Fix my son, tell me what to do!:Fix my son, tell me what to do!:

Daily challenges Daily challenges for a Helpline Workerfor a Helpline Worker

Sam Poynter- Sam Poynter- Drugs / HIV Helpline, Drugs / HIV Helpline,

Dublin, Ireland.Dublin, Ireland.

TheThe Drugs / HIV HelplineDrugs / HIV Helpline

Statutory Service, nationally accessibleStatutory Service, nationally accessible 10yrs in existence10yrs in existence Two helplines in one Two helplines in one Open 5 days a week between the hours of Open 5 days a week between the hours of

10am-5pm10am-5pm

Our Helpline……Our Helpline……

Does NOT tell callers what to do, but instead Does NOT tell callers what to do, but instead we create a supportive space for the caller we create a supportive space for the caller to discuss their next step forward. to discuss their next step forward.

We respect that all callers are self-determining We respect that all callers are self-determining and to take this away from them only dis-and to take this away from them only dis-empowers them. empowers them.

StatisticsStatisticsTotal of 46,449 calls in 10 years (mid 97-mid 07)Total of 46,449 calls in 10 years (mid 97-mid 07)

42% of 42% of all callsall calls are about drugs/ alcohol are about drugs/ alcohol

13% of 13% of all callsall calls are from mothers are from mothers2.5% fathers; 2% partners; 2% siblings2.5% fathers; 2% partners; 2% siblings

28% of all drug calls are about cannabis28% of all drug calls are about cannabis 21% heroin; 12% cocaine; 10% alcohol21% heroin; 12% cocaine; 10% alcohol;;

Reported effect of cannabis calls Reported effect of cannabis calls on my colleagueson my colleagues

Feeling BulliedFeeling Bullied Feeling ‘put on the spot’Feeling ‘put on the spot’ Being pushed for personal opinions,Being pushed for personal opinions, ““What do you think I should do?”What do you think I should do?” Being dragged into a ‘debate’ about the Being dragged into a ‘debate’ about the

seriousness of cannabis useseriousness of cannabis use Pushed to take sides Pushed to take sides Problematic alcohol use was minimised, Problematic alcohol use was minimised, But I don’t But I don’t

mind him having a drink”mind him having a drink” FrustratedFrustrated

The nature of helpline workThe nature of helpline work No appointment necessary/ no waiting – Just Call!No appointment necessary/ no waiting – Just Call! Free or low costFree or low cost No contract signed and negotiatedNo contract signed and negotiated Callers preception of the service- They will ring Callers preception of the service- They will ring

and get an answer!and get an answer! Caller may not be telling you the whole truthCaller may not be telling you the whole truth The caller may have an agenda prior to callingThe caller may have an agenda prior to calling Callers sense of urgency/ may be in crisis, this Callers sense of urgency/ may be in crisis, this

affects their ability to take in information affects their ability to take in information The Helpline relationship is once off/ not ongoing The Helpline relationship is once off/ not ongoing The caller may feel that other help didn’t workThe caller may feel that other help didn’t work

Common issues that arise in Irish Common issues that arise in Irish drug callsdrug calls

Family breakdown / Separation / DivorceFamily breakdown / Separation / Divorce Active addiction in the family homeActive addiction in the family home Systemic Issues – Adult children living at Systemic Issues – Adult children living at

home. home. “I know he’s 35 but he is immature for “I know he’s 35 but he is immature for his agehis age!”!”

S ‘mothering’ – Not letting GoS ‘mothering’ – Not letting Go Learnt HelplessnessLearnt Helplessness

ChallengesChallenges Context of call – Context of call –

Is the caller distracted? Have they just had an Is the caller distracted? Have they just had an argument or confrontation? Is their son upstairs?argument or confrontation? Is their son upstairs?

Clash Of Agendas- Caller wants me to be directiveClash Of Agendas- Caller wants me to be directive Anger Anger FearFear Frustration – these may be masking other feelings Frustration – these may be masking other feelings

such as fear and helplessnesssuch as fear and helplessness

Empathy & RapportEmpathy & Rapport

Transference, Projection & Transference, Projection & Projective IdentificationProjective Identification

TransferenceTransference

Sigmund Freud – Early 1900’sSigmund Freud – Early 1900’s Origins in PsychoanalysisOrigins in Psychoanalysis A Definition,A Definition,

““A process by which a patient displaces onto A process by which a patient displaces onto his analyst feelings, ideas, which derive his analyst feelings, ideas, which derive from previous figures in his life, but which he from previous figures in his life, but which he relates to his analyst as though he were relates to his analyst as though he were some former object in his life” Rycott (1979)some former object in his life” Rycott (1979)

Projective IdentificationProjective Identification

Melanie Klein – Child Psychoanalyst (1946)Melanie Klein – Child Psychoanalyst (1946) A definition,A definition,

“ “ The client may project this dis-owned part of The client may project this dis-owned part of themselves onto another; to which the person themselves onto another; to which the person who is at the receiving end of this will adopt this who is at the receiving end of this will adopt this dis-owned aspect of the self”dis-owned aspect of the self”

Clark (1995)Clark (1995)

ProjectionProjection

A definition,A definition,

““Projection is a psychological process that Projection is a psychological process that involves the attribution of unacceptable involves the attribution of unacceptable thoughts, feelings, traits or behaviours to thoughts, feelings, traits or behaviours to others that are characteristic of oneself”others that are characteristic of oneself”

Crawley & Grant (2005)Crawley & Grant (2005)

Helpful InterventionsHelpful Interventions

Exploring Power DynamicsExploring Power DynamicsHelpline Example: Helpline Example:

The caller may have tried everything to make him stop and The caller may have tried everything to make him stop and he still hasn’t. This can make the caller feel tired, he still hasn’t. This can make the caller feel tired, powerless and frustratedpowerless and frustrated

A Helpful Intervention might be;A Helpful Intervention might be;

“ “I sense that you are feeling powerless over this, what is I sense that you are feeling powerless over this, what is that like?that like?

You are demonstrating your EMPATHYYou are demonstrating your EMPATHY

You are MIRRORING their experienceYou are MIRRORING their experience

You are LISTENING to themYou are LISTENING to them

Name what is happening in the callName what is happening in the call

Helpline example: Have you ever been on a call Helpline example: Have you ever been on a call and it is going no-where or the caller is and it is going no-where or the caller is repeatedly asking you what they should do?repeatedly asking you what they should do?

A Helpful Intervention might be: A Helpful Intervention might be:

“ “ So we’ve discussed some options and not really So we’ve discussed some options and not really come up with any answers, what is your sense come up with any answers, what is your sense of that now?” of that now?”

Helpful InterventionsHelpful Interventions

The caller may organise their relationship with youThe caller may organise their relationship with you Helpline example: Sometimes the caller may have Helpline example: Sometimes the caller may have

questions and make a presumption that we are the questions and make a presumption that we are the experts and project this onto us;experts and project this onto us;

Intervention: Intervention: “Before you came on the call, did you “Before you came on the call, did you have an idea what you would do?”have an idea what you would do?”

Caller: “Caller: “You’re the experts!, that’s why I am You’re the experts!, that’s why I am ringing you”ringing you”

Helpline worker: “Helpline worker: “Maybe it doesn’t feel like it now Maybe it doesn’t feel like it now but you are the expert in dealing with your son or but you are the expert in dealing with your son or daughter. How have you dealt with challenges in daughter. How have you dealt with challenges in the past?…..”the past?…..”

Helpful InterventionsHelpful Interventions

Helpful InterventionsHelpful Interventions

Asking for our personal opinionsAsking for our personal opinions

Helpline example: Helpline example: “Is this something that I should “Is this something that I should be worried about? Do you think it is a dangerous be worried about? Do you think it is a dangerous drug?”drug?”

Intervention/ technique:Intervention/ technique:

Side Stepping and de-personalising it –Side Stepping and de-personalising it –

Helpline PersonHelpline Person: “Well there is a school of thought : “Well there is a school of thought that says this… and a school of thought that says that says this… and a school of thought that says this….”this….”

Our toolbox of skills- AnalogyOur toolbox of skills- Analogy

Use of Analogy / Play on words to explore Use of Analogy / Play on words to explore ideas with callerideas with caller

Exploring Powerlessness & Control –Exploring Powerlessness & Control –

“ “You can drag a horse to water You can drag a horse to water

but can you make him drink it?” but can you make him drink it?”

Exploring their management of situationExploring their management of situation

““I sounds like you are juggling lots of things I sounds like you are juggling lots of things there, how is that for you?”there, how is that for you?”

Our toolbox of skillsOur toolbox of skills

Empathy: tone, pace, verbal nods, silenceEmpathy: tone, pace, verbal nods, silence Being non-judgementalBeing non-judgemental Staying in ‘the here and now’. We have only the Staying in ‘the here and now’. We have only the

information that is available to us in the call. information that is available to us in the call. Having a focus on caller and his/her needs. Having a focus on caller and his/her needs. Having policies and guidelines to followHaving policies and guidelines to follow Being the ‘constant’Being the ‘constant’ Using ‘we’ rather than ‘I’.Using ‘we’ rather than ‘I’.

Our toolbox of skillsOur toolbox of skills

Using Clinical Supervision – This is a reflective Using Clinical Supervision – This is a reflective space to look at your skills and explore how space to look at your skills and explore how calls may impact on youcalls may impact on you

Being aware of how your body is feeling after a Being aware of how your body is feeling after a call- Are you frustrated? Are you bored by what call- Are you frustrated? Are you bored by what they were saying to you?they were saying to you?

And Finally………And Finally………

Accepting that we are not miracle Accepting that we are not miracle healers or magicians! healers or magicians!

Your intervention may not fix their Your intervention may not fix their son or tell them what to do but it son or tell them what to do but it may be planting a seed for them to may be planting a seed for them to think about looking at other aspects think about looking at other aspects of the situation of the situation

ReferencesReferences

Grant, J., & Crawley, J., (2002) Grant, J., & Crawley, J., (2002) Transference and Projection: Mirrors to the Transference and Projection: Mirrors to the self. 3self. 3rdrd Ed. Open University Press. UK. Ed. Open University Press. UK.

Kahn, M, (1997) Between Therapist & Kahn, M, (1997) Between Therapist & Client. 2Client. 2ndnd Ed. Henry Holt & Company, New Ed. Henry Holt & Company, New York. York.