Back to previous
9. Tools and support
The Royal College of Psychiatrists and the Money Advice Trust have developed a series of drills, set out below, to help advisers identify and support clients in vulnerable circumstances. Public Health Scotland runs Scotland’s Mental Health First Aid (SMHFA) courses – see smhfa.com/find-a-course.aspx for details.
Advisers should prioritise their wellbeing alongside their clients’, and seek support from colleagues, line managers or appropriate external agencies if they feel overwhelmed or ill-equipped to handle a situation.
TEXAS
When your client tells you about themselves
Thank
Thank the client.
Explain
Explain how the information gathered from the client will be used.
EXplicit
Obtain explicit consent.
Ask
Ask the client questions to get a better understanding of their circumstances.
Signpost
Signpost or refer to internal or external specialist help when appropriate.
BRUCE
For clients experiencing a mental capacity limitation
Behaviour
Look for clues of a limitation in the client’s behaviour and speech.
Remembering
If they are struggling to remember the advice, ask what might help, write it down or see if someone can help them.
Understanding
Ask them to summarise their understanding. Fill any gaps by repeating advice or using different explanations by simplifying or rephrasing.
Communication
How would they prefer to communicate? Try to accommodate this. Allow enough time and pause regularly.
Evaluation
Discuss each option simply, writing down any pros and cons.
IDEA
This technique is useful when talking to a client about their vulnerability
Impact
How does it impact on your personal and financial situation?
Duration
How long have you been living with this?
Experience
Have you experienced this before, does it fluctuate?
Assistance
Is there anything we should know about the support you are receiving which could help us support you better?
BLAKE
This technique is to help advisers when dealing with a suicidal client
Breathe (to focus)
To help deal with the shock and fear when dealing with a suicidal client, take a moment to breathe and focus your thoughts.
Listen (to understand)
Listen carefully and assess the risk of harm to the client.
Ask (to discover)
If you need more information, ask questions.
Keep safe (from harm)
If the client is at risk of imminent harm, the emergency services should be contacted.
End (with summary)
Everything that has been discussed and agreed should be summarised when suitable.
SPIDER
This technique can be useful for causing minimal distress when you have to deliver bad news to a client
Set the scene
Thank you for calling, we need to talk about…
Perspective
How are you feeling and what are you planning to do next?
Invitation
Invite questions: Can you talk through this today or would you like to talk another time?
Deliver
Use simple, clear language. I’m sorry this news is disappointing. I’ll explain it, and we can go through the options.
Empathise
Listen carefully and give the client space to express their feelings.
Recap
Summarise the information and check understanding. If they are not ready to make a decision, rearrange the meeting and offer reassurance.
RED FLAGS
Vulnerability indicators to look out for
Potentially vulnerable
Signs include difficulty, distress, or life events that might lead to a vulnerable situation.
Vulnerable
More likely to experience harm, loss or disadvantage compared to others.
Particularly vulnerable
Heightened or imminent risk of detriment (a more serious or negative impact). Offer support quickly to avoid significant harm.
Individual factors
Illness, disability, contact with health or social care workers and getting certain benefits (like personal independence payment).
Wider circumstances
Excessive or unusual expenditure, life events (eg, bereavement) or income shocks (eg, unemployment).
Organisational actions
Something ’has been done’ causing difficulty (eg, a change in communication method) or things that ’haven’t been done’ (like no consideration of a third party trying to help).
CRISIS
Ways to support a client in crisis, and yourself
Calm
Be calm and take appropriate action.
Listen
To a concerned third party. Check if the client is available. If not, don’t share data, note their observations, explain your plan and take action.
Acknowledge
Refer to BRUCE, SPIDER or BLAKE cards for support.
Ask
For support, debrief and take time out if you feel upset or worried.
Protect
Anyone in an abusive situation must be taken seriously, given support and referred to those who can protect them.
Signpost
Or refer to those who can help – eg, Samaritans (telephone 116 123) for suicidal or despairing people, 24 hours a day.