Holding the Line: Stressors, Wellbeing, and Coping in Crisis Supporters

Abstract

Crisis lines provide vital suicide prevention services, yet little is known about the wellbeing of those providing this support. Crisis supporters have a demanding role and are routinely exposed to trauma and suicidality. This thesis examines the contemporary state of stressors, wellbeing, and coping in crisis supporters, and explores avenues for intervention. Guided by the Appreciative Inquiry framework, findings from four empirical studies are integrated to inform a tailored wellbeing program.

Chapter 2 reports a quantitative survey of 422 crisis supporters across 38 Australian crisis lines, identifying key stressors. While many reported high compassion satisfaction, a subsample experienced high compassion fatigue and psychological distress, with coping strategies linked to wellbeing outcomes. Chapter 3 presents qualitative interviews with 15 crisis supporters, providing deeper insights into role satisfaction, impacts to wellbeing, coping, and support preferences. Chapter 4 synthesises existing evidence through a systematic review and meta-analysis of wellbeing interventions for roles that provide counselling to people in crisis. Mindfulness, ACT, and psychoeducation interventions showed promise in improving wellbeing. Chapter 5 describes the co-design of the first documented wellbeing intervention for crisis supporters. Designed in collaboration with an Advisory Group, the prototype received positive feedback on its feasibility, relevance, and practicality.

Overall, crisis support work offers meaningful rewards but significant demands. Effective coping and interventions may help mitigate the impact of stressors and promote wellbeing. By integrating varied methodologies within an Appreciative Inquiry framework, this thesis advances understanding of crisis supporter wellbeing and developed the first tailored intervention prototype. Future research should test its effectiveness and explore implementation to sustain this workforce's vital role in suicide prevention.