Helplines Intervention Helplines Intervention OptionsOptions

Vanda Baptista, IDTVanda Baptista, IDTLisboa, 2007Lisboa, 2007

Helplines: easy; accessible; counselling; information.

Key aims:

Providing answers to a particular request or question with: clarity, objectivity, credibility and impartiality;

Providing support for a particular problem by clarifying and debating alternatives for its resolution and empowering the search for the right solutions;

Referral to the available institutional resources and motivation to search for the answer that may contribute to changes.

Functions:

They change implicit requests in specific and explicit ones;

They unravel false questions, giving place to the genuine search for help;

They redefine chaos and misperceptions, helping to define important questions to the problem clarification.

How can Help Lines become an option to provide support to those who call for an answer to cannabis questions or problems?

Let’s consider a teenager whose parents found out that he/she is smoking cannabis. All the reactions that will come from that fact will depend on the following:

What the parents know about cannabis and its side effects;

Parents perception about the cannabis users;

The perception of cannabis itself: “It’s perfectly harmless”, “Nowadays, all teenagers use it” or “This is the way to become a drug addict”;

From conflicts that have emerged from already vulnerable relationships - often fed by the constant challenges posed to both parents and teenagers at this stage of life.

Parents tend to overreact, sometimes, with unjustified anxiety. In reaction to this, the teenager can increase his/her consumption as a way to fight back against his/her parent’s emotions.

Teenager can react in an aggressive and compulsive way.

This escalation is typical in a situation where both parties see the situation as unfair and where they cannot find any suitable answers from each other. The usage of cannabis is often seen as the root of all evil and the lack of communication and understanding is overlooked.

At this stage, finding a quick way to get assistance and support is very important in order to prevent further escalation of the tension and/or drug use. This support needs to make both parties aware that the relationship difficulties and the lack of communication are the heart of the problem;

Pascal Hachet (2005) is adamant of the need to create listening spaces in order to prevent further escalation of the drug addiction, namely in those cases where there is evidence of cannabis use. These initiatives will act as preventative and as a complement to the treatment services.

At helplines, although the calls may be sporadic, it is possible to create a reassuring and clarifying relationship, in which:

Having the opportunity to question what they want and what they can do, the person is allowed to think about the situation;

Anguish and anxiety can be contained by analyzing and reflecting on the motivations, easing them into the start of the changing process;

Mobilizes all the person’s resources to solve the problem.

All this will only be possible with an active listening attitude, which implies:

Availability; Respect for the caller and for their timing; Empathic comprehension and neutralism.

The prompt delivery required and the short time available (specificity of the helplines) forces the counselor to a quick decision about the possible intervention options.

Facing this limitation, what are the counselor's options?

Will he be centered on substances and its consume, trying to realize the risk of the situation?

Will he be centered on personal and interpersonal conflicts?

Will he be centered on the client’s discomfort and/or suffering?

Will he be centered on the referral of the situation?

Interventions with cannabis users

Users call the helplines looking for information about cannabis and its side effects, to obtain information on legal aspects relating to cannabis, etc. The counsellor shall answer with objectivity and can go further trying to detect possible psychological or relational difficulties.

This type of intervention implies a warm and emphatic welcome, which will allow the user to speak comfortably about himself and his condition.

The counselling can be orientated as follows:

The counsellor gives the user enough space so that he poses questions in whatever way he/she sees fit;

The counsellor asks questions that will allow him/her to fully understand the overall context. Although the counsellor leads the discussion they should not be intrusive;

Lead the conversation towards: the relationships with family, friends and him/her self, his/her projects, interests, etc.;

Only after that, the cannabis issue is addressed (this is done in order to avoid the consumption of cannabis becoming the focal point):

When did the use of cannabis start; Type of consumption and what it means:

experimental, social, regular or addictive; How the family is reacting; What events, if they exist, the user identifies as

possible causes for consumption;

Finally, the information given by the user is reorganised and structured by the counsellor, as well as including their own perceptions and then brought to the user’s attention. In some cases this is also done to refer the case to a proper psychotherapeutic setting, if deep suffering is detected.

Working with adolescent’s parents

Parents often call the helplines, searching for advice and/or information for two main reasons:

a) their son/daughter shows signs of behavioural problems;

b) they discovered that their son/daughter is using cannabis.

In such cases, normally parents have an inappropriate reaction – after all, they’re scared of possible drug addiction.

Helplines shall assume a preventative intervention. However, the counsellor can chose not to centre his approach strictly on information and advising, but to scan and deconstruct the all situation.

The counselling can be conducted in the following fashion:

The counsellor allows parents to pose their questions as they’re able to do it;

Assistance and guidance is then provided to the parents so they are able to begin their own analysis of the origin of their suspicion (or discovery) that their son/daughter is using cannabis;

Help the parents to analyse the relation with their son/daughter and how to make it helpful to face the present crisis;

Promote the parent’s reflection about the importance of the consume in their son/daughter’s life;

At last, the information given by the user is reorganised and structured by the counsellor, as well as including their own perceptions, in order to advise and orientate the user correctly;

This option allows:

The parents to expose the lack of trust and to recognize the family conflict and the consequent suffering for both parts;

A space for reflection, acting as a stronghold for the parent’s anxiety;

To sensitize parents for the reestablishment of the trust and communication;

By being made aware of the conflict, the parents can understand the underlying problems in their relationship with their son or daughter and motivate them to look for face to face specialised counselling services;

In cases where psychological problems are present amongst one or both parents, they should be advised to look for a psychotherapist who could help – this addition would complement the counselling.

Conclusions:

It is possible, in this kind of service, to take advantage of the caller’s urgency to initiate a changing process. Nevertheless, the counsellor must accept and respect the client’s timing and capacity to expose and deal with his/her difficulties.

The counselor options depends always on the other’s acceptance – as so, the ability to change those options whenever it’s necessary is welcome.

It’s crucial that the counselor centers his intervention on the caller, making possible to establish a relationship. This relationship path requires the permanent reformulation of the counselor options.

This is the biggest problem for the counselors – often, they’re the firsts to question the options they took during the calls. After all, the counselor feels the responsibility and the urge to decide well, before multiple situations and facing always many options. For this to be possible, extreme flexibility and creativeness are required from the counselor.