3. Focal Points: Basic Skills

There's more than a little overlap and interaction between the two basic categories of drug-related problems we'll consider in this book, overdoses and psychological emergencies.

Still, to be effective as a crisis helper, it's important to keep your role in perspective as it applies to both types of crisis.

In a psychological emergency: You're there to create a safe environment and provide emotional support until a person is able to resume emotional control.

In an overdose: You're there to help monitor vital signs and provide needed life support until emergency medical support (EMS) arrives.

It's as simple -- and complex -- as that. Still, in both contexts, the same personal qualities are essential to effectiveness.

They probably include a lot of the same traits you'd bump into if you were searching for words to describe a good therapist or qualities you'd look for in a friend.

Stay calm. There's no special trick to remaining calm in a crisis. If you know what you're doing and you're doing what you know, you shouldn't have problems staying calm.

Still, problems can come up when you stumble into areas in which you're not fully comfortable. No matter how well prepared you are, there will likely always be situations you're not fully knowledgeable about or comfortable in.

On top of that, we all have psychological "buttons" that get pushed in specific situations or by particular people. Some can't stand the sight of blood. Others freak out in stressful circumstances. Others handle stress well in a one-to-one encounter, but are less effective when they're called upon to deal with groups.

No matter what plugs you in or weirds you out, remain in emotional control. We're not asking you to deny your feelings or "pretend" things are other than the way they are. We're simply suggesting that you allow whatever feelings you have to be on the inside, while on the outside you're busy attending to what needs to be done.

How do you best do that? Focus on the person you're helping, not on your feelings. Respond to the circumstances that present themselves, and apply the principles we'll present in this book.

And remember: Fear and uncertainty are contagious, but so is confidence and self-assurance.

Don't impose your values. Maintain a non-judgmental attitude. Attitude is important, but opinions aren't -- at least not in the context of resolving a crisis.

Stay friendly, supportive, and non-threatening. Your attitude is of fundamental importance because it creates a climate of acceptance in which to conduct the intervention. People are more likely to open up in an atmosphere of trust. Let them.

Communicate. Acknowledge, reflect, reassure. Help the person work through any embarrassment or fear he or she might have. Remind the person that others have been through similar situations with similar feelings.

And when you communicate in a crisis, make the power of suggestion work for and not against you.

Often, suggestibility runs wild in a drug emergency. Physical and psychological effects can snowball from apprehension and fear as much as from the drug itself.

Reassure the person in a psychological emergency that their problem is a result of drug use and will go away.

Still, don't lie -- or unnecessarily distort reality.

If someone asks you a question and you're not sure of the answer, tell them so. Forget having to have all the answers. To be effective as a crisis helper, it's enough to ask the right questions.

Be sensitive to contextual cues. Learn to look above and below the surface of a crisis. Get to know the characteristics and flavor of different crisis situations and respond accordingly.

Just as you refrain from imposing your values and judgments, you should also avoid forcing yourself too far into the foreground in certain situations -- or too far into the background, when the situation calls for you to assert a leadership role.

Simply put, the way you respond to a person who's behaving dangerously on PCP may well be different than the way you'll respond to someone who's overdosed on heroin or barbiturates.

Similarly, be sensitive to the personalities present. If a parent is present with a child undergoing a bad LSD reaction, for example, you might choose to play a secondary role to the parent.

Then again, you might not, depending on how you evaluate his or her rapport and effectiveness.

Those are the main personal qualities you should bring to any crisis.

They're not the only important personality traits by any means, but they do provide a basis for working effectively with others.

But beyond personal qualities, there is one other attribute you should focus on as we prepare to move into a discussion of specific intervention and life-support techniques. It becomes increasingly important as the level of physical intervention increases in a crisis. It's just this:

Know your limitations. Don't try to provide treatment beyond the limits of your skills.

If you attempt a life-saving technique which you may be unqualified or unprepared to perform (CPR, for example, or moving a seriously-injured person), you can cause more harm than good. Serious, even permanent, harm.

That's why crisis workers -- no less than medical doctors and other health professionals -- should always be guided by the ancient oath: "Primum non nocere."

Don't speak Latin? Here it is, in English:"First, do no harm."

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This is one in a series of publications on drugs, behavior, and health published by Do It Now Foundation.
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