The impact of their role on telephone crisis support workers' psychological wellbeing and functioning: Qualitative findings from a mixed methods investigation.

Little is known about how telephone crisis support workers are impacted by frequent empathic engagement with callers in crisis, including those who are suicidal. This is the only known qualitative study to specifically examine the impact of their role on telephone crisis support workers' psychological wellbeing and functioning. Eighteen telephone crisis support workers participated in semi-structured interviews, providing detailed accounts of the impact of the role on their wellbeing and functioning. Interpretive Phenomenological Analysis of interview data resulted in four key themes. Results suggest that telephone crisis support workers' motivations, background, personal help-seeking and coping practices are likely to impact their experiences of psychological wellbeing and functioning in relation to empathic engagement with callers in crisis. Telephone crisis services should seek to integrate an understanding of workers' experiences into the provision of training, supervision and support strategies to optimize workers' wellbeing and functioning.

The impact of their role on telephone crisis support workers' psychological wellbeing and functioning: Quantitative findings from a mixed methods investigation.

Research suggests that frequent empathic engagement with others in distress places helpers in registered professional roles (e.g. medical practitioners, psychologists) at risk of functional impairment related to symptoms of psychological distress, including the delivery of sub-optimal care to patients. Preliminary research suggests that telephone crisis support workers may also be impacted in a similar way. This repeated measures study is the first known research to examine telephone crisis support workers' functional impairment related to symptoms of psychological distress before and after speaking with callers in crisis. A representative sample of telephone crisis support workers from Lifeline Australia participated by completing three surveys: 1) directly before; 2) directly after; and 3) one week after completing a shift on the national crisis line. Surveys included standardised measures of functional impairment, psychological distress, lived experience of mental health issues and suicide, motivations for volunteering, coping strategies and help-seeking. Categorical items were used to assess personal and shift-related factors. Repeated measures analyses of variance were used to identify changes in symptoms of psychological distress and impairment across time points. Structural equation modelling was used to test relationships within a hypothesised model of impairment. A significant proportion of participants reported functional impairment related to symptoms of psychological distress. Significant differences in functional impairment and symptoms of psychological distress were detected, and were associated with different mechanisms, across time points. An important outcome of this study is empirically-supported models which explain how telephone crisis support workers come to experience functional impairment in relation to their TCS role, as well as other work/study, home/family and social/leisure activities. Results warrant the deliberate development and/or modification of existing service strategies to optimise telephone crisis support workers' psychological wellbeing and functioning, including by structuring the work environment and emphasising certain messages during training and supervision.

Telephone Crisis Support Workers' Psychological Distress and Impairment.

BACKGROUND: In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. AIMS: A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. METHOD: Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. RESULTS: Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. LIMITATIONS: While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. CONCLUSION: There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

Telephone Crisis Support Workers' Intentions to Use Recommended Skills While Experiencing Functional Impairment.

BACKGROUND: Empathic engagement with distressed others can lead to elevated symptoms of psychological distress and functional impairment, which preclude helping professionals' delivery of optimal patient care. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. AIMS: This study examined the relationship between functional impairment and intentions to use recommended support skills in a representative national sample of 210 telephone crisis support workers. METHOD: Participants completed an online survey including measures of functional impairment and intentions to use recommended telephone crisis support skills with callers reporting suicidal ideation, symptoms of depression, and anxiety. RESULTS: As a group, participants who experienced greater functional impairment during the past month reported significantly lower intentions to use recommended support skills with callers than those who reported lower functional impairment. LIMITATIONS: Future research is needed to clarify the extent to which results generalize to telephone crisis support workers from other organizations. CONCLUSION: Results warrant further research to (a) identify determinants of telephone crisis support workers' functional impairment, and (b) for the deliberate management of telephone crisis support workers' functional impairment through developing and/or modifying existing service strategies to optimize workers' psychological well-being and delivery of support to callers.

Testing a Model of Functional Impairment in Telephone Crisis Support Workers.

BACKGROUND: It is well known that helping professionals experience functional impairment related to elevated symptoms of psychological distress as a result of frequent empathic engagement with distressed others. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. AIMS: The purpose of this study was to test a hypothesized model of factors contributing to functional impairment in telephone crisis support workers. METHOD: A national sample of 210 telephone crisis support workers completed an online survey including measures of emotion regulation, symptoms of general psychological distress and suicidal ideation, intentions to seek help for symptoms, and functional impairment. Structural equation modeling was used to test the fit of the data to the hypothesized model. RESULTS: Goodness-of-fit indices were adequate and supported the interactive effects of emotion regulation, general psychological distress, suicidal ideation, and intentions to seek help for ideation on functional impairment. CONCLUSION: These results warrant the deliberate management of telephone crisis support workers' impairment through service selection, training, supervision, and professional development strategies. Future research replicating and extending this model will further inform the modification and/or development of strategies to optimize telephone crisis support workers' well-being and delivery of support to callers.

Development and Evaluation of the Telephone Crisis Support Skills Scale.

BACKGROUND: Although telephone services continue to play an important role in the delivery of front-line crisis support, published evidence of the standardized assessment of such services does not exist to date. AIMS: To describe the development of the Telephone Crisis Support Skills Scale (TCSSS), an instrument to assess workers' intentions to use recommended skills with callers, and to evaluate its factor structure and reliability. METHOD: TCSSS items were mapped to a national telephone crisis support practice model. A national sample of workers (n = 210) completed the TCSSS as part of a larger online survey. Principal axis factoring was used to evaluate the structure of the instrument. Internal consistency was assessed by Cronbach's α values. RESULTS: A single factor accounted for more than 40% of the variance within TCSSS ratings, indicating unidimensional structure. Cronbach's α coefficients suggested adequate internal consistency. CONCLUSION: Results indicate that the TCSSS is an internally consistent, unidimensional scale, sufficiently sensitive to detect workers' skill priorities for different caller problem types. Further study is required to confirm the factor structure and reliability of the TCSSS using workers from different organizations. Following further evaluation, the TCSSS may be applied to assessing readiness for and quality of service delivery.