Microsoft word - caller behaviour profiles august 2011.doc
Caller Behaviour Profiles UPDATED AUGUST– 11 PLEASE DO NOT REMOVE FROM PHONE ROOM PLEASE REMEMBER THESE ARE ONLY A GUIDE The Callers
‘Farmers Wife’ Taken off profiles 17/08/11 Graham Taken off profiles 17/08/11 Michael Updated 17/08/11 Political Man Updated 17/08/11 Andy Taken off profiles 17/08/11 Erin Taken off profiles 16/08/11 Olivia Updated 16/08/11 Bill/Ivan (see guideline in book from National Office) Brooke 17/08/11 Sex Callers- Please get the number (even private) and write down the time they called. Shelley will send the information to National office for the number to be blocked.
These time and frequency guidelines are especially important with callers who phone often. For callers who are obsessive or delusional, long or frequent calls may be detrimental, as they may feed their obsessions or delusions. For all of these callers, other ways of coping need to be developed and encouraged. Duration: 10-15 minutes Frequency: 1 call per day No Overnight Calls - unless in crisis
(Definition of a crisis: A situation that is strongly impacting the caller’s ability to function)
Margaret: Can be very low, may need up to 20 minutes at these times. LifeLine Waikato Regular or Long Term Callers
Margaret One 10 minute call per day NO OVERNIGHT Updated & no changes 17/08/11
IDENTIFYING CHARACTERISTICS: • Usually identifies herself by name.
• Supporting a man who was in prison for 5 years. Margaret finds this a huge
• Likes to call LifeLine first thing. It helps Margaret focus.
• Identifies herself as New Zealand born Chinese.
• Very intelligent, may talk about politics, religion.
• Very grateful for the service LifeLine provides.
• Talks about her partner who committed suicide.
• May discuss historic sexual abuse or financial pressures.
• Now attends crafts on a Tuesday morning.
• Has an 80 year old brother who she is a bit scared of. Margaret thinks he
drinks too much. Sometimes where he drinks he will abuse Margaret over the phone.
• Margaret’s mother died at 37 years old. Margaret was 12. See Guidelines
1. General Psychiatric 2. Bi-polar / Manic Depression
3. When Margaret is a bit low try asking some of following: * How would you like for things to be different?
* If you could change one thing what would it be? (this could open up an opportunity to use some MI techniques * Ask Margaret if you can take a minute to work on all the pros & cons of making a decision if this is where she is struggling. * Look at the handouts that might apply to her situation. e.g problem-solving and decision-making facilitation of change & innovation stress management assertiveness and self-confidence Please keep reminding Margaret that she does have a very full and busy life. Please keep to one 10 minute call a day.
. One 10 minute call per day UPDATED 16/08/11 NO OVERNIGHT IDENTIFYING CHARACTERISTICS:
• Raspy, wheezy breathing, heavy smoker, may be long silences.
• Spent time in Lake Alice at the age of 23 for 6 years. This was after raping a
16 year old girl at the end of 1980(was psychotic & depressed at the time) Her spirit appeared to him in 1999 after she died and blames him for her death (although he has never verified that she did die.)
• Intermittent paranoia – FBI, CIA, SAS watching, tapping phones.
• Talks about inventing technological devices (generator/voltage).
• Can be very angry, usually angry with God, sometimes talks about plans
involving revenge, plans can be violent.
• Sometimes talks about his wife / ex-wife.
• Michael’s dog died on January 5th 2011 due to accidently poisoning her. Her
• Both parents suffered from mental illness, bipolar & schiz. Father was
Scottish & mother died of cancer at 49years.
• He isn’t planning to move because his arthritis is bad 31/12/10
• New puppy purchased 09/02/11. He sleeps with Michael to keep him company.
• Michael’s best friend moved in November and contact has ceased. This has
• Blames Jesus for not being well. He will sometimes swear at a counsellor if
he is aggravated. If he has been rude he will sometimes call back to say sorry.
• Gave up smoking at the beginning of July. He said in August he can’t give up
completely. This has frustrated Michael.
• Michael is hoping to get a walker because he has been falling over regularly
• If Michael makes threats towards a person such as wanting to kill a child etc. please remind him threats of this nature are a Police matter. You could ask him to ring the Horowhenua Community Mental Health Team (He has the number) for support, the Police himself or inform him you need to break confidentiality & ring your supervisor (Crisis Phone).
• Delusion / Paranoia Contact Crisis Support Team if specific threats of harm are made.
Political Man (Mr Neville) 0278775486 One 10 minute call per day Updated 17/08/11 NO OVERNIGHT IDENTIFYING CHARACTERISTICS:
• Political man will talk about being hypocritical on certain topics and then ask
what you think? For example he has saved $10k and then calls himself a hypocrite.
• Obsessed with relationships with women on the internet.
• Talks about his wife’s treatment in the mental health system. His wife is
Schizophrenic and he is her full time caregiver. Lives with his wife’s mother who he doesn’t get on with after the earthquake. Talks about how he hates paying rent to a wealthy landlord and would prefer to pay rent to the state.
• Struggling to find a job as a solicitor.
• Talks about communism vs. capitalism
• Gets very angry about NZ and it’s people, culture. Sometimes says this is a
• Will repeating himself over and over if feeling frustrated.
• Thinks people are judged on how much money they earn.
• Started taking Prozac at the beginning of July 2009 which has made a
difference. He still has some irrational thoughts but they don’t have the same impact as they used too.
• Caller’s G P wants him to see a psychologists or psychiatrist but he doesn’t
like them. (they are objects of capitalism)
• He might hang up if he isn’t ready to get off the phone & you ask what he is
going to do after the call. He will also hang up if challenged or if you try to draw him back to the here & now.
• Would like his mother to die. She lives in Wanganui 01/02/11.
• Recent stay in psych ward after Police put him there. He spent his time
manipulating the psychiatrists.(11/01/11)
• He will generally recognise if he has spoken to you before.
• Decided on 27/08/10 that he might look for a job & tidy up.
• He knows particular T/C’s voices & will say “You haven’t been on for a while”
or he will ask “Have I spoken to you before?” if he is unsure of a voice.
See Guidelines • Time Restricted Calls
• Refer to Managing Difficult Caller Handout. This is located on the desktop in
• If this caller gets personal with you end the call straight away. We need to
keep strict boundaries. WE ARE NOT HERE TO TAKE ABUSE. REMEMBER CALLERS DO HAVE CHOICES. THIS CALLER CAN MAKE A CHOICE. FOR EXAMPLE (1) DOES HE WANT TO STAY IN THE SAME SITUATION OR (2) WORK ON MAKING SOME POSITIVE CHANGE IN HIS LIFE. PLEASE READ THE ARTICLE BELOW. IT IS REALLY IMPORTANT WHEN YOU DEAL WITH A CALLER LIKE POLICITIAL MAN OR THE TAURANGA MUM YOU DON’T GET CAUGHT UP IN A GAME AND BECOME A RESCUER. PLEASE FEEL FREE TO DISCUSS FURTHER WITH SHELLEY. REMEMBER WE WANT TO EMPOWER OUR CALLERS TO MAKE POSITIVE CHANGE.
The roles of the drama triangle are: Victim, Persecutor and Rescuer. Karpman shows the relationship between these three roles by putting them on an upside down triangle. This shows the Persecutor and Rescuer in the one-up position that they take to the Victim.
• A Persecutor is someone who puts other people down and therefore goes one-up.
They can act actively or be passive in response to the Victim.
• A Rescuer also goes one-up. They do more than their share and do they things
• Victims don’t take responsibility for themselves. They will often feel
overwhelmed with their feelings or even numb to them. They go one-down.
The arrows on the triangle indicate the direction of the transactions, but the drama in the Triangle comes from the switching of roles. As the drama triangle is played out, people change roles or tactics. Others in the triangle will then switch to match this. Sooner or later the Victim, sick of the one-down position, turns on the Rescuer. Or the Rescuer becomes fed up with a lack response or any appreciation of their efforts, becomes persecuting. The Drama Triangle role names are part of our everyday language. Most people who are in relationship with depressed person will be familiar with being called a Rescuer when they are perceived as helping too much. A depressed person can also be labeled a Victim. While the Drama Triangle illustrates the problem quite clearly, it’s not always that easy to get out when you are in the middle of the drama. That’s why I like the Winner’s Triangle. The Drama Triangle has been around long enough for there to be many derivatives and modifications. The Winner’s Triangle uses the same structure as the Drama Triangle but uses adult roles to replace the parent/child roles of the Drama Triangle. I first came across the Winner’s Triangle in a paper presented to the 1984 TA Conference by Acey Choy, she says she didn’t invent it and doesn’t know who did!
The roles of the Drama Triangle each have their equivalent role in the Winner’s Triangle. Each of the three roles in the Winner’s Triangle is an ‘OK’ role and requires the development of a different set of skills (see table below).
Triangle Role Triangle Role to be Developed
Any technique that the Vulnerable person can use to get themselves thinking about options and consequences is valuable. In the Caring role the development of listening skills that involve emphathising with the Vulnerable person is required. Listening is frequently the only Caring response needed. Assertiveness is about getting your needs met without punishing. Self awareness is essential in all three roles.
Caller may be attempting to gratify hard-to-meet needs in an anonymous modality rather than in a constructive wayCaller may be angry and unable to express it in an adaptive wayCaller may be frustrated with life generally and deal with it by impacting on othersCaller may be bored or lonelyCaller may be a child/adolescent
Reframe: Whatever the motive, these callers are dissatisfied with SOME aspect of their lives – An opening to discuss real issues?Decrease likelihood of caller’s nuisance-calling behaviour
Change talk Resistance talk Olivia one 10 minute calls per day Please note the change of one 10 minute call a day 16/08/11
IDENTIFYING CHARACTERISTICS: • Surname Heehan & middle name Jane.
• She is a twin. Her sister died 15 years ago.
• Mother was from the Cook Islands & Father a Maori/Pakeha.
• Olivia is now pregnant to a 16 year old at her school. On the 05/08/11 Olivia
was carrying twins and miscarried one. Olivia & her boyfriend are both living with her 81 year old Great-Grandmother. Olivia is due in November. Become engaged to her partner at the start of August. Olivia is suffering from bad morning sickness and will often comment that she doesn’t like being pregnant.
• Had a termination at 13 and then two more at 14 & 15. Olivia said she was
forced to terminate by CYFs, Police & family.
• Had glandular fever and a kidney infection in July.
• Mother died the Christchurch earthquake. Mother aged 41. Olivia has been
• Raped by several people including her brother.
• Likes to get drunk and have “random sex.”
• Has a 19 year old brother who is in the Army & found her mother in the
• Will often start a call with “Hi – why was I abused?” Olivia will also ask ‘was it
• Loss cell phone & the school found it. The school informed the Police about
the rape. Has discussed an older man she likes & feels safe with.
• Father has passed away 7 years ago. Anniversary on June 24th.
• Has a horse & works part time on a farm. Enjoys motor bikes.
• Good at sport especially netball. Good swimming and lifesaver.
• Rings Nadine her mental health worker every day at 3pm.
• Was raped late 2010 by a 55 year old. The court case was in March/April and
• Took a long time for ACC money to come through for counselling.
• Olivia reported it to the Police. Kate (Policewomen in Balcutha) Kate is now
on maternity leave 04/01/11. Tessa (CYFS Social worker)
• Has been abused for 12 years. Foster parents abused her at 3 years old.
• Has a new puppy. He is a fox terrier called Ralph.
• Listens to CD’s when can’t sleep.
• Favourite subject at school is Human Biology.
• Has a sister (23) who lives in Matamata. Olivia would like to live her.
• Lives with her grandparents in Balcutha. 021 143 6044 (Her Nana’s phone)
Likes her Nana and worries about her Grandad who she thinks is “nuts”Landline 03 4128702. Olivia cell 0278696523. Granddad works at freezing works, grandma works on a farm.
• Attends Catlin’s school South Otago. Year 11.
• Has two counsellors (March 23) Olivia is seeing one of them once a week and
Olivia has some significant tragic life events to work through. Please focus on one area of her life during a phone call. For example you might focus on only grief, her sexual abuse or her pregnancy. This will be more productive for Olivia.
See Guidelines 1. Sexual Abuse Theme In our library refer to the books The Courage to Heal Workbook (CP69) & Outgrowing the Pain (CP63) to get an insight to the trauma survivors of sexual abuse face. The first area to focus on with Olivia is supporting her to create a place of safety. This can include finding safe places and maintaining a strong support system. When Olivia phones in get her to think about where she feels safe. It might be her bedroom or a favourite place in her house etc. Encourage her to think about a place that gives her some peace or makes her happy. Even get her to list where she feels safe and what times of the day. Also refer to the identifying characterises for some guidance.
Try and get Olivia to create a list of a support system. Get her to list everyone she knows and then tick who could be in her support system. These could be people she can turn in a time of need. This phone list can be used when dealing with the particularly hard times.
You can also use the Kubler Ross Grief Cycle over the page as a guide when dealing with losing her mother. Using the grief cycle is an opportunity to talk about Olivia’s feeling and normalise her grief. If it is the right moment try and explain the grief cycle to Olivia such as the shock, denial, anger, depression, and then finally acceptance. Again this is another way to normalise her grief and inform her that her emotions will be everywhere and then she will eventually accept what has happened.
Brooke number 06 833 6549 or 0272358119 One 10 minute calls per day Please follow the guidelines of one 10 minute call a day. If Brooke calls back please let her know you are going to hang up because you have to keep the line open for other callers. Please then put the receiver down. 16/08/11
• Lives with Mother & step-father.
• Has a boyfriend who works in the library at tech.
• Has two older brothers. One brother is in Thailand and the other in
• Attends EIT computer course which she finds hard.
• Loves animals and has a cat called Fidel Castro.
• Has talked about getting some face to face counselling at Elt.
• Likes to talk about beaches, swimming and time with her brothers & their
• Brooke grandmother just lives around the corner.
• Breathing can be quite rapid at times. Guidelines When Brooke is tearful refer to her cat which usually cheers her up. Brooke’s breathing can become quite rapid when she is upset. Please use the guidelines below or any other techniques you think will be useful.
Lie down with a small book on your stomach. Practice breathing deeply so that the book
moves up and down each time you breathe in an out.
This is an excellent way to practice deep breathing.
Find a nice comfortable position to sit or stand. Keep your back straight and breathe out
Try to breathe out as much air from your lungs as possible. Then, take in a deep breath
through your nostrils. As you take in the air, allow your stomach to expand.
Once your lungs are filled up, slowly breathe out through your mouth. Do this exercise
Stand straight. Place your hands along your lower ribs with your fingers pointing down
Take in a slow deep breath through your nose. You should feel your lower ribs move
outward. Fill up your lungs with as much air as possible, then try taking in another puff
Next, let the air out slowly through your mouth. Keep your lips partly closed so that
there is a small amount of resistance. Try to breathe out all the air you possibly can. You
can gently push in your lower ribs to help you do this.
Callers not to use LifeLine THESE ARE BEEN UPDATED REGULARLY PLEASE FOLLOW THIS GUIDELINE FOR ALL SEX CALLERS. Sex Callers
See LifeLine Policy and Procedures Manual page 32, Sexually Abusive Callers. GENERAL GUIDELINE • We will not take calls from sex callers
• If you have spoken to them before don’t feel like you have to keep giving
them a referral, as they have been referred to several agencies, multiple times.
• If you are aware that you are speaking to a particular sex caller end the call
Facelifts As part of the aging process which happens to all of us sooner or late, our skin progressively loses its elasticity and our muscles tend to slacken. The stresses of daily life, effects of gravity and exposure to sun can be seen on our faces. The folds and smile lines deepen, the corners of the mouth droop, the jaw line sags and the skin of the neck becomes slack. Around the eyes,
CONTENTS Page Introduction Diabetes politics………………………… 4 Philosophy and aims of care.… Assessment of control Treatment of type 2 diabetes Preliminary observations………………… Overview of treatment…………………… Thiazoledinediones………………………. Prandial glucose regulators………………. Insulin and tablet combi