Social work concepts: Crisis intervention

Contents

  1. Introduction
  2. Implementation
  3. Misuse
  4. SAFER-
  5. Critical incident debriefing

Introduction

Crisis intervention is a time-limited intervention that uses a specific psychotherapeutic approach to stabilise those who are in crisis.

Implementation 

A crisis can have both physical and psychological consequences. The latter, which is usually more severe and widespread, lacks the obvious signs of the former, complicating diagnosis. Crisis is defined by three factors: negative events, feelings of hopelessness, and unpredictable events. People who have gone through a crisis perceive it as a negative event that causes physical emotion, pain, or both. They also feel helpless, powerless, trapped, and as if they have lost control of their lives. Crisis events typically occur unexpectedly and without warning, giving little time to respond and resulting in trauma. When a mass trauma event, such as a terrorist attack, occurs on a global scale, counsellors are trained to provide clients with resources, coping skills, and support to help them through their crisis. An assessment is frequently used to initiate intervention. Crisis intervention is an individual therapy that lasts four to six weeks in countries such as the Czech Republic and includes assistance with housing, food, and legal matters. Long wait times for resident psychotherapists, as well as explicit exclusions of couples therapy and other therapies in Germany, make implementation difficult. Licensed professional counsellors (LPCs) provide mental health care to those in need in the United States. Licensed professional counsellors concentrate on psychoeducational techniques to prevent crises, individual consultation, and the research of effective therapeutic treatment to deal with stressful environments.

School-based

The primary goal of school-based crisis intervention is to help restore the crisis-exposed student's basic problem-solving abilities, allowing the student to return to pre-crisis levels of functioning. Crisis intervention services are provided in an indirect manner. School psychologists are frequently found working behind the scenes to ensure that students, staff, and parents are well-positioned to realise their natural potential to overcome the crisis. School psychologists are educated professionals who must continue their education after receiving their degree. By collaborating with other staff, such as school resource officers and law enforcement officers trained as informal counsellors and mentors, they help to maintain a safe and supportive learning environment for students.
 
When a traumatic event occurs, such as a student death, school psychologists are trained to prevent and respond to the crisis using NASP's PREPaRE Model of Crisis Response. PREPaRE trains educational professionals in roles based on their involvement in school safety and crisis teams. PREPaRE is one of the first nationally available comprehensive training curricula developed by school-based professionals with firsthand experience and formal training.

Misuse

 When using crisis intervention methods for the disabled individual, every effort should be made to first find other, preventative methods, such as providing adequate physical, occupational, and speech therapy, as well as communication aides such as sign language and Augmentative Communication systems, behaviour, and other plans, to help that individual express their needs and function better. Too often, crisis intervention methods such as restraining holds are used without first providing more and better therapies or educational assistance to the disabled. School districts, for example, may frequently use crisis prevention measures and "interventions" against disabled children without first providing services and supports: In the 2011–12 school year, at least 75% of cases of restraint and seclusion reported to the US Department of Education involved disabled students. During the 2011–12 school year, the Department of Education involved disabled children. Furthermore, school districts conceal the restraint or seclusion of their disabled child from the parents, denying the child and their family the opportunity to recover.

The United States Congress has proposed legislation, such as the "Keeping All Students Safe Act," to limit the use of restraint and seclusion in school districts. The bill has repeatedly died in committee, despite bipartisan support.

SAFER-R

The SAFER-R Model, along with Roberts' 7 Stage Crisis Intervention Model, is a popular model of intervention among law enforcement. The model views crisis intervention as a tool for assisting clients in regaining their baseline level of functioning followinga crisis. This intervention model for dealing with people in crisis consists of 5+1 stages.

They are:
  1. Stabilize 
  2.  Acknowledge
  3.  Facilitate understanding 
  4. Encourage adaptive coping 
  5. Restore functioning or, 
  6. Refer
Lerner and Shelton's 10-step acute stress and trauma management protocol is another model. The SAFER-R model can be combined with the Assessment Crisis Intervention Trauma Treatment model. ACT is a crisis intervention model with seven stages. This model, like the SAFER-R model, is used to restore one's mental state, but it is also used to prevent any psychological trauma that may occur during a crisis. It can also assist experts in determining a solution for those suffering from mental illness.

Critical incident debriefing

Critical incident debriefing is a popular approach to assisting those in crisis. This technique is performed in a group setting 24–72 hours after the event and is typically a one-time meeting lasting 3–4 hours, but it can be done over multiple sessions if necessary. Debriefing is a process in which facilitators describe various symptoms of PTSD and other anxiety disorders that individuals may experience as a result of trauma exposure. They process their negative emotions in relation to the traumatic event as a group. Each member is encouraged to continue treatment participation so that symptoms do not worsen.

Many people have criticised critical incident debriefing for being ineffective at reducing harm in crisis situations. According to some studies, those who have received debriefing are more likely to exhibit PTSD symptoms at a 13-month follow-up than those who have not. The majority of those who received debriefing said it was beneficial. Some critics argue that reported improvement is a misattribution based on symptoms found in those who received no treatment at all, and that the progress would occur naturally without any treatment.

References

  1. Berger P & Riecher-Rössler A (2004) Definition von Krise und Krisenassesment. (in German) In Riecher-Rössler A, Berger P, Yilmaz AT, Stieglitz RD (eds.) Psychiatrischpsychotherapeutische Krisenintervention. Göttingen: Hogrefe, 19–30 
  2. Aguilera, D.C. (1998). Crisis Intervention. Theory and Methodology. Mosby, St Louis. 
  3.  Jackson-Cherry, L.R., & Erford, B.T. (2010). Crisis intervention and prevention. NJ: Pearson Education, Inc.

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