American Journal of Community Psychology, Vol. 3, No. 2, June, 1975
The Training of Telephone Crisis Intervention Volunteers 1,2 Michael C. Dixon 3
George Peabody Collegefor Teachers Jim Burns
Tennessee State Department of Mental Health
Telephone crisis intervention services are growing at a very rapid rate. A review o f the literature reveals that there are very f e w references to this new phenomenon and even fewer that deal with evaluating the effectiveness o f telephone crisis training. Herein 7 articles are reviewed which deal with volunteer selection and training. These articles demonstrate that no consistent rationale for volunteer selection or training exists. Selection o f volunteers typically consists o f a gross screening to eliminate any obviously unsuitable persons, with training serving as a further sorting procedure where volunteers who are uncomfortable with the role o f a crisis interventionist can be encouraged to drop out. The authors suggest that a training model be built around crisis intervention theory using principles o f social learning as the methodology for training.
Throughout the United States, 24-hour emergency telephone counseling has become a standard practice. The vast majority of these services are aimed at crisis intervention and/or suicide prevention and utilize nonprofessional volunteer workers as the primary intervention agents (McGee, 1974). This widespread growth of telephone answering services for crisis intervention and suicide prevention and some involvement with two specific crisis call Editor's note: This article was reviewed by the APA Division 27 Editor and recommended for publication on Journal pages devoted to matters of special interest to the Division of Community Psychology. 2An earlier version of this article entitled "Telephone crisis intervention and crisis volunteers" appeared in CrisisIntervention, 5, 1974, 2-5. 3Requests for reprints should be sent to Dr. Michael C. Dixon, Center for Community Studies, Box 319, Peabody College, Nashville, Tennessee 37203. 145 @1975 P l e n u m Publishing C o r p o r a t i o n , 2 2 7 West 1 7 t h Street, New Y o r k , N . Y . 1 0 0 1 1 . N o part o f this p u b l i c a t i o n m a y be r e p r o d u c e d , stored in a retrieval s y s t e m , or t r a n s m i t t e d , in a n y f o r m or b y a n y means, e l e c t r o n i c , m e c h a n i c a l , p h o t o c o p y i n g , m i c r o f i l m i n g , recording, or o t h e r w i s e , w i t h o u t w r i t t e n permission o f t h e publisher.
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center training programs prompted the authors to look into the literature concerning crisis call training. We were particularly interested in assessing the information, if any, which was available concerning the training of telephone crisis intervention volunteers or the use of telephone answering services as a type of crisis intervention. Since the origin of such services, starting with telephone suicide prevention in Los Angeles in the late 1950s, many major cities and smaller towns have adopted programs aimed at suicide prevention or crisis intervention through a nonprofessional, volunteer-staffed, telephone answering service. A December, 1971, listing in the National Hot Line Directory indicated over 750 such services in existence; the number could be approaching 1000 by now (Potter, 1971). It was surprising to learn, therefore, that despite the large number of telephone answering services for suicide prevention and crisis intervention (McGee, 1971; McGee, Richard, & Bercum, 1972), there is relatively little in the literature concerning these services. We found a total of 40 references, 17 of which dealt specifically with suicide prevention services and 13 with general information and referral telephone services. In addition to these 2 categories, we found 4 articles pertaining to the types of calls received and 6 articles pertaining to volunteer selection and training. We were particularly interested in this last category and examined the journal articles with an eye for any recurrent philosophies on the training or selection of volunteers. As we see it, crisis intervention, even if it is primarily informational in nature (that is, providing either a referral source or concrete information for the caller), is a very different role for a volunteer than most other types of volunteer roles. Many volunteers, for example, serve essentially as distractors. Their function is to help a person focus on something other than his or her current problem or situation. Crisis intervention requires just the opposite of the volunteer. He/she must help the client to be very specific about the problem. Often his/her most useful function is to help the client realize the real nature of his/her problem, so that the caller sees it in perspective with other elements of his/her life. Other volunteer roles may call for very gradual approaches to the nature of the client's difficulty,perhaps never asking for information directly unless the client indicates a desire to talk about it. In crisis intervention, the volunteer must get to the heart of the problem quickly and, particularly with respect to suicide, determine the lethality of the situation. Crisis training, then, is significantly different from other types of volunteer training because the role of the volunteer is very different. There is, therefore, a need for a volunteer training rationale directed at this difference. Brockopp and Yasser (1970) discuss volunteer training for telephone therapy, using as a model the Erie County Suicide Prevention Center. Although the purpose of the center is primarily suicide prevention, their description of the training procedure seems applicable to other crisis intervention programs. They
Telephone Crisis Intervention Volunteers
147
emphasize the areas of selection, phased training, supervision and feedback on individual performance, and follow-up to the training program. It is the philosophy of the Erie center that selection of volunteers serves a twofold purpose: (1) allowing the center staff to evaluate a prospective volunteer, and (2) requiring the applicant to evaluate himself/herself in the light of the types of duties he/she will have to perform and thereby make a better decision concerning his/her willingness to volunteer. The philosophy of the program follows as an extension of the philosophy of selection. Training is phased over a period of a month and consists of 3-hour sessions held twice weekly. During these sessions, the volunteer is instructed in basic skills such as the physical operation of the center and in elementary techniques and philosophies of telephone therapy. Additionally, the training sessions attempt to provide the volunteer with a better self-insight. A component of supervision and feedback is provided by numerous role-playing sessions and eventually an evaluation of the technique in handling actual crisis calls. Follow-up to the training program is provided by opportunities to discuss calls taken during actual service times with supervisory personnel in light of the volunteer's feelings and training needs. Reisman (1967) describes what he feels to be the essential components of a training program. His orientation is more general than specific, however. He lists 3 areas or topics which he feels must be treated in any program. The first is role ambiguity, which Reisman feels must be clarified in the case of each volunteer. Second, training should be phased over a period of time and should progress into all areas a volunteer may encounter; also, the program should include on-the-job training with adequate supervision. Finally, training should be unif i e d - that is, unified in the criterion used for selection of the volunteers in order to strengthen any individual weaknesses, and unified with respect to the varied aspects of the professional supervising the program. Reisman stresses, above all, that unrealistic expectations should not be created for the volunteer trainees. Another article relevant to training is Lamb's (1969/1970) paper on errors and fallacies found in telephone therapy. Lamb points out 6 common misconceptions that, when applied in telephone therapy, usually produce negative results. These misconceptions could be termed a priori errors of philosophy and include such faults as believing that you must do something, feeling that you must "love" everyone who calls, and feeling that you must know about all possible resources. Lamb's point is that telephone therapists must not believe they are (or try to be) perfect; nor should they enter into their work with an inflexible approach to problem-solving. It should be the goal of training, according to Lamb, to prevent the emergence of these errors. Heilig, Farberow, Litman, and Shneidman (1968) discuss the selection and training of nonprofessionals for telephone therapy in suicide prevention. Heilig et al. presented a selection plan consisting of interviews, a written autobiog-
148
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raphy, and an MMPI protocol, which the selection staff used in an attempt to assess the presence of certain characteristics, such as motivation, responsibility, motivating factors in volunteering, and flexibility or openness to training. The training program itself is suggested as an excellent period for further observation and evaluation of the volunteer's abilities and potential. Heilig et al. stress 3 primary areas in training: adequate coverage of theories relevant to telephone therapy and suicide prevention, practice in specific methods for handling calls, and examples of actual calls and case histories. Training is followed by an apprenticeship period during which specific weaknesses are ironed out for each volunteer. Farberow (1969) briefly discusses training at the Los Angeles Suicide Prevention Center. The primary emphasis of his paper is the importance of removing existing feelings about the social stigma of emotional and mental health problems from the volunteers during training. Fowler and McGee (1973) present a scale (the Fowler Technical Effectiveness Scale) to assess the effectiveness of volunteer telephone workers. The goals of this scale are to measure the volunteer's effectiveness in communication skills, assessment of the caller's condition, and production of a plan of action. In the presentation of this scale and its measures, Fowler and McGee have indirectly proposed that the areas measured are the 3 essential areas of expertise a volunteer should possess, which therefore should be the focal point and goal of any training program. While we agree that communication skills, assessment skills, and ability to formulate and start the client on a plan of action are essential for crisis intervention, the enumeration of these needed abilities does not address the full range of skills needed by a crisis interventionist nor does it address the issue of what the conceptual base for training should be. A very recent addition to the literature attempts to address the issue of training and other major issues by setting out a series of judgments which are offered as standards for suicide prevention and crisis centers. With regard to training the following are listed as standards (Motto, Brooks, Ross, & Allen, 1974): 1. Basic. knowledge o f suicidology : The epidemiology of suicides and suicidal behavior. Psychological and motivational elements of self-destructive behavior. Legal aspects of suicide and suicidal behavior. Special considerations applicable to children, adolescents, and the elderly. Fallacies and c o m m o n misconceptions about suicide characteristics of depression. Sociological and cultural aspects of suicide. The relationship of suicide to psychological disorders. Religious and philosophical concepts related to suicide. The rationale of current preventive measures, intervention techniques, and emergency procedures.
Telephone Crisis Intervention Vohmteers
149
2. COmmunity resources: How to choose appropriately from among available resources. Characteristics, requirements, fees, and limitations of principal referral agencies. 3. Ethical considerations: Procedures that ensure confidentiality. The limits of responsibility of the crisis worker. Ethical aspects of taping, tracing calls, contacting police. 4. Record keeping: Specific instruction regarding information to be recorded on each call. Rationale for records and uses to which crisis data will be put. 5. Counseling and intervention techniques: Active listening. Referring and transferring calls. How to secure communication with the caller. Techniques of formulating an action plan. Techniques for systematic follow-up of action plans. Effective utilization of consultation and backup personnel. Technique for covering caller's demand for personal involvement of the crisis worker. Perhaps one of the biggest issues in the operation of crisis intervention centers and the training of telephone crisis workers is that of a criterion or standard by which a volunteer can be judged as to the adequacy of his/her training and a center can be judged as to the adequacy of its training program. A simple count of the number of yes or no responses to these questions (as to whether or not that element is included in training) would serve as a rough index of the quality of training. Likewise, the question "What constitutes a well or adequately trained volunteer?" might be approached by using the above as a standard for what the volunteers should know, and be able to do, after training. Based on this review of the literature, with particular emphasis on the articles noted above, we have concluded that there is no systematically developed rationale for either the selection or the training of "crisis call" volunteers (with the possible exception of the Motto et al. scheme noted above). Selection seems to consist of a gross screening of volunteers to eliminate any obvious "pathological" types, with training serving as a sort of natural selection or "shifting" period where volunteers who begin to feel uneasy over their roles can drop out of the program. Training is centered primarily around discussion of theories of suicide prevention, crisis intervention, and counseling with some use of role playing to simulate actual calls. Volunteers then typically spend a period of time in actually taking calls under the supervision of a more experienced volunteer. While there are literally hundreds of crisis intervention centers across the country, the relative paucity of literature in this area indicates that almost no research has been done to indicate what a viable training model for volunteers consists of. while some research has been done on suicide and suicide prevention, there is an obvious n.eed for much more research in the entire area of tele-
150
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phone crisis intervention. There is a particular need for research which deals with the evaluation o f the effectiveness o f such services, the selection o f volunteers, and the training o f these volunteers. There is also a need for the development o f a model for the training o f telephone crisis volunteers. No one seems to have developed a conceptualization o f the what and how o f training, although Motto et al. (1974) do develop a set o f standards for the contents o f training. We suggest that training for nonprofessional or lay volunteers should be built on the concepts o f crisis intervention. While crisis theory as such is not well formulated and does not y e t constitute a powerful or well-recognized conceptualization o f behavior change, it does have a set o f articulated concepts. These offer some basis for a model o f training (Caplan, 1961, 1964; Kalis, 1970). We further suggest that social learning principles, such as behavior shaping, modeling, and feedback, offer a m e t h o d well suited to the training of volunteers (O'Connor & Rappoport, 1970).
REFERENCES Brockopp, G. W., & Yasser, A. Training the volunteer telephone therapist. Crisis Intervention, 1970, 2, 65-72. Caplan, G. An approach to community mental health. New York: Grune & Stratton, 1961. Caplan, G. Principles of preventive psychiatry. New York: Basic Books, 1964. Farberow, N. L. Training in suicide prevention for professionals and community agents. American Journal of Psychiatry, 1969, 125, 1702-1705. Fowlzr, D. G., & McGee, R. K. Assessing the performance of the telephone crisis workers. In G. W. Brockopp & D. Lester (Eds.), Crisis intervention and counseling by telephone. Springfield, Illinois: Charles C Thomas, 1973. Heilig, S. M., Farberow, N. W., Litman, R. E., & Shneidman, E. S. The role of non-professional volunteers in a suicide prevention center. Community Mental Health Journal, 1968, 2, 287-295. Kalis, B. L. Crisis theory: Its relevance for community psychology and directions for development. In D. Adelson & B. L. Kalis (Eds.), Community psychology and mental health. Scranton, Pennsylvania: Chandler, 1970. Lamb, C. W. Telephone therapy: Some common errors and fallacies. Voices: The Art and Science of Psychotherapy, 1969/1970, 5, 42-46. McGee, R. K. Suicide prevention programs and mental health associations. Mental Hygiene, 1971,55, 60-67. McGee, R. K. Crisis intervention in the community. Baltimore: University Park Press, 1974. McGee, R. K., Richard, W. C., & Bercum, C. A survey of telephone answering services in suicide prevention and crisis intervention agencies. Life Threatening Behavior, Spring, 1972, 2, 42-47. Motto, J. A., Brooks, R. M., Ross, C. P., & Allen, N. H. Standards for suicide prevention crisis centers. New York: Behavioral Publications, 1974. O'Connor, R. O., & Rappoport, J. Application of social learning principles to the training of ghetto blacks. American Psychologist, 1970, 25, 659-661. Potter, G. Hotline for troubled youth. Federal Probation, 1971 (December). Reisman, F. Strategies and suggestions for training non-professionals. Community Mental Health Journal, 1967,3, 103-110.
The Training of Telephone Crisis Intervention Volunteers 1,2 Michael C. Dixon 3
George Peabody Collegefor Teachers Jim Burns
Tennessee State Department of Mental Health
Telephone crisis intervention services are growing at a very rapid rate. A review o f the literature reveals that there are very f e w references to this new phenomenon and even fewer that deal with evaluating the effectiveness o f telephone crisis training. Herein 7 articles are reviewed which deal with volunteer selection and training. These articles demonstrate that no consistent rationale for volunteer selection or training exists. Selection o f volunteers typically consists o f a gross screening to eliminate any obviously unsuitable persons, with training serving as a further sorting procedure where volunteers who are uncomfortable with the role o f a crisis interventionist can be encouraged to drop out. The authors suggest that a training model be built around crisis intervention theory using principles o f social learning as the methodology for training.
Throughout the United States, 24-hour emergency telephone counseling has become a standard practice. The vast majority of these services are aimed at crisis intervention and/or suicide prevention and utilize nonprofessional volunteer workers as the primary intervention agents (McGee, 1974). This widespread growth of telephone answering services for crisis intervention and suicide prevention and some involvement with two specific crisis call Editor's note: This article was reviewed by the APA Division 27 Editor and recommended for publication on Journal pages devoted to matters of special interest to the Division of Community Psychology. 2An earlier version of this article entitled "Telephone crisis intervention and crisis volunteers" appeared in CrisisIntervention, 5, 1974, 2-5. 3Requests for reprints should be sent to Dr. Michael C. Dixon, Center for Community Studies, Box 319, Peabody College, Nashville, Tennessee 37203. 145 @1975 P l e n u m Publishing C o r p o r a t i o n , 2 2 7 West 1 7 t h Street, New Y o r k , N . Y . 1 0 0 1 1 . N o part o f this p u b l i c a t i o n m a y be r e p r o d u c e d , stored in a retrieval s y s t e m , or t r a n s m i t t e d , in a n y f o r m or b y a n y means, e l e c t r o n i c , m e c h a n i c a l , p h o t o c o p y i n g , m i c r o f i l m i n g , recording, or o t h e r w i s e , w i t h o u t w r i t t e n permission o f t h e publisher.
146
Dixon and Burns
center training programs prompted the authors to look into the literature concerning crisis call training. We were particularly interested in assessing the information, if any, which was available concerning the training of telephone crisis intervention volunteers or the use of telephone answering services as a type of crisis intervention. Since the origin of such services, starting with telephone suicide prevention in Los Angeles in the late 1950s, many major cities and smaller towns have adopted programs aimed at suicide prevention or crisis intervention through a nonprofessional, volunteer-staffed, telephone answering service. A December, 1971, listing in the National Hot Line Directory indicated over 750 such services in existence; the number could be approaching 1000 by now (Potter, 1971). It was surprising to learn, therefore, that despite the large number of telephone answering services for suicide prevention and crisis intervention (McGee, 1971; McGee, Richard, & Bercum, 1972), there is relatively little in the literature concerning these services. We found a total of 40 references, 17 of which dealt specifically with suicide prevention services and 13 with general information and referral telephone services. In addition to these 2 categories, we found 4 articles pertaining to the types of calls received and 6 articles pertaining to volunteer selection and training. We were particularly interested in this last category and examined the journal articles with an eye for any recurrent philosophies on the training or selection of volunteers. As we see it, crisis intervention, even if it is primarily informational in nature (that is, providing either a referral source or concrete information for the caller), is a very different role for a volunteer than most other types of volunteer roles. Many volunteers, for example, serve essentially as distractors. Their function is to help a person focus on something other than his or her current problem or situation. Crisis intervention requires just the opposite of the volunteer. He/she must help the client to be very specific about the problem. Often his/her most useful function is to help the client realize the real nature of his/her problem, so that the caller sees it in perspective with other elements of his/her life. Other volunteer roles may call for very gradual approaches to the nature of the client's difficulty,perhaps never asking for information directly unless the client indicates a desire to talk about it. In crisis intervention, the volunteer must get to the heart of the problem quickly and, particularly with respect to suicide, determine the lethality of the situation. Crisis training, then, is significantly different from other types of volunteer training because the role of the volunteer is very different. There is, therefore, a need for a volunteer training rationale directed at this difference. Brockopp and Yasser (1970) discuss volunteer training for telephone therapy, using as a model the Erie County Suicide Prevention Center. Although the purpose of the center is primarily suicide prevention, their description of the training procedure seems applicable to other crisis intervention programs. They
Telephone Crisis Intervention Volunteers
147
emphasize the areas of selection, phased training, supervision and feedback on individual performance, and follow-up to the training program. It is the philosophy of the Erie center that selection of volunteers serves a twofold purpose: (1) allowing the center staff to evaluate a prospective volunteer, and (2) requiring the applicant to evaluate himself/herself in the light of the types of duties he/she will have to perform and thereby make a better decision concerning his/her willingness to volunteer. The philosophy of the program follows as an extension of the philosophy of selection. Training is phased over a period of a month and consists of 3-hour sessions held twice weekly. During these sessions, the volunteer is instructed in basic skills such as the physical operation of the center and in elementary techniques and philosophies of telephone therapy. Additionally, the training sessions attempt to provide the volunteer with a better self-insight. A component of supervision and feedback is provided by numerous role-playing sessions and eventually an evaluation of the technique in handling actual crisis calls. Follow-up to the training program is provided by opportunities to discuss calls taken during actual service times with supervisory personnel in light of the volunteer's feelings and training needs. Reisman (1967) describes what he feels to be the essential components of a training program. His orientation is more general than specific, however. He lists 3 areas or topics which he feels must be treated in any program. The first is role ambiguity, which Reisman feels must be clarified in the case of each volunteer. Second, training should be phased over a period of time and should progress into all areas a volunteer may encounter; also, the program should include on-the-job training with adequate supervision. Finally, training should be unif i e d - that is, unified in the criterion used for selection of the volunteers in order to strengthen any individual weaknesses, and unified with respect to the varied aspects of the professional supervising the program. Reisman stresses, above all, that unrealistic expectations should not be created for the volunteer trainees. Another article relevant to training is Lamb's (1969/1970) paper on errors and fallacies found in telephone therapy. Lamb points out 6 common misconceptions that, when applied in telephone therapy, usually produce negative results. These misconceptions could be termed a priori errors of philosophy and include such faults as believing that you must do something, feeling that you must "love" everyone who calls, and feeling that you must know about all possible resources. Lamb's point is that telephone therapists must not believe they are (or try to be) perfect; nor should they enter into their work with an inflexible approach to problem-solving. It should be the goal of training, according to Lamb, to prevent the emergence of these errors. Heilig, Farberow, Litman, and Shneidman (1968) discuss the selection and training of nonprofessionals for telephone therapy in suicide prevention. Heilig et al. presented a selection plan consisting of interviews, a written autobiog-
148
Dixon and Burns
raphy, and an MMPI protocol, which the selection staff used in an attempt to assess the presence of certain characteristics, such as motivation, responsibility, motivating factors in volunteering, and flexibility or openness to training. The training program itself is suggested as an excellent period for further observation and evaluation of the volunteer's abilities and potential. Heilig et al. stress 3 primary areas in training: adequate coverage of theories relevant to telephone therapy and suicide prevention, practice in specific methods for handling calls, and examples of actual calls and case histories. Training is followed by an apprenticeship period during which specific weaknesses are ironed out for each volunteer. Farberow (1969) briefly discusses training at the Los Angeles Suicide Prevention Center. The primary emphasis of his paper is the importance of removing existing feelings about the social stigma of emotional and mental health problems from the volunteers during training. Fowler and McGee (1973) present a scale (the Fowler Technical Effectiveness Scale) to assess the effectiveness of volunteer telephone workers. The goals of this scale are to measure the volunteer's effectiveness in communication skills, assessment of the caller's condition, and production of a plan of action. In the presentation of this scale and its measures, Fowler and McGee have indirectly proposed that the areas measured are the 3 essential areas of expertise a volunteer should possess, which therefore should be the focal point and goal of any training program. While we agree that communication skills, assessment skills, and ability to formulate and start the client on a plan of action are essential for crisis intervention, the enumeration of these needed abilities does not address the full range of skills needed by a crisis interventionist nor does it address the issue of what the conceptual base for training should be. A very recent addition to the literature attempts to address the issue of training and other major issues by setting out a series of judgments which are offered as standards for suicide prevention and crisis centers. With regard to training the following are listed as standards (Motto, Brooks, Ross, & Allen, 1974): 1. Basic. knowledge o f suicidology : The epidemiology of suicides and suicidal behavior. Psychological and motivational elements of self-destructive behavior. Legal aspects of suicide and suicidal behavior. Special considerations applicable to children, adolescents, and the elderly. Fallacies and c o m m o n misconceptions about suicide characteristics of depression. Sociological and cultural aspects of suicide. The relationship of suicide to psychological disorders. Religious and philosophical concepts related to suicide. The rationale of current preventive measures, intervention techniques, and emergency procedures.
Telephone Crisis Intervention Vohmteers
149
2. COmmunity resources: How to choose appropriately from among available resources. Characteristics, requirements, fees, and limitations of principal referral agencies. 3. Ethical considerations: Procedures that ensure confidentiality. The limits of responsibility of the crisis worker. Ethical aspects of taping, tracing calls, contacting police. 4. Record keeping: Specific instruction regarding information to be recorded on each call. Rationale for records and uses to which crisis data will be put. 5. Counseling and intervention techniques: Active listening. Referring and transferring calls. How to secure communication with the caller. Techniques of formulating an action plan. Techniques for systematic follow-up of action plans. Effective utilization of consultation and backup personnel. Technique for covering caller's demand for personal involvement of the crisis worker. Perhaps one of the biggest issues in the operation of crisis intervention centers and the training of telephone crisis workers is that of a criterion or standard by which a volunteer can be judged as to the adequacy of his/her training and a center can be judged as to the adequacy of its training program. A simple count of the number of yes or no responses to these questions (as to whether or not that element is included in training) would serve as a rough index of the quality of training. Likewise, the question "What constitutes a well or adequately trained volunteer?" might be approached by using the above as a standard for what the volunteers should know, and be able to do, after training. Based on this review of the literature, with particular emphasis on the articles noted above, we have concluded that there is no systematically developed rationale for either the selection or the training of "crisis call" volunteers (with the possible exception of the Motto et al. scheme noted above). Selection seems to consist of a gross screening of volunteers to eliminate any obvious "pathological" types, with training serving as a sort of natural selection or "shifting" period where volunteers who begin to feel uneasy over their roles can drop out of the program. Training is centered primarily around discussion of theories of suicide prevention, crisis intervention, and counseling with some use of role playing to simulate actual calls. Volunteers then typically spend a period of time in actually taking calls under the supervision of a more experienced volunteer. While there are literally hundreds of crisis intervention centers across the country, the relative paucity of literature in this area indicates that almost no research has been done to indicate what a viable training model for volunteers consists of. while some research has been done on suicide and suicide prevention, there is an obvious n.eed for much more research in the entire area of tele-
150
Dixon and Burns
phone crisis intervention. There is a particular need for research which deals with the evaluation o f the effectiveness o f such services, the selection o f volunteers, and the training o f these volunteers. There is also a need for the development o f a model for the training o f telephone crisis volunteers. No one seems to have developed a conceptualization o f the what and how o f training, although Motto et al. (1974) do develop a set o f standards for the contents o f training. We suggest that training for nonprofessional or lay volunteers should be built on the concepts o f crisis intervention. While crisis theory as such is not well formulated and does not y e t constitute a powerful or well-recognized conceptualization o f behavior change, it does have a set o f articulated concepts. These offer some basis for a model o f training (Caplan, 1961, 1964; Kalis, 1970). We further suggest that social learning principles, such as behavior shaping, modeling, and feedback, offer a m e t h o d well suited to the training of volunteers (O'Connor & Rappoport, 1970).
REFERENCES Brockopp, G. W., & Yasser, A. Training the volunteer telephone therapist. Crisis Intervention, 1970, 2, 65-72. Caplan, G. An approach to community mental health. New York: Grune & Stratton, 1961. Caplan, G. Principles of preventive psychiatry. New York: Basic Books, 1964. Farberow, N. L. Training in suicide prevention for professionals and community agents. American Journal of Psychiatry, 1969, 125, 1702-1705. Fowlzr, D. G., & McGee, R. K. Assessing the performance of the telephone crisis workers. In G. W. Brockopp & D. Lester (Eds.), Crisis intervention and counseling by telephone. Springfield, Illinois: Charles C Thomas, 1973. Heilig, S. M., Farberow, N. W., Litman, R. E., & Shneidman, E. S. The role of non-professional volunteers in a suicide prevention center. Community Mental Health Journal, 1968, 2, 287-295. Kalis, B. L. Crisis theory: Its relevance for community psychology and directions for development. In D. Adelson & B. L. Kalis (Eds.), Community psychology and mental health. Scranton, Pennsylvania: Chandler, 1970. Lamb, C. W. Telephone therapy: Some common errors and fallacies. Voices: The Art and Science of Psychotherapy, 1969/1970, 5, 42-46. McGee, R. K. Suicide prevention programs and mental health associations. Mental Hygiene, 1971,55, 60-67. McGee, R. K. Crisis intervention in the community. Baltimore: University Park Press, 1974. McGee, R. K., Richard, W. C., & Bercum, C. A survey of telephone answering services in suicide prevention and crisis intervention agencies. Life Threatening Behavior, Spring, 1972, 2, 42-47. Motto, J. A., Brooks, R. M., Ross, C. P., & Allen, N. H. Standards for suicide prevention crisis centers. New York: Behavioral Publications, 1974. O'Connor, R. O., & Rappoport, J. Application of social learning principles to the training of ghetto blacks. American Psychologist, 1970, 25, 659-661. Potter, G. Hotline for troubled youth. Federal Probation, 1971 (December). Reisman, F. Strategies and suggestions for training non-professionals. Community Mental Health Journal, 1967,3, 103-110.
