Crisis Intervention

 

Definition:  Crisis is a perception of an event or sit. as an intolerable difficulty that exceeds the resources and coping mechanisms of the person.

Generally, crisis states persist approximately 6 to 8 weeks, however,in the aftermath of the crisis event, a person can be transformed into a chronic and long-term period of instability and inadequate functioning; this condition is called the transcrisis state and its severity often demands prolonged treatment.

 

Theories of crisis and crisis intervention

 

Basic crisis theory owes much to Lindemann who developed theory and intervention directed toward sufferers of loss/grief. Normal grief behaviors include:  (1) preoccupation with the lost one, (2) identification with the lost one, (3) expressions of guilt and hostility, (4) some disorganization in daily routine, and (5) some evidence of somatic complaints. These responses are not abnormal nor pathological.

Caplan expanded Lindemann’s ideas to the filed of traumatic events. He viewed crisis as a state resulting from impediments to life goals that cannot be overcome through customary behaviors.

Expanded crisis theory finds contributions from psychoanalysis, systems theory, adaptational theory, and interpersonal theory. Psychoanalytic theory is based on the view that the disequilibrium that accompanies a person’s crisis can be understood through gaining access to the individual’s unconscious thoughts and past emotional experiences. The presupposition is that some early childhood fixation is the primary explanation of why an event becomes a crisis.

 

Systems theory stresses the interrelationships and interdependence among people and between people and events. The theory refers to an emotional system, a system of communications, and a system of need fullfillment and request in which all members within an intergenerationalrelationship bring something to bear on each other.

 

Adaptational theory depicts a person’s crisis as being sustained through maladaptive behaviors, negative thoughts, and destructive defense mechanisms. A person’s crisis will recede when these maladaptive coping mechs are changed to adaptive ones.

 

Interpersonal theory describes how enhancing personal self-esteem and belief in others. When people confer their locus of self-evaluation on others, they become dependent on others for validation of their being.

 

Applied crisis theory:  View each person and each crisis sit. as different. Brammer characterizes applied crisis theory as encompassing 3 domains:  (1) normal developmental crises; (2) situational crises; (3) existential crises. Developmental crises are events in the normal flow of growth. I.e. birth of a child, graduation from college, midlife career change, or retirement. Situational crises are extraordinary events that an individual has no way of forecasting or controlling. Existential crises refer to the inner conflicts and anxieties that accompany important issues of purpose, responsibility, independence,, freedom, and commitment.

 

Crisis intervention models

 

The Equilibrium Model- people in crisis are in a state of psychological or emotional disequilibrium in which their usual coping mechs. and problem-solving methods fail to meet their needs.This model is most appropriate for early intervention when the person is out of control, disoriented, and unable to make appropriate choices.

 

The Cognitive Model is based on the premise that crises are rooted in faulty thinking about the events or sits. that surround the crisis. The goal of this model is to help people become aware of and to change their views and beliefs about the crisis events.

 

The Psychosocial Transition Model assumes that people are products of their heredity and the learning they have absorbed from their social environments. The goals of this model is to collaborate with clients in their assessment of both internal and external difficulties contributing to the crises and to help them choose workable alternatives to their current behaviors, attitudes and use of environmental resources.

 

The Six-Step Model of Crisis Intervention

1.	Define the Problem. Use listening and action skills to truly understand the problem, the client’s experience of the problem, and the meaning the problem conveys to the client.  Assessment of the person and the sit. is the keystone for initiating intervention. The worker needs to evaluate the severity of the crisis; appraise the client’s thinking, feeling, emoting, and behaving patterns; assess the chronicity and lethality of the crisis; look into the client’s background for contributing factors; and evaluate the client’s resources, coping mechs, and support systems.
2.	Ensure client safety
3.	Provide support
4.	Examine alternatives
5.	Make plans
6.	Obtain commitment