Help! Someone I know is in trouble and I don't know what to do!

It is part of the human condition that we sometimes are in a position to recognize that someone close to us needs help, yet we hesitate, perhaps because we fear making the situation worse, and then we feel powerless. That "someone" could be a client, a co-worker, a friend or family member, or even yourself.

THREE 'A's - Attend, Assess, Act

Attend:

Attending is listening with the "third ear"…tuning in to what is being said but also what is the underlying message that is being communicated to you?

· A friend (client, co-worker) says "I'm fine, just a little stressed" but his or her body language is "saying" tense, anxious, overwhelmed and the tone of voice conveys discouragement and hopelessness.

· You may have noticed that he/she has been unusually irritable, agitated or withdrawn, or has been taking a lot of unplanned leave, or seems to be acting impulsively.

· Offer empathy, listen respectfully, and show interest and support. Ask what they have been doing that is helpful and encourage them to let their needs be known – resist requests to keep the information private.

Assess:

Assessment involves active evaluation of the situation. What are you hearing, seeing, feeling?

· Encourage your friend (client, co-worker) to tell you a little more. Stay calm and avoid judging, arguing, preaching or sounding shocked, if you can, so that he/she can feel you can be trusted with more information.

· Use open-ended questions that elicit his/her trust, and a continuing dialogue. "Yes, I've noticed you have been stressed…" and wait for a response, or "What's got you stressed…?" rather than "You're clearly NOT fine!"

· Assess what you know about this person: the support systems (family, friends, community) and how you have observed him/her cope in the past. What is his/her faith/cultural background? How will it help or hurt the current problem? What external factors play into the crisis…legal requirements, health issues, a loss (death, move, job)? What strengths and resilience does this person have?

· ASK about suicide… you will not put ideas in a person's head! Ask if he/she is thinking about suicide and be willing to listen. Many persons feel overwhelmed at times and have thoughts of giving up but these are usually short-lived – a suicidal person may be thinking more seriously about the how and when (buying a gun, stocking pills) and this will help you to assess how serious the situation is. If in doubt, consult a professional or hotline!

Act:

Action is about what needs to happen next?

· Stay involved. Keep the line of communication open and be willing to take the initiative. (Often persons who are depressed or highly stressed are so overwhelmed that they don't know how or where to get help.)

· Keep a list of helpful telephone numbers in your desk, home office. If the situation is not acute, share information with your friend if he/she seems responsive, or call for support and advice as to how best to help your friend

· Take charge. If you have assessed that the person is an immediate danger to self or others, act quickly and decisively. This is not the time to worry about privacy. Don't be sworn to secrecy, it is not a loyalty test but a life-threatening emergency. Call 911, a hot-line, or go to an emergency room, mental health center, crisis center. Do not leave the person alone.

· Encourage your friend (client, co-worker) to access his/her strengths, and find support, be it family and friends, the faith community, a mental health professional, and practice self-care, like exercise, balanced diet, humor, etc.

These three A's can be applied to many common situations, including an honest dialogue with yourself! The three are A's are given as a guideline but are by no means meant to substitute for professional consultation and guidance. Please consult the appropriate professional if you or someone you know is struggling with stressful events.

Celia Ryan, DCSW, LCSW-C, CT, Clinical Social Worker and Certified Grief Therapist

email: celiaryan@griefworks.com

Webpage: http://www.griefworks.com/

Contact: Little River, SC - 843 281 4232