LMSW: Crisis Intervention

Crisis

any situation where an individual experiences an overwhelming event which upsets one’s psychological equilibrium or baseline level of functioning

• one’s usual methods of problem solving or coping are not effective in a crisis

• a crisis is self-defined by one’s own perception of the event or situation

  the crisis state can last from 2days-6weeks

Types of crisis

maturational crisis

situational crisis

Maturational Crisis

• Precipitated by normal stress during the course of life

Situational Crisis

Precipitated by a sudden traumatic event that is unexpected

Factors which influence reactions

• Nature of the event and extent of exposure

• Perception of the event

  • social supports and coping mechianisms

Crisis intervention

a brief treatment initiated when an individual is in a crisis to help restore one’s pre-crisis biopsychosocial functioning

• supportive, focused psychotherapy

• 1-6 sessions during period of crisis

Listen

• Establish therapeutic relationship

• identify precipitating problems'

• explore the clients emotions

Assessment

• Determine the severity of the crisis

• assess the client for safety risks and suicidal/homicidal ideation

• assess coping mechanisms being used

• Determine the client’s perception of reality

• determine client’s social supports and willingness to use supports

• focus on the immediate problem and not the client’s history

Treatment plan:

• Help the client understand their reaction to a crisis as normal and temporary

• Selectively choose and use appropriate approaches to action planning

• modify or eliminate past coping skills so they don’t interfere with your current plan of attack

• Create a contract or have the client sign a treatment pan so you are both on the same page

• identify useful referral resources

• use 3 basic approaches

  • start by being non-directive- let the client tell you why they have come to you

  • be collaborative-work together on a joint plan

  • be directive- if the person does not or will not make a plan

Termination

• Review progress

• review resources and support system

• schedule a follow up session

Goals

• Main focus is on resorting a client’s equilibrium or baseline functioning

• assist the client in developing new coping mechanisms (and/or building on past coping mechanisms) to deal with the immediate crisis and any future difficulties

• assist the client in developing problem-solving skills

• assist client in mobilizing social supports and services