Fix my son, tell me what to do: Daily challenges for a Helpline Worker

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Fix my son, tell me what to do!Daily
challenges for a Helpline Worker

• Sam Poynter-
• Drugs / HIV Helpline,
• Dublin, Ireland.

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The Drugs / HIV Helpline

• Statutory Service, nationally accessible
• 10yrs in existence
• Two helplines in one
• Open 5 days a week between the hours of 10am-5pm

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Our Helpline

• Does NOT tell callers what to do, but instead we
  create a supportive space for the caller to
  discuss their next step forward.
• We respect that all callers are self-determining
  and to take this away from them only dis-empowers
  them.

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Statistics

• Total of 46,449 calls in 10 years (mid 97-mid 07)
• 42 of all calls are about drugs/ alcohol
• 13 of all calls are from mothers
• 2.5 fathers 2 partners 2 siblings
• 28 of all drug calls are about cannabis
• 21 heroin 12 cocaine 10 alcohol

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Reported effect of cannabis calls on my
colleagues

• Feeling Bullied
• Feeling put on the spot
• Being pushed for personal opinions,
• What do you think I should do?
• Being dragged into a debate about the
  seriousness of cannabis use
• Pushed to take sides
• Problematic alcohol use was minimised, But I
  dont mind him having a drink
• Frustrated

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The nature of helpline work

• No appointment necessary/ no waiting Just Call!
• Free or low cost
• No contract signed and negotiated
• Callers preception of the service- They will ring
  and get an answer!
• Caller may not be telling you the whole truth
• The caller may have an agenda prior to calling
• Callers sense of urgency/ may be in crisis, this
  affects their ability to take in information
• The Helpline relationship is once off/ not
  ongoing
• The caller may feel that other help didnt work

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Common issues that arise in Irish drug calls

• Family breakdown / Separation / Divorce
• Active addiction in the family home
• Systemic Issues Adult children living at home.
  I know hes 35 but he is immature for his age!
• S mothering Not letting Go
• Learnt Helplessness

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Challenges

• Context of call
• Is the caller distracted? Have they just had
  an argument or confrontation? Is their son
  upstairs?
• Clash Of Agendas- Caller wants me to be directive
• Anger
• Fear
• Frustration these may be masking other feelings
  such as fear and helplessness

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Empathy Rapport
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Transference, Projection Projective
Identification
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Transference

• Sigmund Freud Early 1900s
• Origins in Psychoanalysis
• A Definition,
• A process by which a patient displaces onto his
  analyst feelings, ideas, which derive from
  previous figures in his life, but which he
  relates to his analyst as though he were some
  former object in his life Rycott (1979)

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Projective Identification

• Melanie Klein Child Psychoanalyst (1946)
• A definition,
• The client may project this dis-owned part of
  themselves onto another to which the person who
  is at the receiving end of this will adopt this
  dis-owned aspect of the self
• 
  Clark (1995)

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Projection

• A definition,
• Projection is a psychological process that
  involves the attribution of unacceptable
  thoughts, feelings, traits or behaviours to
  others that are characteristic of oneself
• Crawley Grant
  (2005)

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Helpful Interventions

• Exploring Power Dynamics
• Helpline Example
• The caller may have tried everything to make
  him stop and he still hasnt. This can make the
  caller feel tired, powerless and frustrated
• A Helpful Intervention might be
• I sense that you are feeling powerless over
  this, what is that like?
• You are demonstrating your EMPATHY
• You are MIRRORING their experience
• You are LISTENING to them

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Helpful Interventions

• Name what is happening in the call
• Helpline example Have you ever been on a call
  and it is going no-where or the caller is
  repeatedly asking you what they should do?
• A Helpful Intervention might be
• So weve discussed some options and not really
  come up with any answers, what is your sense of
  that now?

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Helpful Interventions

• The caller may organise their relationship with
  you
• Helpline example Sometimes the caller may have
  questions and make a presumption that we are the
  experts and project this onto us
• Intervention Before you came on the call, did
  you have an idea what you would do?
• Caller Youre the experts!, thats why I am
  ringing you
• Helpline worker Maybe it doesnt feel like
  it now but you are the expert in dealing with
  your son or daughter. How have you dealt with
  challenges in the past?..

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Helpful Interventions

• Asking for our personal opinions
• Helpline example Is this something that I
  should be worried about? Do you think it is a
  dangerous drug?
• Intervention/ technique
• Side Stepping and de-personalising it
• Helpline Person Well there is a school of
  thought that says this and a school of thought
  that says this.

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Our toolbox of skills- Analogy

• Use of Analogy / Play on words to explore ideas
  with caller
• Exploring Powerlessness Control
• You can drag a horse to water
• but can you make him drink it?
• Exploring their management of situation
• I sounds like you are juggling lots of
  things there, how is that for you?

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Our toolbox of skills

• Empathy tone, pace, verbal nods, silence
• Being non-judgemental
• Staying in the here and now. We have only the
  information that is available to us in the call.
• Having a focus on caller and his/her needs.
• Having policies and guidelines to follow
• Being the constant
• Using we rather than I.

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Our toolbox of skills

• Using Clinical Supervision This is a reflective
  space to look at your skills and explore how
  calls may impact on you
• Being aware of how your body is feeling after a
  call- Are you frustrated? Are you bored by what
  they were saying to you?

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And Finally

• Accepting that we are not miracle healers or
  magicians!
• Your intervention may not fix their son or tell
  them what to do but it may be planting a seed for
  them to think about looking at other aspects of
  the situation

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References

• Grant, J., Crawley, J., (2002) Transference
  and Projection Mirrors to the self. 3rd Ed.
  Open University Press. UK.
• Kahn, M, (1997) Between Therapist Client. 2nd
  Ed. Henry Holt Company, New York.