Strategies for suicide intervention by telephone.

Abstract

Within the authoritative role, the telephone counselor engages the caller in realistic talk of dying in an effort to reinstate control. Anxiety reduction is accomplished through problem clarification. Narrowing down open negative statements reduces diffuse anxiety, while reinterpreting events reduces energized anxiety. To provide hope, care can be proven as genuine implicitly by using the caller's name, filling conversation with emotive gestures, and extending "why" questions. Explicit proof can be in the form of active listening, tolerance of dispositions, and involvement such as suggesting milk, tissues, or calling on significant others. To further provide hope and to reinstate control, allowance is given for manipulation such as the caller setting the initial mood of conversation. A model is presented for pursuing alternatives and a technique of interrogative restating to broaden resources. Time-outs are posited for stymied intervention, detective work for discovering critical information, and guilt inducement as a means of recourse. To close the call, promises are extracted from and reinforcement statements are administered to the caller.