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

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

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

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

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
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

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,

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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