How the helping process unfolds for clients in suicidal crises: Linking helping-style trajectories with outcomes in online crisis chats

Objectives
Crisis counselors’ active listening and collaborative problem-solving helping styles have been associated with outcomes for clients in suicidal crises. These associations have been based on static conceptualizations of helping (i.e., helping style for the entire session). Our aim was to further understand how the crisis counseling helping process unfolds (i.e., helping trajectory) and helping trajectories’ association with clients’ outcomes.
Methods
Online crisis chats (N = 269) with suicidal adults were coded for crisis counselors’ helping styles (i.e., active listening and collaborative problem-solving) and clients’ outcomes (i.e., resolved or unresolved). Each talk-turn was coded for helping style, which were used to examine helping-style trajectories.
Results
Growth-curve models indicated that helping styles varied over the course of chats and that helping trajectories were different for resolved and unresolved chats. In resolved chats, helping styles moved from primarily active listening to primarily problem-solving—with a deceleration in the middle of chats. In unresolved chats, helping initially moved from primarily active listening to primarily problem-solving, but this trajectory decelerated in the middle of chats and then turned back toward primarily active listening.
Conclusion
Our findings demonstrate that how the helping process unfolds is related to clients’ outcomes. Implications for practice and research are discussed.