle specific protocols for parents.
NON-PARENT FREQUENT CALLERS
• We are here to serve parents and their children. Non-parents who call need to know who we are and why we are here.
• Once you’ve ascertained that the caller is a non-parent who is not dealing with child issues, you should minimize the call to approximately 10-15 minutes and provide them with an appropriate referral and let them know the purpose of the line- to serve parents and care-givers with children under the age of 18. We need to keep the line open for these calls.
• If the non-parent caller is in distress you can then refer him/her to a more appropriate hotline or outside resource.
• If the frequent caller is bringing up sexual material, please follow the staff’s guidelines on “sex callers” and ask them for their name and phone number so that a supervisor can call them back. All crisis lines get callers who tell sexual stories for their own gratification. These calls need to be kept brief to discourage frequent calling.
IV. THIRD PARTY CALLERS
We define third party callers as anyone who calls with a concern about a child or family who isn’t directly involved in that child’s care (not the child’s caretaker). They could be anybody from a neighbor to a relative.
Treat the third party caller like any other client. Reflect feelings. This is the best place (and the first place) to meet the caller. Often they call us in an attempt to sort things out.
Typical feelings are concern, confusion, and ambivalence. Sometimes they’re outraged at something they have seen or heard, or something they think is going on.
Many third party callers identify with the child. As a result, it can be difficult for them to be objective. Some of our third party callers are filtering through things in their own histories. They may have endured some form of abuse.
Your role is to help them sort through feelings (fear, ambivalence, confusion) to get to the particulars of their concern/suspicion.
The call(s) should consist of getting their story, holding their feelings, affirming their willingness to be involved and validating their concern.
The story is in the details. There is a lot of gray in these situations. Particularly with non-emergency calls, your job is to find out.
← Who?
← Where?
← What?
← When?
← How often?
← Has your caller ever interacted with the family?
← How old are the children?
← How many children are there?
← How long has your caller been aware of a problem?
← Are there times when the problem is more evident?
← What does your caller know for certain?
The answers to these questions also give you a fair amount of information about your caller.
Often, third party callers want to make a report to Child Protective Services (CPS). Our general rule of thumb is if anyone calls willing to make a report, we do not discourage them. It is better to err on the side of over-reporting.
If something is happening right in the moment, have them call 911.
The general timelines that CPS follows are either a two-hour response (immediate), or a ten-day response (they’ll respond between one and ten days).
CPS inputs every call into their database (whether report is made anonymously or not). This means that even if they do not go out to investigate a report immediately if numerous reports are made on a family over time, CPS will have that information. This is why we don’t discourage people from making reports.
Always do everything you can to follow up a third party caller, at least once. If they are going to call the police or CPS, get their names and telephone number so you can follow up and find out how things progressed, and/or how they’re feeling.
Resist the urge to criticize the parent or family about whom your caller has a complaint. It’s more productive to reflect your callers’ concern—i.e., “It does sound like what you’ve seen/heard is worrisome or dangerous for the child(ren). It sounds like that parent could really use some help.”
With very clear-cut cases of reportable abuse, it’s important to work with the caller around their ambivalence over getting involved. They may be ambivalent for many reasons, such as:
▪ not wanting to get involved;
▪ not wanting to get a family “in trouble”;
▪ being afraid of being identified as the person who reported a problem;
▪ they may not trust the system.
Your job is to hold the caller’s feelings, and, where possible, give information (to dispel myths, and/or demystify the process). This could take several calls. Also, where appropriate, your goal is to try to get the caller to the point where they’re willing to call CPS and make a report. CPS prefers that the report be firsthand because it’s easier to get the details from the most primary source. But if a caller refuses to make a report when it is indicated, we will do it.
Some third party callers will ask you to call the family they’re concerned about. We do not make cold calls. It’s usually perceived as invasive, and thus, not the best way for us to build a relationship.
Work with the caller to see if they can get the parent to call us. In less urgent situations, an option is for you to mail literature about us to the caller, who can then give the literature to the family.
Some third party callers can be your client for several weeks. It can take a while to sort through the story as well as their feelings.
Remember to get as much information as you can from the caller. From there, you and your supervisor will figure out the next appropriate steps to take.
V. FOLLOW-UPS
The follow-up call begins at the end of the initial call. You invite yourself back into their lives when you say, “I’d like to call you back next week to see how things are going.” Some of our clients feel they’re imposing, so your expression of interest and willingness to follow up can be very helpful to some of them.
We always do at least one follow-up unless the caller refuses.
Don’t ever promise more than you can deliver. Beyond the first follow-up call, your supervisor will help you figure out whether or not the person should be followed. It may be that the caller is already followed by another volunteer, or they may be a frequent caller.
The essential things to get during your initial call (to enable you to do the follow-up) are:
← caller’s name
← phone number
← good times to call
← what to do if you get an answering machine, or if someone else answers
If the caller is someone your supervisor determines you should follow, the first two or three calls might be used to build rapport; to get to know the caller; allow them a little bit of time to get used to you.
After that (and sometimes sooner) you’ll also want to focus on a particular issue—especially with a parent expressing multiple concerns. The caller may indicate what their top priority is, or your supervisor may suggest a focus.
It can be uncomfortable for you to make those first calls. The initial call was made by the caller—reaching out to us. Now you have to reach out.
Often, callers are surprised when you follow up. They may not be accustomed to someone caring, or keeping their word.
Always ask whether or not it’s a good time to talk.
It may take a while for the person to get comfortable with you. Take your time. Let the relationship unfold.
Your shift consists of a combination of follow-up calls and receiving incoming calls.
If you tell your client you’re going to call, call.
Please limit your calling to your shift time.
Sometimes, in the group of people you follow, there may be someone you procrastinate calling. You may be uncomfortable with a particular caller. Talk to your supervisor; explore your discomfort.
Always enter all calls and call attempts to contact a caller into ETO.
VI. TERMINATIONS
Termination can happen for many reasons:
• your shift time may change
• you or your caller may be moving out of the area
• the issue that initially led your caller to seek out TALK Line may be resolved, etc.
It may be time to consider termination (always talk to your supervisor first) if the conversation between you and your caller becomes less focused, more casual than usual; if you can never get through to a caller (may be their way of letting you know they’re done).
There should always be some form of closure. If you’re unable to reach the person directly, you would leave a message, e.g., “This is _____ from the TALK Line. We haven’t spoken in a while and I won’t continue to call you. Please know that I’m here between ___ and ____ AM/PM on ______, and please call us anytime you feel you need support.”
With longer term callers, particularly if you know ahead of time that you’ll be ending, allow several weeks for you and your caller to get used to the fact that you’ll soon be terminating.
Termination is a very important part of your relationship with your callers. Many people have not had opportunities for healthy endings in their lives.
Ending, especially with a long-term caller, can be difficult for both of you. We sometimes grow attached to our callers, and to knowing what’s going on in their lives.
There are many possible ways callers might react to knowing your relationship will soon end:
• A new crisis could arise in your caller’s life, which may lead you to feel very needed
• they may be sad about the ending
• they may become unreachable or unavailable
• they may have no reaction, and simply be ready for a new volunteer
As you and your caller prepare for an ending, it’s appropriate for you to share some of your feelings with her/him. I.e., “I’m going to miss talking with you every week,” or “I admire you for all the hard work you do.”
Terminations are very individual. There is no formula. You’ll have a lot of support and guidance from your supervisor.
VII. REFERRALS
Each community has existing services that can be helpful to parents under stress. Parents need to know what they are and how to use them. Making appropriate referrals is a skill. A referral is best made after you have explored the caller’s situation and engaged her/him at a feeling level.
A. Referrals Seem Safe
• Referrals often seem like solutions: They’re not.
The intent of the crisis line is not to be a referral service. Too much pushing of resources and referrals can cause the caller to feel rejected and we will lose him/her.
Giving referrals is a quick, easy and simple way of not dealing with a caller’s feelings. Primarily, a volunteer’s task is to listen to the caller, elicit his/her feelings, help clarify the problem and offer possible options the caller might have.
• Sometimes referrals are not appropriate.
Be sure to say to the caller: “It would help me in giving you the most appropriate referral if you could tell me a little bit more about what’s going on.”
Frequently, calls will come in and the caller directly requests a referral. You will very likely make the mistake of wanting to give the referral immediately without first checking to see if the referral is an appropriate one for the caller’s needs. If the caller insists and begins to become agitated, please give the referral they are requesting.
• Referral requests can mask a caller’s problem.
There are times when a caller will use the referral request as an “excuse” to call. By giving an immediate response to their request, you cut off any further exploration as to why the caller is really calling, which is usually to talk about his/her problems.
• The caller may be too overwhelmed to follow through on referrals.
Upon gathering information to make an appropriate referral it is important that you assess how well the caller can follow through with it.
If the caller is well-motivated and in a non-crisis situation, you can give the referral and offer to follow up at a later date to see how it worked out for the caller.
For callers who are in crisis or in a high-stress situation, the effort and concentration of checking out a referral may be too overwhelming for them. You can then offer to do some of the footwork for the caller by checking the referral out and calling the caller back. There is a caveat, however. You can “over-do” for a client and they can end up feeling incompetent.
B. Some Other “Rules” in Making Referrals
1. Always check out what city the parent is calling from. If San Francisco, find out what part of the city s/he lives in. Sometimes referrals are area-specific and/or transportation can be a real problem.
2. Also check out the parent’s income level. “Can you afford private counseling or would you like someplace with a sliding scale?”
3. If a request is most likely only for a referral, i.e., childcare, or if you can’t draw the parent out, be sure to try to get the client’s number so you can check back to see if the referral worked out. Often it doesn’t and the caller is left feeling disappointed, helpless or overwhelmed.
4. Always tell the client you want to check back to see if the referrals worked out, and that you will work with him/her around other referrals if it doesn’t.
5. Unless you’re absolutely sure about a referral always check with staff before giving it to the caller.
VIII. HIGH RISK SITUATIONS
SUICIDE CALLS
• Assess the threat:
a) Is there a plan?
b) Has the caller attempted suicide previously?
c) Does the caller have immediate access to their chosen means?
• If you find that drugs have been taken or they have already hurt themselves, you must act quickly to obtain relevant information and at the same time, letting them know how concerned you are.
□ “I’m concerned you might die…”
□ “You called for help…I can get you help…”
• Find out if anyone is there with them. Frequently, children will be home and if they are young--motivate the parent to protect them. If older, talk to the child to get the information you need.
• Tell the parent you will call for help.
• IT IS IMPORTANT FOR YOU TO GET: Name, address, city, and phone number.
• Call your supervisor—on the other line if you can. Tell the parent/caller that you will talk with them until help comes. Make sure s/he unlocks the door. If s/he passes out before an ambulance can get there and the door is locked, they will not break in. YOUR SUPERVISOR WILL CALL 911.
• If the caller resists your help, simply state, “I’m concerned that you might die…”
• Remember, a very depressed caller may not say s/he is suicidal. It is up to you to ask if the caller has thought of dying and if s/he has done anything about it. You will not precipitate a suicide by asking a person whether s/he has thought of it. Being able to talk about suicidal feelings lessens the potential for acting on them.
WHEN A CHILD HAS BEEN HURT
Occasionally a parent may indicate during a call that she has hurt her child. This is a difficult admission and is often accompanied by feelings of guilt or self-loathing. It is important to ask questions that will elicit the whole story while supporting the parent’s feelings.
Work to keep the parent engaged so you can ascertain the seriousness of the situation (i.e., whether the child needs medical help) as well as get information necessary for the staff to evaluate what steps may need to be taken to protect the child.
Avoid using the term “abuse” or mentioning child abuse reporting issues. These will be handled by your supervisor.
Once you have completed the phone call, contact staff immediately for instruction and support.
OFFICE PROCEDURES/PROTOCOLS
I. OFFICE PROCEDURES
• TALK Line Guidelines
• Phones
• Calls
• Follow-up Calls
• Filing
• Diverting & Undiverting
• Back Up
• Volunteer Shifts
• Resources
• Library
• Shredding
CLOSING UP PROCEDURE
ON- CALL SUPERVISOR
POWER FAILURE PROCEDURES
PARKING
RESPITE CARE PROCEDURES
I. OFFICE PROCEDURES
TALK Line Guidelines
• Every phone logged in is available for incoming calls. If there is an incoming call and no one is available, the strobe light on the wall will flash. The light will continue to flash for awhile after the call is answered. If no one is available to answer, the caller will hear a recording to leave a message. Please check the messages after you have completed your call.
• Check the white board for any messages/ updates and information on new protocols
• Please check for any general messages as well as “frequent caller” information when you start your shift.
• Please don’t ever give a client anyone’s home phone number. Call the staff members or volunteers yourself if a client needs to talk to them.
Phones
• Please note that you cannot hear the hotline ring from outside the main room. So if you are going to the bathroom, kitchen, etc., go on unavailable. Remember to go back on available when you return.
• Please remember to check for messages at the beginning of each shift and frequently thereafter. If messages begin to pile up, please seek out staff for assistance. It is of utmost importance that clients who leave messages receive a call back as soon as possible.
Calls
• There is a “In Coming Call Sheet” for recording incoming calls. (This is all in ETO; our computer database). The upper half of the call sheet is identifying information, e.g., name, age, home number, address, etc. will be kept on record at the office. Files are not to be removed from the office at any time. Get as much information as you can without making the caller uncomfortable. Most information will come out in the course of a conversation.
• If you are alone in the office and need to leave the room for a drink, the restroom, etc., please go on unavailable.
• Always read the phone number back to the caller to verify that you wrote it down correctly.
• Please leave all messages for staff, volunteers, and/or interns with your charts
Follow-Up Calls
• When you decide a caller should be called back by you to see how they are doing, if referral contact has been made, etc., please arrange a time with the caller when you can call.
• It is your responsibility to make sure a person is called.
• Please indicate in chart any attempted follow-up—even if the client was not reached should be entered into ETO.
• Please complete follow up calls to your clients in ETO once you’ve been trained on ETO.
Filing
• Current callers are filed under their first name.
• Inactive files are located in the filing cabinets in the copy room. For frequent callers please check with staff and also see if there is a protocol in the resource book for the caller.
• Please do not remove files from office.
• Files are ready to be filed when they have been reviewed. When you finish writing up a call, place with your charts. At the end of your shift, place all of your charts in the end of the shift bin. Feel free to consult with staff regarding difficult calls or any problems you encounter on the Line or anything else you wish to discuss.
Diverting and Undiverting
Please read and follow these instructions carefully.
To Undivert/Login:
• Pick up the phone and press the four-digit extension button, ‘Ext 1427’, then press the ‘ACD Login/Logout’ button.
• You’ll see ‘Enter Agent ID’ on the phone—desk 1: “Press “1001#”.
• Password is “#”
• Group ID is “*”
To Divert:
Before you divert, every phone must be logged out!!
Call the person you’re diverting to – ensure they’re ready to take incoming calls and pass on any key information from the days’ previous Volunteers. Hang up.
1. Press “Ext 1427”
2. Press the handwritten ‘Divert’ Button
3. Press #6011 [you’ll hear two tones]
4. Press “9 + (the full number with 1 + area code) + #”
5. Call 415-441-5437 and make sure it worked! If you skip this step, and the divert didn’t work correctly, the phone system will automatically divert to whomever was last diverted to.
Backup
Should you need immediate consultation on a specific call when there is no staff in the office, you can call any of the supervisors at home, anytime. On weekends there is a specific backup person assigned whose picture will be left on the first desk. During the week, there is an assigned on call supervisor for each day whose picture will be up on the desk as well. You can always call your supervisor if you are unable to reach the on call supervisor.
Volunteer Shifts
• Please show respect for your fellow volunteers by arriving for your shifts on time. It causes an undue burden on others if you are not prompt. Please call if you will be late. Under no circumstances should the phones be left unattended without checking with staff or volunteer coordinator.
• If you are unable to cover your scheduled shift time, it is your responsibility to call the volunteer coordinator and your YOPS (your own personal supervisor) ASAP.
• Please do not take yourself off of the schedule, or make changes, without doing so through the volunteer coordinator or YOPS. (A copy of current schedules is on the wall.) Please notify the volunteer coordinator and YOPS of any vacation times as soon as possible and sign up for makeup shifts.
• Please be reminded that each volunteer is expected to give four hours per week (one shift) minimum and one overnight every month. You are more than welcome to do more if you wish!
Resources
There are two resource binders on the volunteer shift desks that you can utilize for resources. In addition, you can find this resource binder on as well.
Shredding
Please shred any and all pieces of paper containing client names, phone numbers, addresses, or any other client information. This is vital to insure that we do not accidentally breach client confidentiality via the trash. NOTE: Sometimes in tearing up notes, the names and numbers are still legible. Make sure that any identifying information is illegible.
II. CLOSING UP PROCEDURES
When you are the last person to leave the building (even if it is mid-day—with the next shift being diverted):
• Divert the line—please be sure to pass on any messages from the answering machine that you were not able to attend to the next volunteer.
• Turn off all lights as you leave.
• Lock up the building using the lock box
• Go in peace. (
III. On-Call Supervisor: For TALK Line shifts done on the weekend
There is one staff member each weekend who is totally dedicated to helping you with any problems that might crop up.
When: The on-call person is available by cell phone from 5:00 pm Friday to 8:00 am Monday.
Where: Posted on Desk #1
How: Please call the number listed on the picture of the supervisor on-call (posted on Desk #1).
IV. POWER FAILURE PROCEDURE
If we have a power failure the phone system’s battery backup should operate for at least 30 minutes (making an annoying beeping sound all the while), meanwhile, the lights will go out.
• Call the On-Call Supervisor or Heather.
V. PARKING
If you park in the driveway of our building (1757 Waller), please be sure to parallel park, so you won’t get a ticket. Also—beware of the neighborhood’s residential parking. Read signs carefully. If you cannot find a parking place around, park in the Kezar Parking Lot (off Beulah & Stanyan).
Do not park at McDonald’s as we’ve had cars towed from there.
VI. RESPITE CARE PROCEDURES
Our respite program is limited and for emergencies/ infrequent use only. The goal of the program is to give stressed parents breaks from their children.
• For all respite calls use a respite request form.
• Obtain all of the information.
• Get the day, dates, and times, and reason the caller is requesting respite.
• Your supervisor will follow up and contact our respite care providers to see if respite is available and someone will get back with the caller to let them know
• NEVER GUARANTEE RESPITE!!!!
• Fill out both a respite request form and a TALK Line in Coming Call Sheet (on ETO). Please keep both forms together with your folder and place in the end of shift bin at the end of your shift.
• Tell all new callers that someone will get back to them to confirm their request date.
• If you’re working nights or weekends and get a next day or same day request, call your supervisor but make no guarantees. Let the caller know that this is short notice and that you will try but cannot guarantee anything. Ask them if they have family or friends that can watch the children.
• If you have a situation where there is imminent danger to the child—even in the middle of the night—and the parent can’t be calmed down, call the on call supervisor or 911.
• Please never hesitate to ask questions if you have questions about the respite program.
-----------------------
[1] From the pamphlet “Families in Stress” by Carol A. Johnston, available from the U.S. Department of Health, Education and Welfare, pp. 19-22.
-----------------------
CHILDD
PARENT
CRISIS
DECODING
PROCESS
MOTHER
He's frightened
CODE
CHILD
Fear
ENCODING
PROCESS
"Will you hold my hand when we go to school?"
Active Listening
"It sounds like you're feeling a little scared."
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- the talk deals and steals
- the talk deals this week
- the talk show daytime deals
- how does the money line work
- equation of the regression line calc
- how to find the regression line calculator
- equation of the tangent line calculator
- find the tangent line equation calculator
- equation of the tangent line of 2sinxcosx
- slope of the tangent line calculator
- find the tangent line at point
- where is the poverty line in usa