Crisis Textline

Lakukan tugas rumah & ujian kamu dengan baik sekarang menggunakan Quizwiz!

Equality v. Equity

"When you plant lettuce, if it does not grow well, you don't blame the lettuce. You look for reasons it is not doing well. It may need fertilizer, or more water, or less sun. You never blame the lettuce." - Thích Nhất Hạnh Equality and equity are similar terms that, when applied, can result in different lived experiences. Both are related to fairness, but they approach it in different ways. In brief, equality gives people the same treatment, while equity ensures people with different needs can achieve the same result. These two concepts can be challenging to understand in the abstract. To make them concrete, art director Tony Ruth visualized them into this example of two people trying to pick apples from a tree. Tony Ruth's Equity Series, 2019 (Links to an external site.) Inequality is unequal access to opportunities. This is like apples only growing on one side of a tree, which is leaning toward the side with more fruit. Two people waiting for apples to fall on either side of the tree have very different chances to get apples. Tony Ruth's Equity Series, 2019 (Links to an external site.) Equality is the presence of evenly distributed tools and assistance. In this scenario, the same two people get ladders to reach the tree. The ladders are the same height, but because the tree itself is bent, one person still can't reach the tree. Tony Ruth's Equity Series, 2019 (Links to an external site.) Equity is the presence of essential resources that identify and address inequality. This means the person on the far side of the tree gets a taller ladder to reach the apples. Both people now have the same ability to reach the tree. But, because there are fewer apples on one side to begin with, the person on the far side still ends up with fewer apples. Tony Ruth's Equity Series, 2019 (Links to an external site.) Justice is fixing the system to offer equal access to both resources and opportunities. Here, planks are propping the tree up straight. There is abundant fruit on all sides, and both people have ladders at the appropriate height to reach. While this graphic series helps us understand the difference between equality and equity, it also has its limitations. The original "injustice," the tree bending toward one side, is naturally occurring. The tree is also separated from contextual factors like sun, water, and other trees that affect how the "injustice" came to be in the first place. The path to justice is also not as straightforward as propping up a tree to be upright. Achieving justice often takes time, energy, resources, and sometimes a complete overhaul to get to the root.

Five core principles

1. Human first - We believe people in pain deserve human-to-human, non-judgemental empathy. It's brave to reach out for help, and that bravery deserves human kindness in return. This also means our volunteer community receives human support. Your main sources of support are Coaches and Supervisors. Coaches are your support off the Platform, including in training. They're your go-to person for questions about your skills, your commitment, and your experience. Supervisors are your professional, real-time support on the Platform, watching every conversation and providing guidance. 2. Non-Discriminatory - We're here for all people in pain. We support individuals regardless of issue, age, race, religion, sexual orientation, or gender identity. We also have volunteers from different backgrounds and all levels of experience. 3. Focus on Crisis Intervention - We provide crisis intervention that empowers texters. This means you are only guiding the conversation; the texter is actually coming up with the next steps. Crisis intervention is not therapy, nor is it long term support. We're in-the-moment support via a channel that many people feel comfortable using—text. Our team of Supervisors are crisis intervention experts who are always there with you in real-time while you talk with texters. Together, the #1 thing we can do is show texters they have a safe space to share and be heard. 4. Have best In Class Technology - We believe texters and volunteers around the world deserve fast, reliable technology that meets them where they are. Our dedicated engineers and product team help build the Platform and protect its infrastructure. This allows texters to use their mobile phones or apps to reach us while you respond on our secure platform using your computer. 5. Were Secure - We adhere to the highest data security and privacy standards in the world. Our data is the largest set of real-time mental health data representing a wide variety of texter issues. Our passionate data team uses our findings in two ways. First, to improve our service. This includes improvements to our training, tech, and policies. Second, we use data to make the world better. Our unique data is shared to inform the public and media, to shape government and school policies, and to help drive cutting-edge academic research. Together, we're a diverse group of data-lovers, mental health professionals, software engineers, and coaches all working hard to support you while you support texters. We use tech and data to bring texters the support they need in a place they trust. But, this work requires human connection—that's where you come in! You're the most critical part of the equation, and we couldn't do any of this work without you. By being there in the moment, we're able to intervene in the texter's crisis, provide connection, and empower them to deal with future crises. You have a team of dedicated people guiding you and cheering you on at every stage, both on and off the Platform. Here's to starting our journey together. Let's do this!

Explore abuse

Abuse can be one of the most unclear high-risk scenarios we have on the Platform. Luckily, Supervisors have the professional training to understand what is legally considered abuse and what we need to report to try to get texters additional support. With that in mind, there are a few definitions that will help you understand who we consider being at high risk of abuse and what you can do when you are in a conversation with someone being abused. First up, vulnerable population abuse. Vulnerable Population Abuse Vulnerable Population Abuse is the physical, emotional, or sexual maltreatment (including incest and neglect) of a person in a vulnerable population. People considered vulnerable are: (1) Children under the age of 18 (2) Elder adults aged 60 and older (3) Dependent adults We listen to and support all texters who are abused. However, we take additional steps to support vulnerable population abuse victims: we report cases of abuse to Child Protective Services or Adult Protective Services when necessary. We aim to ensure a high-quality experience for every texter while complying with the law. If a texter is actively being abused or their abuser has means to contact them, we might, by law, need to file a mandatory report. Mandatory Reporting Mandatory Reporting is the process of submitting an official report about the abuse of someone in a vulnerable population. The purpose of mandatory reporting is to help ensure the safety of children, the elderly, and legally dependent adults who are being abused or neglected. We take them seriously. A mandated reporter files the actual report. Many teachers, social workers, health care providers, and law enforcement officers are mandated reporters. Here, at Crisis Text Line, Supervisors are the mandated reporters. When a texter tells you they have experienced abuse or neglect and you think they may be part of a vulnerable population, flag your Supervisor to review the conversation so they can determine if a report is needed. Your Supervisor will only file a report if there is reasonable suspicion that the texter is experiencing abuse or neglect and it has been confirmed that the texter is a minor, elderly adult or a legally dependent. We have a procedure for determini

Explore risk

After exploring a texter's crisis, we consider whether the texter is at high risk for suicide, abuse, or self-harm. Earlier in training, we defined risk and the potential high-risk convos of suicide, self-harm, and abuse. As we talk about how to consider and assess texters for risk, we'll talk about each of these "high risk" scenarios more. Some texters might have openly shared that they're potentially in danger when they first texted. In most cases, texters will open up about their risk level during the exploring stage. Even so, texters might not always mention their risk level at this stage, and they might choose to talk about it later in the conversation. Either way, we want to be mindful of risk both during the exploring stage and throughout the conversation. During this part of exploring, we use questions to help determine how "at risk" a texter is. We'll start with abuse.

How to: Identify the Goal

After we explore the texter's situation, risk, and feelings, we identify their goal. Many texters' main goal for reaching out is to feel heard. This means they want to let out what's distressing them, or vent. Reaching out to be heard is a worthy goal for someone in a crisis, and it can be enough for texters to move to a calmer and safer state of mind. Other texters are looking for something more tangible from their conversation. However, it's common for texter's not to share their goal during the first part of the conversation. That's completely normal. Their crises can feel overwhelming, and many texters reach out without knowing quite how we will respond. Identifying the Goal helps bring the texter back into the present moment so we can make our conversation as supportive as possible. When texters are going through so much, it can be challenging to narrow in on their most pressing concern or the issue they feel most ready to tackle. To make sure we're always following the texter's lead, we ask them about their goal. Texters respond in many ways to questions about their goals. In the following pages, we'll discuss how to deal with the following scenarios: Texters Who Know Their Goal Texters Who Have Multiple Goals Texters Who Don't Have a Goal Texters With Goals We Can't Meet No matter how you ask, make sure your tone is warm and allows the texter to lead the conversation.

How to: Explore Impact

After we've gathered practical information about the texter's crisis, and determined whether they're at risk, we explore the emotional impact the crisis has had on them. In many cases, texters have shared how they've been feeling about what they're going through. Even so, this is our chance to connect with how they're feeling right now in the conversation. We intentionally put this section after exploring risk because we want texters to know we care about more than their safety. We care about them. There is no one perfect question for asking how a texter's crisis is impacting them. The goal is to ask open-ended questions to give you a sense of: How long they've been experiencing their crisis How their crisis is making them feel What other feelings come up for them around their crisis How their crisis is causing them to behave If they're thinking, feeling, or doing something that might be related We want to understand what's different for them now. Many times, in the beginning, texters will openly share the facts of their crisis, but it's our job to delve into the feelings even more so than the facts. Remember, we can't change the circumstances of the texter's crisis, but we can help them process and cope with their emotions. Example Volunteer: It makes sense to feel upset given what you've been through. How has the bullying been affecting you lately? Texter: I guess right now I just feel numb to it. I've been doing it for so long though, it's hard to remember when it even started Example Texter: My brother is constantly yelling at me. He thinks everything is my fault. I just feel so small Volunteer: It's no wonder you're feeling overwhelmed and low with those constant attacks. No one deserves to feel like everything is their fault. Example Texter: it's just so strange to feel like one second I was a mom and now I'm not Volunteer: I imagine it all feels so devastating. How have you been managing all of the pain since learning about the miscarriage? Exploring Impact with High and Imminent Risk Texters It can be tempting to skip this part of exploring with high and imminent risk texters. After all, these texters are experiencing pain that can be difficult to imagine. Even if it feels slightly uncomfortable, th

Asking for texters name

After your opening message, you may find yourself wanting to ask texters their name. This is a perfectly normal instinct. We ask others for their name during other conversations. However, on the Platform, our data shows that it's best to ask the texter for their name after you've built some rapport instead of in your first couple of messages. We stay away from asking texters their name in the first message. It can be jarring for people reaching out to a confidential service to be asked a personally identifiable question right away. Asking them their name so soon can give the impression that what they share isn't private. By taking the time to build rapport before asking, texters have the chance to feel like they can trust us. If you're going to ask a texter their name, our data shows that it's best to ask after the 5th message. Here are a few ways to phrase the question: Do you feel comfortable sharing your name? If you feel comfortable sharing, what's your name? I'm wondering, can you tell me a name I can call you by while we talk? What name would you like me to use for you while we chat today? Some texters won't feel comfortable sharing their name. That's okay. We don't need their name to support them during their crisis. If you choose to ask a texter their name, let them know it's totally optional.

Active Rescues

An Active Rescue (AR) is the process of a Supervisor contacting emergency services to ensure the physical safety of a texter. Supervisors only work with emergency services to call in an Active Rescue as a last resort. Our data shows less than 1% of all conversations end in an Active Rescue. This means our Five Stage Philosophy is good at helping de-escalate texters. The less than 1% of conversations that do end with an Active Rescue happen because of two different scenarios: A texter is at imminent risk of suicide AND unable to come up with next steps to keep themselves safe A texter is at imminent risk of suicide AND they've stopped responding to our messages As a reminder, imminent risk texters are those who have "laddered-up" through the Ladder Up Risk Assessment with thoughts, plans, means, and a timeframe for suicide. Each conversation is unique. Supervisors have the expertise to determine when an active rescue is needed. On the next page, you'll learn about your role during an active rescue and how the Supervisor supports you and the texter while we try to keep them safe.

Flagging Prank & Inappropriate Texters

An inappropriate texter is someone who does not use our service for its intended use. While not frequent, we do see these texters occasionally (about 1 in 100). Inappropriateness can take various forms: texters who are aggressive, verbally abusive, ask too many personal questions, are explicit about violence or sex, or make jokes that cross a line. How to Determine if a Texter is Inappropriate It can be easy to dismiss texters who are being inappropriate, but people who are in pain often say things that are misplaced. Talking to a truly inappropriate texter is not helpful to them and can be difficult for us, so we try to redirect the conversation before closing it out. When supporting these texters, we remain nonjudgmental and try to build rapport and steer them in the right direction. To do this, we use the "Three Try" rule. We try to redirect the conversation three times, or in three different ways, to determine whether or not the texter can be guided towards an appropriate conversation. This process will help you navigate the difficult emotions of dealing with an inappropriate texter. Example Texter: Hi. I'm feeling really f*cked up. I really want to have sex. Volunteer: Hi there, I'm Joan. It sounds like you're feeling frustrated right now. Texting in was a great first step to dealing with your difficult emotions. Texter: Yeah - would you have s*x with me? Volunteer: I'm here to talk about what's bothering you and to listen. Can you tell me more about what happened today that was painful for you? Texter: Ok, fine. I guess I just feel so ugly. No one likes me, and I can't get a girlfriend. Takeaway: This texter is feeling isolated and is struggling to cope with their negative emotions. We can support them, so you'd continue the conversation. If we immediately closed this conversation, the texter may never have gotten the opportunity to talk about their real pain. Example Texter: Hi. I'm feeling really f*cked up. I really want to have sex. Volunteer: Hi there, I'm Joan. It sounds like you're feeling frustrated right now. Texting in was a great first step to dealing with your difficult emotions. Texter: Yeah - would you have s*x with me? Volunteer: I'm here to talk about what's bothering you and to listen.

How my coach will support me

Answer questions you have about training and volunteering Provide feedback on practice activities and explain automated feedback Support you during your time in training and as a Crisis Counselor

Starting with warmth

At the beginning of every conversation, it's important to give a warm introduction to the texter—even if the texter seems panicked, pressured, or scared in their first message. Think of your opening message as the texter's first impression of you. You want them to feel like you're a person they can talk to about their pain. Since you can't rely on your tone of voice, it is important to pay attention to the tone of your words. Here's an example of a warm opening message: Volunteer: Hi there, I'm Sasha. I see that you're feeling overwhelmed today; can you tell me more about what's making you feel this way? Your warm opening message can take many forms, but it should include: A greeting Your first name (or an alias) An acknowledgment of what the texter shared An invitation to share more A Greeting Starting your first message with a welcome to the texter acknowledges them and lets them know you're there. You can use any form of "hello" that feels most comfortable to you: "hi," "hey," and "hi there," or even "thanks for reaching out." The goal is to welcome the texter in a way that feels natural. Your First Name After your warm welcome, introduce yourself. Because your greeting follows an automated message, you want to be sure the texter knows they're now talking with a real person. The best way to do this is by sharing your first name. You can use an "alias" if you don't feel comfortable sharing your real name with texters. An Acknowledgement of What the Texter Shared This is the first time in a conversation where you'll be responding to something the texter specifically said. Maybe they're reaching out about their challenges with a diagnosis or stress at work. Either way, we want to acknowledge what they've shared. We can do this using Good Contact Techniques. The purpose of this part of the opening message is to show texters you're already invested in what they have to say. Reflection. You can choose to use reflection to paraphrase what they shared to show you understand. Using reflection at the beginning of the convo lets texters know you're actively listening to them. Strength ID. You can use a strength ID to acknowledge the courage it took to reach out and talk about whatever it is they've shared. Tentafi

How to: Explore the Crisis

At the very beginning of the exploring stage, we likely know a little bit about what led the texter to reach out. Now that they're more comfortable with us, we can dive a little deeper. To understand what a friend is thinking or feeling, we listen intently, validate their feelings, reflect on their experience, and ask thoughtful questions. We do the same for texters in crisis. Active Listening Active listening has two roles during exploring. First, it allows texters to feel heard and understood. Second, it helps us understand what they're experiencing, so we can be as helpful and supportive as possible. The Good Contact Techniques that are especially helpful to show that you're actively listening during the exploring stage are validation, reflection, and open-ended questions. Validation Validation is how we acknowledge, normalize, and accept a texter's emotions and experiences without judgment. It's our way of saying, "it's okay to feel the way you're feeling right now." By validating during this stage of the conversation, we show texters we believe their crisis is real and important. Example Texter: My partner and I just got evicted from our house. Everything is falling apart. Volunteer: Getting evicted can be such a devastating experience, and it sounds like this has been overwhelming. It's understandable to feel unsure where to turn. Takeaway: Using the phrase "it's understandable" validates that the texter's uncertainty makes sense given their situation. Reflection Reflection is summarizing what a texter has shared to show that you understand. It's effective during exploring because texters tend to share a lot of information. By reflecting the main points they've shared, you're able to check your understanding and show them that you're listening. If you're unsure about your reflection, you can always add a tenatifer, which gives texters a chance to correct you. Example Texter: I just started dating this new guy and now my best friend won't even talk to me, even though I've texted her like a million times. Volunteer: I'm hearing you feel abandoned because you haven't heard from your friend. On top of that, you've been putting in a lot of effort that hasn't been returned. Open-ended Questions Open-ended

Empathy, Active Listening, and Tone

Before we share the techniques we use to talk to texters, let's review a few key skills that are the basis for our techniques: empathy, active listening, and warmth. Even over text, people can sense when someone doesn't care about what they're saying. For the techniques to work, they must come from a genuine place of empathy, a true desire to listen, and a willingness to be warm even when the topics feel uncomfortable. Let's start with empathy. Empathy Empathy is the foundation of supporting others. In practice, empathy is being there with the texter, attempting to step into their shoes without pretending that we understand exactly what it's like to walk in them. It's leaning into the conversation with the texter and inviting them to open up more. We don't shy away from their difficult experiences; instead, we want to make them feel less alone. This is different from sympathy because we aren't feeling sorry for the texter and expressing regret for their situation. We don't pity them. And, we don't try to distance ourselves from how difficult the situation is. We actually stay away from saying "I'm sorry" because it's a way to show sympathy. Texters reach out because they are looking for a connection—not pity. We trust their lived experiences and attempt to see their perspective. In short, we meet them where they are by actively listening and hearing their crisis. Active Listening To respond to texters, we first need to understand them and their crisis. Active listening is truly understanding what another person is expressing. Often people listen to figure out when they can speak next. When listening just to respond, we miss the opportunity to really hear the texter and show them we care. Active listening via text requires carefully reading what texters are sharing before thinking about how to respond. It also requires making our response about them and not us. Every texter's crisis is different. In the face of more serious issues, we tend to panic and think about ourselves. It turns into: What can we say to fix the situation? What if we say the wrong thing? What are we liable for? What is the protocol if they say this or that? When we focus on ourselves during conversations, we aren't present and connected to the texter, which is what texters want the most. When we use active listening, it shifts the focus from us to them. It becomes: What does their unique crisis require? What is the right response for them in this moment? What support do they need? What do they need to hear to move from their hot moment, to a cool calm? In person, we use nonverbal cues to let others know we're engaged in what they're saying. For example, eye contact and head nodding are common ways we show others we're paying attention. Since we can't physically show texters we're listening, we have to express that we understand solely with our words. Warm Tone Imagine receiving a one-word text response from a friend after a long message. Sometimes we interpret short messages as cold and wonder if our friend doesn't care. We're trying to decipher the tone of their message. Tone expresses your attitude toward what you're talking about. Or put simply, it's how you sound to someone else. Without realizing it, we can sometimes sound cold, harsh, or even judgmental. Being intentional about our tone ensures that texters can feel that we care about them. While tone can be expressed through the pitch in verbal conversations, expressing tone through text can seem more subtle. In fact, a message can have the same meaning but completely different tones. For example, a message that says, "Why would you do that?" can sound judgmental in comparison to a message that says, "What do you think made you try it that way?" Although both questions are asking for the same information, one comes across as warmer than the other. Our goal is always to use a warm tone with texters. This prevents our messages from seeming harsh. Not only do our words need to be supportive, we also need to make the texter feel understood and heard. Reading a message out loud is a good way to judge how it sounds. If it feels choppy or robotic, your tone might not be warm. Remember, you and the texter are both real people. Fill the conversation with kindness. --- At this point, you might be wondering how to show texters you're empathetic, actively listening, and warm. On the next page, we'll introduce you to the six key Good Contact Techniques that help demonstrate genuineness and presence with texters in crisis. You'll also learn why they work and how you can use them!

Exploring Emotions

Being empathetic is more about connecting to an emotion than connecting to a specific experience, situation, or identity. Regardless of who the texter is, you can connect to how they're feeling in the conversation. We use a technique to show texters we empathize with how they're feeling called the Empathetic Response Formula. The Empathetic Response Formula is a technique that combines tentafiers and strong feeling words and connects them to what has caused the texter to experience those feelings. For example, if a texter is feeling defeated because they can't find resources in their area, we can link their feeling of defeat with not being able to find resources. By combining these techniques, we're able to show we are listening and give space for the texter to share more without asking them another question. Remember, even though we want to explore with them, we don't want the conversation to feel like an interview, or worse, an interrogation. Let's break it down: Tentafier: Using a tentafier before the rest of the statement acknowledges that we're inferring how the texter feels and what they're going through. "It seems..." "I wonder if..." "What I'm hearing is..." Strong Feeling Word: A strong feeling word shows we're trying to understand the intensity of what a texter is feeling and experiencing. "...like you're feeling terrified..." "...you're feeling anxious..." "...you feel anguished..." Source of the feeling: Adding the source of the feeling shows we've been listening to them and validates that what they're feeling is understandable given their experience. This is a great place to include specific details they've shared about their situation, so the conversation feels more personal and less robotic. "...because..." "...after learning..." "...now that..." Example Texter: I was laid off from my job at a magazine a few years ago. Since then, I've been freelancing. It doesn't pay as well. It's put a strain on my marriage. Volunteer: It sounds like you're feeling distressed because you aren't able to provide for your family. It makes sense to feel overwhelmed while trying to find work and be present at home. Example Texter: I told him exactly what I was doing. I went out to eat and had 2 drinks and went ho

CARES

CARES is an acronym we use to outline the steps for determining if a mandatory report is needed. Each letter is a different part of the process. Here's how it works: C - Check-in with your Supervisor. Flag your assigned Supervisor who will review the conversation with you and determine whether mandated reporter language should be shared with Texter. A - Alert Texter. If it is determined by the Supervisor overseeing the conversation, describe what it means to be a mandated reporter and let the texter know that if they choose to share more information, and they confirm they belong to a vulnerable population, we are required to make a report. (Be mindful, if the texter is a minor that you use language that is age appropriate so they fully understand the message). If the texter is willing to continue sharing, explore the details of the texter's experience, as much as they are comfortable sharing and ensure a report is necessary. You can always reach out to your Supervisor for guidance. R- Reveal Concern for Safety. Validate the texter's experience with empathy and expressions of care. Reiterate our role as mandated reporters, so that the texter clearly understands our mandated role. E - Establish belonging to a vulnerable population. Confirm that the texter is either a minor (under 18), an elderly adult (over 60) or a dependent adult. S - Secure additional details. Work with your supervisor to ask for Texter's details such as date of birth, full name, and full address. In Conclusion: Ultimately, we leave it up to the texter to decide to share specific information with us. If a texter outright tells you about the abuse they have experienced or based on the conversation, you suspect the texter is a vulnerable population, flag your Supervisor. After reviewing the conversation, your Supervisor will guide you to let the texter know that you're responsible for reporting abuse in certain situations. Always clarify that it's up to them if they want to share. Here's an example: Texter: I don't know. Most of the time I don't but then every once in a while he's nice to me and is an amazing dad. Texter: But then 1 small thing later it's back to me being a horrible daughter and getting screamed at about how he wishes I was ne

How to: Discover Next Steps

Discovering Next Steps is likely what you imagine. This stage is called "discovering" because it's our job to work with texters to uncover what works best for them. It's a collaboration. We aren't here to tell them what their next steps should or shouldn't be. Instead, we discover through open-ended questions, non-judgmental listening, and genuine support how they can manage their crisis. Next steps can come in all shapes in sizes, but they typically fall into one of three categories: Coping skills Social Support Resources None of these categories is better than the others. They all offer texters a way to continue to fight through their crisis, find relief, and continue to get the support they deserve.

Step 2: Plan

Does the texter have a plan for ending their life? When a texter is having suicidal thoughts, the second question in the Ladder-Up Risk Assessment is to ask about a specific plan for how they would kill themselves. When asking about their plan, we want to keep the question as open-ended as possible. Your role isn't to determine how realistic the texter's plan is, but to see how much thought they've given to how they would die by suicide. Example Volunteer: I know this is tough to share. You're so brave for opening up. I'm wondering, what's your plan to end your life? Texter: I would do it quickly, with a gun. Takeaway: Because the texter shared that they're thinking about shooting themself, they have a plan, so you can move on to ask the next rung of the ladder. Example Volunteer: I know this can be hard to talk about, and I appreciate you sharing that with me. Have you thought about how you might kill yourself? Texter: Yeah, I have. Takeaway: Sometimes, when we don't ask about their plan with an open-ended question, texters will respond with a yes or no without telling us what their plan is. In this case, we'd want to ask a clarifying question. Volunteer: I get the sense that you're in a lot of pain. How are you planning to end your life? Texter: I want to jump off the bridge in my town. No one cares anyway. Takeaway: Since the texter shared their plan, we keep climbing the ladder to "Means." Example Volunteer: I know this is tough to share. You're so brave for opening up. I'm wondering how you would end your life? Texter: I haven't thought about it that much, no. It seems scary to let myself think that way. Takeaway: Since the texter said no, you can stop climbing the ladder. We've responded using Good Contact Techniques to let them know you're there to listen: Volunteer: It sounds like even though there's a part of you that wants to die, there's also a part of you that wants to live.

Step 4: Timeframe

Does the texter have a time set to carry out their plan? When we learn that a texter has the thoughts, a plan, and the means to die by suicide, the fourth and final question of the Ladder-Up Risk Assessment is to ask about a timeframe. We ask about the timeframe in an open-ended way. We don't want to limit a texter's answer by adding a specific time or asking a simple 'yes' or 'no' question. When a texter has a timeframe within 48 hours, they're considered an imminent risk, so you'll flag the conversation for your Supervisor. If a texter has a timeframe that is not within 48 hours, they aren't considered an imminent risk. In that case, you move to explore how the texter's crisis has and is currently impacting them. Example Volunteer: I want to help you stay safe tonight. When do you plan to go through with your plan to kill yourself? Texter: Yes, tomorrow because it's my anniversary of when I lost her. I'm just sitting here staring at the gun... Takeaway: With this response from the texter, we now know that they are at imminent risk for dying by suicide. It's time to flag your Supervisor and continue supporting the texter. Example Volunteer: I want to help you stay safe tonight. When do you plan to end your life? Texter: I wrote a note earlier, I want to do it right now. That's why I reached out. Takeaway: Since this texter's timeframe is tonight, they are at immediate risk. It's time to flag our Supervisor then continue exploring with the texter. Example Volunteer: It sounds like you've given this a lot of thought. What time have you chosen to go through with your plan? Texter: I haven't set a time. I just want to feel like I have a purpose. I don't want to go through with it Takeaway: Since this texter doesn't have a timeframe, we don't flag our Supervisor. Instead, we continue exploring with the texter. Volunteer: I'm here with you, and we can work to keep you safe. Reaching out and wanting to find a purpose both show a part of you still wants to live.

When are you finished building rapport?

Maintaining a good rapport with a texter is important for the whole conversation. For that reason, you'll continue to build rapport with a texter throughout the conversation by making sure you're responding supportively and empathetically. However, once the texter has begun to share more details about their crisis and feelings, you're ready to move on to the second stage of the conversation: Exploring

Step 3: Means

Does the texter have access to what they would use to kill themselves? When we learn that a texter has the thoughts and a plan to die by suicide, the third question of the Ladder-Up Risk Assessment is to ask about means. Means are what they would use to carry out their plan. We want to know whether or not they have access to what they'd need to die by suicide, or if they're planning on getting access. Whenever possible, ask about the texter's access to means with an open-ended question that refers back to their specific plan. We don't want to make assumptions about what a texter may use to take their life. For example, if the texter responds that they intend to hang themself, we don't want to assume that they'd use a rope. We also want to avoid being too general by simply asking if they have access to any means. Example Volunteer: Thanks for being open and honest with me today. That takes real courage. Do you have the gun you would use to end your life? Texter: Yeah I have a gun on the table in front of me. Takeaway: If a texter has access to means as in this example, then it's time to move up to the next rung in the ladder to ask about the timeframe. Example Volunteer: Thanks for being open and honest with me today. That takes real courage. I'm wondering what bridge do you have access to kill yourself? Texter: I'm at work right now. The bridge is on the way home. Takeaway: Although the texter isn't near the bridge at the moment, it's unclear if they plan to stop at the bridge on the way home. In this case, we'd want to ask a clarifying question to see if they plan to get access to their means. Volunteer: I'm hearing that you're occupied at work right now, but that you might pass the bridge on your way home. Are you planning to stop at the bridge after work? Texter: Yeah, I want to end it all. Takeaway: Because this texter said they do plan to get access to their means, we move up the ladder to timeframe. Example Volunteer: Thanks for sharing that with me. I admire your courage. What do you have access to hang yourself with? Texter: Yeah, I'll use the belt in my closet Takeaway: Because this texter has access to their means, we move to timeframe. Example Volunteer: It sounds like you've given this some though

How to: Discover Next Steps - Abuse

Earlier in training, you learned about our process for reporting abuse of vulnerable populations (children under 18, elderly adults over 65, and legally dependent adults). Whether a texter decides to share their information for Supervisors to report it, we still work with them to come up with the next steps to keep them safe and bring them to a cooler calm. Sometimes this means finding sources of support they can trust or finding ways to cope with their painful situation. Example Volunteer: Thank you for letting me know, Alex. It truly takes so much strength to tell me all this and be open to sharing. You've been through so much, and you deserve support. Texter: Thanks I guess I just don't know what to do now. Volunteer: It takes a lot of courage to keep talking. I'll have my supervisor reach out to CPS. What is something you can do in the meantime to help take your mind off of things? Texter: I don't know I usually write in my notebooks but I don't have them. Volunteer: Writing sounds like a good way to express yourself. You mentioned earlier you see a therapist—when are you talking to them next? Texter: Yeah I guess I can write somewhere else. And I will see her in a couple days. Volunteer: I can tell how resourceful you are in trying to find ways to make the most of your situation. You've been through so much stress today, and you deserve to feel relief. Texter: Yeah it's been a terrible day but I'm feeling a little better since maybe this will make my dad stop. Volunteer: It was such a smart decision to reach out for support when your dad was treating you like this. I'm hearing talking things through also helps bring you to a cooler calm.

Texters Who Don't Have a Goal

Even when we ask the texter to tell us what they'd like to focus on or what they're looking for from the conversation, we don't always get a direct answer. Texter:I don't know what would be helpful, sorry if I'm wasting your time. Texter: I just don't feel like anything's gonna change. When texters are reflecting on and sharing their feelings and experiences, it can be helpful to ask them to imagine how things could be different. Think of a time you felt overwhelmed—it might have been difficult to see how things could turn out okay. Here, we're not at all asking texters to find a silver lining to their situation; that often feels dismissive of the complicated feelings they just shared. Instead, we are asking them to use their imagination to see a future in which they feel some sort of relief. If we identify what that relief might look like, no matter how unrealistic, we have a better grasp of their goal. Example Volunteer: I hear how difficult this is, and I can tell how much you want things to improve. In an ideal situation, if everything went your way, what would happen next? Volunteer: What might some type of relief look like for you right now? I hear how much pain you've been in, and you deserve to feel supported. Takeaway: When we help the texter identify their goal for the conversation, we let them lead the conversation. They decide what crisis is most pressing to them at the moment, and they determine what relief or even an ideal resolution might look like. Learning this from the texter puts us in a better position to help them brainstorm and discover next steps.

Five Stage Philosophy

Every conversation with texters has a beginning, middle, and end. Based on our data and experience, to support texters from a hot moment to a cool calm, we need to go through five stages. We call this process our Five Stage Philosophy. Each stage is unique and serves a different purpose. In this video, you'll get a brief overview of each of the five stages of a conversation. Throughout the rest of Training, you'll have time to learn about each stage in depth and practice your skills. The Five Stages are: (1) Build Rapport, (2) Explore, (3) Identify the Goal, (4) Discover Next Steps, and (5) End the Conversation. No matter the crisis, the five stages are the foundation for every conversation. Let's start at the beginning. Stage one: Build Rapport Starting with our first message, we want to establish trust with the texter. This stage helps us create a safe environment for them to connect with us. Through building rapport, we begin to learn what led the texter to reach out. All conversations start with a greeting. Especially with texters in crisis, we want to make this greeting warm. Consider this stage how we introduce ourselves and set the tone for the conversation. Stage two: Explore During the second stage, we give the texter room to open up about their crisis. Here, we encourage the texter to share the situation or feelings behind what led them to seek support. We also consider if they're at risk of harming themselves or others, or being harmed by someone else. Throughout all of this, we listen and validate with empathy and warmth. Together, Building Rapport and Exploring set the stage for the whole conversation. These two stages are crucial for helping texters feel heard and understood. Sometimes, people wonder if reaching out was the right thing to do. We want them to know we recognize getting support takes courage, and we're ready to listen to them without judgement. For that reason, these stages of the conversation especially center on feelings—that's what we want. Remember, texters are trying to describe their situation to a complete stranger. We give them space and encourage them to share whatever they feel is important. Stage three: Identify the Goal So far, you've listened, validated, and reflected back the texter's experiences and emotions. This stage is our chance to ask what they hope comes next given everything they've been going through. Texters often experience a loss of control in the midst of their crisis. Things are not going the way they hoped. More than anything, they often want things to feel manageable again. This stage is a turning point in the conversation. We work with the texter to identify what parts of their crisis are most important in the moment and what a cool calm looks like for them. Here, we encourage the texter to transition from reflecting on the past to taking steps to improve their situation in the present. Stage four: Discover Next Steps Having the opportunity to share what's on their mind has most likely provided the texter with some relief. They might feel less alone and more hopeful than when they first reached out. The point of this stage is to help the texter continue to manage their emotions after the conversation ends. When people are in crisis, taking action can feel impossible and the suggestion to do so can feel pushy or dismissive. That's why we wait until later in conversation to start talking about next steps. During this stage, we invite texters to brainstorm and identify things they can do to cope with their crisis individually or with the help of their support systems. For some texters, next steps might include journaling, making an appointment with their doctor, calling a friend, or getting some rest. Every texter is different. Having a sense of what they'll do when the conversation is over can give texters a sense of control. We let them lead the conversation to figure out what's best for them. Stage five: End the Conversation The conversation should come to a warm close to allow the texter to exercise the next steps they brainstormed. This stage is crucial because it allows us to reflect with the texter on their progress, reiterate their coping skills, and end on a supportive note. The Five Stage Philosophy helps guide the conversation. It gives structure so you aren't wondering, "what's next?" Each stage is important, and they work together to best support the texter. Once we've built some rapport, we can explore the texter's thoughts, feelings, and risk level. After they've shared about their situation, we can transition to learning about the type of support they need and help them brainstorm how they can get it. Finally, we wrap up the conversation and reiterate their strength. Together, these five stages help you create a safe space for texters to process their crisis, feel heard, and reach a cooler calm.

How to: Discover New Coping Skills

For some texters, their crisis is new, and reaching out to us was the first thing they've done to manage it. That's okay! Even if they haven't already tapped into their coping skills for this specific crisis, we can explore what type of things have brought them relief when they've felt similarly in the past. We can also explore activities, hobbies, or skills they haven't yet tried, and might be interested in doing. We support texters in discovering coping skills by brainstorming with them. To support texters in brainstorming, we focus on their feelings and how they've managed them in the past. For instance, if a texter is feeling angry and frustrated about a situation outside of their control, we can ask how they've dealt with feelings of anger in the past. The focus doesn't need to be on the crisis itself; it can be on the emotions surrounding the crisis. Example Texter: I feel so much and nothing. I need help with dealing feeling high one day and low the next. Volunteer: It makes sense that you're not sure what might help you cope with all the emotions of having a miscarriage. Would you be open to brainstorming what might help? Takeaway: There are many ways to start brainstorming with texters; the most transparent approach is to ask if they're open to brainstorming with you directly. Example Texter: There's nothing I can do about the project change at work, I can't believe they're cutting me out! Volunteer: It's understandable to be unsure about what might make you feel less angry. I'm curious, what do you usually do when you're feeling upset? Takeaway: In this example, we're asking the texter to think of how they can cope with their feelings instead of the situation. By framing the coping skills as a way to improve their emotional state and not the situation, texters are usually able to discover more options. Texters who are High or Imminent Risk Working with these texters to identify coping skills they might already have or brainstorming ones that might be helpful to them is critical in helping them reach a cool calm. Sometimes it can be beneficial to frame the next steps as a way for them to stay safe or to reach the goal they've identified. Example Texter: I don't want to hurt my family. But, I can't ke

Running errands recap

From this activity, you can see how two people with different circumstances have vastly different experiences doing the same things. Equality ensures everyone is given the same treatment. In the activity, each person was given $100 and until 9 pm to run the same errands. This is an example of equal treatment. Equity ensures everyone has equal opportunity to achieve the same outcomes. Equitable treatment in the activity would mean Sandra receives more time and money than Willa to run the same errands. Beyond equality and equity, there is justice and liberation. In the activity, all neighborhoods could have easily accessible transportation and fresh produce. It could also mean that people's basic needs (i.e., healthcare) are taken care of for much cheaper or for no money at all. Getting to know each texter's situation and needs requires our full attention. Giving different texters the same "equal" responses may not be what they need. The listening skills you'll learn and develop in training position you to support different people with intention and care.

High risk conversations

High-risk conversations make up less than half of total convos on the Platform. Most of our texters are in pain and really want to share with another person about it. That's what we're here for. We care about every texter's safety. Identifying certain texters as high risk allows Supervisors on the Platform to report necessary information to local authorities when needed. We have systems in place on the Platform for making communicating with your Supervisors about all conversations, including high-risk ones, simple. All texters deserve our support and attention, not just high-risk texters. The term "high-risk texter" is simply how we classify the likelihood of a texter being in immediate danger. Regardless of the risk level, our goal is to help all texters reach a cool calm. In fact, 85% of texters reported their conversation improved their moods such as anger, frustration, hopelessness, or helplessness.

Help and FAQ

If at any point you have questions related to Canvas, assignment submissions, or grading, see our Trainee Support Guide. For additional tech support issues, email [email protected]. For questions about course content and improving your skills, email your Coach. If you have both tech-support and content questions, we ask that you email [email protected] and your Coach with those inquiries separately. It helps us with internal tracking, and it gets you the answers you need more quickly from the people who have them!

How to: Discover - New Resources

In some cases, texters won't know what resources are available to them or where to look for credible support. We have a database of resources we can share with texters. Our resources help connect texters to support that goes beyond what we can provide, or when texters need extra support to reach their goal for the conversation. Our resources are best for texters seeking additional information, alternative coping skills, new support systems, or long-term support. Sharing Resources We always want to ask the texter for permission before we share resources. Some texters want to feel heard and validated, and they don't need or want an additional resource. Sending a resource without asking the texter's permission can hurt rapport and make texters feel like we're pushing them away. We only send Crisis Text Line approved resources from our resources database on the Platform. Texters take our recommendations seriously so, the links we send must be consistent with the values and data that make us ... us! We always share with the texter what the resource is for and how it will be beneficial to them. We have descriptions of all of our resources on the Platform. Plus, we keep an up-to-date list of our resources available on our website's resources page. Example Texter: I just don't know what else to do. Volunteer: If you're comfortable, I can share a resource with you that might help you get more support for your addiction. Takeaway: Offering a resource without making sure the texter actually wants it is a form of advice-giving. We aren't here to give advice! We only send resources to texters that are listed in our resources database on the Platform. Why? They're vetted and approved! Our resources are accessible, up-to-date, and non-discriminatory. Example Texter: I guess I want to know what being bipolar means... I just really want to understand so I can help my daughter. Volunteer: It's totally reasonable to want to know what's going on with you. I have a few resources that might be able to help. Is it okay if I share them with you? Example Volunteer: I know you're in pain and I'm still so impressed with your openness to brainstorming options to cope. You mentioned that coloring and watching makeup videos have worked befo

How to explore

In the flow of a conversation, think of exploring as the ramp-up. We start exploring once the texter feels comfortable enough to share the details of their crisis with us. Our data shows, Of the texters who responded to an optional post-conversation survey, over 60% said that they had shared an experience or feelings in their conversation with their vCC that they had not shared with anyone else. We stay in the exploring stage until we have a good sense of what the texter is experiencing and they've had the opportunity to share their emotions and thoughts openly. At this point, you might be wondering what exactly we are exploring with texters. During this stage of the conversation, we explore: The crisis. What experiences and thoughts led to the texter's crisis? The risk. Is the texter high risk for suicide, abuse, or self-harm? The impact. How is the texter's crisis impacting them? It's normal to wonder if exploring with a texter in crisis will bring up more than you're able to handle. Luckily, that's not the case. Texters share what they believe you need to know to understand what they're going through, and you use open-ended questions and encouraging messages to help fill in the rest. Your role is to listen. This is truly the time where texters share just how heavily their crisis is weighing on them. And, you'll be there to validate them along the way.

Institutional and Societal Levels

Institutional impacts on identity are felt through wide-reaching, systematic practices. This includes the legal system, hiring practices, professional dress codes, media representation, and more. The cultural level is even broader; it transcends policies and media. This level includes collective ideas about who or what is good or bad. They can result in inequality (i.e., discriminatory treatment) and inequity (i.e., discriminatory outcomes). These broader levels are important for us to understand because they inform our interpersonal work with texters. Institutional and societal factors, including experiences shaped by social inequities, are part of why texters reach out to us. In this section, we will discuss: Equality versus equity Our position at Crisis Text Line

Step 1: Thoughts

Is the texter thinking of suicide? The first question of the Ladder Up Risk Assessment is pretty straight forward. We want to know if the texter is thinking about taking their life. Some texters have thoughts about suicide, while others have thoughts about not existing. Either way, we ask if they have thoughts of suicide using the "expression of care" method. The "expression of care" method is a special way to ask your texter about suicidal thoughts that shows you both hear and empathize with their crisis. First, we show the texter we hear and support them by directly mentioning their reason for reaching out. Then, we ask about the texter's risk of suicide by citing our care and concern for their safety. Example Volunteer: With all this family conflict going on, I just want to check in about your safety. Have you had any thoughts about killing yourself? Texter: I mean, yeah... I've thought about it before. Takeaway: The texter responded with a 'yes,' so we would continue up the ladder to Plan. Example Volunteer: We've been talking about how terrifying it is with your family and your breakup. Through all of this pain, has it gotten to the point where you've thought about suicide? Texter: I dunno. Kind of. Takeaway: The texter responded with an unclear answer. Vague answers to questions, especially about suicide, often happen. When they do, we ask clarifying questions to eliminate ambiguity: Volunteer: Just to clarify, do you mean you want to end your life? Texter: I guess I have been thinking about it. Takeaway: "I guess" is considered an affirmative response, so we'd move up the ladder to Plan. Example Volunteer: You mentioned earlier that you wish you'd never been born. I want to check-in on your safety, are you having thoughts about taking your life? Texter: No. Volunteer: Thanks for being open and honest with me. I want you to know that if you ever do, you can always tell us. Takeaway: When a texter responds no to a question about thoughts, we can stop climbing the ladder. It's crucial here that you don't say "good" or just move on without acknowledging the texter's response. If you're overtly glad they don't have those thoughts ("Oh thank goodness!"), or we don't acknowledge what they shared directly, they

Texters Who Are High or Imminent Risk

It may feel odd asking a texter who has shared that they're suicidal, self-harming, or experiencing abuse what their goal is. However, even for these texters, we want to give them the space to share what they're hoping comes next for them. It's crucial for them to feel like the conversation is supporting them and what they need. As we mentioned before, texters reach out about several issues at once, and high-risk conversations are no different. For instance, for some texters who are suicidal, they may not say their goal is to keep living. They might say they want things to get better, or want the bullying to stop, or need a way to get money so their family doesn't lose their home. For them, addressing underlying emotions, taking a step forward, or finding a better way to manage can all be a goal. Of course, our goal is to keep the texter safe. However, we need to understand what safe means for them and what other types of support they need. Example Texter: I do want to stop self-harming, I really, really, do but all the stress isn't going to go away, so idk how I can even begin to stop. Volunteer: I hear how overwhelming this is. You're strong for managing everything this far. In an ideal situation, if you could manage some of the stress, what would happen next? Example Texter: I don't even know why I want to die, I just do. I can't see the point anymore. I cry all the time. Volunteer: I hear how much pain you've been in, and you deserve to feel safe. What would you say is causing you the most pain right now? In all cases, instead of making suggestions, we use open-ended questions and validate their feelings of indecision to see if there is a goal we can support. If not, there are still ways the texter can practice small ways to find relief and be distracted to reach a cooler calm. We're here to listen.

Discover Next Steps - Overview

It's natural for humans to want a quick fix for their pain. No one wants to carry around difficult emotions all the time. After texters have identified a goal for the conversation, they need our support in thinking of ways to reach that goal. We aren't an advice service, though. We want to work with texters to think of ways they can continue to manage their crisis after the conversation ends. We do this through Discovering Next Steps. At the end of this section, you'll be able to: Describe why we collaborate with texters to create next steps Identify which type of next step best supports a texter Help both low and high-risk texters come up with next steps Share resources with texters who need additional support

Self Reflection Activity: Running Errands

Let's think through a more realistic scenario to ground our understanding of equality and equity. Imagine you need to plan two different people's schedules. They both need to run the same errands in the same amount of time, and they are both given $100 to finish. Willa is a married woman who works from 9 am to 5 pm with a one-hour lunch break. Her wife usually drives their 4-year-old daughter to a daycare near their workplace downtown. Willa usually takes a 15-min train to a different part of town. Willa's job provides her with health insurance that covers her whole family. There is a grocery store with fresh produce two blocks away from her office, and there is a pharmacy two blocks from their apartment. Sandra is a single parent whose work is a 20-min train away. She does not have a car, and the closest public transportation is a 20-minute walk away from home. Sandra's mother lives nearby, so Sandra usually drops her 4-year-old daughter off with her before work. She works her first job from 8 am to 2 pm, then she walks to her second job, which is from 3 pm to 8 pm. Both the closest grocery store with fresh produce and the closest pharmacy are a 30-minute walk away from home. Sandra has health insurance from the government. Both Willa and Sandra need to: - Get to work on time. - Pick up medication for their daughters at the pharmacy, which is open from 10 am to 9 pm. - Buy groceries for their families. - Tuck their daughters into bed by 9 pm. Costs: - Train fare: $2 each way - Willa's daughter's medication (covered by insurance): $15 - Willa's grocery bill: $30 for three days of groceries - Sandra's daughter's medication (no insurance): $45 - Sandra's grocery bill: $50 for five days of groceries

How to: Discover Social Support

Many times the best thing for texters is not to be alone with their crisis. While we're always here for them in a hot moment, we can't offer them long-term support. The second category of "next steps" is reaching out to their social circle, who can give them ongoing support. What connection and social support look like are different for all texters. In general, getting social support means connecting with someone in their life who they trust and who will listen. When we explore their current support systems, we are working to identify who they usually talk to about their issues: family, partners, friends, therapists, teachers, colleagues, etc. Regardless of who the support person or people are, the texter needs to feel comfortable reaching out to them. To start exploring a texter's social support, we ask who the texter has shared their crisis with besides us, or who they've been able to trust in the past. Similar to identifying coping skills, we want to support texters in discovering who in their life might be someone they can reach out to. Example Texter: Focusing on feeling safe I guess. I love him, but the hitting is out of control. Volunteer: I'm hearing that you want support on finding a way to safely get some space from your husband. I'm curious, have you been able to talk to anyone else in your life about the situation? It's likely that in the earlier stages of the conversation, texters mentioned someone in their life. Sometimes the people they mention are unsupportive while others they can trust. Either way, it's our role to listen and explore with open-ended questions. Takeaway: Not all support systems are truly supportive, and we want to be mindful of that. Texters know who they can connect with best. Many texters come to us because they don't have enough support. So we want to hear what texters are saying about their fears and continue to follow their lead. Example Texter: My parents aren't supportive, though. They don't believe depression is real. I don't think they'd care unless I actually went through with killing myself. Volunteer: You deserve to feel supported and believed. I can tell you're hurting. I'm curious, have you shared how you're feeling with anyone besides them? Takeaway: When askin

How to: Explore Risk - Suicide

Nearly 1 in 4 texters tell us they have suicidal thoughts. However, many of those texters don't have plans to end their lives. Since it's a frequent topic, volunteers usually have lots of questions! So, we're dedicating this entire section to suicide and how we assess texters for suicidal risk. When it comes to suicide, there is no one cause. Research finds that more than half of people who die by suicide do not have a known mental health condition. In addition, our data show that some texters who experience thoughts of ending their life show little to no detectable signs of suicidal thinking. Suicide & Stigma We want to reduce feelings of shame about suicide whenever we can. Some phrases to avoid when talking about suicide are "commit suicide" and "successful suicide attempt". These perpetuate the stigma around suicide dating back to when suicide was illegal and considered sinful. People who die by suicide are not criminals; they are dealing with a difficult, painful situation. Stick to the terminology "die by suicide "or "end your life," both of which are very direct but don't come with any added stigma. Our data show it's easier for many texters to respond to a direct, empathetic question about suicide than it is to bring up the topic on their own. Through our Expression of Care method, we show that we are taking their situation seriously and are concerned for their wellbeing. That's why it's our policy to risk assess all texters for suicide — even those who show no immediate indicators of risk. We've found risk assessing between 3-20 messages to lead to the most supportive conversations because you have already built rapport and gained a better understanding of their situation. This helps us create a safe environment to discuss a deeply personal experience. Taking some time to develop trust and rapport allows space for the texter to feel heard and the flow of conversation feels a little less formulaic/like you're just checking off boxes. Even if the texter is "coming in hot" and mentioning suicidal ideation right away, we still want to build rapport and begin to explore first before we jump into the risk assessment. Try to complete the ladder up risk assessment during the middle of the Explore stage. Th

Our position at crisis text line

Often, the crises texters share with us have systemic and institutional roots. We cannot take away the realities of racism, xenophobia, classism, homophobia, transphobia, and ableism that many people face. No amount of individual-level coping skills a texter gains from our conversation can suddenly bring these systemic forces under their control. However, we still have the power to support them in meaningful ways during an intense moment of crisis. Our work at Crisis Text Line is individual and interpersonal. The connections we make with texters have the potential to provide them with a sense of hope and belongingness. That feeling of being listened to and understood can lead to healing. Throughout the rest of this course, you will learn how to create an empathic, warm environment for the texter to open up.

Part 2: The Conversation

Our Five Stage Philosophy supports all texters. In this section, we'll walk you through each stage individually, and you'll have the opportunity to practice your skills. We'll cover: Building Rapport Exploring Identifying the Goal Discovering Next Steps Ending the Conversation You'll also learn how we assess texters for risk and see our Good Contact Techniques in action. In part three, you'll see how what you learned in the Foundation and this section work together on the Platform. Let's start with Building Rapport.

What you'll learn

Our approach to crisis intervention About our Platform Skills needed to support people in crisis

Message length

Our data suggest that longer messages are associated with the most effective conversations. It's not surprising that texters may judge how much we care by the length of our messages. Longer messages usually require us to be especially thoughtful about the words we choose. We want texters to know we care. For that reason, we stay away from short messages. You have up to 160 characters when writing messages in training and on the Platform. Sometimes your messages might be longer. That's okay! In those cases, you can send two messages in a row. Example Volunteer: It sounds like you've been through a lot since your husband passed away. It makes sense that it's taking you time to sort out how you feel about him... Volunteer: ... cheating when you never got to confront him about it. Example Volunteer: It sounds like you've been through a lot since your husband passed away. It makes sense that it's taking you time to sort out how you feel about him cheating (1/2) Volunteer: when you never got to confront him about it. (2/2) The messages of our most effective volunteers are 99 characters, on average. That's our expectation of you in training and on the Platform! If you can hit the 160 character count, even better. The takeaway is to always be thoughtful in your responses to texters by actively listening, responding empathetically, and using a warm tone. Note: You're unable to send messages longer than 160 characters in training activities.

Build rapport - overview

Our goal is to put texters at ease. Although people want to use our service, talking to strangers can be scary. The first stage of the conversation helps us create a safe space for texters to open up. Picture the last time you visited someplace new—a new doctor, a new class, a new job, a new restaurant. How were you treated when you first arrived? Chances are how they communicated either put you at ease or made you feel out of place. Our service is a safe environment for texters, so we want them to know that from the beginning. We do this through Building Rapport. At the end of this section, you'll be able to: Describe how and why we build rapport Use Good Contact Techniques to create a safe space Craft a warm opening message Demonstrate active listening skills

Interpersonal Level

Our identities are shaped at the interpersonal level by other people's actions and language.In the most basic sense, it's how the people you interact with treat you. As volunteers at Crisis Text Line, your interactions with texters, staff, and each other fall in this category. Shortly, we will define and discuss: Intersectionality In-groups and out-groups Later in training, we will discuss our texters' identities and experiences in more depth.

Remaining content divided into four parts

Part 1: The Foundation Foundation for supporting people in crisis via text. We'll introduce you to how we approach crisis conversations, the techniques you'll use, and what to expect when using our Platform. Part 2: The Conversation learn how a Conversation looks and feels and, most importantly, how best to respond to texters. You'll see plenty of examples and will get the opportunity to practice each part of a conversation. Part 3: The Platform learn about the Platform and how it works. You'll take a tour, watch a Crisis Counselor take conversations, and read about policies and procedures that keep both you and texters safe. Part 4: The Support learn about the Support you can expect from us. We'll talk through the tools to help you schedule shifts, the resources to grow your skills, and the fun ways we plan to celebrate the work you do.

Engaging in self harm

People engage in self-harm for many different reasons. Self-harm means any act of deliberately causing injury to one's body, without intent to die. Texters who self-harm aren't trying to kill themselves. Self-harm, self-injury, or non-suicidal self-injury (NSSI) are all in the same category, so we use the term self-harm because it's a more inclusive, human first term. Self-harm can be a coping strategy for dealing with severe emotional distress. Like other coping strategies, self-harm can provide a distraction from emotional pain by translating it into physical pain. Sometimes texters self-harm to feel a sense of control, to find relief, or to communicate distress to others. When supporting texters who reach out about self-harm, we explore if they're currently self-harming and, if so, if they've injured themselves more than intended. Self-harm can bring a sense of escape and release when texters are feeling intensely overwhelmed, stressed, frustrated, upset, or angry. Some texters mention that they self-harm so that they can release their feelings without hurting others. Although texters who self-harm aren't intending to die, they can harm themselves more than intended, which can put them in danger. Regardless of if they are in danger of being seriously hurt, we are here to support them.

How to: Discover Next Steps - Self Harm

Recovery from self-harm is not a linear process. This may be the texter's first time reaching out for help regarding their self-harm. It's also possible your texter has been self-harming on and off for years. Our job is to meet the texter at their individual level of readiness, even if that means they are not ready to stop self-harm at the moment. Whether a texter agrees to stop self-harming during the conversation or not, we ask if they're open to exploring alternative ways of coping. Our hope is to identify the feeling they are trying to get from self-harm and find safer alternatives for them to get the feeling of relief they are looking for. Example Texter: It like makes it go away for a little bit and makes me feel better for like five minutes. Volunteer: It sounds like the physical pain brings some sort of momentary relief from the emotional pain. It makes sense to want to feel better. Texter: Yeah. Volunteer: Thank you for being open with me about this, it's not easy to talk about. During the months you weren't self-harming, how did you find relief? Texter: I played video games, I drew on my arm, I listened to music, I played with my dog, or I took a hot bath. Volunteer: Those sound like good ways to calm down, and it's resourceful to have those in your back pocket. Do any of those sound doable today as an alternative to cutting? Texter: Right now I'm in the car with my friend but when I get home I'm gonna take a shower and then go to therapy. Volunteer: That sounds like a good plan to cool down from the urge to self-harm, and it sounds like you've been able to cope and seek support in your own ways for a while. Texter: Yeah I've learned a lot of things just sometimes I hold my emotions in for too long and then I explode and I relapse and then I like feel really upset and I regret it but then I still have urges to do it even tho I know it's a bad idea. Volunteer: It's important to track how you're feeling, and you've been brave managing all of this and seeking help. How are you feeling right now? The texter's safety is always our priority. Even though it's rare, some people who engage in self-harm will hurt themselves more severely than they planned. If this happens, reach out to your supervisor. Rememb

Module 1 Learning Objectives

Reflect on your personal and social identities Explain how your socialization has affected your personal identities Understand how social identities can affect our texters' experiences Understand the difference between equality and equity Reflect on how your identities brought you to volunteer at Crisis Text Line

How to explore self harm

Self-harm makes up about 12% of conversations we have with texters. We define self-harm as the act of purposely causing harm to one's body without the intent to die. In conversations that are tagged as self-harm, some of the main words we see texters mention are: cut, cutting, urge, razor, blade, relapsed, scar, punishment. The feelings texters most often associate with self-harm are feeling "freaked out," "overwhelmed", and "stressed." As you might notice, these feelings aren't unique to self-harm. While we might not personally have experience with self-harm, we can identify with the emotions that texters struggling with self-harm experience. We've all felt overwhelmed before. That's why when exploring risk with high-risk texters, we focus our messages on our concern for their well-being as well as their safety. When it comes to self-harm texters, they are sometimes actively engaged in self-harming when they reach out. It takes courage to be honest with us about that, and we want to do our best to make sure they're safe. During the exploring stage, we do this in two ways. Separate the texter from the means If a texter is harming themselves or shares that they have the means to harm themselves in the room, we ask them if they'd be willing to stop self-harming or to put the means in a less visible place, while we talk. Example Texter: I know I should stop, but I can't. Volunteer: I hear you. Stopping even for a little bit can be difficult. Would you be willing to put your blades away while we talk? You deserve to be safe, Gino. Texter: I guess I can do that, but it's the only thing that makes me feel calm. Ask if they're self-harming with the intent to die As we mentioned before, self-harm is causing harm to one's body without the intent to die. However, because some types of self-harm can lead to death, we want to check-in on the texter's intent, if they've expressed that they're actively self-harming during the conversation. We do this by directly asking them if they intend to end their life. Example Volunteer: It makes sense that you'd want to feel calm, everyone deserves some relief. I want to check-in, are you cutting because you want to end your life? Texter: No, I just feel overwhelmed and it relaxes

Socialization

Social identities influence the way we experience the world because of a process called socialization. This is how we learn norms and beliefs. It influences how we think about ourselves, understand what is expected of us, and interact with others. We internalize messages about how the world functions and how we should act. We are socialized throughout our lives based on our social identities, upbringing, surroundings, and other factors. For example, you might have been a fan of a certain sports team since you were a child because someone else in your family liked them. You didn't understand the game yet, but you were taught that the team from your city was better. To give another example, you may know not to interrupt authority figures. This may have been socialized by teachers instructing you to raise your hand before you speak. Even though our individual-level identities are made up of our personal beliefs and values, these beliefs and values are shaped by how we are socialized as part of different groups.

Alternative Endings

Some conversations end before you've had a chance to go through all Five Stages of the Conversation. Texters Disengage Some texters simply stop responding. While it can be difficult not to take personally, it's not about you or your skills as a volunteer. They may have gotten what they needed from the conversation, been interrupted, or fallen asleep. To help you check-in on these texters, we have automated reminders. They will appear on conversation boxes up to three times if a texter isn't responding: two check-ins, then a warm close. By checking in twice before saying goodbye, you're allowing the texter to re-engage. The reminders are there so you can remember to check-in on texters. The system doesn't send the check-ins for you! We leave that up to you since you know what is going on with the text at the moment. Here are a few examples for how to check-in and close if a texter disengages: Texter: They all rejected me it was all for nothing. Volunteer: It's devastating to not get accepted into your top school. It sounds like you've been working hard for a long time and are feeling burnt out. Check-in 1 Volunteer: It's been some time since I've heard from you, Brad. I'm here if you still want to chat. Check-in 2 Volunteer: You deserve to feel supported, and it was smart to reach out. Is now still a good time to talk? Warm Close Volunteer: It seems like now might not be the best time for you to talk. I'm going to end this conversation now, but we're here 24/7 if you're in crisis again. Take care. Texters message "STOP" Texters can opt-out of conversations by texting "STOP." Your first thought here might be, "what did I do wrong?" When a texter contacts us, they first receive a set of automated messages. One clearly states that if at any time they want to opt-out or end the conversation, they can text the word STOP. STOP messages can feel disheartening, but it's not a reflection of your skills as a volunteer. In fact, 99% of our active volunteers have experienced at least one STOP this past year. Example: Volunteer: It's devastating to not get accepted into your top school. It sounds like you've been working hard for a long time and are feeling burnt out. Texter: STOP Automated message: The conversation is now

When are you finished Identifying the Goal?

Some texters understandably fixate on the causes, consequences, and feelings of their situation. This sometimes means they may find it difficult to move from exploring to identifying a goal. Listening is important, and it's the core of what we do. However, only fixating on their distress without asking them how they want to be supported can lead to circling back to the beginning. This ultimately makes it hard to move the conversation forward and could prevent the texter from reaching a cooler calm. Below is the list of the questions to support a texter in narrowing in on their goal: What would you say is causing you the most pain right now? What do you think would be helpful for us to focus on today? Which of the situations you've talked about today, if resolved, would have the greatest impact on how you're feeling right now? What do you see as your options right now? What would you want your (friend/partner/boss/etc.) to understand if you were to reach out to them? In an ideal situation, if everything went your way, what would happen next? What might some type of relief look like for you right now? Identifying the Goal allows you to bring the conversation to the present moment. Work with the texter to identify a focus for the rest of the conversation. When you do, you can support them through the next stage of the conversation: Discovering Next Steps.

Building trust

Some texters will feel comfortable opening up right after your opening message. Other texters might still feel reluctant to share their story with you. There are many reasons for this. Some texters aren't sure what's okay to share or how much to share. Our data suggests that 77% of individuals who texted CTL for support had not received help from a doctor or therapist before. Reminding ourselves that reaching out for support is challenging helps us remain empathetic even when it takes texters some time to warm up to us. You can create a safe space for texters by showing them they can trust you and that you understand them. Using Validations, Strength IDs, and Strong Feeling Words can help show them you care, and it's okay to open up. Validations To validate is to recognize, normalize, and accept a texter's thoughts, feelings, and experiences. Common validating phrases are: "It makes sense to feel...," "It's normal to be...," "It's reasonable to feel...," and "It's understandable that..." Example Texter: People at school suck Volunteer: Hey, my name is Rosa, and I'm here for you. Struggling with people at school can be draining. Will you share more about what's going on? Texter: they make fun of me for being homeless Volunteer: It makes sense to want support when you have to face them alone. How did it feel to go to school today? Strength IDs Strength IDs show texters that they have inherent positive traits, and have the strength to fight through their struggles and find relief. Any quality viewed as a positive trait can be used as a strength ID. Example Texter: My boyfriend just hit me. What should I do? Volunteer: Hi, I'm Priya. Having someone hit you can be terrifying and it's hard to know what to do. You're not alone. I'm here for you. Texter: thanks. Volunteer: Of course. It took courage to reach out tonight. No one deserves to be hurt. Do you feel comfortable telling me what happened? Strong Feeling Words Strong Feeling Words match the intensity of the emotions a texter is feeling during their crisis. Using strong feeling words shows texters you take their crisis seriously, and you believe that their pain is real. Example Texter: suicidal thoughts, I guess. Volunteer: Hey, I'm Madden. Having thoughts of sui

Social Identities

Someone's social identities are based on how others perceive them in different contexts and situations. For example, a Guatemalan American person could be considered "Latinx/Latine" (a gender-neutral term for people with a Latin American identity) in the US, "Guatemalan" in Venezuela, and "American" in Guatemala. That person's racial and ethnic social identities change based on how they are perceived in different environments. Social identities include race, ethnicity, sexual orientation, gender, ability, socioeconomic class, nationality, and more.

Texters With Goals We Can't Meet

Sometimes, texters have specific goals we can't meet. They might ask for specific advice, or need support we can't offer. It's important to keep the focus on empowering texters. Texters Who Want Advice When a texter's goal is to get advice from us, we can redirect their goal in a way that's supportive and less concrete. We continue to let them lead the conversation by encouraging them to reflect on and find ways to cope with the feelings associated with their crises. Example Texter: I just want to know if I should text my ex right now. Just tell me what to do. Volunteer: It's normal to feel confused about texting your ex after a breakup. What would you want your ex to understand if you were to text them? Takeaway: By leaning into what the texter wants from reaching out to their ex, we're able to continue to support them without telling them what to do. We don't know for sure what the texter should do about their situation because, no matter how long we've been talking, we don't have the whole picture. If we give our opinion, we are not allowing them to make their own decision. This approach avoids us giving unreliable advice and makes sure we don't take power away from them. Texters Who Need Additional Resources A texter may ask for more concrete resources and guidance on a substantive issue they have little control over. We can help them get closer to that goal, even if we can't meet it concretely. Example Texter: Can you get me a ride to a shelter? If I don't find a way to get there now, the cops are gonna come. Volunteer: This seems like an intense situation, and it makes sense to feel stressed about how much time you have. While I can't call you a ride myself, it sounds like you've thought a lot about this. What do you see as your options right now? Takeaway: We cannot personally get this texter a ride, nor can we intervene with the police or communicate with a shelter on their behalf. Just because a texter reaches out to us with a concrete goal that we can't practically meet doesn't mean we can't still be there for them. The feelings they experience as a result of their situation are important, and we can still listen to support them to a cooler calm. If they're interested in resources, we can provide th

Texters Who Know Their Goal

Sometimes, texters will make their goal clear during your exploration together. They might say something that indicates what they're looking for. Texter: I've been wanting to see a therapist to help with my eating disorder, but I don't know how to find one. What should I do? Texter: My girlfriend puts me down all the time and I need help breaking up with her. In conversations where texters share their goal without us asking, we still get clarification about their goal before moving on. Example Texter: I think my best friend has an eating disorder, but I'm not sure. I want to be there for him but I'm scared. Do you know what I can do? Volunteer: I'm hearing you're worried about your friend and want to find ways to support him, but you aren't sure where to start. Is that right? Takeaway: Paraphrasing what the texter shared and including a clarifying question gives them space to correct us if we're wrong and elaborate on their goal. We want to clarify a texter's goal instead of assuming what would be most helpful for them. The best way to make sure we understand them correctly is to ask. Other texters who know their goal are sometimes those who reached out to feel heard, seen, and supported. Example Volunteer: Deciding if you can take your sister's kids while she's in the hospital is definitely a complicated choice to make. What do you see as your options right now? Texter: I know what I have to do. I just really need to tell someone how I'm feeling about it all. I can't tell my family without them thinking I'm a horrible person. Volunteer: There's no wonder you want to talk to someone outside your family. On top of being concerned for your sister, you have to think about how your life might change. Takeaway: When texters are looking to vent or share, we validate their goal and continue supporting them. A part of being in the middle of a crisis is talking through what you feel before you can move forward. We're here to listen, even when that's all texters need us to do.

When are you finished Exploring?

The goal of exploring is to understand what the texter is feeling right then and what led them to reach out. Once we have a grasp on how they're feeling and what's been contributing to them feeling this way, we can start moving forward. A texter may not know "why" they are feeling a certain way — they are often reaching out because they don't know, and that's what's overwhelming them. After a texter has opened up and shared their thoughts and feelings surrounding their crisis with you, you're ready to move on to the third stage of the conversation: Identifying the Goal.

Confidentiality & Data

Texter Confidentiality We're a confidential service. However, for texter safety, there are two situations in which we request personally identifiable information (PII) from a texter: when they are at imminent risk of suicide or homicide and when we suspect abuse or neglect of a vulnerable population. Sometimes, we get asked for conversation transcripts. We take our promise of confidentiality to our texters seriously. So, we will only consider releasing conversation transcripts to law enforcement. And, law enforcement must provide a court order requesting a specific transcript. All requests are reviewed by staff and our legal support team. In the rare case you suspect you know a texter, we ask that you immediately transfer that conversation to another volunteer. STOP & DELETE These are two important words at Crisis Text Line. Approximately 10% of the time, a texter will end the conversation with us by using the word STOP. If we receive a "STOP," we are legally required to end the conversation (this is a rule from the Cellular Telecommunications Industry Association that all text services follow). Texters will choose to use this for many reasons: maybe someone came into the room, perhaps they were secretly texting us in class, maybe they were rushing to catch the bus and didn't want to have to explain. In other words—it's not about you! It'll be hard to remember at first, but if this happens to you, it probably has nothing to do with the conversation, and everything to do with the environment they're in. DELETE is clarified in our Terms of Service and Privacy Policy to an external site.and means the texter would like their data scrubbed from our system. DELETE requests go straight to our engineering team.

Texters Who Have Multiple Goals

Texters can reach out about a lot of issues at once. Life is complicated and messy. In these cases, it's most helpful to ask the texter what they feel is their most pressing issue. With texters facing complicated crises with multiple parts, asking them to prioritize one can make the whole situation feel more manageable. As with most situations, it can be challenging to set just one goal when there are multiple concerns. By learning what is most helpful to focus on, we can adjust the rest of the conversation to center on their goal. Here are a few questions to ask the texter to share their goal. Remember, in all our messages, we want to incorporate good contact techniques to make our tone as warm as possible. Example Texter: I lost my job and my mom and I don't get along. I can't stand to be in this house any longer. Volunteer: What would you say is causing you the most pain right now? It shows strength to open up about this, and you deserve to feel some sort of relief. Texter: I guess I just don't want to stay at home right now. I feel like I can't breathe here. Example Texter: Everything's falling apart. I'm failing classes and my gf dumped me and my parents are always onto me about something. Volunteer: It's understandable that you're feeling overwhelmed with so many difficult things at once. What do you think would be helpful for us to focus on today? Texter: I don't know, I'm just sad. I just don't want to feel so depressed anymore. Example Texter: And on top of everything, my boss keeps yelling at me in front of the whole office and it just makes me want to disappear. No one ever stands up for me. Volunteer: Which of the situations you've talked about today, if resolved, would have the greatest impact on how you're feeling right now? Texter: I don't know how it'd be resolved, but if my boss stopped yelling at me, that'd be great.

Putting it All Together: Explore Risk

That was a lot of info! So, let's review some important key points: Many texters won't be high or imminent risk. However, a part of being a crisis intervention service is considering the risk and safety of our texters. Some texters might feel reluctant to share if they're in danger at this point in the conversation. That's okay. Texters can share they're in a high-risk situation at any time. For example, a texter could mention later on in the conversation that they're being abused or using self-harm to cope with the other issue they reached out about. That's perfectly normal. Your role is to continue to listen, check-in on their current safety, and flag your Supervisor as needed. Through this collaborative process with the texter, you will have the opportunity to discuss steps for safety, and with the support of your Supervisor, you can confirm safety from suicide. As you will learn in the following sections, there are a number of considerations you can build into this plan with the texter. Although it may be tempting to come up with a plan to ensure the texter is safe, the most powerful thing you can do at this point is to actively listen. Through listening and validating, you can learn more about how their suicidal thoughts are impacting them. You can use the tools you learned in this section at any point in the conversation. We encourage you to be flexible and use the skills you've learned throughout the entirety of training to help the texter feel supported no matter their risk level. What's most important is that we follow the texter's lead and work with them to get clear answers and a good understanding of their crisis. Frequently Asked Questions about the Ladder Up Risk Assessment Do I have to ask the question in this order? Yes! The questions are ordered in a specific way, and asking in this particular order is most helpful for Supervisors if a texter is in immediate danger. What if a texter answers multiple questions in one answer? This may happen. Some texters share things when we don't directly ask. We love it when texters feel comfortable enough to share with us. You can move on to the next step on the ladder. What if I'm unsure about a texter's response? Risk assessments are rarely ever black

How to Use the Ladder Up Risk Assessment

The Ladder Up Risk Assessment is a tool to better understand the texter's current experience with suicide. With this information, you can flag your Supervisor to notify them that the texter has laddered all the way up. From there, they can make an informed decision about the texter's risk of suicide, and they can support you as you continue the conversation. Remember, your Supervisor is there to support you as you explore their crises and the texter's options for safety. It's normal to be nervous asking questions about suicide. Research and our data show that it's important to be open when talking about suicide. Avoidance of the topic can make a texter feel more alone and even anxious to ask someone for help. Open talk about suicide and genuine concern about a texter's thoughts of suicide is often a source of relief to the texter. The Ladder Up Risk Assessment was designed to help you talk to texters about suicide in a way that's supportive and easy to follow. Thoughts: Are they having thoughts about suicide? Plan: Do they have a plan for how they would end their life? Means: Do they have what they need to carry out their plan? Timeframe: Have they set a time to go through with their plan? For each question, we'll go through what happens when a texter gives a yes response, a no response, and an unclear response. It may be helpful to save the above image to reference later. To save it to your computer, just right-click and select "Save Image As..."

Roles & Responsibilities

The idea of calling emergency services can be nerve-wracking for many volunteers, both new and seasoned alike. People often wonder what happens when an active rescue is called in. On this page, you'll learn what to expect during an active rescue, so you can feel prepared and supported. Your Supervisor's Role Supervisors are responsible for determining if we should start an active rescue. They use all the information in the conversation and their crisis intervention experience to decide if calling EMS is the next best step for the texter. If they decide it is, they will initiate an active rescue. Your Supervisor is doing a few things behind the scenes during an Active Rescue: Your Supervisor will tell you if they are going to start an AR They might instruct you to ask the texter their location Call the local authorities based on the texter's location Provide as much information as possible to Emergency Services When your Supervisor makes a call for an Active Rescue, we hand-over responsibility for the conversation to Emergency Services. The Supervisor provides information we have about the texter to Emergency Services, and it is out of our hands. Your Role Together, our role is to let emergency services know someone needs their help. After you've flagged a conversation as imminent risk, you're expected to continue to support your texter using the five stages of the conversation. That means exploring the impact of their suicidal thoughts, identifying their goal for staying safe, and supporting them in discovering the next steps that will keep them safe. Meanwhile, your Supervisor will be in the background monitoring the conversation and supporting you as needed. Their first goal—and yours—is to move your texter from a crisis to a state of calmness. If the texter is willing to provide it, ask their location Continue to support the texter using Good Contact Techniques Respond to your Supervisor's messages Always Check-in with your Supervisor before closing the conversation Suicidal texters are reaching out because a part of them wants to live. They want to connect with another person and feel that they matter. You can let them know you're there for them, and you're listening. Meanwhile, your Supervisor will be at

Intending to die by suicide

There are many feelings of shame, uneasiness, and confusion around suicide. We want to reduce the stigma associated with suicide whenever we can. For that reason, we encourage texters to talk openly with us about their suicidal thoughts. Since suicide is the intentional act of taking one's own life, texters who experience suicidal thoughts are considered high risk. Most crisis lines respond to texters in the order they reach out. We act more like a hospital emergency room. Our algorithm runs in the background and assesses a texter's suicidal risk based on their first few messages. Texters who are considered at a high risk of killing themselves are placed at the top of the Queue. Our data indicate that texters don't always come right out and say they're thinking about suicide. Often texters who deal with other issues such as bullying, depression, financial stress, and isolation report wanting to end their life. Whether texters mention suicide directly or not, we always look for signs that texters are feeling extremely hopeless.

Experiencing abuse

There is no one definition of abuse. Abuse comes in many forms, including physical abuse, emotional abuse, sexual abuse, and neglect. Texters don't always use the word "abuse" when describing their situation or crisis. Regardless of the type of abuse, we take texter's concerns seriously, and we believe the pain they're experiencing is real. Some texters are reaching out because they want to get away from their abuser, while others are looking for ways to cope. In other cases, texters aren't currently being abused, but they experienced abuse some time prior that's still impacting them. We listen and support all texters regardless or when the abuse happened or what type of abuse it is. For some cases of abuse, we are legally (and morally) responsible for reporting it. Even if these texters aren't planning to end their own lives, it doesn't mean they aren't in danger. That's why they make the list of "high risk" texters. You'll learn more about how your Supervisor reports abuse later in training and how the five stages help support you in conversations where abuse is a concern.

How to: End the Conversation

There's no perfect way to close a conversation. Ending the conversation can be difficult and feel uncomfortable at times, but we're here to listen and support to de-escalate from texters from a hot moment to a cool calm. It's important to remember that it's not only okay to end the conversation, but it's necessary to help the texter transition into taking action on their next steps. When you're ready to End the Conversation, you've provided invaluable support. Giving the texter the space to try what you've brainstormed together is an empowering experience. When you're considering ending the conversation, ask yourself: Did you explore the texter's situation and provide a space for them to feel heard? Did the texter get a chance to share their pain? Throughout the conversation, did the texter move from a hot moment to a cool calm? There are three parts of Ending a Conversation. They include: We signal to the texter the conversation is closing soon. We remind them of their strength and next steps. We leave them with a warm and supportive sentiment.

When should you close the conversation?

Throughout a conversation, the texter's concerns are probably not fixed—this makes sense because we are not here to solve any of their problems. We don't have a magic solution, but they may feel some relief from talking. Some texters might not feel better, and that's also normal. One conversation cannot bring their loved one back or stop bullies at school, but that doesn't mean talking hasn't helped bring them to a cooler calm. Texters often need more space to heal and work on their next steps. Trying to prolong the conversation until they feel better does not support them. We show our warmth and reinforce their strength by ending the conversation.

Other Types of Conversations

These conversations aren't flagged for Supervisors, but they are different from typical conversations on the Platform. A Third-Party Conversation A third-party conversation is one where a texter is seeking support for another person who is in crisis (the third party). For example, if a parent reaches out about their child self-harming or someone is concerned about their friend being bullied at school. How We Handle Third-party Conversations: Encourage contact with the first-party. If appropriate, ask the texter to encourage the third party to contact us directly. Direct the texter to emergency services. If the texter believes the third party is at immediate risk of harming themselves or others, advise the texter to call 911. We do not risk assess the third party. Focus on the texter. We still want to ensure that the texter moves from a hot moment to a cool calm. So proceed through the five stages of the conversation with the texter as usual, and be sure to give plenty of strength IDs. Sometimes a texter becomes a third party during a conversation. This happens when someone takes the phone from the texter (i.e., a parent or spouse takes the phone). We always respect the texters' confidentiality. If a texter becomes a third party, inform the texter you will be ending the conversation, then closeout. One notable exception If the texter met all four criteria for Imminent Risk before they became a third party, flag the conversation for your Supervisor to review. Managed Texters Some texters have such a great experience with us, they reach out several times within a short period. We refer to these texters who text in often within a short period as managed texters. We have a unique way of working with, or managing, them. Managed texters often text with us as if we're their best friend or their therapist. Unfortunately, we aren't able to offer these texters the ongoing relationship they want. In order to support, instead of enabling these texters, we've created management plans for them which include tools and policies: Management Plans A management plan is an outline that clarifies how and for how long to support that specific texter. When you get a managed texter, you'll receive a pop-up box informing you tha

Good Contact Techniques

Think about the last meaningful conversation you had. What made you feel comfortable sharing? What made you feel safe and vulnerable? In this section, we'll take a look at the skills you can use to help texters feel comfortable sharing and being vulnerable in a conversation. Providing a safe space for texters is our number one priority. We do this by actively listening, being empathetic, having a warm tone, and using a combination of communication techniques. At the end of the section, you'll be able to: Differentiate between empathy and sympathy Distinguish a warm tone from a cold tone Use active listening skills Identify each Good Contact Technique

Explore the crisis

Think of a time when you felt rushed telling a story or explaining a situation. How did you react? People often feel misunderstood or ignored when others don't take the time to hear their stories. The second stage of the conversation helps us understand what texters are feeling and thinking in their own words. Our goal is to allow them to lead the conversation and share what they believe is relevant to their crisis. We do this through Exploring. At the end of this section, you'll be able to: Describe what exploring is and why we do it Use Good Contact Techniques to explore a texter's crisis Assess texters for risk Explain the Empathetic Response Formula

Identify the Goal - Overview

Think of a time you asked a friend for a favor or went for a walk to clear your head. Even when we aren't intentionally considering it, our actions are often motivated by goals. They typically represent what we expect to happen or feel after we've put effort into something. For example, the goal of cleaning could be to have a tidier space or to feel a sense of accomplishment. Either way, goals guide us and let us know we've done what we set out to do. During a conversation, some texters want help finding next steps, some want to vent and feel heard, and some might not be sure what they want. That's okay. They already took the vulnerable first step of reaching out, and our job is to meet them where they are and identify what might help bring them to a calmer and safer state of mind. We do this by Identifying the Goal. At the end of this section, you'll be able to: Describe why we identify a texter's goal for the conversation Recognize a texter's goal when they openly share it Ask warmly and directly about a texter's goal Help a texter identify a goal if they don't have one yet

How Long Do Conversations Last

Through our data, we've found texters are most satisfied with their conversations when they last around 45-60 minutes. This makes sense because we are a short-term crisis service. Our goal is to bring the texter to a cooler calm, not provide ongoing support. So, while it may seem like it's more supportive to have a longer conversation, remember that a longer conversation is rarely a better one. We always want to set proper expectations, draw healthy boundaries, and empower the texter to take the next steps apart from us. The more texters you support, the more comfortable you'll feel with ending a conversation—you'll develop a "sense" that it's time. It can still be difficult when a texter is reluctant to end the conversation. Many of our texters don't feel they have a strong support system, and your warmth and empathy have probably meant a lot to them. At this stage, we remember how crucial it is for the conversation to come to a close so the texter can act on their next steps. Texters are welcome to reach out to us again in the future, and you've shown them how valuable their vulnerability and strength can be toward finding a sense of relief. Circling Texters Circling texters revisit issues you've already explored together or bring up new issues as the conversation is coming to a close. Texters may circle when they don't feel ready to end the conversation. This may be because they don't feel heard or soothed in the way they expected to be, or they simply don't want to feel alone again. It makes sense why a texter may want to circle as they're reaching a cooler calm. However, we're not meant to be a long-term care solution. Staying in a conversation with a circling texter isn't providing better support. Allowing these conversations to continue beyond the Five Stages encourages circling, which does not empower texters to identify ways to find relief and comfort. These conversations can be a bit more challenging to end; however, they only make up ~3% of convos. The best thing to do is to avoid open-ended questions, which may lead to more circling. The steps to ending the conversation are the same, so continuing to firmly and warmly lead the conversation to a close will create more realistic expectations for the

The 3 Parts of Ending a Conversation

Transition Statement First, we want to signal that the conversation is coming to an end. We do this by providing a brief recap of the conversation. It's important to reflect on the primary cause of the texter's crisis to begin this closing process. Ask yourself, what was painful for them today? By doing this, we remind the texter how far they've come during the conversation. Example Texter: Yeah, I guess that's something I could do. Volunteer: Earlier, we talked about how frustrating your boyfriend has been and how overwhelmed you've felt with him and school. How are you feeling now that we've been talking for a while? Summary of their Next Steps A clear summary reminds the texter of all the reflection, vulnerability, and brainstorming they've done to reach a cooler calm. Summarizing also reinforces the texter's next steps to try after the conversation ends. While the nature of texting in our day-to-day lives is an ongoing conversation, in our context, it's okay to reference that you're going to end the conversation directly—you're not abandoning them. Indicating a clear ending provides closure, allowing the texter to prepare to start their next steps mentally. Example Texter: A little better. but still sad, ya know. Volunteer: It makes sense to still feel upset. It'll take time for things to feel more manageable. So, you have a plan to watch your favorite show until you fall asleep and spend tomorrow with your mom, right? Warm Closing Message Now that you've transitioned into the closing stage and reviewed the texter's next steps, it's time to send a warm closing message that reassures and empowers the texter. Example Texter: Yeah, thanks. Volunteer: It was strong of you to reach out and come up with a plan to reduce your anxiety tonight. If you're in crisis and would like to talk again, we're here 24/7. Take care.

Who we are

We (and our volunteers) practice active listening and empathy to help texters move from a hot moment of crisis to a cool calm. We have five core principles that drive our unique approach to crisis intervention. Free, confidential, available 24/7

End the Conversation - Overview

We aim to help texters get what they need to manage their short-term emotional state as well as future crises. At the end of this section, you'll be able to: Describe how and why we end the conversation Implement the three parts of ending a conversation Describe alternative conversation endings Give examples of how to wrap up a conversation

How to: End the Conversation - Imminent Risk Texter

We always check-in with our Supervisor before closing out Imminent Risk Conversations. Here's an example of how Ending the Conversation could look after your Supervisor has told you it's okay to close the conversation with a texter who was an Imminent Risk. Example Volunteer: I'm inspired by how much you've done to empower yourself today. How about we review the steps you have for when the suicidal thoughts overwhelm you? Texter: Ok, that sounds like a good idea. Volunteer: Great. So you'll be on the lookout for when social media is draining you and take a break from FB and Instagram since they are distressing you. Volunteer: You also mentioned you're going to use dancing to build some more joy and distraction back into your life. Texter: Yep. I can definitely do that. Volunteer: We also talked about using your community from dance to bring you some relief as well as talking to your mom about the conflict with your friends. Texter: I think that will make me feel a lot better. It's crazy how much this helped. I think I really just needed to vent and get it all out to see how I really don't want to die, I just want to feel better but I feel so much better having just talked. Volunteer: You did the brave work of showing up throughout our convo today. Talking about your experience took a lot of courage. Texter: Thanks so much. I guess I'm stronger than I realized. Volunteer: It can be hard to see how strong we are until we go through tough things. The power you have to make it through is clear. Take care.

How to: Discover Resources

We are many texters' first resource in their moment of crisis. Reaching out to a crisis line for crisis support is a great first step, and we always want to honor that. However, it's not always the last step the texter needs to take to manage their crisis. While we listen and provide support during a hot moment of crisis, we don't provide all types of support texters are looking for. Some texters want to find longer-term support, like someone to talk to in person or a community of people who can empathize with their experience. Some texters are ready to try new coping skills and aren't sure where to start. We can help them brainstorm what additional resources might be helpful as they explore their next steps. Discovering additional resources is similar to discovering coping skills and social support. It begins with active listening and open-ended questions. This category of next steps is last because we want to give texters as much support as we can before discussing what other resources might be available. The purpose of providing additional resources is to help texters after the conversation ends, however, not to replace the support we are providing them at the moment. To discover additional resources available to texters, we ask them if they're open to talking about other resources and sources of support. This is most effective when we connect our question to something they shared. Example Texter: I don't know what else to do. I've tried so many things to stop purging. I guess that's what I need help with. Volunteer: It's difficult when nothing seems to be working. Are you open to talking about additional resources that might help with your bulimia? Takeaway: We keep our questions broad and let the texter lead because we still don't know what the texter has access to. Example Texter: I feel bad because I don't even know how I feel about being trans and what happens next and my gf isn't there for me. Volunteer: Talking through how you feel about transitioning takes courage, even if your partner can't be a source of support. What else do you see as your options? Takeaway: We avoid recommending a resource or suggesting someone they could talk to instead. Leaving the question open empowers the texter to come

Part 1: The Foundation

We believe supporting others starts with a strong foundation. Our foundation for bringing texters to a cool calm includes: Our Five Stage Philosophy Good Contact Techniques Understanding Risk The Platform In this first part of training, we'll introduce you to each piece of the foundation. In part two, you'll see how each piece of the foundation works together in a conversation. Let's start with our Five Stage Philosophy.

Self-Reflection Activity: Crisis Text Line and You

We highlight social identities and biases to give you one central takeaway when interacting with texters: We cannot compensate for our lack of personal experiences, but we can listen to people when they share their personal experiences. Our most powerful tool to honor people of different social identities is active listening.

How to: Discover Current Coping Skills

We start by asking texters how they've been coping with their crisis up until this point. Coping Skills are activities, hobbies, distractions, and self-care texters can do on their own to find relief. Using coping skills is a productive next step because texters can immediately tap into them, and they are available to everyone. When texters are in crisis, it's common for them to disregard their regular coping skills as not being enough. In other cases, sometimes texters may feel too overwhelmed to even think about their own coping skills. The most important part of discovering coping skills is allowing the texter to lead. We don't want to suggest what we think are the right coping skills for them. They know their situation best. So, we always start this stage with open-ended questions instead of questions directed at specific coping skills. Example Texter: Yeah, i guess improve my balance with all my work. Volunteer: It makes sense you're feeling overwhelmed. I'm wondering what you have tried to help you manage your stress from work? Takeaway: This open-ended question leaves room for the texter to share several different activities that help them cope. In contrast, a question like "I'm wondering, have you thought about trying meditation?" is close-ended and suggests that meditation is something they should consider. Example Texter: I need to tell him that he can't come back to the house anymore. Volunteer: I can tell having him there is really increasing your anxiety. How have you dealt with talking with him in the past? Takeaway: Asking how they've been dealing with their crisis reminds them they have some control over their situation. Digging into their coping skills helps us better understand what they consider as their options, so we can better support them. Keep your questions open-ended to discover what coping skills would best help the texter. There is no perfect way to ask about coping skills, but asking these questions in this manner usually encourages texters to open up. Texters Whose Goal is to Simply Be Heard Many texters who reach out to be heard or vent aren't really expecting to leave the conversation with next steps. That's okay. We don't want or need to force next steps on them. Hopefully,

Understanding risk

We support texters with all types of crises. Some issues that texters reach out about are riskier than others. When we talk about risk, we are referring to the likelihood of a texter being in immediate danger. In crisis intervention, risk is on a spectrum from low to high. Texters who are more likely to be in danger are considered "high risk," while texters who are less likely to be in danger are considered "low risk." So what exactly is "danger" for a texter? For us, a texter might be in danger when they are: Intending to die by suicide Experiencing abuse Engaging in self-harm Remember how we talked about your well-being? Especially with these intense topics, it's a great time to check in with yourself and practice self-care, if needed. Make sure you're in a comfortable environment, take breaks if you need them, and do what works for you. In this section, we'll review each of these "high risk" scenarios. Later on, you'll learn how our Five Stage Philosophy supports all conversations, including high-risk ones. For now, keep in mind, you'll always have your Supervisor with you on the Platform.

Individual level

We understand identities on the individual level through how we might think or feel about ourselves. This includes how we choose to express ourselves and how we categorize ourselves. Reflecting on our individual experiences with identity allows us to identify what perspectives and beliefs we hold about ourselves. This self-reflection makes it easier for us to empathize with others, including our texters, about how they may perceive themselves. In this section, we will explore our individual identities by learning about and reflecting on: Personal identities Social identities Socialization

Good Contact Techniques

We use Good Contact Techniques throughout the entirety of our conversations. Good contact techniques help us build a strong connection with the texter. A good connection is the most important part of moving a texter from a hot moment to a cooler calm. In this video, you'll learn what role Good Contact Techniques play in the overall conversation and how they communicate our support to texters. What are Good Contact Techniques? Our six Good Contact Techniques are reflections, strong feeling words, tentafiers, validations, strength IDs, and open-ended questions. These are methods of communicating we've developed from research and our data. Good Contact Techniques are conversational tools that help us frame our thoughts and support. Each Good Contact Technique is a way to show texters we're empathetic and we care about them and their experiences. 1. The first technique is using reflections. You've likely used this technique when trying to check your own grasp of a situation. When you reflect, you rephrase what you've heard to show you're actively listening and to check if you correctly understand what's been shared. For example, if a texter is dealing with a chronic illness, a reflection could be "It sounds like you're constantly monitoring your health and trying to make adjustments." We don't repeat word-for-word what they shared with us. Instead, we paraphrase their thoughts to show we understand. 2. The second technique is using strong feeling words. Strong feeling words describe and express a texter's emotions during their crisis. Since texters in crisis are usually feeling strong emotions, we want to use words that best represent the intensity of their experience. For example, devastated is a stronger form of upset. 3. The third technique is using tentafiers. Tentafiers come before strong feeling words or actions to make them tentative. In other words, it's our way of interpreting how a texter is feeling and leaving room for them to correct us. For instance, in the examples, "It seems as if you're feeling upset," and "I wonder if you're feeling frustrated?" we're trying to gauge how the texter is feeling based on an experience they shared. 4. The fourth technique is using validations. To validate is to recognize, normalize, and accept a texter's thoughts, feelings, and experiences. People often feel alone in their situation and think no one else cares or could possibly understand what they're going through. A good validation could be, "It makes sense to feel frustrated when you keep trying to feel better but nothing seems to be working." Validations can help texters feel heard and encourage them to open up further. 5. The fifth technique is using Strength Identifications, also known as Strength IDs. Strength IDs are words that describe a texter's inherent positive qualities based on information they shared. For example, "brave" is the Strength ID in the message, "It was brave to reach out today." How do we know they're brave? Because it takes courage to get support. All texters have positive characteristics. Identifying their strengths based on what they share with us shows them they have the resilience to fight through their struggles and find relief. 6. The sixth and final technique is using open-ended questions. Open-ended questions allow texters to expand on their thoughts and emotions because they can't be answered with a simple yes or no. For example, "How long have you been dealing with this?" gives the texter space to share more. Using open-ended questions helps you explore the situation and helps the texter share relevant information you may not know to ask directly about. We use open-ended questions to dig a little deeper. Together, reflections, strong feeling words, tentafiers, validations, strength IDs, and open-ended questions make up your Good Contact Techniques. Why are Good Contact Techniques important? It can be difficult to think of what to say to someone in crisis, let alone someone we don't know, can't see, and can't hear. We can't offer any physical, visual, or audio affirmation that we're listening and we're here for them, so our messages need to be as warm and empathetic as possible. Good contact techniques give us a starting point to create warm messages to support and empower our texters. Good Contact Techniques amplify our ability to build trust and actively listen to texters when we don't have face-to-face contact with them. We use Good Contact Techniques throughout the conversation to let the texter know we believe what they're telling us and their experiences are worth sharing. Most importantly, they help texters feel comfortable sharing what's really going on. Because they reflect and validate what the texter is experiencing, our use of these techniques in itself normalizes their feelings and strengthens our connection. While using Good Contact Techniques in every message may feel unnatural or forced at first, as you gain more practice on the Platform, you'll notice more how they help texters open up fully about what they're experiencing. This is the most effective way to support texters and convey our empathy.

Texters who can't stop self harming

What if a texter doesn't stop self-harming during the conversation? We recognize that self-harm is a coping skill for many texters. Therefore, our goal is to work with them and check-in on their safety without being pushy. If a texter is self-harming to cope and is unable to stop during the conversation, we check-in later in the convo and ask if they're currently self-harming. Example Volunteer: Despite the drama with your family, you've started making art again. That's so inspiring. I want to check-in on how you're doing, are you cutting right now? Texter: Yeah, a little bit...talking about all of this is helping, though. In addition to checking in later in the convo, we can ask the texter to let us know if they've self-harmed more than they intended. Even though it's rare, some people who engage in self-harm will hurt themselves more severely than they planned. We want them to feel safe telling that to us in case they end up needing medical attention. For instance, a texter might share that they're bleeding more than intended, or they're feeling faint. If a texter indicates they have self-harmed severely, let your Supervisor know so they can help with the next steps. Recovery from self-harm is not a linear process. This may be the texter's first time reaching out for help regarding their self-harm. It's also possible your texter has not self-harmed for quite some time. Our job is to meet the texter at their level of readiness, even if that means they are not ready to stop self-harming at the moment, or they don't want to talk about self-harm at all. The texter's safety is always our first priority. Keep in mind we do not provide medical advice. Especially in a medical emergency, people often want to try and assess the medical situation. This is not the service we offer, even if you're medically trained. If a texter needs medical attention, flag your Supervisor, who assesses the situation and will get the texter help if needed. Self-Harm Texters Who Intend to End their Life If a texter tells us they are self-harming with an intent to die, then we'd support them like a texter who reaches out about suicide. You'll learn how best to support suicidal texters in the next section.

How to build rapport

When we talk in person, we usually begin the conversation by introducing ourselves and learning more about the other person. Sometimes we might actually share about ourselves, hoping that the person will also want to share. On the Platform, we get the conversation going by introducing ourselves and learning about what led the texter to reach out. We do this using our Good Contact Techniques. Unlike the conversations we have with friends, we don't spend time talking about ourselves. It's important that we focus on what the texter is going through.

Flagging Active Rescues

While rare, Active Rescues may also be performed for texters at risk of Homicide, Medical Emergency, and Crimes in Progress. These are very rare (of all conversations, only 0.01% mention homicidal desires; that's less than 1 in 10,000). If you see a conversation mentioning these, refer to the relevant tipsheets on the Platform, and flag your Supervisor. Homicide: If a texter mentions they are thinking of homicide, we ask that you explore if they have ideation, plan, access to means, and target and then flag for your Supervisor. Federal Crimes-in-progress: These are uncommon situations, but if you see one of the following situations flag your Supervisor: Kidnapping (noncustodial) Trafficking Child exploitation Terrorism Medical Emergencies: If a texter reports a medical emergency that could result in their death and they are unable to call for help due to physical ability and/or because doing so will put their life in danger, flag your Supervisor. An example of a medical emergency is a texter who self-harmed more than they intended without the intent to die.

Policies and Procedures

While the Five Stages of a Conversation can be used to support all texters, we have specific procedures for handling conversations where privacy and safety are a primary concern. Our goal in this section is to introduce you to these types of conversations, so you recognize them when you see them. At the end of this section, you'll be able to: Identify what type of conversations to flag Explain why and how to flag conversations Describe our confidentiality policy Define a third party conversation Identify a managed texter Flagging Conversations We want to make getting in touch with your Supervisor fast and easy, especially in conversations where privacy and safety are a primary concern. To make it simple, we've created a flagging system. Earlier in training, you learned about flagging conversations where texters are at risk of suicide. Now, we'll review other times you need to flag your Supervisor.

After a Ladder Up Risk Assessment

While we follow the same Five Stages with all texters, we recognize that supporting texters who are suicidal can feel more stressful. In imminent risk conversations, we work with texters so they can explore safety from suicide. Getting used to risk assessing can take time. If you're ever unsure about how a Ladder Up Risk Assessment is going, you can reach out to your Supervisor. Below is what we expect after you've completed a Ladder Up Risk Assessment. When a Texter is Imminent Risk, Flag the Conversation Once you've performed the Ladder Up Risk Assessment and confirmed that the texter has thoughts, a plan, means, and a timeframe within 48 hours, flagging your Supervisor notifies them of the high risk of the conversation. Your Supervisor is monitoring multiple conversations at once, providing oversight and insight to each conversation assigned to them. A few notes about Supervisors and flagged conversations: Supervisors prioritize imminent risk conversations. When you flag a conversation, your Supervisor will see a notification. They will navigate to it to offer you real-time support as you continue to work with the texter. Your Supervisor will confirm that you completed the Ladder Up Risk Assessment correctly. They may provide you with direct feedback to Explore more, or ask you to get clarity about the texters intentions. Throughout this process, continue to engage with the texter using Good Contact Techniques. Ultimately, the goal is to work with the texter to Discover Next Steps for safety. You'll learn more about how you can support texters in coming up with a plan to stay safe in the Discover Next Steps section. Separation from Means After the Ladder Up Risk Assessment is complete, ask the texter to put the means away or to remove themselves from the means during the conversation so they are safe in the moment. Explore More Explore what brought these feelings on today. Support the texter with non-judgmental compassion and remind them how brave they are to be sharing these feelings with you. Take time to connect with the texter and show you are there to support them. Validation It can be beneficial to validate the texter's perspective, including their views about their situation, their feelings, and

How to: Discover Next Steps - Suicide

While we follow the same process for discovering next steps with all texters, we recognize that supporting texters who are high risk can be especially stressful. For that reason, we're dedicating this section to walking you through this stage of the convo with texters dealing with suicidal thoughts, abuse, and self-harm. It can be especially tempting to rush through discovering next steps with suicidal texters because we want to help take their pain away. However, many texters are in crisis because they don't feel connected. Loneliness and isolation are symptoms of suicidal thoughts, anxiety, and depression. The most powerful thing we can do for someone in crisis is to offer connection first. Coping Skills Texter: When I'm feeling this way, I usually play my video game. Volunteer: Video games can be a great distraction for when you're feeling especially numb. Have you tried playing the game today? Texter: Yeah, but the urges to just hang myself is too strong. It honestly just made me feel worse. Social Support Volunteer: That makes sense. You've been dealing with a lot and you deserve support. Texter: Yeah. Volunteer: I'm here for you, but I want you to have ongoing support too. Have you shared these thoughts with anyone else? Texter: I've kinda hinted at them, but I'm not really ready to talk to my family about it. i love them too much though. Volunteer: I hear you. It's hard when you don't know how they'll react. It sounds like you care about them though and they care about you. Texter: Yeah, that's true...I'm just afraid I guess. maybe I can text my sister. Volunteer: That's such a good next step. Reaching out to someone who cares can ease some of the pain. You deserve to feel safe. Texter: Yeah, I might not mention the suicide to her, but I can at least talk to her and she'll help me feel a little more like me. Resources Volunteer: You're strong for talking with her even though you're nervous. I'm wondering, in addition to talking with your sister, what else do you think you can do to get some relief? Texter: I'm not sure...i feel like I don't have many more coping skills honestly. Just the game. Volunteer: It's okay to be unsure. I have a resource that might give you some ideas on how to deal with these

In-Groups and Out-Groups

While we have some agency in shaping who we are, we are inevitably influenced by our communities. Our beliefs, stereotypes, and assumptions about different groups affect how we interact with others, including people in crisis. It's important we understand that our communities shape us. That way, we can better understand how we perceive and judge ourselves and others. In 1979, social psychologist Henri Tajfel coined "social identity theory." This is the idea that people understand who they are based on their group memberships. He called people who are similar to you "in-groups" and people who are different from you "out-groups." We face influences from both in- and out-groups. For example, we might mold our behavior after people in our in-groups and avoid behavior we associate with out-groups. Being part of someone else's out-group might feeling othering or lonely, while being among people from your in-group might make you feel like you belong. The character and behavior associations we have with people of different groups and social identities are stereotypes. Even if a stereotype does not seem hostile, all stereotypes are harmful. For example, the stereotype that all women are nurturing may seem positive, but it can be confining. Women who don't want to take care of children are oftentimes forced or expected to do so. At the same time, women who want to take care of children have their hard work and skills undervalued and dismissed. All stereotypes are based on assumptions, and in our work, they can prevent us from listening to what someone is telling us. People hold multiple social identities, and those identities place us in different in- and out-groups. Most often, we are aware of discrimination between different social identity groups. However, there is also discrimination within groups. This is because groups are diverse within themselves and people have multiple intersectional identities. [In the following example of intersectionality, we will mention terms you may not be familiar with. They will be defined in more detail later in training in the "Our Texters" section.] For example, a nonbinary (someone who does not identify exclusively as a man or woman) Hmong person who uses a wheelchair has many marginalized identities. If they are looking for a community where they feel like they belong, they have many different factors to consider. There are transphobic people within the LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, plus) community. This means not all LGBTQIA+ spaces are safe for trans people. There are xenophobic and racist people within trans and disability communities. There are transphobic people within Asian communities. Any of these groups may also be inaccessible to them because of their disability. From the outside, someone might assume that this person wants to be a part of any Asian American, disability, or trans community they can find. But in reality, their experience trying to be a part of these communities is much more complicated. People, regardless of identity, are individuals with different needs, preferences, and experiences. Connection and belonging are essential factors in wellbeing. However, we need to avoid assuming what groups someone belongs to. Our assumptions and stereotypes are harmful because they stop us from trusting people as the experts of their own situations. This example focused on one person's experience. When a whole group of people is repeatedly discriminated against based on interpersonal assumptions and stereotypes, they are facing discrimination on institutional and societal levels.

How to: Discover Social Distraction

While we want texters to have strong support systems, it's not always the case that they do. Even so, they can still benefit from some of the positive aspects of social support by simply being around other people. We consider this Social Distraction. Social distraction is different because it doesn't require texters to talk with anyone in particular about their crisis or feelings. It's simply the act of being around others. Connecting with people or visiting easy-going social settings (coffee shops, places of worship, busy parks, exercise classes, stores, etc.) can provide relief from negative emotions. More than anything, social distraction reminds texters they are not alone and can give a sense of belonging. Example Texter: I just can't be alone anymore and no one will text back. Volunteer: Dealing with feelings of isolation takes courage. Some people find being near others useful even if they don't know them. How do you think that'd make you feel? Takeaway: Social distraction is not beneficial for all texters, and it's not our place to suggest it. Our goal is to help texters feel less alone, though. Being around other people is an option for texters who aren't ready to talk with someone in their life about their crisis. Texters who are High or Imminent Risk Social distraction can benefit high or imminent risk texters because it's a way to help them stay safe even when they aren't ready to talk with people in their lives about their pain. Example Volunteer: You mentioned people you know through dance. Are they people who could provide some relief and distraction from the suicidal thoughts? Texter: Yeah, they definitely could. I don't want to talk to them about it but they can definitely make me laugh and not think about all this as much. Volunteer: It's great that you have a community of people you can be around when you're feeling this way. It sounds like they care about you and share your passion.

Open-ended Questions

Why Open-Ended Questions Work As we create a safe and open space, texters tell their stories. Open-ended questions show texters you're interested in understanding what they're going through. We avoid close-ended questions unless we need just a 'yes' or 'no' response since they limit how much a texter could share. How to Use Open-Ended Questions The most effective open-ended questions start with 'how,' 'when,' 'what,' and 'who.' Use open-ended questions together with other Good Contact Techniques. Since "why" questions can sound judgmental and accusatory over text, we avoid them. For example, "Why are you failing classes?" can sound accusatory, and "Why did you cheat on your husband?" can sound like criticizing. When to Use Open-Ended Questions Open-ended questions can be used throughout the conversation. They are most useful when you need to understand a texter's feelings and thoughts better. Have a look at the three different responses to the same text below: the first example uses an open-ended question, leaving room for the texter to open up more. However, the other two can come off as judgmental (why questions) or leading (close-ended questions). See the difference below and stick to open-ended questions whenever possible. Example Texter: My stepsister is the bane of my existence. I just can't take it anymore. Volunteer: It sounds like your stepsister is really upsetting you. What has she done that makes you feel frustrated? Takeaway: Asking for more information allows the texter to expand upon their feelings, and the empathetic statement gives more depth to the message. ------ Example Texter: My stepsister is the bane of my existence. I just can't take it anymore. Volunteer: It sounds like your stepsister is really upsetting you. Why does your stepsister make you so upset? Wish: "Why" questions can sound accusatory to the texter as if their crisis is their fault. Asking a different way lets them explain without feeling guilty for what's happening in the moment. Example Texter: My stepsister is the bane of my existence. I just can't take it anymore. Volunteer: It sounds like your stepsister is really upsetting you. Did she do something to you? Wish: Closed-ended questions, like this one, typically result in a single-word answer such as yes or no, and don't leave room for the texter to expand about their situation. ------- Asking Multiple Questions in a Row We avoid asking too many questions in a row. If we ask texters a lot of questions, it might make them feel like they're being interviewed or interrogated. We recommend not asking more than two questions in a row unless you're getting specific information from a texter. You'll learn more about times where this might be necessary later on! For now, avoid the trap of asking a question in every single message, or even worse, multiple questions in one message. Open-Ended Questions Below is a list of questions to help you dig a little deeper with texters. It's not always possible to use an open-ended question, we we also included a few close-ended and clarifying questions that can also help texter's open up. QuestionsOpen-Ended QuestionsClose-Ended and Clarifying QuestionsWhat have you tried to deal with...?How did doing XYZ make you feel?When do you feel that way?How have you made decisions like this in the past?If you had a friend going through something similar, what would you tell them?What do you usually do when...?How long have you been feeling X?Who do you usually talk to when you're feeling this way?How has X been affecting you?Have you thought about....?What does that mean to you?How are you feeling?Who do you usually go to for advice?How long have you been dealing with X?When do you usually feel at your best?What led you to reach out?How have you been managing to deal with X so far?What would you try if you knew it would work out?What have you thought about trying, but haven't?Could you tell me....?I'm wondering if....?Can you say more about....?Are you saying....?Do you have a specific example in mind?Can you expand on that idea....?Would it be accurate to say...?Would you be willing to...?

Reflections

Why Reflections Work Reflections show texters you're listening closely and doing your best to understand their specific crisis. Without reflection, it's hard for texters to know if they're communicating what they want you to know. How to use Reflections Reflection requires paraphrasing what the texter has shared. A common mistake when using this technique is repeating what the texter says word for word, also known as parroting. Especially when texting, parroting comes across as robotic and doesn't show that we understand what the texter is going through. Instead, take some time to read what the texter has shared then summarize their thoughts in your own words. This shows the texter that you really hear them. When to use Reflections Reflection is primarily used to double-check that you understand the texter correctly or to summarize large chunks of information. Example Texter: I'm so alone and the fight with my boyfriend is just really pissing me off and now I can't even talk to him about what I'm going through. Volunteer: So you already felt isolated, and today's fight just added fuel to the fire? In this example, the volunteer reflects how the texter is feeling (alone) and why they're feeling that way (the fight with their boyfriend). Example Texter: I cheated on my final exam. I don't think anyone will find out, but I...idk...it just sucks. I can't believe I did that. Volunteer: I get the sense you regret cheating. It's understandable to feel unsure about it even if no one else will ever know. In this example, the volunteer reflects how the texter is feeling (guilty) and why they're feeling that way (cheating on their exam). Takeaway: Take a moment to process what a texter shares, then reflect your understanding using your own words.

Strength IDs

Why Strength IDs Work Strength IDs point out the positives in a texter's actions. People in crisis often focus on negatives, so it's useful to remind them of the positive things they're doing. For instance, "It takes courage to reach out for support." Strength IDs like this can guide texters toward being more receptive to help while reflecting their inherent strengths back to them. This can also alleviate feelings of helplessness and hopelessness. How to Use Strength IDs Strength IDs should be used to connect a positive trait to an action the texter has taken. For instance, if a texter says, "It was stupid to text in," you wouldn't say, "You're not stupid, you're smart." Texters who think they are stupid will not believe you. You could instead say, "I see someone who reached out for help, and that shows how smart and insightful you really are." When to Use Strength IDs This technique is most effective when a texter shares details about their experience. This helps build trust or to empower the texter to work toward next steps. You can truly use a strength ID at any stage of the conversation. Even so, it's not effective to praise a texter with a Strength ID that you can't tie to a visible action. For example, saying "you are a good friend" wouldn't be appropriate if the texter hasn't mentioned anything that makes them seem supportive to their friends. We don't want these words to feel empty. Always tie the strength ID back to something the texter has shared or done. Example Texter: I'm terrified right now. My uncle was diagnosed with cancer and it's not looking good. I heard they don't have enough money for the hospital bills and I wish I could help but I'm in school. I suck. Volunteer: I'm honestly impressed with your strength. You care greatly about your uncle and are carrying the weight of his pain. You seem like a thoughtful person. This strength ID relates directly to the texter's issue, and it points out good qualities that are backed up by the texter's own experiences and feelings. Example Texter: yeah, i can probably sign up for the personal finance class and get this debt under control Volunteer: That's a great next step. Your ability to come up with some really solid ideas shows how creative you are. Takeaway: When telling a texter something positive about themselves, avoid being vague or generic. Praise without context can seem empty. Strength IDs Below is a list of strength IDs paired with an action that's observable from a conversation. Remember, the key to a good strength ID is to combine it with a real action the texter shared or has done. Strength IDsMessage Strength ID It takes real courage to text in when you're feeling XYZ. Courage It takes real strength to make your wellbeing a priority. Strength I can tell that you have great insight because you're able to identify that this is a problem and you're willing to work on it. Insight It's inspiring how much work you're putting into getting help for yourself. Inspiring, hard-working It shows true compassion to reach out, out of concern for your friend. Compassion You're resilient for dealing with XYZ for so long.ResilientI can tell you're self-aware by how well you know yourself and what you're going through.Self-awareI can tell how committed you are to getting the support you deserve.CommittedI appreciate your bravery; I know it's not easy to share these things.BraveryYou're smart for identifying what could help you feel better.Smart The fact that you care so much about says a lot about your character. Caring, CharacterI can tell that you're putting a lot of effort into XYZ.Effort

Strong Feeling Words

Why Strong Feeling Words Work Using the appropriate vocabulary for describing a texter's crisis helps us capture the uniqueness of the crisis and helps both you and the texter better understand what they're going through. How to Use Strong Feeling Words Strong Feeling Words should be used to help label emotions associated with the crisis a texter is sharing. You can use them in combination with any of the other Good Contact Techniques. Although many strong feeling words don't seem natural, a part of your training here will help you expand your feeling vocabulary. The more feeling words we know, the more specific we can be in understanding a texter's feelings and thoughts. When to Use Strong Feelings Words This technique is best used after texters share the facts of their situation without sharing much about how it's impacting them. It's also helpful to use Strong Feelings Words when texters are minimizing their own emotions as a way to show them that the conversation is a safe space to express how they're truly feeling. See the difference a single word can make below. Example Texter: I got fired from my job at a restaurant today. It was total crap - I didn't do what they said I did but no one would believe me. I feel like I could punch somebody. Volunteer: It seems like you're furious about being treated unfairly and not trusted by your boss. Saying the texter is "furious" instead of "mad" lets the texter know they're truly heard and helps create a safe space as the conversation continues. Example Texter: I just really want them to pay for what they did to me. It's not fair that they're able to still do all the senior events and I'm suspended. Volunteer: I'm getting the impression you're feeling powerless because you were treated differently than everyone else. Takeaway: Match the feeling word with the intensity of the texter's strong emotions. Using a weak feeling word can minimize the texter's experience. Strong Feeling Words Below are examples of strong feeling words we've found effective. Don't worry, you won't be expected to have memorized all of these words. Use your judgment in deciding which words to use, based on the texter's language. Strong Feeling Words: Abandoned Afraid Agitated Angry Anxious Ashamed Confused Defeated Depressed Disappointed Discouraged Distant Distressed Embarrassed Empty Fragile Frightened Frustrated Furious Guarded Guilty Helpless Hesitant Hopeless Horrified Humiliated Hurt Inferior Insecure Intimidated Irritated Isolated Lonely Mortified Overwhelmed Panicked Powerless Rejected Scared Shocked Terrified Tired Worried Uncomfortable Upset Violated Vulnerable

Tentafiers

Why Tentafiers Work Tentafiers help us to avoid making assumptions. You can also use them to encourage the texter to share more about a particular feeling without asking a question. For instance, in the sentence "It sounds like you are feeling worried about how your parents will react," "it sounds like" is the tentafier. How to Use Tentafiers Tentafiers should be used with strong feeling words or thoughts to get clarity on how the texter is feeling. By making our statements tentative, we leave the texters in control. We're not telling them how they're feeling, but instead, we're leaving them in charge to confirm or deny and expand in their following message. When to Use Tentafiers This technique is best used for more complex and subtle subjects, and also when you're unsure of what the texter is saying or feeling. Avoid using this technique in cases where the meaning of the texter is clear. Example Texter: My bff attempted suicide 3 months ago and things have been really touchy ever since. I don't know what to say to her and am afraid I'll make things worse, so I haven't really visited. Volunteer: I get the feeling that you're worried that she's too fragile to talk after what happened. Takeaway: The tentafier "I get the feeling that" gives the texter space to correct us if they aren't actually worried while helping us to understand how their situation is impacting them emotionally. Example Texter: I can't show my face anymore. My so called "friend" told everyone I might have herpes after I hooked up with someone. Volunteer: If I understand you correctly, you're feeling humiliated because your friend told other people that you might have herpes. Takeaway: Tentafiers help us clarify how texters are feeling while leaving them in control. Without tentafiers, we can come across as an authority figure that isn't really listening. Tentafiers Below is a list of tentafiers that can help you express what you think a texter is feeling, thinking, or doing while still giving them room to correct you. Tentafiers: It seems like...I wonder if...It sounds like...I'm hearing that...I'm curious if...So, you're feeling...I hear you're feeling...You seem to be feeling...My hunch is you're feeling...I wonder if you're feeling...I get the feeling that you...I hear you saying that...If I understand you right, you...Let me see if I'm with you so far; you...I'm getting the impression...Would it be accurate to say that you...I'm sensing that you...I get the impression that...I'm thinking that you...

Validations

Why Validation Works Validations are a way to accept a texter's emotions and crisis without judgment. They give the texter space and permission to feel the way that they feel. Validations let you thoughtfully show the texter that you hear and support them. When to Use Validations This technique is best used when a texter has just described a difficult emotion or challenging experience. It lets the texter know that their feelings or experiences are normal, and there's nothing wrong with them for feeling that way. For example, if a texter shared that they just lost their job and are feeling devastated, we'd validate that it's normal to feel distraught after a loss. Validations, like strong feeling words, are also helpful when texters try to minimize their feelings. For instance, if a texter says, "It's stupid for me to feel upset about losing a job," we can validate that it makes sense to feel upset in that situation. How to Use Validations Validations are often used to preface the difficult emotions, thoughts, or experiences of a texter you're hoping to recognize and normalize. Common validating phrases are: "It makes sense to feel...," "It's normal to be...," "It's reasonable to feel...," and "It's understandable that..." Example Texter: It's stupid for me to feel this way, they ignore what I want all the time Volunteer: It's normal to be frustrated with your parents when they don't listen to you. Using a validation acknowledges that it's understandable for the texter to feel the way they do without agreeing that the texter is stupid. Examples Volunteer: It's normal to be frustrated when you don't feel heard by your parents. Volunteer: From what you're saying, it's understandable you don't feel comfortable opening up to your parents. Volunteer: From what you've been saying about the fight, it makes sense thatyou're feeling overwhelmed and upset. Takeaway: For validations to be effective, they should be specific. Connect the validating phrase to the texters thoughts, feelings, and experiences, so that it feels more meaningful to their situation. Be sure to avoid normalizing negative sentiments or behavior. Validations Below is a list of phrases to help validate how texters are feeling about their crises. ValidationsIt's normal to...It's understandable to feel...It makes sense to...It's natural to...It's reasonable to...That's a difficult situationIt makes sense why you're feeling...It's understandable that you're...It's normal to feel...You're going through a lot...It can be overwhelming to...That's a lot for one person to handle...Going through __ can be intense...It can be awful to...There's no wonder that...It can often be confusing when...

Intersectionality

You have reflected upon multiple identities in this module so far. Some of your identities are more likely to be oppressed than others. For example, a cisgender (someone whose gender identity matches their sex assigned at birth) autistic Black woman has multiple identities that are treated differently. Their Black, female, and autistic identities might mean that people make harmful assumptions and stereotypes about them. Their cisgender identity may come with neutral or positive associations. People are not solely one identity or the other, and all of these identities shape this person's experience in different environments. People have many social identities that overlap to make up who they are and how they experience the world. "Intersectionality" was coined in 1989 by Kimberlé Crenshaw, a legal and critical race theory scholar and writer. This term explains how social identities "intersect" to create and influence people's experiences. https://www.youtube.com/watch?v=X5H80Nhmn20&ab_channel=NMAAHC Intersectionality applies to everyone's experiences in the world, including you. You named some of your intersectional identities in the social identity wheel activity earlier in this module.

When are you finished Discovering Next Steps?

You might have noticed that a texter's next steps aren't unique to their crisis. Instead, their next steps are unique to them! Whether a texter is an imminent risk, low risk, or someplace in between, you're there to collaborate with them on what might work best for them. Ideally, every texter has a next step (big or small) after you've been a sounding board for them during this stage. However, that's not always the case. If a texter is low risk and is unable to come up with anything to do after the convo is over, we trust that getting their emotions out brought some type of relief, and we move to the next stage. For texters who are an imminent risk, we check in with our Supervisors first before moving on to the final stage: Ending the Conversation.

Conclusion and Additional resources

Your social identities and experiences shape who you are. We are not asking you to put yourself aside as you learn from this training. We are asking you to acknowledge how your perspectives may influence your work here. We need our volunteers to have a heightened sensitivity to the individual needs our texters have. That starts with being sensitive to your own identities and needs. Additional Optional Resources: Social Identities Overview (Links to an external site.) from Northwestern University Personal Identity Wheel Activity (Links to an external site.) from University of Michigan Social Identity Wheel Activity (Links to an external site.) from University of Michigan Diversity, Equity, and Inclusion 101 (Links to an external site.) from University of Colorado Denver "The problem with that new equity vs. equality cartoon you're sharing" (Links to an external site.) by Richard Leong (Diversity, Equity, and Inclusion Consultant & Leadership Coach) Black and LGBTQ: Approaching Intersectional Conversations (Links to an external site.) by the Trevor Project Intersectionality 101: A Reading List (Links to an external site.) by Black Feminisms

How we give feedback

g

Your wellbeing

g

Introduction modules

you'll reflect on who you are and what brought you to this volunteer opportunity. These modules focus on social identities, intersectionality, and equity. introduction is first because who you are and what brought you here will impact how you do this work


Set pelajaran terkait

Physics Unit E (only the ones i struggle with)

View Set

Chapter 11- Discrimination- Sociology

View Set

Chapter 1: An Introduction to Geology

View Set

ITN-262 Midterm (Chapters 4, 6) Review

View Set