Mais Oui, “Non” Est Un Bon Mot: Comment Dire “Non”

34th Annual I&R Training and Education ConferenceNew Orleans, Louisiana Tuesday, May 22, 2012

10:30AM - Noon

John Plonski – FacilitatorDirector of Online Supervisors

IMAlive National Hopeline Networkjpnysairs@gmail.com

Paper-free Workshop

YESWorkshop Under Construction

You may want to go to another workshop> Or enjoy the process and stay!

So just what is today’s goal?

The goal of the workshop is to look at those times when we should (must) use the word “No” and why we find it difficult to say so or resist saying it.

We will look at

• Which situations in which No is an option

• What it is that makes No a difficult word to use

• How to say No without guilt, fear, and loathing so that to say No….

In the words of the Enterprise’s Chief Engineer, Montgomery Scott, saying

No will become…

“No Tribble at all.”"The Trouble With Tribbles" is a second-season episode of the Original Star Trek Series, first broadcast on December 29, 1967 and repeated June 21, 1968

And most importantly we will come to understand the true nature of the

“Problem”

Our reactions to having to say No.

First, some basic ABC’sThe Information and Referral Specialist must accept:

• The boundaries of I&R - what they can reasonably expect themselves to accomplish and what is beyond their control

• Feelings of helplessness and frustration can and do result from certain types of interactions

• That there is not an ideal solution for every problem, and some problems may have no solution

• We have no control over whether an inquirer follows through or will eventually receive the help they need

• The need to be aware of their personal triggers

• The need to debrief with colleagues and/or supervisors

• I&R cannot “turn” people’s lives around.

YES

Networking time – Left What are the times to say noRight how do I avoid saying No How do I say NoWhat do I do when the Person says No is not an option

Say

Yes!

To NO!

Having to say No gives me a headache! What

more can I do?

Well the basics are….

• Trust your instincts

• Trust your skills

• Think before you talk

• Know and respect your “Buttons”

• Use supervisory and peer support

• Recognize your own value

Also there are skills...

• Remain in the present

• Assertive confrontation

• Address behaviors not situations

• Maintain a professional distance

• Fact checking

• Focus on focusing

There are some Do’s and Don’ts. Let’s start with the

Do’s...• Use a calm but firm voice tone to communicate both caring and certainty to the client

• Acknowledge feelings but do not allow them

to be the focus of the conversation

• Recognize that change can be difficult, scary, and tiring

• If you have spoken to the individual previously let them know you are familiar with them and their situation

Some more Do’s

•

•

• Keep your expectations of what can be accomplished in the interaction realistic and share them with the client

• Keep your interactions focused, pragmatic, concrete, and oriented toward problem solving or appropriately ending the interaction

• Reserve the right not to answer questions

There are also a few Don’ts...

• Don’t invalidate the Caller

• Don’t allow the Caller to dictate how the interaction should be carried on

• Don’t give, or allow yourself to be manipulated into giving advice or information about a topic you are not familiar with

A few more don’ts...

• Don’t ask the Caller how they thought you could help them

• Don’t strive to uncover feelings that lie beneath the surface

• Don’t enter the “world” of the delusional or hallucinatory Caller

• Don’t reinvent the wheel

•

• We tell them to

• We listen

• The "Warm and Fuzzies”

• Inconsistent Reinforcement

• We like them

• They like us

• We have to talk to everyone that calls

So why do Constant Callers call us?

We can define Constant Callers as those Callers who:

• Call frequently over an extended period of time

• Are consistent from call to call

• Have the same presentation call to call

• Are unwilling or unable to effect change

• Are aware of the mechanics of the I&R process

• Initiate contact out of habit

• Have a story that seems rehearsed

So who is a Constant Caller?How do we determine who they

are?

Yes, they are frustrating because:

• They make you feel trapped

• They make you feel like a failure

• Constant Callers are “crazy”

• They are resourceful

• “Why don’t they do something…anything?”

• They are different

• They make us frustrated and angry

• “I can change this Constant Caller!”

But they are so frustrating! They make me angry!

How about reasons for not letting Constant Callers

call? • They are potentially frustrating to and demanding of the staff

• They use up valuable resources

• Their contacts may be preventing them from getting the help they need

• Their contacts may be “splitting” their therapy

• Modeling of inappropriate behavior

• The record of their contacts can provide an inaccurate view of services provided

It’s not quite that easy because:

• We invite them to call us

• They can call us

• Sometimes even Constant Callers need help

• It makes it easier to work with them

So why do we let them call?!Why should we let them call?!

I say just refuse to take their calls and it’s a done deal!!!

However, there is an exceptionto the rule.

In the case of a Constant Caller who is threatening or abusive it would be reasonable to adopt a no contact/no engagement policy. But keep in mind this does not mean they will not contact you again.

First of all we need a method to positively identify them that mitigates the possibility of misidentification.

An effective system would include:

• Basic Information about the Caller

• A more in depth Identification Profile

• The Background and History of the Caller’s contacts

So how do we go about working with Constant

Callers?

Set limits!

Do not be afraid to develop and enforce policy Accept that while Constant Callers ask for help, they are either unwilling or unable to use that help

Consider the likely outcome of your decision to talk with this consumer

Consistent interaction

Work together within the agency

Maintain professionalism and respect

Some rules for working with Constant Callers

Once we are able to accurately identify individual Constant Callers we can then decide which Contact Model we would

like to implement. The 5 Contact models are:

• Constant Callers Do Not Exist • Don’t Do Anything • No Engagement• Agency Dictated Contact Policy• No Therapy - No Contact• Note From the Therapist• Let’s Talk About Your Calls and Make a Plan

We have rules and information. What do we do with them?

Constant Callers Do Not Exist

• Based on the principle that helping agencies exist to help any and all inquirers it denies Constant Callers do exist.

• We may feel we are serving them appropriately by allowing unlimited access we may, in fact, be doing them a disservice

• Leads to “game” playing by Callers and staff

Don’t Do Anything • Admits there are such Callers but doesn’t address the issue

• Has the potential for the workers to interact with the Callers in any manner the see fit

• Leads to inconsistent re-enforcement

• This inconsistency leads to game playing and worker frustration

No Engagement Model

Means that once a Constant Caller is identified as such we don't engage them anymore.

• This is the simplest Model to put in action

• Risk that a non-Constant Caller may be identified as a Constant.

• Can lead to game playing and acting out

• No investment in plan by Caller means little or no compliance

Agency Dictated Contact Policy

Means the agency establishes guidelines for interacting with the Caller.

• It is decision by the agency administration with input from the staff (usually) and no input from the Caller.

• The Caller may see this action as something being “done to them”.

• Making contact policy without the Caller’s involvement might make them angry and they may act that anger out against the line.

Means no agency contact with the Caller until they engage a more appropriate outlet for dealing with their issue.

• Repeated contacts can interfere with their reaching out to a more appropriate resource to resolve their situation.

•While not being able to contact the hotline may induce some Constant Callers to get the longer-term assistance they need others will refuse.

No Therapy – No Contact

Refusal sends us back to square 1.

A variation of the No Therapy – No Contact Model addresses the Caller who is already getting help.

• Caller arranges for their provider to contact you to discuss the Caller’s calls and develop a contact plan

• Often the therapist will request the agency not allow the Caller call

• Therapist is apprised of issues they may not be aware of

• Confidentiality issues

How about the Note From the Therapist?

Can we talk about“Let’s Talk About Your

Calls” This Model makes the Caller a participant in the establishment of policy.

• Many Constant Callers will partake in the process and, in fact, comply.

• Recognizes, delineates, and balances the Caller’s and the agency’s needs

• Recognizes the Caller may need help at some time

• The Caller feels they are part of the policy making process

• Models the behaviors of honesty and candor

• Re-enforces the concept contact is a privilege.

There is an extra special added bonus of the Interactive “Let’s Talk About Your Calls”

Model?Any ideas as to what it may

be?

It is possible the “Plan” will center on a agreement that the agency will contact the Caller.

• Agency can schedule the contacts for when they are best staffed.

• Training tool for new workers

• Affords new workers an opportunity to develop the skills without stress and anxiety

In order to facilitate the Let’s Talk Model we need to add some more information to our Constant Caller

ProfileAdditions to the system include:

• Current Life Issues with which the Caller is coping

• The Caller’s Support System and Strengths

• The actual Plan as well as Limit, Focus and Rationale of the Plan

Once a policy is instituted it is important that...

• Staff, as well as the Caller, to adhere to it

• The policy process is explained to the staff

• We recognize Constant Callers do develop crises which we will define as "Immediate Need".

• A Constant Caller in Immediate Need will be treated as a regular Caller

• Once the Immediate Need is resolved the Caller would return to their contact policy

• Should the Immediate Need situation become long-term (Constant) it would become part of a new policy

What is “Limit”?

"Limit" addresses the number and duration of the Constant Caller’s calls.

• The Limit is not an arbitrary choice

• It is not intended to be punitive.

• The Limit can be in terms of calls per day or week as well as a time limit

• Where the Caller’s contacts follow no discernible pattern or the contacts are intermittent no Contact Limit would be assigned Can you think of why

we wold not assign a limit in this case?

What is focus?

Focus addresses what we will discuss with the Constant Caller during their contacts. Focus...

• Says we will not engage them in rehashing “Old News”.

• Encourages discussion of what is happening in the present and what they are doing to cope with it.

• Does not mean we will “just listen”

• Does mean we will interact with the Constant Caller in a manner defined by the boundaries of their Limit and Focus.

What is Rationale?

• Rationale delineates how the Plan was created

• It gives the workers something to refer to should a particular Caller question a Plan that is being used

•It can be used to remind the Caller that the Plan was something they helped establish

•It allows workers who may feel “attached” to a certain Constant Caller to understand that the Plan was not something arrived at arbitrarily

•It helps ensure the Plan will be implemented uniformly

How do I interact with Constant callers when establishing policy?

Remember:

• You will not be the first seeking to establish policy with the Caller.

• Use your active listening skills.

• To keep the discussion focused on the Caller and their needs.

• Being empathic does not mean lack of focus.

How else do I interact with Constant callers when establishing policy?

Remember:

• To plan how you would like the interaction to go.

• To anticipate possible areas of resistance

• Allow the Caller to tell you what they think would be fair.

• Address the issue of therapy

• Keep in mind that “No” is an appropriate answer