Ch. 2 The Conversation
The Five Stage Philosophy supports all users. In this chapter, 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
Building Rapport
Our goal is to put users 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 users to open up. Picture the last time you visited some place 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 are ease or made you feel out of place. The Haven is a safe environment for users, so we want them to know that from the beginning. We do this by 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
Recognize a supportive opening message
Explain how to build trust with a user
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 other person will also want to share.
On Vera, we get the conversation going by introducing ourselves and learning about what led the user 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 user is going through.
Starting out Supportive
At the beginning of every conversation, it's important to give a warm introduction to the user, even if the user seems panicked, pressured, or scared in their first message. Think of your opening message as the user'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 written words. Here's an example of a supportive opening message:
Peer Specialist: Hi there, I'm X. I see that you're feeling overwhelmed today. Can you tell me more about what's making you feel this way?
Your supportive opening message can take many forms, but it should include:
A greeting
Your name (or an alias)
An acknowledgement of what the user shared
An invitation to share more
A Greeting
Starting your first message with a welcome to the user 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 user in a way that feels natural.
Your Name (or an alias)
After your supportive welcome, introduce yourself. **The goal is to let the user know they are now speaking with a real person. The best way to do this is by stating the name you prefer to go by, so that they can refer to you appropriately.
An Acknowledgement of What the User Shared
This is the first time in a conversation where you'll be responding to something the user 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 users 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 users know you're actively listening to them.
Strength ID. You can use a strength ID to acknowledge the courage it took to reach and talk about whatever it is they shared.
Tentafier.** You can use a tentafier if you're not sure you understand what the user meant in their message. Additionally, you can use a clarifying question such as "Is that right?" or "Is that correct?" to give them a chance to correct you if you aren't quite right.
An invitation to share more
Finally, you invite the user to share more about what led them to reach out. Opening up about painful emotions can be difficult. Inviting a user to share more shows them that you're comfortable and ready to hear their crisis. You can encourage users to share more about their pain by asking a question or sending a reassuring statement such as "I'm here to listen", "I'm here for you" or "Tell me more". Asking a question or sending a supportive message lets them know it's ok to continue sharing.
Examples
User: I just don't want to live anymore. After all of treatments, I'm even worse than before. Peer Specialist: Hi there, I'm X. It sounds like you're feeling hopeless right now. I'm here to listen. Tell me more about what's causing you to feel so exhausted.
User: I'm being bullied. I don't know why they hate me so much :( Peer Specialist: Thanks for reaching out. I'm X. It seems like you're feeling isolated and confused. No one deserves to be treated that way. Will you tell me more about the bullying?
Building Trust
Some users will feel comfortable opening up right after your opening message. Other users might still feel reluctant to share their story with you. There are many reasons for this. Some users aren't sure what's ok to share or how much to share. Reminding ourselves that reaching out for support is challenging helps us remain empathetic, even when it takes users some time to warm up to us.
You can create a safe space for users by showing them they can trust you and that you're understanding them. Using Validations, Strength IDs, and Strong Feeling Words can help show them you care and it's okay to open up.
Validations
Validations helps us recognize, normalize, and accept a user'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
User: People at school suck Peer Specialist: Hey, my name is X, and I'm here for you. Struggling with people at school can be draining. Will you share more about what's going on? User: They make fun of me for being homeless. Peer Specialist: 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 users 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
User: My boyfriend just hit me. What should I do?!?! Peer Specialist: Hi, I'm X. 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. User: Thanks. PS: 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 user is feeling during their crisis. Using strong feeling words shows users that you take their situation seriously and you believe that their pain is real.
Example
User: Suicidal thoughts, I guess. Peer specialist: Hey, I'm X. Having thoughts of suicide can feel terrifying. I'm here to support you. I'm wondering if you can share if something has happened to bring on these thoughts? User: I'm having the worst day of my life, and none of my "friends" will text me back PS: On top of already having an awful day, it sounds like you're also feeling isolated because it seems like your friends are ignoring you. You're dealing with a lot right now.
When are you finished Building Rapport?
Maintaining a good rapport with a user is important for the whole conversation. For that reason, you'll continue to build rapport with a user throughout the conversation by making sure you're responding supportively and empathetically. However, once the user has begun to share more details about their situation and feelings, you're ready to move on to the second stage of the conversation: Exploring.
Explore
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 story. The second stage of the conversation helps us understand what users 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 user's situation
Assess users for risk
Explain the Empathetic Response Formula
How to Explore
Exploring is the second stage of the conversation. We explore to learn more about what the user is feeling and experiencing, and we actively listen to demonstrate our support.
Exploring encourages the user to be open and lead the conversation. We're not rushing them into finding a solution; instead, we're meeting the user where they are in the moment.
One of the most important things we do for users is to help them release difficult emotions by talking through their situation. We explore to allow the user to bring up whatever is relevant to their situation in the moment.
In the flow of conversation, think of exploring as the ramp up. We start exploring once the user feels comfortable enough to share the details of their crisis with us.
We stay in the exploring stage until we have a good sense of what the user is experiencing and they've had the opportunity to share their emotion and thoughts openly.
During this stage of the conversation we explore:
The situation: What experiences and thoughts led to the user's situation?
The risk: Is the user at a high risk for suicide, abuse, or self-harm?
The impact: How is the user's situation impacting them?
<aside> 💡 It's normal to wonder if exploring with a user in crisis will bring up more than you're able to handle.
</aside>
Users share what they believe you need to know to understand that 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 the time where users share just how heavily their situation is weighing on them. And you'll be there to validate them along the way.
How to: Explore the Situation
At the very beginning of the exploring stage, we likely know a little bit about what led the user 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.
Active Listening
Active listening has two roles during exploring. First, it allows users 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 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 user's emotions and experiences without judgement. 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 users we believe their crisis is real and important.
Example
User: My partner and I just got evicted from our house. Everything is falling apart. Peer Specialist: Getting evicted can be such a devastating experience, and it sounds like this has bee overwhelming. It's understandable to feel unsure where to turn.
Using the phrase "it's understandable" validates that the user's uncertainty makes sense given their situation.
Reflection
Reflection is summarizing what a user has shared to show that you understand. It's effective during exploring because users tend to share a lot of information. By reflecting back the main points they've shared, you're able to check your own understanding and show them that you're listening. If you're unsure about your reflection, you can always add a tentafier, which gives users a chance to correct you.
Example
User: 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. Peer Specialist: I'm hearing that 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 questions help users expand on their thoughts and feelings. They encourage people to say more than a simple yes or no. Open-ended questions help you explore how their situation is making them feel, how long they've been feeling the way they are, and the different aspects of their situation. We want to focus on their feelings and thoughts more than the facts of the situation. Messaging us can help them better process what is going on and shift how they're feeling, but we can't change the reality of their experience. By focusing on their thoughts and feelings, we center the conversation on the present moment.
Example
User: I don't even know how I'm supposed to have a life. My parents won't let me have friends or go out and they just want me to study all the time. Peer Specialist: Not being able to choose how you spend your time makes it seem like you don't have a life of your own. How does it make you feel when they want to to just study all the time?
Explore Takeaways
As with all stages of a conversation, you can use any or all of the Good Contact Techniques to express your warmth and empathy. When it feels appropriate, use a strong feeling word. When a user isn't feeling sure of themselves, share a strength ID. The goal of exploring their situation is to learn what they're dealing with, so we can support them.
How to: Explore the Risk
abuse
self harm
suicide
Ladder up:
Thoughts: having suicidal thoughts?
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?
Exploring Emotions
Being empathetic is more about connecting to an emotion than connecting to a specific experience, situation, or identity. Regardless of who the user is, you can connect to how they're feeling in the conversation.
Using empathetic responses is a technique that combines tentafiers and strong feeling words and connects it to what has caused the user to experience those feelings. For example, if a user 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 that we are listening and give space for the user to share more without asking them another question.
Even though we want to explore with them, we don't want the conversation to feel like an interview or an interrogation.
Let's break it down:
Tentafier
Using a tentafier before the rest of the of the statement acknowledges that we're inferring how the user feels and what they're going through.
Strong Feeling Word
A strong feeling word shows we're trying to understand the intensity of what a user is feeling and experiencing.
Source of the Feeling
Adding the source of the feeling shows we've been listening to the user 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.
Example
User: 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. Peer Specialist: 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
User: I told him exactly what I was doing. I went out to eat and had 2 drinks and went home. He tells me he trusts me, then demands a picture. I have no words. I don't know what to do about this relationship. Peer Specialist: I wonder if you're feeling frustrated since he is demanding proof that you actually did what you said. It's normal to be unsure about relationships that lack trust.
Example
User: My friends wouldn't understand my situation. They're parents are perfect. They don't know what it's like to be hit every day. Peer Specialist: I get the sense that in addition to the pain of abuse itself, you're feeling isolated because no one else around you seems to understand.
When are you finished Exploring?
The goal of exploring is to understand what the user is feeling in the moment 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 user 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 user has opened up and shared their thoughts and feelings surrounding their situation with you, you're ready to move on to identifying the user's goal.
Identify the Goal
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 motivated by goals. They typically represent what we expect to happen or feel after we've put effort towards 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 users want to 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 lower their emotional intensity. We do this by identifying their goal.
At the end of this section, you'll be able to:
Describe why we identify a user's goal for the conversation
Recognize a user's goal when they openly share it
Ask warmly and directly about a user's goal
Help a user identify a goal if they don't have one yet
How to Identify the Goal
Identifying the Goal is usually the shortest stage, but it serves as a key turning point in the conversation. In this stage, we shift our focus from exploring the past to thinking about the present and the future.
Proactively identifying the goal shows you are invested in what the user wants from the conversation and empowers them to take the lead.
After we explore the user's situation, risk and feelings, we identify the goal. Many user's 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 great goal for someone in an emotionally difficult situation, and it can be enough for users to lower their emotional intensity.
Other users are looking for something more tangible from their conversation. However, it's common for users not to share their goal during the first part of the conservations. That's completely normal. Their situations can feel overwhelming and many users reach without knowing quite how we will respond. Identifying the Goal helps bring the user back into the present moment so we can make our conversation as supportive as possible.
When users are going through so much, it can be challenging to narrow in on their most pressing concern or the issue that feel most ready to tackle. To make sure we're always following the user's lead, we ask them about their goal. Users respond in many ways to questions about their goals. We'll look at the following scenarios:
Users who know their goal
Users who have multiple goals
Users who don't have a goal
Users with goals we can't meet
No matter how you ask, make sure you use a supportive tone and allow the user to lead the conversation.
Users who know their goal
Sometimes, users will make their goal clear during your exploration together. They might say something that indicates what they're looking for.
User: 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?
User: My girlfriend puts me down all the time and I need help breaking up with her.
Example
User: 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? Peer Specialist: I'm hearing that 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?
Paraphrasing what the user 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 user's goal instead of assuming what would be most helpful for them. The best way to make sure we're understanding them correctly is to ask.
Other users who know their goal are sometimes whose who reach out to feel heard, seen, and supported.
Example
Peer Specialist: 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? User: 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 that I'm a horrible person. Peer Specialist: There's no wonder you want to talk to someone outside your family. On top of concerned for your sister you have to think about how your life might change.
When users are looking to vent or share, we validate their goal continue supporting them. A part of being in the middle of a heightened situation is talking through what you're feeling before you can move forward. We are here to listen to and validate our users.
Users who have multiple goals
Users can reach out about a lot of issues at once. Life is complicated and messy. In these cases it's helpful to ask the what they feel is their most pression issue. With users facing situation with multiple parts, asking them to prioritize one thing can make the whole thing feel more manageable. As with most situations, it can be difficult 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.
Example
User: I lost my job and my mom and I don't get along. I can't stand to be in this house any longer. Peer Specialist: 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. User: I guess I just don't want to stay at home right now. I fee like I can't breathe here.
Example
User: Everything's falling apart. In failing classes and my gf dumped me and my parents are always onto me about something. Peer Specialist: 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? User: I don't know, I'm just sad. I just don't want to feel so depressed anymore.
Example
User: 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. Peer Specialist: Which of the situations that you've talked about today, if resolved, would have the greatest impact on how you're feeling right now? User: I don't know how it'd be resolved, but if my boss stopped yelling at me, that'd be great.
Users with goals you can't meet
Sometimes, users 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 users.
Users who want advice
When a user'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 situations.
Example
User: I just want to know if I should text my ex right now. Just tell me what to do. Peer Specialist: 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?
By leaning into what the user 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 user 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.
Users who need additional resources
A user may ask for more concrete resources and guidance on a tangible issue they have little control over. We can help them get closer to that goal, even if we can't meet it concretely.
Example
User: 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 Peer Specialist: 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?
We cannot personally get this user a ride, nor can we intervene with the police or communicate with a shelter on their behalf. Just because a user reaches out to us with a concreate 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 lower their emotional intensity.
Users who don't have a goal
Even when we ask the user to tell us what they'd like to focus on or what they're looking for from the conversation, we don't always get direct answer.
User: I don't know what would be helpful, sorry if I'm wasting your time. User: I just don't feel like anything's gonna change.
When users are reflecting on and sharing their feelings an experiences, it can be helpful to ask them 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 users 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
Peer specialist: 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? Peer specialist: 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.
When we help the user identify their goal for the conversation, we let them lead the conversation. They decide what about the situation is most pressing to them in the moment, and they decide what relief of even and ideal resolution might look like. Learning this from the user puts us in a better position to help them brainstorm and discover next steps.
When are you Finished Identifying the Goal?
Some users understandably fixate on the causes, consequences, and feeling 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 user from lowering their emotional intensity.
Below are the list of questions to support a user 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/boss/partner] 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 user to identify a focus for the rest of the conversation. When you do, you can support them through the next stage of the conversation.
Discover Next Steps
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 users 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 users to think of ways they can continue to manage their situation after the conversation ends. WE do this through Discovering Next Steps.
At the end of this section, you'll be able to:
Describe how we collaborate
Identify which type of next step best supports a user
Help them come up with next steps
Share resources with users who need additional support
How to: Discover Next Steps
Discover Next Steps is the fourth stage of the conversation. During this stage, we empower the user to brainstorm ways to begin to reach the goal they identified. This stage is all about letting the user lead and honoring their ability to make their own decisions.
Discovering Next Steps is likely what you imagine. This stage is called "discovering" because it's our job to work with users 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-judgemental listening, and genuine support how they can manage their situation.
Next steps can come in all shapes and 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 users a way to continue to fight through their situation, find relief, and continue to get the support deserve.
Discovering Current Coping Skills
We start by asking users how they've been coping with their situation up until this point. Coping Skills are activities, hobbies, distractions, and self-care users can do on their own to fined relief. Using coping skills is a productive next step because users can immediately tap into them and they are available to everyone.
Sometimes users disregard their regular coping skills as not being enough. In other cases, users are too overwhelmed to even think about their coping skills. This is why we explore them at this stage of conversation instead of at the beginning.
The most important part of discovering coping skills is allowing the user 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
User: Yeah, I guess improve my balance with all my work. Peer specialist: It makes sense you're feeling overwhelmed. I'm wondering what have you tried to help you manage your stress from work?
This open-ended question leaves room for the user to share a number of 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 they meditation is something they should consider.
Example
User: I need to tell him that he can't come back to the house anymore. Peer specialist: I can tell having him there is really increasing your anxiety. How have you dealt with talking with him in the past?
Asking how they've been dealing with their situation reminds them that 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.
Leading with a close-ended question or making a suggestion sends the message that the user isn't in control. Keep your questions open-ended to discover what coping skills would best help the user. There is no perfect way to ask about coping skills, but these questions usually encourage users to open-up.
Users Whose Goal is to Simply Be Heard
Many users who reach out to be heard or vent aren't really expecting to leave the conversation with next steps. That's ok. WE don't want or need to force next steps on them. Hopefully, they feel validated and listen to because of the warmth, empathy, and space you've given th em during the first three stages of the conversation. However, during this stage for them, it can be helpful to ask what they plan to do after the conversation ends. That way, we can check-in without them feeling like they have to think of next steps for our benefit.
Example
User: Exactly, my friends don't get it, and there's no way I could tell my parents. Peer specialist: That makes sense. Sometimes talking to someone who isn't involved can help you see things more clearly. User: Yeah, thanks. Peer specialist: Now that you've been able to get that out, I'm curious, what's one kind thing you plan to do for yourself after we're done chatting? User: Probably take a bath, it's been a long day.
Discovering New Coping Skills
For some users, their situation is new and reaching out to us was the first thing they've done to manage it. That's ok. Even if they haven't already tapped into their coping skills for this specific issue, we can explore what type of things have brought them relief when they've felt similarly. We can also explore activities, hobbies, or skills they haven't yet tried, but might be interested in doing.
We support users in discovering coping skills by brainstorming with them. To support users in brainstorming, we focus on their feelings and how they've managed them in the past. For instance, if a user 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 situation itself, but the emotions surrounding the event.
Example
User: I feel so much and nothing. I need help with dealing feeling high one day and low the next. Peer specialist: 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?
There are many ways to start brainstorming with users, but the clearest way is to directly ask if they're open to brainstorming with you.
Example
User: There's nothing I can do about the project change at work, I can't believe they're cutting me out! Peer specialist: 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?
In this example, we're asking the user to think of how they can cope with their feelings instead of the situation (event). By framing the coping skills as a way to improve their emotional state and not the situation, users are usually able to discover more options.
Discovering Social Support
Many times the best thing for users is not to be alone. While we're always here for them in a heightened 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 looks like is different for all users. 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 user needs to feel comfortable reaching out to them.
To start exploring a user's social support, we ask who the user 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 users in discovering who in their life might be someone they can reach out to.
Example
User: Focusing on feeling safe I guess. I love him, but the hitting is out of control. Peer specialist: I'm hearing that you want support on finding a way to safely get some space from you 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 users 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.
Not all support systems are truly supportive, and we want to be mindful of that. Users know who they can connect with best. Many users come to us because they don't have enough support. So we want to hear what users are saying about their fears and continue to follow their lead.
<aside> 💡 protocol for assessing suicide/selfharm/abuse?
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Ending the Conversation
Our aim is to help users get what they need to manage their short-term emotional state as well as future situations. Think about how you feel when someone abruptly stops replying to your messages. Abrupt endings can leave anyone feeling unsure and confused. For that reason, ending a conversation is a process and can take a number of exchanges back and forth with the user. We want you to be using as much care and empathy here as you do in other stages of the conversation.
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
End the Conversation is the final stage. We lead with warmth, encouragement, and the assurance that we're here if the user is reaching out for support again.
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 users lower their emotional intensity.
Regardless of the contents of a conversation, tone of the ending consistent. We use a series of warm statements that bring the conversation to a close without making the user feel abandoned. This is a space to us to check in with how they're feeling, affirm the next steps they brainstormed, remind them we're here for them in another moment of crisis, and leave them with warmth.
It's important to remember that it's not only ok to end the conversation, but it's necessary to help the user transition into taking action on their next steps. When you're ready to the End the Conversation, you've provided invaluable support. Giving the user 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 user's situation and provide a space for them to feel heard?
Did the user get a chance to share their pain?
Throughout the conversation, did the user lower their emotional intensity?
There are three parts of Ending a Conversation. They include:
We signal to the user that the conversation is closing soon.
We remind them of their strength and next steps.
We leave them with a warm and supportive sentiment.
3 Parts of Ending a Conversation
(1) Transition Statement
First, we want to signal the conversation is coming to an end. We do this by providing a brief recap of the conversation. It's important to reflect back the primary cause of the user's situation to begin this closing process. Ask yourself, what was painful for them today? By doing this we remind the user how far they've come during the conversation.
Example:
User: Yeah, I guess that's something I could do Peer Specialist: 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?
(2) Summary of their Next Steps
A clear summary reminds users of all the reflection, vulnerability, and brainstorming they've done to lower their emotional intensity. Summarizing also reinforces the user'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 ok to directly reference that you're going to end the conversation—you're not abandoning. Indicating a clear ending provides closure, allow the user to mentally prepare to start their next steps.
Example
User: A little better. but still sad, ya know. Peer Specialist: 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?
Supportive Closing Message
Now that you've transitioned into the closing stage and reviewed the user's next steps, it's time to send a closing message that reassures and empowers the user.
Example
User: Yeah, thanks. Peer Specialist: It was strong of you to reach out and come up with a plan to reduce your anxiety tonight. If you'd like to talk again, please request another session?
When should you close the conversation?
Over the course of the conversation, the user's concerns are probably not fixed—this makes sense, since 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 users 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 their emotional intensity down. Users 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 support and reinforce their strength by ending the conversation
The Conversation: Takeaways
Building Rapport sets the stage for the rest of the conversation. At this stage, we show users we're warm, empathetic, and ready to hear about their situation. Although we build rapport at the start of the conversation, we continue to maintain good rapport throughout the whole conversation. Good Contact Techniques help us show users we're actively listening and care about them and their safety.
Exploring is where we find out the most information about a user's situation. We dive into their situation and how it is impacting them. We let the user lead and share what they think is relevant. While this is likely the time you'll use the Ladder Up Risk Assessment, a user may bring up that they're at risk sooner or later in the conversation.
Identifying a Goal helps us get a better sense of how to lower a user's emotional intensity. Some users will know what type of support they need and others won't. That's ok. We can support them in identifying a goal for the conversation to help them feel a little more in control.
You can Discover Next Steps with all users, regardless of risk. Some users might have bigger next steps than others. Either way, we collaborate and brainstorm with them to determine what coping skills, social support, or resources might help them stay cool after the conversation ends.
Ending the Conversation supports users in their next steps. Leave the user feeling supported and empowered.
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