Crisis Theory and Intervention

Crisis Theory Overview

• Crisis Theory is the theory used in clients who have experienced an event (genuine harm, the threat of harm, or a challenge) that is an aberration from the person’s typical pattern of functioning
• Used when individuals lack knowledge about how to manage their situation
• Crises with individuals may be biological, interpersonal, environmental, or existential.
• Crisis Intervention can be used in several cases and presenting problems
• This intervention focuses on a strengths-based approach and founded on several assumptions.

Origins & Social Context of Crisis Theory & Intervention

• Crisis Theory emerged during the 1940s through the work of psychiatrists Erich Lindemann & Gerald Caplan

Origins & Social Context of Crisis Theory & Intervention

• Lindemann’s ideas were based on observations of the grief reactions of survivors & friends/relatives of the individuals who passed away.

• Identified common crisis (grief) reactions of “somatic [relating to the body] distress, guilt, anger, disrupted patterns of conduct, and preoccupation with images of the deceased.”

Lindemann

Origin & Social Context

• Lindemann concluded that the length and outcome of a grief reaction depends on a person having:
• Time to mourn;
• Time to adjust to their changed environment (e.g. not having person who passed away around);
• Time to develop new relationships.

• Caplan believed that people are the most vulnerable to crisis reactions during developmental transitions (e.g. adolescence adulthood)
• Specficied two types of crisis: Normal Life Transitions and Hazardous events.
• Caplan was also the first to describe the three
• stages of a crisis reaction.

Origin & Social Context

• Lydia Rapport, a social worker, in the 1960s, emphasized the importance of rapid assessment and easy access to the client when it comes to doing crisis intervention.
• Naomi Golan (1978) emphasized that people were more open-minded about receiving help “during the most difficult period of a crisis,” and that during this time intensive, brief interventions are more successful because a client is more motivated to get through their crisis.
• The suicide prevention movement, that expanded during the 1960s also influenced the adaption of the crisis theory, along with the community mental health movement.
• In the 1970s, crisis intervention services grew even more because of the geographic mobility in the United States and other countries, as well as the new scientific discoveries that linked psychological trauma to long-term neurological functioning/disorders.

Major Concepts of Crisis Theory

• Psychological Stress
• Traumatic Stress
• Biological Coping
• Psychological Coping
• Social Support
• Crisis

The Client/Worker

Relationship

Structured stages are as follows:

• Rapid establishment of a constructive
• social worker/client relationship
• Eliciting and encouraging the client’s expression of painful feelings
• Assessment
• Restoration of cognitive functioning
• Planning and implementing interventions
• Environmental work
• Ending and follow up

Nature of

Problems & Change

• With Crisis Theory, problems stem from physical, psychological, and social events that exceed an individual’s coping capabilities.
• Change can occur in one of three patterns:
• Growth pattern: client recovers from the event and then develops new skills and strengths.
• Equilibrium pattern: client returns to their pre-crisis level of functioning, but doesn’t experience any improved social functioned.
• Frozen Crisis pattern: client does not improve and develops negative coping strategies, which keeps them in a chronically troubled state.

Assessment

• Gather information from the client to help mobilize resources quickly
• Must be completed quickly, less in-depth
• Questions that should be a part of the assessment :
• Does the client require immediate medical or psychiatric attention?
• What are the client’s strengths? Areas of life stability?
• Is the client self-destructive?

• ·Suicide assessment includes the social worker’s attention in 5 areas:
• Historical information about the client
• Personal information
• Specific symptoms of the client’s distress
• Person-environmental interactions
• Protective factors.

Intervention

· Intervention strategies are adopted from other practice theories ; does not suggest a unique intervention

· From Ego Psychology

· From Behavior Theory

· From Cognitive Theory

· From Structural Family Theory

· From Solution-Focused Theory

· From Narrative Theory

What is NOT Crisis Theory?

• It is not disaster management.

Disaster management focuses on the event, versus the psychological needs and responses of those who experienced the disaster. (Katrina)

• Stress & Trauma

These can end in crisis, but they alone don't meet the criteria for crisis

Spirituality in Crisis Theory

• Different from religion, BUT CAN involve religion.
• Used to find meaning/purpose and direction.
• Believed that body, mind, and spirit are all connected. Connectedness attempted to be found through prayer mindfulness, mediation, tai chi/qi gong, yoga, social support groups, etc.
• Church, other places of worship
• People of all ages: https://www.youtube.com/watch?v=SpjWb9teKSY
• Active/Empathic Listening/Mobilize supports.

Issues of Social Justice

• ALL INJUSTICES ARE CRISIS
• Trauma, stress, poverty, discrimination, unemployment, etc.
• Can engage in social activism by activities such as raising awareness (speaking out), using resources such as grassroots volunteers, community partners, etc.
• Must be cultural competent

How Effective is Crisis Intervention?

• Effective in treating child abuse and domestic violence victims and families, reducing hospitalizations, reducing out-of-home placements.
• Shown ineffective in suicide prevention BUT changes have been made to suicide prevention programs to improve effectiveness
• Ideal for females, elderly, and patients w/higher SES.
• Effective in treating schizophrenia, bipolar disorder, and major depression disorder.

Limitations & Criticisms

This theory is an undeniably essential intervention.

• The criticisms of this theory cannot be subject to the "thematic" criticisms raised with other theories.
• Crisis theory as a human behavior theory has uniform stages in the experience of crisis for all people.
• The assumption that a client's dependence on a crisis practitioner is superior to a client's natural supports.
• Limited imperical evidence to support crisis assessment and intervention techniques (Victim of rape)
• It is not clear if group or independant intervention is most effective
• It will not address long-term, underlying psychological problems.
• Bandaid, not surgery.

• Memorize the steps involved in crisis intervention and suicide assessment

Triage Assessment Model for Crisis Intervention by Dr. Rick Myers

How to assess affective, cognitive and behavioral functioning.

• The most important part of crisis intervention is the relationship between the client and the worker.

• Stay healthy! Practice self-care. Your clients' improvement depends on it!

• Memorize the steps involved in crisis interventi...

References

Crisis Intervention and Suicide Assessment for Social Workers: Part 1 [Audio blog interview]. (2007, January 29). Retrieved August 6, 2017.

Walsh, J. (2013). Theories for Direct Social Work Practice (3rd ed.). Stamford, Conneticut: Cengage Learning.