Frequently-Asked-Questions  (FAQ)  & Resources

      for OTR Listens Volunteers

                      Volunteer Handbook

                      Provide the Seeker with emotional support and a cathartic outlet:

                      • With an attentive listening ear, understanding and compassionate heart
                      • Create and holding a safe space, non-judgementally
                      • Engage with empathy and empathic communication
                      • Shed light on own coping skills and available informal support resources that they can access
                      • Share information on available community support resources - to seek further help as required


                      Data collection:

                      • Try to find out the seeker profile (age, gender, support resources, professional help, suicidal risk) during the chat session with Seeker, if possible
                      • To fill up this Seeker info when you create a case in CRM 
                      You are to refrain from posting content on social media that:
                      • You are a volunteer with OTR Listens, details of OTR Listens’ internal operations, etc 
                      • Describe issues or name any seeker you came across or cause seeker to be identified Include any information pertaining to seeker

                      You are NOT to arrange to meet a seeker outside or communicate with a seeker outside of ‘OTR Listens’ shift duties. In exceptional cases, this will be the decision and consultation of SListeners – not your own unilateral decision.

                      Maintain a professional relationship with seekers
                      Never promote any specific or personal cause, belief, value, lifestyle or product to seekers

                      Being fully present, with: 
                      • An attentive listening ear
                      • A caring compassionate heart An open non- judgmental mindset

                      Make a difference in someone else’s life
                      Learn about yourself
                      Help create a caring society

                      Respect for all seekers regardless of age, gender, beliefs and values 
                      Ability to listen actively
                      Empathy
                      Option generating 
                      Patient and perseverin
                      Give Seekers sound advice. 
                      Give answers to problems. 
                      Share your personal experience/story
                      Teach Seekers remedies that work for you
                      Listening 
                      Sensing 
                      Questioning 
                      Responding
                      The following are the key guidelines which should be observed while carrying out your online duties.

                      Professionalism
                      • Refrain from using inappropriate language towards seekers (eg. no use of profanity even if seeker uses it).
                      • Be sensitive not to casually use any words of endearment to seekers (though with good intentions) - eg. ‘Darling’, ‘Sweetheart’, ‘Dear’, ‘Honey’, etc. Keep in mind - not everyone appreciates being referred to as such.
                      • Always maintain a decorum of mutual respect and courtesy in words and deeds for ALL within OTR Listens - even if there are differences of opinions, etc. Raise any unresolved issues to SListeners.
                      • Able to commit to a 4-hour duty slot and 4 sessions per month. Book your slots 4 weeks ahead.
                      • Be punctual for duty shift (log on at least 10 mins before time).
                      • If I have to change my shift due to an emergency - inform Service Manager as soon as possible. Give as much advance notice as possible (minimum 1 day advance notice).
                      • If you are taking a volunteering break for more than 2 weeks, do inform the Service Manager ahead of time.
                      • Have mobile phone close at hand in case SListener needs to reach me.

                      Accountability
                      • Ensure I am in a private and uninterrupted space when I am on duty shifts - not in a public space.
                      • I will not involve any unauthorized person to respond to the chat messages from seekers or share information pertaining to the seeker - such as showing chat messages on the screen to unauthorized personnel (including family or anyone who could be near me) during my shift.
                      • I will NOT promise or arrange to call or meet seeker outside of my OTR Listens shift.
                      • I will NOT divulge any personal information about myself to any seeker eg. – name, profession, age, where I live, etc. My persona is ‘Avie’ on OTR Listens.
                      • I will key in all relevant information into the system for record after the end of my shift
                      • I will consult my shift SListener when in doubt or when faced with problems.
                      • I will trust and accept feedback from SListener/s as a continuous learning opportunity and the ultimate goal to provide my best ‘listening skills’ to seekers.
                      A good listener listens to what is being communicated through the text – directly or implied.

                      Effective listening skills are comprised of five elements. They are:

                      • Asking questions
                      • Expressing empathy
                      • Rephrasing or reflective listening 
                      • Acknowledging, and
                      • Use of silence

                      Common Mistakes in Listening:
                      • Focus on responding instead of Listening. Making assumptions ... jumping to conclusions.
                      • Unaware of personal prejudices and biasness.
                      • Listening Tips
                      • Check out message received from seeker. Summarize the content.
                      • Reflect back the feeling (empathize)
                      Asking the right question is at the heart of effective communications.
                      Effective questions are powerful and thought provoking – how well do we ask?

                      Use more Open-ended Questions Change closed-ended questions into open- ended questions by using:
                      • What
                      • How
                      • When
                      • Where
                      • Who

                      Examples of Open-Ended Questions:

                      • How can I help you?
                      • What seems to be the challenge? 
                      • What happened this morning? 
                      • Why are you upset?
                      • Where were you when you heard?

                      How to start an empathetic response:

                      • You sound….

                      • You feel….

                      • I’m picking up that you feel…

                      • You are saying you …..

                      • I sense you that perhaps you feel….

                      • It sounds like you….

                      • You seem to be feeling….

                      • You must have felt…..

                      • You appear……..

                      • This is so…….. for you.

                      • It seems you are/feel……..

                      “It sounds as if you feel... [feeling word] ... because... [reason].”
                      • For example: “It sounds as if you feel that we don’t have the resources for this project because everyone is too busy.”, “It sounds as if you feel anxious because you have to make that presentation tomorrow”

                      “It must be...[feeling word]...when...[reason].”
                      • For example: “It must be frustrating to work so hard on a project when no one else appears to recognize that work.”
                      • Or, “It must be irritating when it seems that no one is listening to your point of view.”
                      “I can understand that...[reason]...would make you…[feeling word]).”
                      • For example: “I can understand that the amount of time it took us to make a decision would make you upset.”
                      • Or, “I can understand that getting appointed to this new job would be very exciting for you.” 
                      Ask questions to help seeker come out with the possible ways he/she could handle the problem.
                      Do not offer to list the ways – without exploring with seeker for his/her answers first.
                      Evaluate the Alternatives – together with seeker.
                      How much will the alternative help versus harm the person or other people in the person’s life?
                      Explore and support seeker to decide on the Best Alternative. Which alternative will bring the most help and least harm?
                      ASK ASK – allow seeker to think and answer questions himself/herself
                      Problem 
                      • What are the triggers? Focus. Past coping.

                      Attempted Solutions
                      • What didn’t work - and why?
                      • What worked?

                      Options
                      • Identify / Highlight Resources
                      • Explore options (Information and Resources) -> Pros? Cons?
                      • Suggest Reflection -> Decision / Action

                      Look out for signs of suicide risk (Suicide Risk Assessment)
                      • Low Risk
                      • Medium / High Risk
                        • Consult S-Listener
                        • Create a safety plan
                      • Empathetic Responses: Ask Open-ended Questions
                      Low Risk
                      Medium / High Risk
                      • Consult S-Listener
                      • Create a safety plan
                      Empathetic Responses: Ask Open-ended Questions

                      Out-of-Bound Issues & Possible Responses

                      What should I do if Seeker is ...

                      (May be subtle - like "life is pointless", "no one cares", etc)
                      Never brush off/belittle  
                      EMPATHIZE
                      Do probe/explore and talk about it
                      Do be direct (“Are you thinking of suicide?”)  
                      Continue to engage with seeker
                      Assess suicide risk - CPR
                      Do your best to work out an agreed safety plan
                      Have resources ready (National Care Hotline OR SOS etc.)
                      Contact SListener for support
                      (Past/Present)
                      Victims feel a deep sense of shame and contempt of themselves.
                      ‘Hear’ them out. Empathize with their trauma.
                      Never directly or indirectly lay blame on them for what happened. Check their current safety. Explore alternatives Case Reported?
                      Reasons?
                      Explore options (have resources ready)
                      Remember that it takes a lot of courage to own up to it 
                      Explore the feelings/reasons behind their sharing (e.g. guilt)
                      Surrender to authorities? 
                      What is stopping them? Explore options (have resources ready)
                      Empathise
                      Explore options (have resources ready)
                      Be supportive of their decisions
                      Identify and encourage them to seek help from support network
                      Empathise
                      ‘Hear’ them out 
                      Explore options (have resources ready – eg COM CARE hotline, Social Service Offices etc)
                      Do Not agree to ‘pass’ any money to them in one way or another.
                      ‘Hear’ them out
                      Allow ‘airing off’ of pent up emotions 
                      Empathise with the feeling / emotion (frustration, fear, etc.) behind their anger 
                      Keep calm – do not take it personally
                      Do empathise/listen 
                      Identify specific issue(s) – confusion of identity, sense of rejection etc.
                      Explore options (have resources ready)
                      Respect their beliefs 
                      Encourage them to find their own answers 
                      Identify and encourage religious habits/traditions that work for them
                      Do empathise/listen 
                      Allow them to talk about loved one - even happy times together, etc.
                      Grieving effectively (have resources ready)
                      Be assertive (but non- judgmental) – the purpose of this online chat is  [...], "if there isn’t anything else, I am logging off now.”
                      Empathize with emotions felt
                      Refer to the proper experts / resources 
                      Refer to the proper experts / resources

                      Common Triggers for Young People to Seek Help Online

                      Self-esteem
                      Internal conflicts on different values by people around
                      Trust issues
                      Identity crisis
                      Gender issues
                      No objectives and goals, aimless
                      Boredom
                      Mood swing
                      Anger / Rage
                      Depression
                      Self-harm
                      Suicide
                      Health
                      Addiction
                      Abuse (physical / sexual)
                      Single parent family
                      Money problems/Financial pressure
                      Problems with parents/siblings
                      Abuse by parents
                      Tragedy in family, e.g., death of a loved one
                      Exams/academic pressure
                      Communication / relationship issues with teachers
                      Social pressure to be an A student in all areas
                      Bullying
                      Rejection/made fun of by classmates
                      Bullying
                      Boyfriend/girlfriend issues
                      Peer pressure
                      Rejection/laughed at by friends
                      Joblessness
                      Money problems/Financial pressure
                      Lack of job satisfaction
                      Lack of career direction
                      Victimized at workplace

                      Platform Operational Guide & Useful Tips

                      Be punctual for duty shift (min. 5 mins early)
                      • Start the day's first shift on time for timely handover from the earlier shift
                      Begin the duty by joining the VOLUNTEER ON DUTY (VOD) Channel and drop a greeting so others can see you
                      • Remain online on VOD channel throughout the shift (to be connected with your Shift Buddy).
                      Join the OTRListens.net Channel
                      • Get ready to receive chats.
                      Check platform calendar for the SListener on duty
                      • Some SListeners will be on platform to communicate via Direct Messages, while others will leave their WApp no for you to text them when needed.
                      You can access (and download) the Platform User Guide  here .
                      Inviting SListener / Shift Buddy to chat
                      • Follow the instructions strictly on the Platform User Guide.
                      Create a CRM case a d ensure all steps are completed and checked before submitting the case
                      • Add a snapshot / summary of Seeker’s key issues on “Log A Note” - on the right-sidebar of CRM page.
                      • Use the correct naming convention - e.g. ‘Opportunity 21234’ & ’Name: 21234’ or ’Name: 21234 Alice’ (to include Seeker’s name). DO NOT add additional Seeker numbers of description to ’Name’ (e.g. 21234 / 20855 / 20674) to indicate they are the same Seeker. Instead add these info to Log A Note.
                      • Complete Seeker’s profile info: Tags (select ’seeker’), age, gender, etc.
                      • For issues, select 1 or more key issues from the dropdown list. If nothing fits or Seeker leaves before revealing them, select ‘Others’.
                      • Submit CRM cases for all interactions (including missed or short chats).
                      Missed out on "/Lead" function after ending a chat
                      • Click “+ CREATE” to set up a new case in CRM and proceed with the rest of the steps including Log A Note and Seeker’s profile info.
                      • However, your chat session history will not be attached to the CRM page (need to inform SM via App (with Seeker no. and tim) for follow-up.
                      Seeker on silent for 10 or more min, you may end chat by sending an invitation for Seeker to reconnect later
                      • Use shortcut “:Sign-off” - “I have not heard from you for a while. Please reconnect by starting a new chat. Thank you for connecting with us today.” 
                      Unable to attend to a new chat as currently overwhelmed with Seeker(s)
                      • Use shortcut “:busy” - “Sorry I cannot attend to you at the moment. Please connect back a bit later. If an emergency, please call National Care hotline @ 6202 6868 or SOS Hotline @ 1800 221 4444."
                      Chats should last not much longer than 1 hour
                      • Chats should not last beyond 2 hours especially if Seeker is not highly distressed or suicidal.
                      Taking a short break (5-10 mins)
                      • Inform your shift buddy, LEAVE the channel, and re-JOIN once you’re back, to avoid missing a chat while you are away.
                      Avoid missing chats by checking your computer screen frequently
                      • Most Seekers tend to drop off between 1-4 mins if no reply. 
                      • The number of missed chats has increased in recent months, so need to be vigilant in checking the incoming chats.
                      LEAVE the OTRListens.net Channel (to stop receiving Seekers) and LOGOUT from the platform
                      • Please Do Not LEAVE the channel until your next shift buddy takes over.
                      Busy with a chat at the end of your shift
                      • Do stay longer (extra 30 mins) to complete the chat OR invite your incoming shift buddy to take over the chat.
                      Book your duty slots 4 weeks ahead
                      • We encourage you to book duties ahead of time, to secure your preferred slots.
                      • This will also help us reduce the admin time and the challenge of needing to fill up slots at the last minute.
                      • If any schedule change, do WApp Service Manager (Denise) asap.
                      If you need to take a a volunteering break for 2 weeks or more, do Service Manager ahead of time.
                      We are here to give time and ‘hear’ the Seeker out – that’s the role of Avie:
                      • However, duration of chats should end between 1-1.5 hours, at most 2 hours. 
                      • Chats should not extend much beyond 1 hour - to 2 or even 3 hours (your whole shift or even beyond) – especially if the seeker is not highly distressed or suicidal.
                      • This can become ‘addictive’ – e.g. we had the same seeker coming in every shift (with a different volunteer) on the same day – hanging onto chats for hours and hours.
                      • The last thing we want is to create a ‘dependency’ from seekers with marathon sessions – where the seeker seeks solace with hours and hours of chat as an ‘escape’ from their real world. 
                      Preparation to ending a chat:
                      • Start from 30 mins or so into the chat, help seeker focus on the immediate concerns/triggers that made them connect. 
                        • Eg. “ It must be so hard to be anxious about this as well. May I suggest that you focus on this immediate issue first?”
                      • After 1 hour, start summing up KEY points with Empathy in the chat
                        • Eg. “From our chat, it seems this is a very stressful time for you as you ~~~~~~~”

                      Steps to ending a chat:
                      • “We have chatted for quite a while already, please do think about what we discussed and come back to chat with us again.”
                        OR "We have chatted for some time now, Do think about ~~~~~~. Do get some rest and take care of yourself in the meantime.”
                      • Proceed to send the ‘Goodbye' message.
                      • If seeker doesn’t want to end chat and raise another issue, repeat as above.
                      • If seeker is still insistent to hang on:
                        • Can say "I need to be available for another person on the platform now. Thank you. ~~~~”
                      • END CHAT

                      Even if suicidal thoughts and self-harm is mentioned, they are not in immediate danger if:
                      • No specific /immediate plans and accessibility to means.
                      • They have people (Family, friends, even other people) physically near them.
                      • Ask – “Do you have plans of how you are going to kill/harm yourself?”
                      • If it is a ‘Yes’ to suicide question
                        • OK to ask – “Who is at home with you right now?” 
                        • OR – “Where are you now? – Who is near you?” OR “Are there people near you?”
                      • Give them SOS number (1800-2214444) – encourage them to call to speak about their suicidal thoughts to SOS as they are 24 hours operational.

                      For assistance with regards to a  Seeker, Listeners are encouraged to contact our S-Listeners: 

                      • Check our Platform Calendar for the S-Listener on duty
                      • Check if the S-Listener is online and send your message via "Volunteer on Duty" Chat or Direct Message* from our platform. S-Listener will respond to your message accordingly
                      • Some S-Listeners may choose to leave their WhatsApp number for you to contact them directly, as they will not be on the platform throughout the shift
                      • If there's NO S-Listener name or WhatsApp number on the duty slot, please send WhatsApp message to Service Supervisor (Lai Chun) at +65  8023 1822
                      • For any other assistance do contact Service Manager (Denise) at +65  8875 8702

                      Frequent Seekers

                      CAT
                      Sounds Female but uncertain.
                      Has been coming onto the platform very often lately, almost everyday and sometimes few times within a day.

                      Identifying Clues:
                      Recently talks about ‘Cutting’ self, see suicidal as a backup plan. Take a few Panadols, drink poison, jump, put rope around the neck, put needle to the back/neck, punch herself, etc.
                      Often uses expletives like – “Fuck” “Fucking” etc.
                      “Hate self” – Uses words like ‘Repulsive’, ‘Disgusting’ etc. Often suggests – “You can end this chat!”

                      Background
                      Social Science Uni student – but no interest – talks about ‘Boredom’.
                      Spent 1.5 years in treating depression can then return back to Uni.
                      Feel bad about the time lost.

                      Mentioned did something ‘bad’, being a ‘bad’ person who doesn’t deserve to live and need to punish self.

                      Uninvolved parents in his/her childhood, However, relationship seems better now (according to her.) Home is the place grounding her, anxious when need to stay away from home (eg: campus, anuty house).

                      When agitated - would not give more information when probed –
                      Gets upset as to reason Listener needs to know ‘details’ etc.

                      Seeker does seem to have - ‘persecution’ complex – believing people around are ‘persecuting’ her and there is consistency shown in self-persecution too. Has trust issues.

                      Issues shared
                      Usually comes onto platform to chat about her daily life stress in coping with issues faced – school work, assignments, exam and her OCD, internship. She comes to OTR platform to seek for comfort through chatting.

                      Sharing in May22 - mouth hurt (ulcer) - fear to interact with people especially new colleagues – worry about work attire make her look ugly – stressful with the job assigned during internship – anxious and lonely as she moved out from her house in order to stay close to her work place.

                      Post exam triggered her bad childhood memories – rely on caffeine for soothing.
                      Sometimes, she comes onto platform – threatening suicide and cutting self, drinking nasal drops etc. Wants to write in ‘blood’. (But tells Avie - she is not ‘dying’) etc – acknowledges that she is doing this to ‘get attention’.

                      Sometimes sounds angry and “hates everyone” – “Nobody Cares”.
                      Claims to be a Bully, a ‘Villain’ – but doesn’t give details what was done etc. - and even wants to pay someone to ‘kill him/her’.

                      Often claims she ‘fakes’ her illness to get attention to die.

                      Super low self-esteem. She finds herself selfish, self-absorbed, fragile self-esteem, disgusting horrible, not in line with society and deserves to die.

                      Questions Avie about ‘Munchausen’s syndrome’.
                      Acknowledges she comes onto the platform to ‘get attention’.

                      Munchausen's syndrome is a psychological disorder where someone pretends to be ill or deliberately produces symptoms of illness in themselves. Their main intention is to assume the “sick role" so that people care for them and they are the centre of attention.)

                      Resources 
                      Mentioned her family is ‘OK” but she has no friends.
                      Not exactly Resources but mentioned coping with these: Mentions drinking alcohol and gaming all day

                      Prof Help

                      Mentioned professionals don’t help. (Had sought help in the past)
                      Said he/she has ‘given up and nobody can help.’ – Claims professionals don’t help.

                      “Not close to family or friends”.
                      Talking doesn’t help.

                      Mentioned she had help from a psychologist but stopped cos it is “too expensive” – but fears a relapse.
                      Currently seeing a counsellor but not regular basis.

                      Seeker definitely needs professional help. Encourage her to seek help from the list of Mental Health Resources from OTRListens website
                      (Note Polyclinics that provide help for mental health conditions.)

                      OTR Listens Approach

                      Empathise and hear him/her out – especially his/her sense of isolation, feelings of being overwhelmed etc

                      When angry - Seeker can seem manipulative. Seems to want to bethe one who ‘controls’ the chat by withholding any information when probed. Challenges and criticises Listener’s response. Claims it is ’her’ right for ‘autonomy’ for not telling details.

                      Seeker will get angry and become defensive - ask listener to end chat as she ‘does not want to become a burden’. She ‘thrives’ to instil guilt in others and even Avie.

                      Do not get defensive, nor need to explain and apologise in response to her criticisms. Ignore the criticisms and challenges.

                      If Seeker gets argumentative or repetitive:

                      Don’t be afraid to end the chat -if chat goes round and round and if seeker starts to get aggressive.

                      Empathise - “ It must be hard to feel the way you do. I am here to hear you out but it is your choice if you want to chat. Please log on again when you are ready to chat. Thank you.”

                      DO NOT get caught in any argument with her. END Chat by saying ‘goodbye’ and then do NOT respond to her comments any further.

                      She will log off eventually. DO NOT allow her to control the chat nor Avie’s response.

                      If she threatens suicide – encourage him/her to call SOS @ 1767.

                      “I am concerned about your safety and encourage you to reach out to SOS.”

                      Regardless - Seeker does find comfort and claims she is happy when she is not agitated.
                      Came to our platform few months ago, disappear for quite some time and re-connect again lately. He/she usually comes to OTR platform during weekends.

                      Background

                      The seeker feels left out and lonely. Perception is that nobody cares for him/her. No friends. Family also does not talk to him/her but scolds her/him instead.

                      Poor social skills, cannot express his/her feelings and thoughts sometimes. Cannot express feelings and thoughts then claims that counsellors not able to help.

                      Lives with parents, only child at home. Currently Working.

                      Issues shared

                      Desperately needs someone to love and care for him/her.

                      Afraid to fall asleep - feels discomfort in mouth, ears, hand and body after waking up. Hard to explain these discomforts which started many years ago.

                      He/She suspects ‘ghost’ in the room as the parents said so. Believes could be the cause of the ‘discomforts’.

                      Mentioned her/his threshold is high...he/she keeps holding feelings within self.

                      Likes ‘Pink” - Wishes to have all items in pink - eg: bag, shoe, shirt, laptop and handphone but does not have any of them in reality.

                      He/she tried to make new friends via online platform but claimed that nobody likes to talk her/him after some time.

                      Hating everything and anyone. Having trust issue...

                      Mentioned Hospital (IMH?) did not help, did not arrange her/him to  see therapist. He/she felt waste of time staying in hospital.

                      This seeker seems not ready to take action but just dwells in the helpless mode. Often not giving a lot of information but just vent out his/her anger and frustration during the chat. He/she keeps repeating - nothing to look forward to, and nothing can help him/her...

                      Resources

                      Parents cannot give her/him comfort, family doesn’t talk to him/her.
                      No friends
                            
                      Prof Help

                      Claims professional help did not help.

                      OTR Listens Approach

                      It is not easy to handle the chat cos there seems to be a great sense of helplessness and hopelessness but yet – he/she is not willing to give more info.

                      It’s OK to acknowledge - you have chatted with him/her before.

                      (We are all Avies) – so she doesn’t repeat everything from ground zero. Can refer –“I remember you mentioned ~~~~~)

                      Empathise and hear her out, acknowledge the tiredness and frustrations again and again. OK to repeat the empathy - just like he/she repeats same thing. But YES- Must end chat after a while  – not drag on for too long.
                      “WE have chatted for etime. Do take a rest and come chat with Avie again when you are ready to consider what you can do to help yourself feel better. Do take care....”

                      OK to ask after chatting for quite some time - (if seeker shuts every option to explore) – “You said you tried everything and nothing helps – what do you hope to do when you log on to chat today?”

                      Just ask seeker to ‘consider’ any options discussed during chat – no need for him/her to make decision on what to do – then end chat.

                      Sometimes the seeker “Just want to chat.” - we can give some time but can end chat after a while – no need for seeker to feel better or find answers at the end of chat.
                      (He/she said just want to ‘chat’ – so we give some time and that’s all – IT’s OK. That could be all he/she wants.

                      *Do Not try to ‘find’ any answers for seeker as he/she may not want that.

                      ‘Avie’ can get frustrated and drained by chatting with this seeker who puts a ‘No’ to everything.

                      Give some air time but be firm to end the chat after a while – and that is OK.
                      Comes to our platform often in April’22

                      Addy

                      Background

                      Seeker talks about the relationship with his/her god brother - getting worst and little about work.

                      His/Her God brother used to be her emotional support. He encourages seeker to get professional help.

                      She is currently working.

                      On anxiety med – antidepressants (from polyclinic) but feels they do not help.

                      Being put on different meds for her sleep issues but claims nonehave worked.

                      Issues shared

                      Went to IMH early May - god-brother accompanied her - mentioned the psychiatric is sarcastic – wish to change psychiatric but the process makes her worry.

                      Feels lonely as nobody cares for her – even her god brother (who felt upset with her self- harm behaviour recently.)

                      But she continues self-harm as it makes her feel calm and sleep well after that.

                      Self -cut – seeker’s coping mechanism when anxious.

                      Resources

                      God brother used to be her only support (informal support). Family not aware that she/he having mental issue.

                      When stressed, mentioned swimming helped.

                      Brother seems going thru hard time too (divorced with his wife), - as such not available for seeker.  

                      Prof Help

                      Patient of IMH
                      Mentioned she had help from a psychiatrist but do not feel any better.
                       
                      OTR Listens Approach

                      It’s OK to acknowledge - you have chatted with her before. (We are all Avies) – so she doesn’t repeat everything from ground zero.

                      Can refer –“I remember you mentioned ~~~~~)

                      Empathise and hear her out, acknowledge emotions.
                      She sounds like Ryleigh’s friend

                      Coming to our platform very often lately.

                      Background

                      A student
                      Parents' never-ending conflict
                      Sister – selective mutism
                      Hobby: Ballet
                        
                      Issues shared

                      Worry of changing counsellor – Separation anxiety as her counsellor leaving (migrating for good) – fear to start a new relationship with an experienced counsellor (who is in private sector).

                      Exhausted and tiredness for keep supporting her friend – Ryleigh guilty if she cannot keep Ryleigh safe.

                      She is not happy with her currently job but cannot quit as she will be required to pay a sum of money due to the breach of contract – she feels discomfort when people touch her body. She feels disrespectful emotionally, especially when Ryleigh has self-harm thoughts – feel as one of her colleagues insisted touching her even after shared her discomfort feeling.

                      Feel hard to form a healthy relationship/ friendship as she always playing a caregiver role which make her exhausted eventually.

                      Resources
                      N/A

                      Prof Help

                      Seeing a counsellor regularly – currently she is in the midst to adopt new counsellor.
                      Seeing a psychiatrist - on medication.

                      OTR Listens Approach

                      Empathise and hear her out, acknowledge emotions.
                      Background

                      A student – (said she is 20 years old)
                      Studying bio-engineering (Year 2 in August 2021)
                      Works in Production during vacation in the past
                      May’22 update – Undergoing internship (computer science)

                      Issues shared
                          
                      Overdosed on 10th May and 13th May - mentioned she want to live but her emotions are not – currently undergoing internship (computer science) which is totally different from what she studies in Uni, makes her feel stressed and exhausted.

                      Usually, she comes onto platform to chat about her daily life stress in coping with issues faced – school work, assignments, parents, work, her first-responder volunteer work, her taekwondo classes/instructor/tests, her mental health issues etc.

                      Chats with Avie - when she is on the bus, MRT etc

                      Initial contact – on previous counsellor leaving – felt abandoned etc – adapting to new counsellor etc.
                      Mentioned ‘freaking out’ during exams period.
                      Boring work in production

                      Often mentions – being ‘Disassociated’, and suffering from PTSD from childhood, having attachment issue etc - parents arguing etc.

                      Mentions abandonment issues, eating disorder, suicidal thoughts...self-harm behaviour but does not seem to be in immediate danger as she mentioned her self-harm is only ‘superficial’ But - that family doesn’t know about her self-harm etc.

                      Does mention suicidal thoughts when really upset* - recently mentions ‘cutting’ herself with her finger nails etc.

                      It seems like she resorts to cutting self- and talks about suicide whenever she is emotionally distressed – That’s her way of coping.

                      Hopefully, she will be able to learn coping with distress in more productive ways through the professional help she is getting.

                      Was warded in IMH in July 2021 due to suicidal tendencies. Warded in IMH again from 11th Apr 2022 due to self-harm thoughts.

                      Has plans to go overseas to study (Australia?)– seems excited about it.

                      Resources

                      When stressed, tried stretching which used to help, used to do ‘taekwondo’ too

                      Mentioned:
                      • Music (instrumental) helped her -sings, Reading books, Enjoys watching CSI on TV.
                      • Journaling helps too.
                      • Resorted to rocking back and forth as a coping mechanism when stressed.
                      • Often says nothing helps her condition but highlight to her that they had helped her in the past – even though for a short period.
                      • Encourage her to continue doing things that helped - even though short term.
                      • Being in Peer Helper Training. (A programme by Singapore Association of Mental health for those with mental health conditions to help others in same conditions too).
                      • Being a registered first-responder for 1st Aid. 
                      • ‘writing suicide letters’ is healing. We are not here to encourage her to write suicide letters but ’writing’ seems to be a short-term ‘outlet. Emphasize that ‘writing’ can be healing.

                      Prof Help

                      Seems to be seeking help from multiple places.
                      • Recently update in Apr’22, she was seeing 3 therapists at the same time. IMH psychiatrist encourage her to stop one of the therapies but she was reluctant to listen.
                      • Seeing Counsellor and Psychiatrist
                      • Under Trauma Therapy and under the care of the Campus Crisis Management Team in University
                      • Another counsellor at a Family Service Centre

                      Encourage her to stick to same help rather than ‘counsellor-hopping’.

                      OTR Listens Approach

                      She usually just needs to ‘air’ her daily life stressors and usually appreciative of Avie just hearing her out.

                      It’s OK to tell her you have chatted with her before. (We are all Avies) – so she doesn’t repeat everything from ground zero.

                      Can refer –“I remember you mentioned ~~~~~(Even though it might not have been you.)

                      Empathise and hear her out. Attend to her immediate distress/concern.

                      But Limit to 1.5 hour – once a day – (Max)
                      She might need a Listening ear and finds comfort connecting with ‘Avie’ –

                      BUT we do not want to create an obsessive dependency where she spends marathon sessions on the platform – hour after hour repeatedly – and not attempting to ‘carry on’ her life.

                      If you notice she has already chatted with us in earlier shift – same day – (OK to be directive) Tell her to end chat and do something (refer to her resources).

                      Note* - Avie cannot find a ‘cure’ to her mental health issues but only a listening ear - She acknowledges that Avie helps her cope ‘in between’ her sessions with her counsellor and Psychiatrist.

                      If suicidal :

                      Direct her to do something that had helped her in the past to stop from cutting self – See Resources above.

                      Ask if someone is with her and to even go to nearest clinic / A & E - if she feels out of control and needs to harm self.

                      Encourage her to contact SOS too.

                      Actual Seeker Chats - with Suggestions for Improvement (for Learning)

                        Case with comments  in Blue  CHAT A

                      SEEKER : Hi Listener: hi! Listener: you came back  SEEKER : oh, was it the same visitor number?  LISTENER : I’m glad you decided to stay with us  LISTENER : oh, perhaps it’s just the system glitch  LISTENER : hahaha

                      LISTENER : how are you today?
                      SEEKER : not too bad I guess
                      SEEKER : but spiralled down a lot recently
                      SEEKER : oh wells
                      LISTENER : oh no
                      LISTENER : do you want to talk about it?  (Closed question – Say –‘Tell me more’)
                      (Empathy – That must have be hard on you with the spiral down recently. )
                      LISTENER : or is there something else on your mind
                      (Pick up from what  Seeker  said - Get  Seeker  to tell more about ‘Spiral down’- Don’t change course of  chat -unless  Seeker  doesn’t want to talk about it when asked)
                      SEEKER : maybe it's just another relapse lol
                      SEEKER : sick and tired of everything
                      LISTENER : relapse?  (Empathy – You sound drained.)
                      LISTENER : it sounds like you feel defeated
                      SEEKER : yea
                      LISTENER : did you anticipate it?  (Closed question. Try more open-ended- question. “Tell me more” OR  “What happened to make you sick and tired of everything)
                      SEEKER : it's not new to me
                      LISTENER : did it feel the same this time?  (Closed question again. Try “ You said it’s not new – what  happened in the past?” OR “You mentioned ‘another relapse” – tell me about this?” Always follow up  on what  Seeker  mentioned.))
                      SEEKER : feel what
                      LISTENER : this spiral, you mentioned it wasn’t new. you've gone through it before, and from what you said, a few times now  (Yes- you tried to explore here.)

                      page1image29406144

                      SEEKER : I have relapsed time and again in the past 9 years
                      SEEKER : it got particularly bad in the past 3 years such that I could not attend school for extended periods of time
                      LISTENER : that sucks  (Try empathy – rather than an expression like this. “ The past 3 years must have  been a tough time for you.”)
                      SEEKER : it's only the start of a new semester and I’m already in a bad place
                      SEEKER : I fear that I may not complete it if I try suicide again and get forced to take long leave from  school
                      LISTENER : is completing school important?  (Another Closed question. Try – “You seem anxious about not being able to complete school.)
                      SEEKER : of course
                      SEEKER : but if I manage to die then I don’t care
                      LISTENER hahaha  that’s one way to put it
                      ( I Do not recommend ‘hahaha’ response to the mention of Suicide. As mentioned – it could be  interpreted as ‘nervous’ giggle to cover discomfort on the mention of suicide felt by  LISTENER .)  LISTENER : but hey, okay you want to finish this school thing
                      LISTENER : sorta like a mission
                      LISTENER : do you like what you're studying?  (Another Closed question)
                      SEEKER : okok
                      LISTENER : hahahaha that’s a start  (Not recommended to use ‘hahaha’ response)
                      LISTENER : if you don’t mind sharing, what are you studying?
                      SEEKER : ah then it'll be pretty obvious who I am
                      LISTENER : oh?
                      SEEKER : it’s at uni level
                      LISTENER : no worries! we can keep it general
                      LISTENER : what’s something you like about it?
                      SEEKER : I can’t see the pic
                      LISTENER : aw man  (Try empathy instead –“Must be hard not to like what you’re studying....” )  SEEKER : let's not talk about what I study
                      LISTENER : its the 'alright then, keep your secrets' meme
                      LISTENER : the one with frodo  (not sure what this means. Just cautious with using too many ‘very  informal’ phrases we use with personal friends – not too colloquial)
                      LISTENER : sure, I’m here to listen and keep you company  (good, Supportive)
                      SEEKER : statistically, each relapse increases the chances of the next relapse

                      SEEKER : used to have treatment but it was useless so now I don’t even care anymore
                      SEEKER : rly wish I had the courage to jump
                      LISTENER : courage comes in many forms  (follow-up with what was said – “ You sound disappointed with  the treatments you had.”
                      SEEKER : instead of just being on the railing but not jumping yet
                      LISTENER : from what I’m hearing so far, you sound like someone who has read up a lot on this  ( Don’t  change the direction of what he is saying - Address the suicide thoughts – “Are you having suicide  thoughts right now?” – Check risk OR – U mentioned ‘being on the railing, what happened? )
                      SEEKER : I know that my life will just be relapse after relapse
                      SEEKER : and I don’t want to be here alive anymore
                      SEEKER : exhausted
                      LISTENER : when you say you don’t want to be here alive,
                      LISTENER : do you mean you wish you didn’t have to be exhausted all the time  (A closed question here -  Don’t be afraid of asking – You said you don’t want to be here alive – what do you mean exactly? Are you having suicide thoughts again?”
                      LISTENER : to get away from that state of being
                      SEEKER : yes
                      SEEKER : and I also  wish to be dead  (Listener doesn’t mention the word ‘suicide’ - though  Seeker  is talking about it again and again. Try Empathy – “Sounds like you feel helpless and don’t know what to do. I am very concerned. Are you having suicidal thoughts right now?))
                      LISTENER : and if I’m hearing you, you tried
                      LISTENER : you did the medications, you tried to find ways out of that state that were not death
                      - they did not work
                      LISTENER : someone opened an option for a possible different state and it didn’t help
                      SEEKER : lol meds are a joke. a psychiatrist I saw took me off it cold turkey. perfect recipe for disaster.

                      LISTENER : good grief, psychiatric care here seems to be a hit or miss  ( Not recommended  to ‘side’ the view or agree that psychiatric care seem ‘useless’. We do not know the detailed circumstances of the  kind of help he has gotten- somehow – regardless - it has kept him alive so far...)

                      * Individuals suffering from a mental health issue may face a lifetime of medication and not uncommon  – they feel hopeless – cos they want a ‘cure’ quick – which may not happen. Often they feel impatient  and want a cure. That unfortunately may not be something that can happen quickly or possible – but if they continue their medications and treatments - it can still keep them going. Relapses are also

                      common – mental health conditions could be chronic – but can managed with treatment – though likely - throughout their lives – unfortunately..
                      We need to empathise with their sense of hopelessness when they relapse but still encourage and steer them gently - to continue the professional help they are getting- usually better option than no treatment at all.)

                      SEEKER : I was on it for a few months. then once I said I was better, they stopped it immediately.

                      LISTENER : why on earth would they do that?  (NOT recommended response – We are not the psychiatrist – there could be medical reasons that we nor the  Seeker  understand. Try empathy instead – eg. – “You were surprised with that change.” Then let  Seeker  tell you more – explore if it was explained  to him etc etc...If not, could he ask Dr about this etc etc....)

                      SEEKER : the proper professional practice is to wean off gradually
                      SEEKER : how would I know
                      LISTENER : did you talk to them about it ? (Closed question. Try – “What did you do when they  stopped?”)
                      LISTENER : that going cold turkey dd not help?
                      SEEKER : I was doing fine without the med for two months  (So Dr stopping medications seemed to have worked??? 2 Months is long period to be without medication – highlight that and explore the reason for the concern that Dr stopped medication? It actually did work for 2 months-  Seeker  stated himself he was fine for 2 months? )

                      SEEKER : I didn't follow up anymore since they were like that
                      LISTENER : do you think the meds would help you out of the bad place you mentioned you were in?  LISTENER : *restarting the meds
                      SEEKER : weirdest thing on earth is even though I told the psychiatrist the particular med was not really helping and maybe only helped a bit, they kept prescribing it and then stopped immediately when I spontaneously recovered
                      (Not uncommon for individuals under medication to say ‘Meds not helping” cos they usually expect quick results. Psychiatric meds usually take at least a month or even 2 to see some small results – longer term to have more results. ‘Results’ is not ‘Cure but helping the individual to ‘manage’ their condition – eg – longer duration before another relapse etc – Doesn’t mean no relapse or totally symptoms-free- eg someone with depression will still have depressive episodes.)

                      SEEKER : it seemed like the clinic didn’t have other meds
                      SEEKER : or maybe I wasn’t depressed in the first place
                      SEEKER : yeah my depression was fake lol
                      LISTENER : I’m glad you had that moment of recovery
                      LISTENER : I don’t think anyone can really say what is real or 'fake' depression
                      SEEKER : I don't know what they counted a few psych hospitalisations, suicide attempts, low mood, etc. as not depression or anything serious

                      SEEKER : *how they counted
                      LISTENER : if it felt real to you, that you sought help
                      LISTENER : I believe its real
                      SEEKER : because of the experiences, I now see that even if I commit suicide, it is nothing much, nothing serious
                      (Try Empathy - It seems like you feel that your condition is not taken seriously? You must feel so alone in your condition)
                      LISTENER : are there other clinics you could go to?
                      SEEKER : oh another psychiatrist at the clinic told me I was not depressed but just spoilt and irritable

                      LISTENER : that was rude of them  ( Don’t judge other parties  on what was told to you. Focus on  Seeker ’s  emotions – Address feeling - Empathise instead –“ That must have hurt you.”

                      SEEKER : my depression diagnosis came from another place at an earlier time  SEEKER : but I don't see them anymore
                      LISTENER : could you go back to the earlier place?
                      SEEKER : no because of other reasons

                      SEEKER : that I don't wish to reveal
                      LISTENER : that’s okay
                      SEEKER : so my conclusion is that I’m not going to seek professional help ever again  LISTENER : how did you arrive at that?
                      SEEKER : I have tried quite a number of places
                      SEEKER : most of them overbooked and lacking capacity for new cases
                      LISTENER : I’m sorry you haven’t found a good place yet
                      LISTENER : but I admire you for trying
                      SEEKER : nah its enough. I’m not searching anymore.
                      SEEKER : I have accepted my fate of suicide as the eventual outcome

                      SEEKER : I won't live past 30

                      (As mentioned earlier – our role will probably to empathise the pain of going thru such long treatments and yet not see clear results. We can help  Seeker s with such long-term mental health issues to find day- to-day resources – small things/steps they can do – just to manage their ‘depressive moods’ when they happen. But ultimately – is to encourage the  Seeker  not to give up treatments – assure them it is not uncommon to feel discouraged etc etc – validate their sense of hopelessness sometimes etc....)

                      LISTENER : I’m sorry you feel that way
                      LISTENER : was, as you said, a lack of courage the only thing that held you back?
                      LISTENER : what are your thoughts on your friends and family?
                      SEEKER : everyone dies someday, some earlier some later. mine will be earlier.
                      LISTENER : does that make you feel less anxious?
                      SEEKER : my suicide is inevitable, and I can't help it and my family can only accept it
                      SEEKER : yes
                      LISTENER : have you talked to them about it?  (Use this opportunity – ask about family – Who - specifically? Anyone close? Etc – possible resource? )
                      SEEKER : they already know from my past suicide attempts
                      SEEKER : of course they want me alive but there’s no hope
                      (Explore - Ask who specifically want him alive – a Resource?)

                      LISTENER : what about the recent one?
                      LISTENER : do you feel you can talk to them about it  (Closed question)
                      LISTENER : every person is different, and often depression stems from chemical imbalances in the brain. some meds help to even out the imbalances, but they all come with risks and other side effects  (Encourage them to ask DR questions to clarify and understand more. We are not to give opinions about meds – not our place to comment on Meds.)
                      LISTENER : how you feel right now is real, it is as real to you as anything could ever be
                      SEEKER : no recent attempt
                      SEEKER : not that recent
                      SEEKER : its just that recently a lot of bad things happened and sometimes I feel close to attempting  again
                      SEEKER : recent means these few months
                      LISTENER : what do you do when you feel this way that helps?

                      LISTENER : how do you cope?
                      SEEKER : I imagine myself falling down the building. it brings relief.
                      SEEKER : sometimes I tell somebody
                      (ASK specifically – WHO he told - the last time he felt that. – Nail down a  specific  Resource)
                      LISTENER : does telling somebody help?
                      SEEKER : a bit
                      SEEKER : ultimately the decision to live or die lies with me
                      LISTENER : how does it help?
                      SEEKER : I won't let them control me to prevent me from dying
                      SEEKER : not sure
                      SEEKER : I guess they offer empathy and encouragement
                      (This is a resource  – ask specifically  who offered empathy and encouragement – that kept him alive for a while. – We need to establish what kept him alive the last time – even for a while. )

                      LISTENER : did it help you feel less anxious in that moment?  (Another closed question – Open question -  Try “How did you feel when you had empathy and encouragement at that time?”)
                      SEEKER : no
                      LISTENER : I want to assure you that, we, Avie, this platform, is not here to tell you what you should or should not do. Your life is your own . ( Careful not to sound ‘detached’ when suicide is mentioned  Try –  “ Even though we are not here to give advice but when it comes to life and death – you are precious  regardless - cos you are a human being.” )  As are the decisions and choices you make. We're hear only to listen and help you explore your thoughts  (Careful not to come across as even if he takes his life- nothing we can do except to listen. Instead say - do express care and concern - – “I am very concerned about you. If you do feel suicidal and tempted to harm yourself , I want you to contact SOS at this number ~~~~ . (Give him a resource to get help – 24 hours a day) But continue to engage and ‘hear’ him out – not to quickly end chat – after giving another resource. That may come across as just ‘passing  the buck.”

                      LISTENER : exploring a line of thought with people you know can be difficult cause it creates impressions and expectations even if you don’t intend to follow through
                      SEEKER : mhm
                      LISTENER : you mentioned you're not keen on professional help, you have some people in your life you reach out to who help sometimes and you want the bad feeling to stop  (Good to explore possible resources in his life).

                      LISTENER : what would you like to explore further, just as a thought  LISTENER : or to clear your mind

                      SEEKER : how do I make the bad feelings stop?

                      LISTENER : I cant tell you what would work for you. but in these past 9 years you've survived
                      LISTENER : you can share, if you're comfortable, what you think worked for you to make the bad feelings stop, and we can explore that thought together
                      (Empathise more – “You are feeling so tired and drained trying so hard to cope.”)

                      SEEKER : they went away after a long time, then came back, repeat
                      (Empathise – “That must be frustrating for you....” Assure  Seeker  – “Everyone has bad feelings – and we may not be able to make them stop totally and it’s OK. We are just being human. You are no different  from anyone – having bad or even depressed feelings now and then. Etc..)
                      This is true and sometimes individuals suffering from mental health condition don’t see that or able to accept that and ‘beat themselves up for having ‘bad days. Just like any other health conditions –  sometimes there are good days – sometimes ‘bad’ days’ and it is OK etc...

                      LISTENER : did something significant happen for them to go away??  SEEKER : no
                      LISTENER : *only 1?
                      LISTENER : across family, school, relationships, hobbies,  (Closed Question)  LISTENER : was there anything in your life that changed?  (Closed Question)  SEEKER : what "only 1"?

                      SEEKER : what is your question
                      LISTENER : as in only 1 question mark. I accidentally typed 2 just now
                      LISTENER : I wanted to brainstorm with you if there was anything significant that changed in that time across family, school, relationships, hobbies, etc
                      LISTENER : and if it changed suddenly (like you woke up one day and you felt lighter)
                      LISTENER : or it was gradual
                      SEEKER : gradual
                      LISTENER : did it feel like it got better or that you got used to it?  (Closed Question)
                      SEEKER : both
                      LISTENER : when did you notice it went away?
                      LISTENER : was it only when it came back again?  (Closed Question)

                      SEEKER : yes when I started to feel happier
                      LISTENER : do you have a memory of feeling happy?  (Closed Question)
                      LISTENER : you don’t need to share it with me if you're not comfortable
                      SEEKER : yes
                      LISTENER : awesome  😊  LISTENER : are you thinking of it now?
                      SEEKER : no
                      LISTENER : do you want to hold it for a moment now?  (Pay attention to what seeker is saying – He just  said ‘No’ to memory of feeling happy)
                      LISTENER : it not for the exploring, we've been talking for a while on some heavy things. do you feel you need a break or shall we continue?
                      (End chat by asking  Seeker  with suicidal thoughts if he can agree to contact SOS hotline anytime he feels highly suicidal – give him number- (It’s a resource)

                      SEEKER : lol my life nowadays has been heavy  SEEKER : but anyway, I'm quite sleepy now  SEEKER : I will go and prepare to sleep SEEKER : good night!

                      LISTENER : good night! thanks for reaching out today
                      SEEKER : and thanks for chatting with me  LISTENER : pleasure is mine
                      LISTENER : anytime you feel you need to talk, we're here
                      SEEKER : ok
                      SEEKER : goodbye
                      LISTENER : goodnight!  LISTENER : Thank you for connecting. Feel free to connect again.

                      SEEKER : Hello Avie
                      LISTENER : Hi. I'm Avie. Thank you for connecting with OTR Listens. How are you doing today? Anything you would like to talk about?
                      SEEKER : sometimes I’d feel really sad/ anxious, and I don't really know why and it sort of hinders my learning
                      LISTENER : Would you like to share more about what's causing this feeling?
                      SEEKER : Uhh I don’t know?
                      LISTENER : It seems like you are unsure of what is causing you to feel this way.  (Good empathy)  LISTENER : How did you cope with it?
                      SEEKER : like sometimes something happened at home etc. then ofc id feel upset but other days when nth happens sometimes I feel the same way too
                      SEEKER : I’d cry or watch something to distract myself
                      SEEKER : but watching a movie doesn’t really help because after it finishes sometimes I still feel the same  way
                      LISTENER : That must be frustrating for you.  (Good empathy)
                      SEEKER : and I'd feel guilty for not being productive- like doing my work
                      LISTENER : I see. Have you tried something else that might help you cope with this?  (Closed Question – Try - What else have you tried?)
                      SEEKER : umm they didn’t really work?
                      LISTENER : Would you like to share more on what you have tried?
                      SEEKER : ... listening to music?
                      LISTENER : That seems like a good option, why did it not work?  (What is the reason it did not work? –  Instead of ‘Why’)
                      SEEKER : Well, I don’t know
                      SEEKER : If I knew and if it worked I wouldn’t be here I suppose
                      LISTENER : Must be troubling for you.
                      LISTENER : Have you talked to anybody about it?  (Closed Question - You must be disappointed that what you tried did not work. I am here to explore further with you. What else do you think you can try?)  SEEKER : no
                      LISTENER : Are you planning to do that?  (This is a leading question – could imply talking to someone can help but that may not be something seeker is ready to do – or want to do).
                      SEEKER : no

                      LISTENER : Seems like it is a difficult situation for you. Do you have any plans/methods that you want to try to deal with these emotions?  (Try an open-ended question rather than another closed-ended question?) Sometimes too many closed-ended question can cut short a chat.
                      SEEKER : no- and never mind Avie I kind of need to go  (Notice the 3 ‘No’ answers with the closed questions? Seeker doesn’t want to continue chat)

                      LISTENER : No worries. Glad you are here today. Hope you found this chat useful.
                      LISTENER : Thank you for connecting. Feel free to connect again whenever you need a listening ear. You may also want to check out the self-care resources available on this site. You have a good day.

                      (A Good chat with lots of Empathy and Open questions)

                      SEEKER: need someone to talk to
                      LISTENER: Hi. I'm Avie. Thank you for connecting with OTR Listens. How are you doing today? Anything you would like to talk about?
                      SEEKER: need someone to talk to. very stressful at work -not feeling good
                      LISTENER: you sound overwhelmed, tell me what has led you to feel stressed out at work (Good empathy and open question)
                      SEEKER: I like my current company - worked there for many years - there are two of us in one team - me and my junior - we came from the same ex company
                      SEEKER: I found out 2 months ago -that my junior is leaving - and I was completely blindsided by it -: considering the relationship that we have
                      LISTENER: it must be quite shocking news for you, given how long you have worked together (Good empathy)
                      SEEKER: I expected to be informed - yes!!! so shocking!!!- but wait there is more - after that his attitude towards me is very bad - like I asked him one work related stuffs - he replied -find yourself - then I told my boss
                      LISTENER: you must be frustrated at how he talked to you (Good empathy)
                      SEEKER: that my junior is being rude to me - extremely angry - then my boss told me to talk in the group chat - me my boss and my junior - and despite that- it makes no difference - like yesterday there is a bug in one of the program - and I was swamped - and I asked my boss to ask my junior -: like @junior can you help? - thank you very much - since I have yet to receive the handover documentation from you - and he replied – wtf - please la why you need my documentation -I one look see the problem -already know the issue-
                      LISTENER: you must be feeling so angry (Good empathy)
                      SEEKER: very - he still say -and you need my documentation? - champion and yet - my boss - didn't say anything - like dude - can't you see he is being unreasonable
                      LISTENER: you sound upset that your boss did not step in (Good empathy)
                      SEEKER: but all my boss asked is - can you please check? blah blah blah- yes - primarily I am angry that he did not say anything - so I just reply the junior- yala yala you are the best-wish you all the best in the new company
                      LISTENER: seems like you feel unsupported by your boss (Good empathy)

                      page12image29470528 page12image29459776

                      SEEKER : and the junior replied - not the best - but I am better than you - then only my boss said stop it- frankly speaking even he said stop it - I expect him to say something along the line of - @junior please stop.  Let’s  be professional and civil - but nah nothing - just stop
                      LISTENER that’s  a lot happening at work, you must be feeling so frustrated  (Good empathy)

                      SEEKER : very swamped at work - cause only left me in my team - and everything push to me- like I clearly told my boss now I want to concentrate on this project
                      LISTENER : sounds like a difficult time for you, since you mentioned that the leaving teammate isnt helping  (Good empathy)

                      SEEKER : and after I finish this project - I will work on the next project- and he replied- why can't you work on the next project now? - like take some time every day to work on the next project- seriously, I can't even have control over my work
                      LISTENER : you must be feeling stressed out about these expectations around workload  (Good  empathy)

                      SEEKER : yes - and I even ping him - that I can't join the team meeting - because the junior is like that- it will be a shouting match- and all my boss says is- you are running away- blah blah blah- and immediately asks me about the  project’s  status- wtf= completely 0 empathy- so yes I am overwhelmed- and it is so weird -that I have been crying few times already -in silent

                      LISTENER : it sounds like you feel unsupported by your boss and stressed about all that is happening  (Good empathy)
                      SEEKER : yes - I think I am being too sensitive
                      LISTENER : how have you been dealing the anger and feeling upset so far?  (Good open question)  SEEKER : not strong enough - since April - usually whenever I am upset- I will er - cry it out - last time I would talk to my friends - or colleagues - but scared that I may end up crying

                      LISTENER : with all that is happening, you must be overwhelmed. how do you feel after crying it out?  (Good empathy and open question)
                      SEEKER : so, I didn't really talk to them about everything - slightly better - today I cried few times already

                      LISTENER : you must have been so upset today  (Good empathy)
                      LISTENER : you mentioned you stop talking to friends or colleagues, how do you think they will react if you cry?  (Good empathy and open question)
                      SEEKER : sorry for blurting this all out to you - my colleague recommended me to try this 
                      LISTENER : no worries at all, i am here to listen to you  (Good encouragement)
                      SEEKER : I think they will be nice if I cry in front of them - but I am too paiseh to do that - the only person at work that I cried in front of - is the director - who is my boss's boss - I really couldn't take it

                      - and she called me - and that is why the tears came flooding out - she talked to my boss about what I told her - like he is being very nasty - should be nicer when talking with me - and what happened next was- my boss went to the group chat and asked - where is xxx? later if I ping her again, she will complain to the director about me again - I have been losing sleep- appetite

                      LISTENER : you must have felt so helpless and frustrated at how things turned out  (Good empathy)  SEEKER : and can't concentrate at work - I found out today I got a new job - but I don't know why I still feel like crying
                      LISTENER : other than crying it out, are there other coping mechanisms you use to help tide you through difficult times?  (Can re-phrase into an Open question  – “What other coping U have used.....?”)

                      SEEKER : er no - usually crying -or talking to my father - but video calling my father - after that - makes me cry even harder - I should be happy that I get a new job - I guess is the thought of having to go through - another one month - under my boss
                      LISTENER : i see, must be heart aching sharing your troubles with family
                      SEEKER : and still need to see that junior - who is also leaving around the same time as me  –  yes -I used to go back to Malaysia every week  –  but- since the pandemic - already 1 year plus - didn't see my family back home
                      LISTENER : it must be tough dealing with the conflicting emotions  (Good empathy )
                      SEEKER : yes - I don't know why - usually I am not like that
                      LISTENER : has the thought of a new work environment helped in tiding you through these difficult times? ?  (Can re-phrase into an Open question  – “What do you feel about  the upcoming new work  environment?”)

                      SEEKER : actually, I was very happy -I am waiting for the right time to resign - after I get my bonus - yesterday is bonus day btw - and it is also the same day - that junior was being really rude in the team chat - and my boss did nothing as what I have mentioned earlier - negative > positive feelings and when I finally give the resignation letter - is like happy only for a few hours

                      LISTENER : congrats! it sounds like you have actively worked towards getting yourself out of the environment you find negative
                      SEEKER : thank you very much - the sad thing is - I really like the company -but ever since this boss takes over the team - every weekday is a struggle - like omg I need to go to work -have to deal with the boss

                      LISTENER : sometimes people feel like it is a heartbreak when they leave a company  SEEKER : I want to leave on a good note 

                      LISTENER : hoping you get a fresh start at your new work environment and start building positive relationships
                      SEEKER : yes I really hope so - but I feel sad  –  used to have good relationship with junior
                      LISTENER : must be so overwhelming emotionally. sometimes when people are overwhelmed by work, they try to find outlets after work to shut out work and relax (e.g. exercise, listening to music, watching tv, engage in hobbies). what do you think works for you?

                      SEEKER : I tried watching drama - or playing games - to distract myself -but just don't have the mood -used to work last time
                      LISTENER : must be regretful watching a relationship sour. sometimes relationships  don’t  go the way we want it to, and we need to find ways to move on

                      SEEKER : yes
                      SEEKER : and it is ending on a very bad note
                      LISTENER : sounds frustrating, on the other hand, from what you have mentioned, there are other supportive colleagues around you. have they helped you feel better? ?
                      SEEKER : yes - like they listen when I was talking to them - I am supposed to work from home - but I went to the office - just so that I can er - chat with them - about my unhappiness -but I feel bad - cause they are busy already
                      LISTENER : good to hear that you have an outlet, and it sounds like these are relationships that are more positive than the ones that are troubling you  (Good highlight to Seeker of a resource)  SEEKER : and I felt like I am disturbing them
                      LISTENER : it sounds like you have some supportive people around you. i hope you can continue to find support to tide through this tough month
                      SEEKER : but now I think I feel much better - after chatting here - really felt much better
                      LISTENER : glad you are here today and that you find the chat useful
                      SEEKER : sorry for taking your time
                      LISTENER don’t  worry about it, i am here to listen to you
                      LISTENER : Thank you for connecting. Feel free to connect again whenever you need a listening ear. You may also want to check out the self-care resources available on this site. You have a good day.  SEEKER : great great
                      SEEKER : thank you very much
                      SEEKER : very grateful
                      LISTENER : welcome, good night

                      Common Questions on Mental Health & Seeking Help

                      Seeing a therapist is expensive, what are some more affordable ways we can seek help? 

                      For professional support:
                      - CHAT by IMH offers free psychological assessment for young people 16-30 y/o
                      - SAMH Counselling Hotline at 1800 283 7019 (toll-free)
                      - Shan You and Clarity Singapore offer therapies at a more affordable rates than other private services

                      For informat support:
                      - Join a peer support group like We Are Hear, Circle of Connexion by OTR, OTR Listens
                      - Find support in online forums
                      - Check out more resources here: https://otrlistens.net/referral-resources

                      Depending on your condition, these might not completely replace therapy. 

                      This is not an uncommon feeling. In fact, this is a conversation that many people are having. :)

                      It's important that you don't dismiss these thoughts and feelings, but to explore them more deeply on why you may be feeling this way.

                      Some good questions to ask yourself if you feel or have: 
                      - A sense of contentment for life - A zest for living and the ability to laugh and have fun
                      - The ability to deal with stress and bounce back from adversity
                      - A sense of meaning and purpose, in both my activities and relationships
                      - The flexibility to learn new things and adapt to change 
                      - A balance between work and play, rest and activity, etc 
                      - The ability to build and maintain fulfilling relationships 
                      - The self-confidence and enough self-esteem to live life to the fullest 

                      Life is precious. Life is short. If the answers to too many of questions is not in the affirmative, it's also time to rethink your narrative and even how to turn things around for yourself. 

                      Check out this page for ideas on holistic self-care: https://overtherainbow.sg/holistic-self-care/
                      There are lots of things you can do to help you find effective stress relief and manage stress better:

                      - Avoid unnecessary stress: Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. You may be surprised, however, by the number of stressors in your life that you can eliminate by 1) Learn how to say “no” 2) Avoid people who stress you out 3) Take control of your environment 4) Avoid hot-button topics 5) Pare down your to-do list.

                      - Alter the situation: If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future. Often, this involves changing the way you communicate and operate in your daily life. 1) Express your feelings instead of bottling them up 2) Be willing to compromise 3) Be more assertive 4) Manage your time better.

                      - Adapt to the stressor: If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude. 1) Reframe problems 2) Look at the big picture 3) Adjust your standards 4) Focus on the positive. 

                      - Accept the things you can’t change: Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. 1) Don’t try to control the uncontrollable 2) Look for the upside 3) Share your feelings 4) Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

                      - Make time for fun and relaxation: Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by nurturing yourself. If you regularly make time for fun and relaxation, you’ll be in a better place to handle life’s stressors. 1) Set aside relaxation time - go for a walk, spend time in nature, call a good friend, sweat out tension with a good workout, write in your journal, take a long bath, light scented candles,  savor a warm cup of coffee or tea, play with a pet, work in your garden, get a massage, curl up with a good book, listen to music, watch a comedy. 2) Connect with others 3) Do something you enjoy every day 4) Keep your sense of humor.

                      - Adopt a healthy lifestyle: You can increase your resistance to stress by strengthening your physical health. 1) Exercise regularly 2) Eat a healthy diet 3) Avoid alcohol, cigarettes, and drugs 4) Get enough sleep.
                      It's a tricky situation, and it's great that you want to help. Here are some things you can try:
                      - Identify if the person recognise they need help
                      - If they recognise they need help, but they are rebuffing you, you can recommend them to talk to others, or seek help where they can keep their identity annonymous
                      - If they don't know that they need help, find a way to let them know about this, via other people whom they trust, or other channels like emails, messages where they have time to think about what you say.
                      Unfortunately, there's no easy cure for mental health conditions.
                      The good news it's definitely possible to get better, or even fully recover.
                      Meanwhile the conditions can be managed.
                      With effective coping and management strategies, people with mental health conditions can still lead a healthy, fulfilling life.
                      This depends on many factors, like what the condition is (chronic anxiety, depression, panic attacks, OCD, etc), what is the trigger, how serious it is, the nature of the breakdowns, etc.
                      There are coping strategies as well.
                      So, some conditions can happen everyday, some a few times a day, or just once in a while.
                      Some signs to look out for:
                      - Extreme changes in moods
                      - Feeling detached, especially when you don't feel joy in things you usually enjoy doing
                      - Feeling numb - Feeling exhausted during the day and struggling to sleep at night - Feeling blue, feeling down
                      - And if the condition persists over a period of time (1-2 weeks)

                      Don't self-diagnose base on what you see on social media. These are just signs for you to seek help, not as a diagnosis.
                      If any of these applies to you, may want to visit to CHAT (from IMH) for a free psychological assessment: https://www.imh.com.sg/CHAT/Get-Help/Mental-Health-Check-FAQ/Pages/Book-an-appointment.aspx
                      In Singapore, if you see a private therapist practice without the involvement of a psychiatrist, the information would remain private and confidential.
                      But if a psychiatrist is involved, then it will appear in your medical record.
                      This is because iSingapore  all psychiatrists need to submit their medical records to the government medical system.
                      Here are some ways you can help:
                      1. Listen without judgement. A lot of times people are looking for someone to validate their feelings and empathise with them. This is a skill anyone can learn.
                      2. If the situation persists for over a period (1-2 weeks), encourage the person to seek professional help if necessary.

                      Do note that even if the person may be seeking professional help, a supportive circle of friends and family is still critical.
                      If needed, can encourage them to visit CHAT (from IMH) for a free psychological assessment: https://www.imh.com.sg/CHAT/Get-Help/Mental-Health-Check-FAQ/Pages/Book-an-appointment.aspx
                      You can acknowledge their feelings and struggles, listen with empathy, and check in on them often. Affirm their efforts.
                      Here are some words you can use:
                      "It must be very tough for you. Please tell me more."
                      "You are trying your best."

                      Things to avoid:
                      "Why can't you snap out of it?"
                      "Why are you complaining all the time? You should be grateful with what you have."
                      "Why are you sad all the time?" "Many others have it worse, what you go through is nothing."

                      You can encourate the person to come to otrlistens.net if they need a listening ear as well.
                      This is a whole-of-society issue.
                      But it starts with each of us - it starts with you, and the community around you.
                      Begin by talking to someone you trust, won't judge you and can support you.
                      Mood disorders are real medical disorders. Anyone can feel sad or depressed at times.
                      Life events and stressors can expose or worsen feelings of sadness or depression. But mood disorders are also very treatable, with medications (prescribed by psychiatrists) and psychotherapy.

                      Some coping strategies you can use for yourself include:
                      - Practicing good nutrition and healthy eating
                      - Getting sufficient rest and relaxation - Exercising on a regular basis
                      - Sharing your problem with others who have had similar experiences; get support from friends and family
                      - Getting a dose of sunlight every day
                      - Limiting alcohol and avoiding cigarettes and other drugs
                      Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened, under pressure, or are facing a stressful situation.
                      Here are some self-help tools and techniques for anxiety attacks:
                      - Practice relaxation techniques (e.g. mindfulness meditation, progressive muscle relaxation, deep breathing)
                      - Adopt healthy eating habits
                      - Reduce alcohol and nicotine
                      - Exercising regularly
                      - Get enough sleep
                      To encourage someone, avoid saying "snap out of it" or "move on". It creates an impression that you are judging the person.
                      Instead, empathise and be a source of support for them.
                      Try to acknowledge their suffering and affirm their self-worth; the person is going through challenges that you may not be aware of.
                      It's great that you are trying to help. Here are some things you can do:
                      1. Acknowledge and validate their feelings and challenges without judgement. They may be dealing with a challenge that you are not able to see, but it doesn't mean that the pain is not real.
                      2. Encourage the person to strive for a healthy lifestyle but take it one step at a time. Celebrate small victories.
                      3. If necessary, encourage the person to seek professional help.
                      4. Be there for them. Check in, even if they don't reach out.
                      It's good to become aware of your emotional wellbeing.
                      Here are some questions you can use to check in with yourself:
                      1. How have you been feeling recently?
                      2. When was the last time you experience joy and happiness?
                      3. How is your physical health?
                      4. How is your sleep?
                      5. How is your appetite? Do you still enjoy the food you like?
                      6. How long has this been going on?

                      Check in with yourself regularly, you may even want to track your mood, physical and mental health. This can teach you a lot about yourself.
                      If you want to learn more about self-care, check out here: https://overtherainbow.sg/holistic-self-care/
                      You can go to CHAT by IHM for a free assessment. https://www.imh.com.sg/CHAT/Get-Help/Mental-Health-Check-FAQ/Pages/Book-an-appointment.aspx
                      There are lots of things you can do to improve your mental health and minimize mood swings, including:
                      - Practicing good nutrition and healthy eating
                      - Getting sufficient rest and relaxation
                      - Exercising on a regular basis
                      - Sharing your problem with others who understand you; get support from friends and family
                      - Getting a dose of sunlight every day
                      - Set aside relaxation time: go for a walk, spend time in nature, call a good friend, write in your journal, play with a pet, work in your garden, get a massage, curl up with a good book, listen to music, watch a comedy.
                      - Avoid unnecessary stressors; do something you enjoy every day
                      - Limiting alcohol and avoiding cigarettes and other drugs

                      Other Resources

                      There are many ways to nurture your physical and mental health—and supercharge  your body, mind, and soul in the process. 

                      Taking care of your body is a powerful first step towards mental and emotional  health. The mind and the body are linked. When you improve your physical health,  you’ll automatically experience greater mental health. Similarly, as you exercise  your mind and spend time connecting with others, you’ll experience a huge  emotional boost. 

                      Enjoying the affection of a pet, enjoying a walk outdoors, volunteering your time,  spending time with friends, and laughing out loud are just some of the many things  you can do to gain strength, both inside and out.


                      Read   Here .

                      I am sharing a book I authored in 2019 when I was with SOS – in its ‘raw’ but final version before it went to the printer.  The book is available in the National Libraries but the hard copies are sold out and no longer available at the bookstores.

                      You are welcomed to download it for your personal reading but appreciate that you not distribute it around.

                      Any comment/feedback is welcomed ( wlc@overtherainbow.sg) - before I write my next book. Lol...  😊
                      Lai Chun

                      Read Here.

                      Silver Ribbon (Singapore) developed this youth mental health resource kit to promote mental health, reduce suicide rates and build resilience among the youths and hopes that parents, school counsellors, students and teachers would be able to:-
                      • Look out for warning signs of common mental disorders
                      • Seek early help
                      • Identify those who need help and support them
                      • Take care of their own mental wellbeing
                      Mental health issues are real and help is available.

                      Read Here.