How to Intervene in a Crisis Situation

Crisis intervention is a needed skill in this topsy-turvy world of ours when almost anything can happen in the blink of an eye: natural or man-made disasters, accidents, health crises, medical emergencies, or even some child's pet being run over by a vehicle. So it is very important to be prepared with at least the very basic skills needed to intervene in a crisis.

Assessing is a pervasive strategy by the crisis worker throughout crisis intervention. This assessment is action-oriented and situation-based, fluid and non-mechanistic, able to adjust to even the slightest change in circumstances. The first three steps you will read are more of LISTENING activities than they are actions. The final three steps are largely ACTION behaviors on your part as the worker, although you are continuing to listen and assess the whole time.

Difficulty: Moderately Challenging

Instructions

1. Define the problem. Understand the problem from the client's point of view. Try to perceive the crisis situation as the client sees it, so that your intervention may not miss its mark. Practice the core listening skills of empathy, genuineness, and acceptance or positive regard. For example, a client just broke up with her boyfriend of 3 months. It may not seem like much of a crisis to you, but it may be a huge crisis to her and that's why she's in the ER with imperfectly slashed wrists talking to you in a hushed monotone.

2. Ensure the client's safety. This means minimizing further physical and psychological danger to the client and others. Although we put this down as Step 2, we apply this step in a fluid way, meaning that client safety is actually a primary concern throughout crisis intervention. I encourage you to make client safety a natural part of your thoughts and behavior as a worker.

3. Provide support. Communicate to the client that you care about her. You cannot assume that a client experiences feeling valued, prized, or cared for. This is your opportunity to show the client that someone actually cares about her, and that someone is you, in an unconditional, positive way, regardless of whether the client can reciprocate or not.

4. Examine alternatives. Given the present crisis, explore people, situations, coping mechanisms, positive and constructive thinking patterns that may just provide a way out of the current dilemma. Think with the client about what would get her out of her present state of numb immobility or hysterical panic.

5. Make plans. This flows directly from Step 4. The plan should identify additional persons, groups, and other referral resources that can be contacted for immediate support, and provide coping mechanisms. By these I mean that the client should be given something concrete and positive for the client to do now, definite action steps that the client can own and understand. Help the client problem-solve and cope.

6. Obtain a firm commitment from the client. This means that you ask the client to verbally summarize the plan. Remember the SMART goal? A goal has a better chance of being reached if it is SMART : S- specific, M-measurable, A-attainable, R-relevant and T-timebound. So it is with goal-setting with your client. Make sure that they get out of that ER/clinic/specific setting in a precrisis equilibrium mode before terminating the contact with the client.
   
   Later, follow up on the client's progress and make the necessary and appropriate reports. Remember the overarching strategy of assessment and the twin components of listening and acting which are incorporated in the six steps of crisis intervention--- and you're all set! Remember that in crisis intervention, it's not enough that you have good intentions; you have to have certain skills as well, and this six-step model is a good way to get you started! So good luck!

[Heart-C]

on 8/10/2008 Well-thought out article for emergencies!

[AudreyBrown]

on 3/10/2008 Very good article. I appreciate all the details. :)