Beverly, Stephanie and I answer the Family Health Line specifically for Post Partum Depression.
The mother and child are in the hospital and what do you think the atmosphere is like surrounding them. How are the partners, parents, nurses and doctors. Who is cleaning and how is the mother eating? If mom or baby is uncomfortable what happens? What is the responsibility of the mother?
Use these questions as an attempt to establish rapport. Questions that bring about negative responses can be put off temporarily and brought back to the surface as you engage the client.
You have heard about listening today. When you are on the phone what are some of the things that help you keep listening. When you find yourself loosing concentration what do you try repeating their words mentally as they say it – it will help reinforce their message and keep you from drifting. The client is not with you and therefore you cannot see their posture or facial expressions. When you are asking the questions listen carefully to the tone of the voice and how the client pauses.
We can never guarantee results we can assure people that they are doing what is in their interest.
Speak up when you are down
1-800-328-3838 Family Health Line Collaborative experience of Beverly Jackson, BA Theresa Carlin, RN Stephanie Williams, MSW, LSW Speak Up When You Are Down
You are a MOM!* *But ….It’ not what you expected
Answering the call <ul><li>Ask the basic demographic questions as discussed previously. </li></ul><ul><li>Establish rapport. </li></ul>
LISTENING BEYOND WORDS Demanding Responsiveness Crying Background noise Tone of voice
Cases Words indicating help is needed. I don’t know what to do…… I am tired……. I have never felt this way before…….I think I have post partum depression My doctor told me to call last week…….
Words indicating the mother may be crisis I have a plan…… I want to end it all…… Help me I need to talk to a counselor now……
<ul><li>Give referrals or transfer to crisis center </li></ul><ul><li>Make sure the client understands what the next step is and if you will follow up. </li></ul><ul><li>Give assurance that what she is doing is in her interest. </li></ul>CLOSING THE CALL
Case 1 <ul><li>Client states she has an 8 month old child and an older child. States she has had depression on and off throughout her life. The symptoms she had in the past were nothing compared to these. </li></ul><ul><li>States she usually dealt by going shopping, getting her nails or hair done. States she is breast feeding and cannot be that free. </li></ul><ul><li>States husband tries to help out with the baby but really has no understanding of why she needs to cry so much. States she does not understand it either. States when she starts to talk to him she usually begins crying yet again. </li></ul><ul><li>States her appetite is poor but she forces herself to eat because of breast feeding. She does get up with the baby at night because her husband works all day and she just cannot expect him to be up all day and at night. </li></ul><ul><li>The only people she has spoken to about her condition are her obstetrician, husband. She does not feel comfortable talking to her friends and other relatives. </li></ul>
Case 2 <ul><li>Client states that her doctor advised her to call the hotline as he feels she is starting with post partum. States the baby is 6 weeks old and she has a 7 year old and a 2 year old. States she thinks she has a history of post partum and was asking her doctor for anti-depressants and that is what brought her distress to the surface. </li></ul><ul><li>States her doctor spoke to her for awhile and the advised her that we would be able to help her. States her last baby had a lot of issues with colic and irritability as she thought that was what was wrong with her. States with her last child all she wanted to do was sleep. This baby is fine and now she cannot sleep. States she is breastfeeding. </li></ul><ul><li>States she experiences memory loss (i.e. goes into the nursery to get something and cannot remember what she was going to get) and then she experiences mood swings and cannot stop crying. </li></ul><ul><li>Client states she does not want to hurt herself or the baby. States her mother is ill and her significant other works during the day. She has no one to assist her or give her breaks. </li></ul>
Case 3 <ul><li>Client states that her baby is 3 weeks and she went to see her physician to talk and he told her to call the number. States she has no desire to hold the baby. States she is breast feeding the baby and hates it. States she does not want to harm the baby but does not like her. States she would not hurt herself. </li></ul><ul><li>Her husband is home today and that is why she was able to get out. States she has horrible mood swings and just cannot stand herself now. States she recently lost her father and is sad about this as well. </li></ul><ul><li>States she has not received any treatment in the past for depression. </li></ul>
Case 4 <ul><li>Client is a 34 yr old white female </li></ul><ul><li>gave birth to her 1st child,14 days </li></ul><ul><li>prior to contacting the hotline </li></ul><ul><li>Trying to conceive for 5 yrs., 2 </li></ul><ul><li>years of IVF treatment, had to </li></ul><ul><li>have a C-section </li></ul><ul><li>Client has her husband and a </li></ul><ul><li>baby nurse present in the </li></ul><ul><li>household 24/7. Client reports </li></ul><ul><li>having a strong support network </li></ul><ul><li>Breastfeeding, but the baby nurse </li></ul><ul><li>does night feedings by bottle </li></ul><ul><li>History of depression, In treatment </li></ul><ul><li>with therapist (5 yrs.) and </li></ul><ul><li>psychiatrist (3 yrs.) for medication </li></ul><ul><li>monitoring (Wellbutrin and Lexapro) </li></ul><ul><li>no meds since became pregnant </li></ul><ul><li>Symptoms: </li></ul><ul><li>Depression, no feelings of happiness, overwhelmed, crying a lot, sleeping a lot, no desire to get out of bed in the morning, no sense of bonding, feels nothing when she looks at him, anxious, does not want to be left alone with him </li></ul><ul><li>Makes statements like: </li></ul><ul><li>“ why don’t I love him? And will I ever?” </li></ul><ul><li>“ will I ever feel better? Is there hope for me?” </li></ul><ul><li>“ do people recover from this?” </li></ul><ul><li>“ what is wrong with me? am I </li></ul><ul><li>abnormal” </li></ul><ul><li>Calls hotline every other night, will </li></ul><ul><li>only speak to one counselor </li></ul>
Case 5 <ul><li>Client is a young woman in her late 20’sof age who resides in the South Jersey area. Client did not want to provide any specific demographic information. This is her first child. </li></ul><ul><li>Client is currently under the care of a psychiatrist. She has been prescribed Celexa and Xanax. Client had depression during her pregnancy and took medication for symptoms. </li></ul><ul><li>Client believes that the medication caused some issues with her baby. Client wants a referral for another psychiatrist because her treating psychiatrist is not giving her direct answers about the possibility of side effects of the medication she took during her pregnancy. </li></ul><ul><li>Client stated that she believes that her 3-month old infant has some developmental issues because she is not cooing or talking like other babies her age. Client believes medication has effected her baby because the baby is not responding or interacting with her. </li></ul><ul><li>Client stated that she just wants someone to confirm whether or not the medication she was prescribed had any effect on her baby. Client stated that she was told by her pediatrician that everything is fine with the baby and that the baby has no issues with developmental milestones in relation to her age and behaviors. </li></ul><ul><li>Client begins to cry and is also having a side conversation with her mother about developmental issues with her baby and the need to see a psychiatrist. Client was upset and asked if she could call back later. </li></ul><ul><li>Client did not express any thoughts of harm to self or to her baby. </li></ul>