Chapter 11 - The Helper at Times of Crisis: Needed Knowledge, Skills, and Disposition

Connecting

it is important to:

• quickly establish rapport and a working relationship

• address immediate threats and concerns including resolving the client's basic and pressing needs; and

• provide the client with information about what to expect and the steps to be taken.

Assessment

it is important to identify the existence of warning signs of maladaptive coping behaviors and responses, including suicidal ideation, and explore the client’s adaptive coping behaviors that may be substituted for exhibited behaviors.

PsychSTART

provides a process for identifying evidenced-based risk markers and serves as a tool for identifying those who will need additional assessment and intervention.

Goals and Interventions

• vital to engage in active listening and nonjudgmental and empathic responding, reflecting crisis-related feelings and clarifying crisis facts, while instilling a sense of realistic hope.

• It is also important to facilitate the client's expression of feelings about the current crisis, including any sense of guilt or responsibility. 

• In helping the client reduce current anxiety and begin to gain a sense of control, it is important to help him or her articulate the nature of the problem(s) being confronted.

Action Plan

• it is important to move the client into finding and engaging with solutions.

• important to engage and empower clients as much as possible. 

• it is important to start with current needs and pressing concerns.

  • Asking clients to identify problems or challenges that they are currently facing and helping to identify tasks that are easily completed can help restore a sense of control and capability. 

• the crisis worker needs to break down goals

Referral

• these immediate interventions are not enough to alleviate their distress or mitigate long-term consequences.

• In those cases, additional interventions targeted to specific client needs may be necessary.

Acceptance

• At the time of crisis or in the wake of a disaster, those needing services are often stripped of those symbols of status, role, and position.

• They are confused, and their view of self and the world may be somewhat muddled.

• It is at these times that they need to experience acceptance for where they are and who they are.

Unconditional Positive Regard and Valuing

• it is important to convey an attitude of deep valuing and respect for this other.

• It is important, especially for one whom in the moment of crisis may feel defeated, to experience the prizing, the valuing, and the non-possessive warmth and respect of the client or disaster survivor.

• This valuing of the other allows the helper to look beyond the conditions of that person's life or current situation, conditions that can serve as filters coloring our valuing of another, and instead simply embrace and value them as a fellow human being.

Genuineness

• Being real and genuine positions us to interact with another to from a truly authentic position

• Genuineness allows us to be congruent in a way that our words, actions, tone, thoughts, and feelings are all conveying the same message 

Self-Awareness as a Foundation for Empathy

sympathy emerges from our viewing the conditions of another from our point of reference, our perspective, as if this was happening to me. 

High Tolerance for Chaos

• individuals in crisis present in a highly emotional state. 

• it is essential that the helper remain calm, non-reactive, and supportive. 

• demands that crisis and trauma workers have a high tolerance for chaos and dramatic situations and a special resiliency under these conditions.