Crisis Intervention
Many times, when people think about helping someone in a crisis it sends the "helper" into something of a crisis, also. He/she become very anxious, the heart starts pounding, the palms of the hands get wet and s(he) may feel flushed. Sometimes learning more about what it is we fear when this happens, helps us fear it less.
The first important thing to know about a crisis is that it is time limited. A crisis always pushes towards some sort of resolution (good or bad) and will usually run its course in about 8-10 weeks. During a crisis, a person's habits, coping patterns and defenses are suspended. It is during this time that the individual is most open to learning new coping skills effectively.
It is vitally important for the advocate to be nonjudgmental regarding the nature of an individual's crisis. One person may go into a crisis and experience intense grief when a pet dies. For another individual, the cat's dying may be of little consequence.
It is extremely important to note that a person who is in crisis is experiencing a number of different feelings, two of which may be anxiety and confusion. Therefore, especially in the initial stages of a crisis, help the person get in touch with the feelings that they are experiencing before attempting to provide any information. In reality, there are a lot of places an individual can go to get information that may or may not help. There are not, however, as many places where an individual can get help clarifying feelings about an event. This is important, as clarifying one's feelings will help in making a decision that will in turn lead to a resolution of the crisis.
Many times, when people think about helping someone in a crisis it sends the "helper" into something of a crisis, also. He/she become very anxious, the heart starts pounding, the palms of the hands get wet and s(he) may feel flushed. Sometimes learning more about what it is we fear when this happens, helps us fear it less.
The first important thing to know about a crisis is that it is time limited. A crisis always pushes towards some sort of resolution (good or bad) and will usually run its course in about 8-10 weeks. During a crisis, a person's habits, coping patterns and defenses are suspended. It is during this time that the individual is most open to learning new coping skills effectively.
It is vitally important for the advocate to be nonjudgmental regarding the nature of an individual's crisis. One person may go into a crisis and experience intense grief when a pet dies. For another individual, the cat's dying may be of little consequence.
It is extremely important to note that a person who is in crisis is experiencing a number of different feelings, two of which may be anxiety and confusion. Therefore, especially in the initial stages of a crisis, help the person get in touch with the feelings that they are experiencing before attempting to provide any information. In reality, there are a lot of places an individual can go to get information that may or may not help. There are not, however, as many places where an individual can get help clarifying feelings about an event. This is important, as clarifying one's feelings will help in making a decision that will in turn lead to a resolution of the crisis.
FEELINGS
What are the feelings that a person in crisis may experience?
þ Anxiety
þ Powerlessness
þ Shame
þ Anger
þ Ambivalence
þ Hopelessness
þ Decreased self-image
What are the feelings that a person in crisis may experience?
þ Anxiety
þ Powerlessness
þ Shame
þ Anger
þ Ambivalence
þ Hopelessness
þ Decreased self-image
It is important that the
advocate show the survivor that there are no right or wrong feelings and that
whatever s/he is feeling is okay. This may become difficult at times because
the survivor may be experiencing a mixture of feelings. Feelings, especially
anger, may be displaced and directed at the advocate. The advocate should not
be offended by this and thereby, act in a negative way. Remember, the survivor
may be in a state of emotional confusion.
Let's examine some feelings that the survivor may have about you—the advocate:
1. First of all, the person in crisis is likely to feel that you, the advocate, are going to solve his/her problem. This is an erroneous assumption, and at times, s/he may need to be reminded that you cannot solve problems for him/her. You can help him/her, though, examine options so that s/he can make the appropriate choices.
2. Secondly, they may feel that you are someone who is concerned, knowledgeable and willing to help. This is an appropriate assumption and it is important that the advocate show the survivor these attributes.
It is important to keep survivors in the "here and now." This will give you a clue as to what issues are presently disrupting their lives and where to begin. Keep them focused on what they are feeling right now and begin the crisis intervention.
Material compiled by Ben Komman, MSW, ACSW from Crisis Suicide Rescue, Inc. and
Suicide and Crisis Center of Dallas From the SEXUAL ASSAULT ADVOCATE TRAINING MANUAL
Let's examine some feelings that the survivor may have about you—the advocate:
1. First of all, the person in crisis is likely to feel that you, the advocate, are going to solve his/her problem. This is an erroneous assumption, and at times, s/he may need to be reminded that you cannot solve problems for him/her. You can help him/her, though, examine options so that s/he can make the appropriate choices.
2. Secondly, they may feel that you are someone who is concerned, knowledgeable and willing to help. This is an appropriate assumption and it is important that the advocate show the survivor these attributes.
It is important to keep survivors in the "here and now." This will give you a clue as to what issues are presently disrupting their lives and where to begin. Keep them focused on what they are feeling right now and begin the crisis intervention.
Material compiled by Ben Komman, MSW, ACSW from Crisis Suicide Rescue, Inc. and
Suicide and Crisis Center of Dallas From the SEXUAL ASSAULT ADVOCATE TRAINING MANUAL
CRISIS
INTERVENTION: COPING WITH THE CRISIS
How Do We Define Crisis?
þ A response to a stressful situation or emotionally hazardous event which poses a threat to the
individual.
þ The individual's usual ways of coping are ineffective.
þ The individual may be unable to maintain the usual pattern of functioning.
SUMMARY OF THE CONCEPT OF CRISIS
þ All people are subject to stress at different points in their lives; all people attempt to maintain a
sense of balance.
þ There are times when the stress is so great that the person cannot maintain a sense of balance
with the personal and environmental resources available to them.
þ At this point a person may not be able to function as usual.
þ The person may perceive the event precipitating the crisis, as a threat, loss or challenge.
Initially, they may feel confused, overwhelmed or frightened.
þ A state of crisis is not an illness or weakness. It represents a struggle with a current life
situation.
þ While a person is in crisis, a minimal force can produce a maximal effect.
þ The crisis situation is time limited. Within 8-10 weeks the person may reach a new balance
(which can be better, the same or worse than the precrisis functioning).
þ A crisis may offer a person an opportunity to grow and develop a new and
more effective means of functioning.
WHAT THEN IS CRISIS INTERVENTION?
Immediate short-term support for survivors to insure that, physical, medical and psychological needs are met.
þ It focuses on immediacy.
þ It focuses on the positive or healthy parts of the personality.
Most importantly, crisis intervention involves helping a person handle the current
crisis effectively, by utilizing their own strengths and support systems.
THE ROLE OF THE ADVOCATE DURING THE CRISIS
þ The crisis intervention advocate connects with a person at the point of crisis or within the crisis
period and in the setting, if practical, of the person in crisis.
þ The advocate does not attempt or intend to overhaul the basic personality of the person in
crisis. Instead, the advocate helps empower the person so that s/he may develop new problem-
solving methods.
GOALS OF CRISIS INTERVENTION
þ To reduce the immediate impact of the crisis.
þ To understand the precipitating circumstances.
þ To help the person access healthy coping skills, capitalizing on strengths, support systems and
resources in the community from which a base of reintegration may occur.
þ To help the person move beyond the crisis so that s/he may get on with his/her life.
How Do We Define Crisis?
þ A response to a stressful situation or emotionally hazardous event which poses a threat to the
individual.
þ The individual's usual ways of coping are ineffective.
þ The individual may be unable to maintain the usual pattern of functioning.
SUMMARY OF THE CONCEPT OF CRISIS
þ All people are subject to stress at different points in their lives; all people attempt to maintain a
sense of balance.
þ There are times when the stress is so great that the person cannot maintain a sense of balance
with the personal and environmental resources available to them.
þ At this point a person may not be able to function as usual.
þ The person may perceive the event precipitating the crisis, as a threat, loss or challenge.
Initially, they may feel confused, overwhelmed or frightened.
þ A state of crisis is not an illness or weakness. It represents a struggle with a current life
situation.
þ While a person is in crisis, a minimal force can produce a maximal effect.
þ The crisis situation is time limited. Within 8-10 weeks the person may reach a new balance
(which can be better, the same or worse than the precrisis functioning).
þ A crisis may offer a person an opportunity to grow and develop a new and
more effective means of functioning.
WHAT THEN IS CRISIS INTERVENTION?
Immediate short-term support for survivors to insure that, physical, medical and psychological needs are met.
þ It focuses on immediacy.
þ It focuses on the positive or healthy parts of the personality.
Most importantly, crisis intervention involves helping a person handle the current
crisis effectively, by utilizing their own strengths and support systems.
THE ROLE OF THE ADVOCATE DURING THE CRISIS
þ The crisis intervention advocate connects with a person at the point of crisis or within the crisis
period and in the setting, if practical, of the person in crisis.
þ The advocate does not attempt or intend to overhaul the basic personality of the person in
crisis. Instead, the advocate helps empower the person so that s/he may develop new problem-
solving methods.
GOALS OF CRISIS INTERVENTION
þ To reduce the immediate impact of the crisis.
þ To understand the precipitating circumstances.
þ To help the person access healthy coping skills, capitalizing on strengths, support systems and
resources in the community from which a base of reintegration may occur.
þ To help the person move beyond the crisis so that s/he may get on with his/her life.
FEELINGS
THAT MAY BE EXPERIENCED BY SOMEONE IN CRISIS
- ANXIETY - This is perhaps the most common feeling. Any substantial threat
produces anxiety. Normal amounts of anxiety assist in mobilizing against the
threat and may be appropriate and helpful. However, great anxiety may produce
confusion, distortion, poor judgment, self-defeating behavior and/or
questionable decisions. Anxiety may be the first emotion the advocate must
learn to work with.
- POWERLESSNESS - People work hard to manage successfully and develop their own
set of coping skills. Then, perhaps because of an external event or a
conglomeration of unfamiliar emotions, they experience a sense of loss of
control that may be overwhelming, bringing with it a feeling of
powerlessness. This feeling of
powerlessness, in turn, may bring with it a feeling of shame.
- SHAME - Many people are taught to be competent and self-reliant, but
during a crisis, a competent,
self-reliant person may have to depend on others and may feel incompetent. This
may produce feelings of shame, and may be closely related to feelings of
powerlessness. Thus survivors may feel that they are not able to handle their
own problems and that they may have to turn to someone else.
- ANGER - There may be very little, some or a lot of anger. However, anger
may often be hidden behind other more obvious expressions. Anger may be
directed at self, others, the listener or an "irrational" event.
- AMBIVALENCE - Feelings of confusion and uncertainty may emerge. As a result
the person may struggle with issues brought on by the crisis. Some of these
issues may be: independence vs. dependence; self-reliance vs. relying upon
others; controlling emotions vs. losing control; increasing self-confidence by
managing for self vs. risking reaching out to another for help or trusting
others too much vs. total distrust of others.
- HOPELESSNESS – Survivors may feel that they will never get beyond the present
incapacitating feelings. They see no hope of ever recovering or moving beyond
the crisis and may talk of ending their lives. Suicidal thoughts or tendencies
may sometimes accompany this feeling.
- DECREASED SELF-IMAGE - The individual may also feel
a decrease in self-esteem. All these feelings may combine and result in a
decrease in self-esteem, leaving the person in crisis extremely vulnerable.
WHAT
A SURVIVOR MAY NEED FROM AN ADVOCATE
þ Trust
þ Clarification of the current situation
þ Anticipatory guidance and rehearsal for reality
þ Realistic reassurance and support
þ Discussion of plans and options, offering available information
þ Trust
þ Clarification of the current situation
þ Anticipatory guidance and rehearsal for reality
þ Realistic reassurance and support
þ Discussion of plans and options, offering available information
ABC’S OF ACTIVE LISTENING
ACHIEVE A RELATIONSHIP
O Listen with compassion to what the person is feeling and experiencing.
O "Check out" what you understand them to be saying to see if you are on the same wavelength.
O Let them experience your warmth and concern. Be genuine.
O Allow them to tell you about the crisis or problem at hand, when it started, how it developed
and how they feel about it.
O Let the survivor know you would like to work together to find something that can be done to
help - preferably to help them to help themselves.
ISOLATE THE PROBLEM
O Help them to sort out the pieces of the problem they are facing.
O Help them in separating those parts about which something can be done from those about
which nothing can be done.
O Encourage them to describe what has been tried. (This way you will not repeat those things that
have not worked.)
O Encourage the survivor to describe or discover other possible options.
O Help them examine each option in terms of their probable consequences. "What will happen
if... ?"
O Help them to decide which of the various options they may want to try now.
ENCOURAGE ACTION
O Encourage the survivor to plan just how they might begin doing what they have decided to do;
the plan should be realistic with achievable goals.
O Encourage commitment to self, beginning soon and at an agreed upon time.
O If you perceive resistance to action on the problem, help them discuss and resolve these
feelings.
O Assure them that someone will be available as they try to act in a constructive way; support with
realistic hope. Remember not to be judgmental if your expectations are not met as to the best
course of action.
O Encourage step taking. (Avoid doing things for them if they can do it alone - this allows them
control of situations.)
O Show support by telling them that as they begin to do things, however small, they may feel
better, less depressed, more hopeful, etc.
O Help examine and discover resources to cope - interpersonal, inner, spiritual.
Crisis Intervention Training taken from the SEXUAL ASSAULT ADVOCATE TRAINING MANUAL – TEXAS OFFICE OF THE ATTORNEY GENERAL
O Listen with compassion to what the person is feeling and experiencing.
O "Check out" what you understand them to be saying to see if you are on the same wavelength.
O Let them experience your warmth and concern. Be genuine.
O Allow them to tell you about the crisis or problem at hand, when it started, how it developed
and how they feel about it.
O Let the survivor know you would like to work together to find something that can be done to
help - preferably to help them to help themselves.
ISOLATE THE PROBLEM
O Help them to sort out the pieces of the problem they are facing.
O Help them in separating those parts about which something can be done from those about
which nothing can be done.
O Encourage them to describe what has been tried. (This way you will not repeat those things that
have not worked.)
O Encourage the survivor to describe or discover other possible options.
O Help them examine each option in terms of their probable consequences. "What will happen
if... ?"
O Help them to decide which of the various options they may want to try now.
ENCOURAGE ACTION
O Encourage the survivor to plan just how they might begin doing what they have decided to do;
the plan should be realistic with achievable goals.
O Encourage commitment to self, beginning soon and at an agreed upon time.
O If you perceive resistance to action on the problem, help them discuss and resolve these
feelings.
O Assure them that someone will be available as they try to act in a constructive way; support with
realistic hope. Remember not to be judgmental if your expectations are not met as to the best
course of action.
O Encourage step taking. (Avoid doing things for them if they can do it alone - this allows them
control of situations.)
O Show support by telling them that as they begin to do things, however small, they may feel
better, less depressed, more hopeful, etc.
O Help examine and discover resources to cope - interpersonal, inner, spiritual.
Crisis Intervention Training taken from the SEXUAL ASSAULT ADVOCATE TRAINING MANUAL – TEXAS OFFICE OF THE ATTORNEY GENERAL