Practice Model: Crisis Intervention

(Regehr, 2011) Two primary types of events can result in a crisis response: situation and developmental. Situational crises span a wide range of events including diagnosis of a life-threatening or serious illness, job loss, or divorce. Developmental crises include the birth of a child, adolescence, marriage and retirement. Whether an event results in a crisis response is highly individualized.

Crisis = the event + the individual’s crisis-meeting resources + other concurrent stressors + the individual’s perception of the event.

Crisis intervention is action oriented, based on a certain situation. It is about immediate concerns, the here-and-now. After the crisis subsides, it is about support to help people adjust. It is a goal-oriented, short-term approach.

You have to be a calm person; keep equilibrium in stressful situations. You need to be aware of self.

You have to make accurate assessments and not make assumptions – experiences are unique. People’s life experience will determine how they cope.

People generally live their lives in a steady state of homeostasis. Events occur throughout life that challenge the homeostasis, and the individual mobilizes resources (physical, psychological, emotional, intellectual and social) to restore balance. When that balance is not quickly restored or a solution to the challenge is not evident, the experience of crisis can occur, i.e. a period of psychological disequilibrium, experienced as a result of a hazardous event or situation that constitutes a significant problem that cannot be remedied by using familiar coping strategies. The inability of normal coping strategies to manage the situation leads to a number of consequences, including (i) emotional distress, (ii) impaired sense of personal self-worth, (iii) inability to enjoy interpersonal contacts, and (iv) impaired task performance, all of which result in the experience of a crisis state.

The central tenant of crisis intervention is that a little help, rationally directed and purposefully focused at a strategic time, is more effective than more extensive help given at a time of less emotional accessibility. In crisis intervention the social worker must engage with the client on a cognitive level to quickly work to solve the problem rather than explore unconscious issues.

(Harms, 2007) Some of the key skills used in crisis intervention are

1. A rapid assessment of functioning Formal tools are often available for this
2. Reassurance of basic, physical safety is often critical
3. Maintaining a needs and rights focus People, during a crisis, can still remain empowered and make their own decisions. Overlooking this has been a major criticism of debriefing situations where people have not been able to act in ways in which they wanted.
4. Validation of feelings As distinct from the task-centred approach, crisis intervention focuses on the often intense emotional state someone is experiencing. Ventilation or expression of emotions is encouraged. This is connected to the psychodynamic approach where cathartic release of all emotions is the first step in being able to control them. Listening and supporting through probing, reflecting and paraphrasing is important. Listening is accompanied by validating all emotions.
5. Information and resource provision Crisis intervention strategies are immediate, active and directive interventions such as education, clarification, and reassurance about the normative, expectable reactions to trauma. The worker’s knowledge of crisis and trauma, and the expectable immediate and longer-term reactions is drawn on at this time. It may involve a normalising statement where the worker draws upon his or her knowledge base to provide resources for the client.
6. Direct influence In some instances you may use directive or influencing skills, e.g. suggest a plan if nothing emerges from the client—contain the options the client is presented with to help the client get through the immediate situation. 195 Maslow’s hierarchy of needs may be relevant, e.g. people in crisis often need the basics attended to in relation to shelter, food, clothing and communication.

(O’Connor et al., 2008) In many situations workers draw on more than one theoretical approach to identify appropriate intervention strategies.