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      Caught Between Expectations and the Practice Field : Experiences of This Dilemma Among Volunteers Operating a Diaconal Crisis Line in Norway


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          Abstract. Background: Volunteer crisis line responders are a valuable resource for suicide prevention crisis lines worldwide. Aim: The aim of this study was to gain a deeper understanding of how volunteers operating a diaconal crisis line in Norway experienced challenges and how these challenges were met. Method: A qualitative, explorative study was conducted. A total of 27 volunteers were interviewed through four focus groups. The material was analyzed using systematic text condensation. Results: The greatest challenge to the volunteers was the perception of a gap between their expectations and the practice field. The experience of many volunteers was that the crisis line primarily served a broad ongoing support function for loneliness or mental illness concerns, rather than a suicide prevention crisis intervention function. Limitations: The focus group design may have made the participants more reluctant to share experiences representing alternative perspectives or personally sensitive information. Conclusion: The findings of this study suggest that a uniform response to callers using crisis lines as a source of ongoing support is warranted and should be implemented in volunteer training programs.

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          Most cited references21

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          Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline.

          We examined the impact of the implementation of Applied Suicide Intervention Skills Training (ASIST) across the National Suicide Prevention Lifeline's national network of crisis hotlines. Data were derived from 1,507 monitored calls from 1,410 suicidal individuals to 17 Lifeline centers in 2008-2009. Callers were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by ASIST-trained counselors. Few significant changes in ASIST-trained counselors' interventions emerged; however, improvements in callers' outcomes were linked to ASIST-related counselor interventions, including exploring reasons for living and informal support contacts. ASIST training did not yield more comprehensive suicide risk assessments.
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            An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers.

            The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.
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              Comparing models of helper behavior to actual practice in telephone crisis intervention: a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network.

              Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.

                Author and article information

                Hogrefe Publishing
                February 28, 2019
                : 40
                : 5
                : 340-346
                [ 1 ]Center for Psychology of Religion, Innlandet Hospital Trust, Hamar, Norway
                [ 2 ]MF Norwegian School of Theology, Oslo, Norway
                [ 3 ]Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway
                [ 4 ]Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
                [ 5 ]Department of Public Health and Clinical Medicine, Umeå University, Sweden
                [ 6 ]Department of Theology, Psychology of Religion and Cultural Psychology, Uppsala University, Sweden
                Author notes
                Ingvild Engh Vattø, Innlandet Hospital Trust, Center for Psychology of Religion, Box 68, 2312 Ottestad, Norway, ingvild.vatto@ 123456gmail.com
                Author information
                Copyright @ 2019
                : January 3, 2018
                : August 27, 2018
                : September 2, 2018
                Funding: This project was funded by The Norwegian ExtraFoundation for Health and Rehabilitation, Norway , and Innlandet Hospital Trust, Norway.
                Research Trends

                Emergency medicine & Trauma,Psychology,Health & Social care,Clinical Psychology & Psychiatry,Public health
                qualitative research,crisis intervention,suicide prevention,hotlines,focus groups


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