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Crisis intervention is recommended for time-limited responses to people in acute crisis.
Dr. Erick Lindemann, psychiatrist, conceptualized crisis theory based on his work with acute and grief-stricken survivors and relatives of 493 victims of a Boston nightclub fire in the early 1940s.
Gerald Caplan, psychiatry professor, expanded Lindemann's work in the 1960s.
Albert R. Roberts, Ph.D. built upon their thinking and created Roberts' Steven-Stage Crisis Intervention Model (R-SSCIM) in 1991.
An acute disruption of psychological homeostasis in which one's usual coping mechanisms fail and there exists evidence of distress and functional impairment...The main cause...is an intensely stressful, traumatic, or hazardous event.
A "crisis" often has five components:
1. a hazardous or traumatic event
2. a vulnerable or unbalanced state
3. a precipitating factor
4. an active crisis state based on the person's perception
5. the resolution of the crisis
Roberts, 2005
Plan follow-up and booster sessions
Restore functioning through implementation of an action plan
Generate and explore alternatives, resources and new coping strategies
Encourage an exploration of feelings and emotions (including active listening and validation)
Identify the major problems, including crisis precipitants (ie: the "last straw")
Make psychological contact* and rapidly establish the collaborative relationship
Brown, F., Rainer, J. (2006). Too much to bear: An introduction to crisis intervention and therapy. Journal of Clinical Psychology, 62(8), 953-957.
Dziegielewski, S. (2004). The Changing Face of Health Care Social Work. New York: Springer Publishing Company.
Roberts, A.R. (2002). Assessment, crisis intervention, and trauma treatment: The integrative ACT intervention model. Brief Treatment and Crisis Intervention, 2(1), 1-21.
Roberts, A.R., Ottens, A.J. (2005). The seven-stage crisis intervention model: A road map to goal attainment, problem solving, and crisis resolution. Brief Treatment and Crisis Intervention, 5(4), 329-339.
Crisis intervention is the recommended approach when working with people in acute crisis and time is a factor.
Health care settings provide many crisis situations where patients need help right away.
The strengths of this approach outweigh the weaknesses. Intervening in crises is an important skill to use as health care social workers.
From Carl Rogers's "Necessary and Sufficient Conditions" for therapeutic change.
"Psychological contact" means a relationship between client and therapist must exist, and it must be a relationship in which each person's perception of the other is important.
Plan and conduct a thorough biopsychosocial and lethality / imminent danger assessment
A mom comes to the emergency room in distress because her 3-year-old daughter S'KyeLeigh just returned from a weekend visit at her dad's house and mom suspects someone sexually abused her. The mom is panicked and wants a doctor to examine her daughter to determine what happened.
Client self-determination is especially important among diverse populations
Crisis can occur as a result of a cultural clash or "mismatch" as when values or customs of traditional culture are ignored or violated.
(Roberts & Ottens, 2005)
Things to consider when assessing the socio-cultural experiences and cultural background of the client:
Remember that a lack of culturally sensitive services can greatly increase chaos and confusion in a crisis situation
(Roberts, 2002)
Crisis intervention is a necessary model to use in clinical health care social work settings.
A patient in crisis in a health care setting is usually experiencing not only a disruption in their psychological homeostasis, but also in theirs or a family member or friends physical homeostasis.
"The health care social worker is essential in helping the client reach a healthier resolution of the problem."
Dziegielewski, 2004
Dzielgielewski, 2004
Roberts, 2005
Dzielgielewski, 2004
Roberts, 2005