Crisis Intervention Overview

Definitions of Crisis

• Crisis Intervention Overview
  • Focuses on individuals in crisis as well as systems in crisis (hospitals, schools, mental health centers).
  • Addresses broad scenarios outside of substance abuse.

Individual Crisis Definitions

1. Caplan (1961):
   • People face insurmountable obstacles to important life goals, leading to disorganization and abortive problem-solving attempts.
2. Sarri (2005):
   • Crises stem from traumatic, unpredictable events causing a shift in values and priorities.
3. Carkhuff & Berenson (1977):
   • A crisis indicates an individual’s lack of a response to a given situation.
4. Belkin (1984):
   • Crises immobilize people, preventing conscious control over their lives.
5. Brammer (1985):
   • Crises involve frustration of life goals, producing feelings of fear, shock, and distress.
6. Poland & McCormick (1999):
   • A temporary breakdown in coping leads to intense emotional responses to unmet expectations.
7. Kleespies (2009):
   • Emotional instability characterized by depression and anxiety arises from external events.
8. Ho, Hallisey, & Ho (2009):
   • Acute emotional upset due to situational, developmental, or sociocultural sources results in compromised coping mechanisms.
9. Golan (1978):
   • A crisis may arise from catastrophic events or life stresses disturbing psychological balance, leading to a state where coping mechanisms fail.

• Summary of Individual Crisis:
  • Crisis involves perceiving situations as intolerable difficulties that exceed one’s coping resources, potentially leading to severe emotional and cognitive dysfunction.

Behavioral Emergencies

• Defined as crises requiring immediate intervention to prevent injury or death.
• Categories:
  • Direct emergencies: self-harm, violence, victimization.
  • Indirect emergencies: poor decision-making leading to dangerous situations.
  • Example: A parent's frantic drive during a traumatic event that endangers themselves and others.

Traumas That Set Off Crises

1. Situational Trauma:
   • Upheavals from events like death, breakups, illness, financial issues.
2. Developmental Trauma:
   • Caused by life stage transitions, like peer pressure or retirement.
3. Intrapsychic Trauma:
   • Internal conflicts causing distress, e.g., identity crises or suicidal thoughts.
4. Existential Trauma:
   • Feelings of emptiness and lack of purpose due to unmet life expectations.

Reactions to Crises

• Common Reactions:
  • a. Shock:
  • Numbness and difficulty concentrating.
  • b. Anxiety:
  • Overwhelming feelings, agitation, physical symptoms like heartbeat increase.
  • c. Depression:
  • Immobilization, preoccupation with trauma, low energy.
  • d. Anger:
  • Outward or inward directed, potentially self-destructive.
  • e. Intellectualization:
  • Rational thinking leads to avoidance of emotions, resulting in unresolved trauma.

Characteristics of Crisis

• Presence of Danger and Opportunity:
  • Crisis threatens with the potential for severe outcomes but also serves as a catalyst for growth.
• No Quick Fixes:
  • Effective intervention necessitates time, thorough approaches, and understanding of underlying issues.
• Necessity of Choice:
  • Decisions made during crises can dictate recovery or downturn.
• Universality and Idiosyncrasy:
  • Crisis affects everyone differently based on personal experiences and resilience.
• Resiliency:
  • Many individuals possess inherent resilience that can be tapped into through proper support.
• Perception of Events:
  • The way individuals interpret crises significantly influences recovery potential.
• Complex Symptomology:
  • Crises manifest differently based on the interplay of various personal and environmental factors.

Transcrisis States

• Crises often extend beyond the immediate crisis period, potentially reactivating with future stressors, leading to long-term impact and unresolved trauma.

Theories of Crisis and Crisis Intervention

• Crisis theories can be categorized into basic, expanded, and applied crisis theories.

Basic Crisis Intervention Theory

• Influential figures: Erich Lindemann and Gerald Caplan.
  • Focus on behavioral responses to grief and traumatic events.
• Stages:
  1. disturbed equilibrium,
  2. brief therapy/grief work,
  3. resolution.

Expanded Crisis Theory

• Integrates multiple perspectives: psychoanalytic, systems, ecosystems, adaptational, interpersonal, and chaos theories to account for the complexity of crises.

Applied Crisis Theory

• Encompasses various domains of crises: developmental, situational, existential, and ecosystemic crises.