If we each stop and think about it, most of the people we come in contact with on a daily basis are usually from our school or work where we spend most of our time. Many of us can even name several people that we often interact with who are or appear to be dealing with difficult issues. If you are in a service profession, including but not limited to being a medical practitioner, physical therapist, teacher, banker, real estate broker, job recruiter, immigration officer, police officer, freshman student orientation leader, support aide, or volunteer, then your expanding work and social connections puts you at a higher likelihood of encountering an even greater number of people who are psychologically struggling and in need of help, support, and resources.
Some of the risk factors that you might hear in your interactions may include:
Feeling overwhelmed by responsibilities:
“I have no time”
“I work a lot”
“I am preoccupied with thinking about everything I have to do”
“If I don’t take care of these things no one else will”
“Everyone depends on me”
“I don’t have any family here/ I don’t feel close to any relatives here”
“I don’t have any real friends”
“I call my mother/sister/best friend/significant other multiple times a day”
“I’m not comfortable/ I don’t feel safe outside my home”
“I don’t trust anyone anymore/ I want to be left alone”
Feelings of Low Self-Esteem:
“I feel so stupid”
“I deserved it”
“I can’t do anything right/ I’m not good enough”
“I feel like nothing will help me”
“I’m afraid to try because I will just screw it up/ it won’t work”
“I barely eat anything”
“I eat when I am not hungry”
“I wake up at night and can’t go back to sleep”
“I sleep too much”
“I love a clean home, and my place is such a mess”
“I am always tired”
“I can’t make any decisions on my own”
“I forgot to take my medication again/ I’m taking more medicine than I’m supposed to be”
“I’m drinking /using substances more than I used to”
These symptoms and statements are often connected to some variations of anxiety and depression, or problems with self-regulation of physical functioning or mood. Some people may even tell you more about the issues that are affecting them, and these issues often connect to the emotional, spiritual, intellectual, physical/medical, environmental, financial, occupational, and social dimensions of health and wellness. On the one hand it may feel good to know that people like you and trust you with their most sensitive information, on the other hand it can be very overwhelming if you are unsure what to do next and how to respond.
So, how can you help?
Take a breath, calm down, and ground yourself first.
Your presence, attentiveness, and way of being has already relaxed people enough to talk with you and trust you, even for just these few moments. This is the most important part of the interaction: the connection itself. To be most effective, and to avoid getting caught up in the other person’s emotional state, it’s necessary for you to maintain your own serenity and stability.
At this point I recommend implementing a grounding exercise for both of you: Look around and identify by name 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, and 1 thing you taste. I find that this exercise slows and calms anxiety experiences, and helps to lift depression by refocusing from the isolating tunnel vision of internal experience back into the expansive external environment. Once you have contained yourself and your own experience you can be more effective in interacting with the person you are trying to listen to, support, and refer. Chances are also good that this exercise can calm other people down enough for them to hear and retain what you have to say to them too.
Observe and Listen with a Solution-Focused Eye and Ear:
The Solution-Focused therapeutic approach was developed through the work of Steve de Shazer and Insoo Kim Berg and their colleagues. The key to using this approach for the situation you find yourself in is to concentrate on finding out what would be most useful to the person you are speaking with. What may be useful for you may not fit what they need, so it’s very crucial that you listen for what they need in the context of their life, not what would apply to yours. Orienting your listening skills this way will help you to connect and relate better with their immediate needs, and figure out which people, places, and resources are most useful for the distressed person and how to access them.
Put It All Together with the 5 C’s of Communication:
Remember that your efforts in these communications are not to be the other person’s therapist or advisor. Your efforts are to connect key information and refer the distressed person to a professional mental health therapist and resources for continuous care. Make your message:
Complete: Provide all the necessary and correct information. If you are talking about a program but aren’t sure of the address or contact number, look them up.
Clear: Enunciate what you say slowly and carefully as you speak to the person, and make sure they are listening and understanding you. Don’t mumble or trail off; if you want to say something, be intentional about it.
Concise: Remember that people in distress are already overwhelmed, and providing too much information may be lost from their awareness. Your message must also be
Cohesive: What you say needs to be in logical and structured statements, and not mixing different issues and subjects together. If your thoughts become as scattered, or more scattered, than the person you are trying to help then the other person’s will become confused and tune you out in order to prevent themselves from being even more dysregulated.
Courteous: Be respectful, upbeat and polite, and considerate of the other person as a human being with their own set of values and sensitivities. Express hopefulness for healthy resolutions.
An effective method of good communication would be to have the person repeat back to you (reciting) what you have said, as a form of review for them and confirmation for you that they understood you correctly. Writing information down, especially contact information for referral sites, is even more effective in relaying messages and most helpful for people in distress who may be already having difficulty concentrating or remembering things.
Where can you refer people for help, support, and resources?
If you are a health professional with a person’s insurance information already on file, you might want to ask if the person wants help in calling their insurance provider and locating a therapist that accepts their insurance. If you are not a health care provider and would not have this information, then encourage the person to call their insurance carrier for a referral with several local options. Technology has made online therapy from the comfort of people’s homes as accessible as in person sessions in a therapist’s office. Some therapists offer a sliding scale for people concerned about costs, and a free consultation. Others may qualify for services under the Employee Assistance Program offered by their employers and may not have to pay at all for a certain number of sessions.
If the person is a student you can refer them to their guidance or college counseling office to meet with a counselor, which are typically free services for enrolled students.
Keep a list of hotlines handy or look some up together. These are some listings for sites in New York City, and there are resources for your areas as well:
NYC Well: 1-888-NYC-WELL (1-888-692-9355) ***Interpreters are available for 200+ languages!
Samaritans 24-Hour Crisis Hotline (212) 673-3000
NY State Suicide Hotline Telephone Numbers, by county:
Safe Horizon Hotline Telephone Numbers:
Domestic violence hotline: 800-621–HOPE (4673)
Support for crime victims & family members of homicide victims: 866-689-HELP (4357).
Rape and sexual assault: 212-227-3000. (Or call NYC’s 311, In an emergency, call 911)
TDD machine for hearing impaired clients for all hotlines: 866-604-5350.
For more info and more numbers, see website: https://www.safehorizon.org/hotlines/
Coalition for the Homeless has a long, long list of hotline numbers (seriously, you might want to
bookmark this one or save it directly to your phone’s home screen!):
211CNY Helplines List (also very long, you might want to bookmark this one too):
There are also Walk-In and Drop-In centers, as well as Hospitals and Crisis clinics, but you might need more time to search for where all the currently active places are and call ahead to confirm before going or referring people to go there. Perhaps you can persuade the person you are speaking with to call someone, a friend, a family member, to meet them where you are and they can take them to a center or a clinic.
In cases of an emergency or an escalating crisis where someone is at risk of harming themselves or other people, or even you if there has been a drastic change in mood, you can also consider enlisting the help of trusted staff of the office or school or wherever you are, to call 911 for emergency medical services. A word of caution, never risk your own safety, and ask the person to sit down to relax their mind and body while waiting for help to arrive and minimize the risk of intentional or unintentional physical movements or reactions.
When the interaction ends, take another breath, calm down, and ground yourself again.
Everything that has a momentum eventually needs to slow down and relax before switching direction, even us. Your day and your own life will come back into focus, and that means letting go of the interaction and trusting that you have provided a path for someone in need if they choose to take it. Take a few minutes to treat yourself to something refreshing and clear your head, and be sure to be just as attentive and compassionate to yourself in taking care of your needs too.
- Corey, M. S. & Corey, G. (2007). Becoming a helper, 5th ed. Brooks/Cole: Belmont, CA
- De Jong, P. & Berg, I. K. (2013). Interviewing for Solutions. Brooks/Cole: Belmont, CA
- Tamparo, C. D. & Lindh, W. Q. (2007). Therapeutic communications for healthcare, 3rd ed. Delmar: Clifton Park, NY
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