Summary: 10 Principles of Crisis Intervention Dr. Dawn-Elise Snipes Ph.D., LMHC, LPC-MHSP Executive Director, AllCEUs.com Objectives ~ Define crisis ~ Identify the 6 basic threats and how they relate to crisis ~ Discuss characteristics of crisis ~ Examine cultural influences in behaviors ~ Explore the SAFERR model ~ Identify 10 principles of crisis intervention Definition of Crisis ~ People are facing an untenable obstacle to goals ~ People’s life cycles are significantly disrupted AND ~ The person has no appropriate response to deal with a situation Temperament ~ Defines how we tend to prefer to act and interact. ~ Extrovert/Introvert (Awareness/Socialization) ~ Sensing/Intuitive (Problem Conceptualization) ~ Thinking/Feeling (Meaning) ~ Judging/Perceiving (Structure/Spontaneity) Characteristics of Crisis ~ Presence of opportunity and danger ~ Change causes crisis and crisis causes change ~ Increasing anxiety can lead to violent reactions Characteristics of Crisis ~ Complicated ~ Generally does not have one simple cause ~ Beliefs may be operating when an emotion or reaction seems out of proportion ~ Precipitating events may impact many different areas of life ~ No Panaceas or Quick Fixes ~ May provide temporary, immediate relief ~ Ensure they do not make problem worse ~ Necessity of Choice ~ Making a choice requires action ~ Choosing not to act is a still a choice Types of Crisis ~ Developmental ~ Identity formation ~ Empty nest ~ Mid-life ~ Medical/Physical ~ Chronic Illness/Pain (HIV, Fibro, Paralysis) ~ Spouse chronic illness ~ Situational ~ Death ~ Relationship ~ Job Loss ~ Homelessness* ~ Cabin Fever Exacerbating & Mitigating Factors/Vulnerabilities ~ Emotional: Pre-existing mood issues ~ Mental/Cognitive ~ Critical inner voice ~ Negative perceptions ~ Unhelpful thoughts (Cognitive distortions) ~ Physical ~ Pain/illness ~ Sleep deprivation ~ Low blood sugar/dehydration ~ New meds or med change Exacerbating & Mitigating Cont… ~ Social: ~ Lack of healthy, supportive social environment ~ Spiritual ~ Sense of interconnectedness and connection to something bigger than ourselves ~ What gives hope, faith, meaning and courage ~ What are a person’s values ~ Environmental ~ Visual triggers ~ Auditory triggers ~ Audience 6 Basic Threats ~ Fear and anger represent responses to a threat ~ Threats to consider in assessment ~ The unknown ~ Loss of control or power ~ Rejection ~ Isolation ~ Failure ~ Death Models of Crisis Intervention ~ Equilibrium/Stabilization ~ Remove reinforcers for aggressive behavior ~ Identify reasons to calm down ~ Cognitive ~ Gain control by changing thinking ~ Psychosocial ~ Assess internal and external exacerbating and mitigating factors ~ Choose workable alternatives Cultural Competence ~ There is no one “normal” range of behaviors ~ Individualistic vs. collectivistic society ~ Language is not always interpreted in the same way ~ We must accommodate the client’s needs ~ Past history certainly impacts current events ~ Be aware of personal assumptions Crisis Intervention-SAFERR ~ Basic Steps ~ Stabilize ~ Acknowledge ~ Facilitate understanding ~ Encourage adaptive coping ~ Restore functioning ~ Refer as needed Stabilize ~ Ensure Safety ~ Physical ~ Remove the client from the situation (if possible) ~ Inform client you want to help, but it is hard for you to focus while… Propose solution that does not take away his power ~ Psychological ~ Remove bystanders (an audience also adds fuel) ~ Reframe the situation with client not being “bad.” Stabilize ~ Assess (ABCs) ~ Affective state ~ Behavioral Functioning ~ Cognitive Functioning ~ Severity of the crisis Acknowledge ~ Define the problem ~ Seek help from the client in understanding what is going on ~ Listen to identify the person’s orientation ~ Feelings or solutions (MBTI) ~ Visual, auditory, kinesthetic ~ Empathize to see the problem as the client does ~ Ask open-ended questions ~ Pay attention to verbal and nonverbal messages ~ Acknowledge the situation and/or the cli
