Befriending Techniques
What are the three main befriending techniques?
Validations, Reflections, Open Ended Questions
The 80/__ Rule
80/20
True or False: if a caller doesn't want to follow our anatomy (ex: says no to name exchange or risk assessment), we must end the conversation.
False
What are the two required questions to ask every caller to begin Safety and Risk Assessment?
"Have you been feeling suicidal within the last few days including today?"
"Have you taken any action to harm yourself today?"
True or False: We can offer a Warm Transfer before completing a full Befriending conversation.
False.
What are two kinds of Reflections we can use to Befriend? Give an example of both.
A simple (or mirroring) reflection, a summarising reflection, a paraphrasing reflection, a complex reflection
Describe the difference between empathy and sympathy.
To be empathetic is to accompany someone in their distress. To merely express sympathy is to feel sorry for them in a pitying, sometimes condescending manner
Name each step of Call Anatomy on a "No Risk" conversation.
Greeting, name exchange, introduction, befriending, risk assessment, befriending, time warning, call end.
True or False: We offer Safety Planning for anyone at Moderate Risk and above.
Slight Risk, Moderate Risk, Acute Risk and Imminent Risk.
What is a Warm Transfer?
A Warm Transfer is when a Befriender directly connects a Caller to another phoneline for further support/resources/crisis intervention. During a Warm Transfer, a Befriender will make introductions between the Caller and Phone Agent before disconnecting.
When a caller is disclosing something about their perspective or decisions that you find troubling or not based on reality, which of the three befriending techniques might you be wary of? Why?
Validations. While we do not discourage using Validations in conversations, it can be very difficult to validate a caller's emotion while also avoiding affirming "negative" judgments, perspectives, actions, or decisions.
Explain the difference between a "customer service" tone and a "Befriender" tone.
The customer service tone is chipper, cheery, and somewhat up-beat. A befriender tone is soft, warm and empathetic.
List the types of calls for which we will offer a Callback and when we will Callback.
All Callers who accept a Warm Transfer will be offered a Callback for the next day (except for de-escalated IR which should be offered for the same day).
If a Warm Transfer is not accepted, offer a Callback based on Risk Level. Moderate and Acute Risk Callers should be offered a Callback for the next day. De-escalated IR Callers should be offered a callback for that same day.
Identify this step in Risk Assessment: "Where are you in relation to to the drill? Would you mind stepping away from the drill while we keep talking?"
Access to means and safe removal of means
Mobile Crisis Intervention-- (Caller located in MA) looking for Crisis Intervention/Further Evaluation
Behavioral Health Help Line-- (Caller located in MA) looking for Behavioral Health Resources
988 Network-- (Caller located outside of MA) looking for Crisis Intervention/Further Evaluation/Behavioral Health Resources
What is the difference between a Validation and a Reflection?
A Validation is an affirmative or positive appraisal of a caller's emotions. A Reflection is a mere representation of what has been said.
What is double-barreling and why do we want to avoid it? Give an example.
Double-barreling is the unhelpful stringing together of two or more befriending techniques. It is important to avoid double-barreling so that a Caller/Texter has a chance to process our Befriending responses and has enough time to share their own perspective/feelings.
Identify all pieces of information needed to make a Callback.
Caller's name, number, time of call, if we can identify as Samaritans, if we may leave a voicemail
How do you judge the Risk Level if the caller says they don't know when they might take their life? Describe how you would proceed if a caller said their timeframe is spontaneous.
An ambiguous timeframe would lead to a Moderate Risk conversation. Re-assess as needed. You can try clarifying "What does spontaneous mean to you?".
A No-Risk caller located in MA reaches out because they are concerned for their cousin who is struggling with active addiction and they are looking for local rehabilitation/treatment programs. What Warm Transfer would you offer this caller? If they accept the Warm Transfer, would you offer a callback and if so how many?
This caller is eligible for a Behavioral Health Help Line Warm Transfer offer.
Yes, all callers who accept a Warm Transfer should be offered a Callback! (If a caller declines a Warm Transfer, offer a Callback based on Risk Level)
What are three elements of a good open-ended question?
steering towards pain, not leading with "why", and keeping questions focused on feelings rather than events
Identify four Befriending tools/principles we'll use on the helpline.
Comfortability with silence, verbal nods, using the caller's language, "save your sorrys", no double-barreling, using the caller's name, neutrality, good transitions in and out of call anatomy pieces.
When is it okay to interrupt a Caller to stick to anatomy?
Risk assessment and call end
What goes in a Safety Plan? (+100 Bonus points if in correct order)
Warning Signs
Coping Strategies
Locating Safe Social Environments
Utilizing Friends and Family
Contacting Health Professionals or Agencies
Reducing Access to Lethal Means
What pieces of information do we need from a caller for each type of Warm Transfer?
988--Name, phone number, & area code of their current location
MCI--Name, phone number, & zipcode (give caller MCI number)
BHHL--Name, phone number, & ask about phone call being recorded (give caller BHHL number)