Workshop № 8

Speaker-psychologist, crisis consultant Anastasia Glazkova, administrator of Lifeline Ukraine

Seminar topic: Crisis online counseling on the suicide prevention hotline for veterans and their loved ones LifelineUkraine

Crisis counseling using real-time chats and email addresses is becoming increasingly popular. Over the past year, according to GlobalLogic, the number of internet users in Ukraine has increased by 33%.

Our hotline started online chat and Mail counseling in 2020. During this period, we received more than 2,000 requests through these channels.

Studying the literature and reflecting on our own experience, we managed to identify the basic principles and rules that help in online text consulting.

Since we are a line on suicide prevention for veterans, their loved ones, and the Prevention of mental health disorders, our focus is on studying and working with the suicidal crisis. Therefore, before talking about the principles of online text consultations, it is important to outline the context of requests from suicidal subscribers.

Edwin Schneidman identifies the causes of suicide as unmet needs for love and attachment, autonomy and influence on the environment, dominance, order and achievement. The general incentive to commit suicide is determined by unbearable mental pain, suicidal emotions – helplessness and hopelessness, the state of the psyche – a state of narrowed consciousness. The general action, according to E. Schneidman, is escape and the task is to stop consciousness. At the same time, the internal attitude is ambivalence, that is, a person does not want to live, but also does not want to die, or does not want to live with suffering, with psychobolism. The general purpose of suicide for E. Schneidman is finding a solution. And then the consultants of our line in Crisis Consulting look together with the subscriber for hope and alternative solutions, drawing up a security plan and a way out of the crisis, encourage them to stay on the side of life.

In March 2021, the share of text consultations was almost 30 %. This is a third of the work of our hotline.

So, text-based online counseling (chat, mail) is part of the project of the hotline for Suicide Prevention and Prevention of mental health disorders. online counseling complements telephone counseling of the hotline and is guided by the same principles, ethics and rules as telephone counseling: accessibility, timeliness, informative content, systematic, respect for the dignity and independence of the subscriber, confidentiality.

In online text counseling, we use general techniques for validating feelings, normalizing them, psychoeducating them, channeling them, and containerizing them. In other words, we recognize the feelings and mental reality of the subscriber, explain the origin of certain states if necessary, give a place to place complex feelings, offer tools for response, and look for ways to stabilize and get out of the crisis.

Among the complexities of text-based crisis counseling, I identify:

1. lack of visual and auditory stimuli that make up a clearer picture, difficulties in tracking changes in the subscriber's emotions (there is no so-called emotional-sensory component of communication).
2. It is easy to fantasize, to interpret what may not be in the situation of the subscriber/TKI. As a result of misunderstandings. You should be in a meta position: distance yourself, track your filters and countertransactions.
3. It is not possible to know about the security level at which the client/TKA is located. The contact may be a person of the wrong gender and age, or with a die of Port wine and the consultation will have an unpredictable level of effectiveness, or rather a predictably low level.
4. Contact may be interrupted. Both for technical reasons and for"silence". This can often be (incomplete contact) a reason for unnecessary worries and burning.

Among the advantages of text-based online counseling, in my opinion:

1. Lack of visual and auditory stimuli, which reduces the risk of secondary injury to a specialist
2. Online counseling develops digital modality (logical, meaningful analytics)and verbal intelligence, written speech
3. There is an opportunity to calmly concentrate when accepting a dialogue and prepare a structured response.
4. It is possible to save the entire consultation dialog to both the subscriber (in order to return to an important point and not forget anything) and the consultant (to analyze their work).
5. By understanding the specifics, you can remain effective in this type of counseling for a long time.

A few practical tips at the end:

1. The beginning of communication is important. It is important to express a willingness to help and understanding/empathy so that contact is established.
2. Focus on resources, support, and self-help. (Who's next to you? Who can support you?).
3. Use interventions carefully. We don't write advice, we write about opportunities and Risks, Alternatives, and possible scenarios.
4. Use short sentences.
5. Use clear words (without professional slang).
6. Literacy, spelling and punctuation.
7. Use the words and phrases subscriber/TKA (careful paraphrasing).
8. Use emoticons carefully and occasionally, and only if they are used by the subscriber/TKA.
9. Using metaphors, if appropriate, is even better – picking up his/her metaphor after the subscriber/Weaver.
10. At the end of the dialogue, use the grounding/return to reality technique: "what will you do now after our conversation?»

What will you do after reading our article? Embrace your loved one and enjoy life here and now.