Presentation at the National Suicide Prevention Conference, Melbourne Australia, July 2013
Help-negation (reluctance to seek help as distress levels increase) occurs among Telephone Crisis Supporters (TCSs) who are exposed to suicidal, depressed and anxious callers, and impacts both personal wellbeing and TCSs intention to use recommended skills with callers (Kitchingman, Wilson, Caputi, Woodward, 2013). Assertiveness is a key clinical skill that facilitates the capacity to effectively and confidently deliver telephone crisis support. Due to the highly specific nature of the telephone counselling context, TCSs face challenges in communicating assertively and establishing of boundaries which are important in effective service provision and the maintenance of counsellor-wellbeing. This paper presents results of two structured literature reviews: Review 1 was conducted to develop an appropriate definition of assertiveness in a telephone counselling context. Review 2 was conducted to examine assertiveness in a practitioner-client context. Results found that assertiveness has never been investigated in the context of mental health provision and never in relation to telephone counselling.
The results also suggest that assertiveness is comprised of learned, situationally specific verbal and non-verbal behaviours to facilitate the establishment and maintenance of helping boundaries. Lazarus (1973) identified that the main components of assertive behaviour are; a) the ability to say ‘no’; b) the ability to ask for favours and make requests; c) the ability to express positive and negative feelings towards others; d) the ability to initiate, continue and terminate conversations. These behaviours facilitate the expression of emotions, opinions and beliefs in direct, honest and appropriate ways when this expression may involve risk or even punishment in the interpersonal interaction (Lange & Jakubowski, 1976) (Rich & Schroeder, 1976) (Heimberg & Becker, 1981). In the telephone crisis support context, assertiveness is defined as behaviour which maintains duty of care throughout a call and operating with caller outcome in mind.
Implications for TC training, preparation, supervision, and current research are discussed.