Crisis intervention strategies and applications

Crisis Intervention

There are a number of stressors in contemporary society. These complex issues act to cause stress, crisis, and trauma -- although the terms themselves are difficult to precisely define since they are individual interpretations of events by their very nature. For example, many report that stress helps them work more productively -- indeed, the reason for stress from a biological point-of-view is to heighten senses to get the body through an event. Crisis, too, can mean many things to many people. Obviously, the individual responds to stress in different ways at different times. The individual is unique, and often what causes a crisis for one person may be a minor difficulty with others. It is important to understand then, that there is no generic rule for crisis -- no absolute for understanding how an event or series of events might cause a reaction in an individual. This, by its very nature, then is the real issue with crisis intervention -- one can develop some basic skills and tools (e.g. listening, guidance, etc.) but each and every intervention is unique, and must be treated in that manner (Seaward, 2008). Most clients have two main needs when they are in distress: to communicate their unresolved pain and to be assured they are still, somehow connected to the human race. In fact, recent developments in the world of counseling seem to suggest a merging of secular science (psychology, etc.), postmodern world-views, and humanism.

Case Study - We are dealing with Mary, a 35-year-old woman divorced woman now remarried. She recently learned that her new husband was having an extramarital affair. Her husband did not try to conceal this, told her he no longer loved her, wanted a divorce and he and his daughter would be leaving for Portugal. This was particularly stunning to Mary because her first marriage ended in divorce partially because she was unable to conceive, and found being a step-mother in her second marriage to be quite fulfilling.

Mary reacted very strongly to this situation -- felt that this was her second failure, and became depressed. She stopped going to work, slept through the day, and began to have suicidal thoughts. She was at the point where she simply had no one to turn to, felt there were no options for her, and finally found a crisis hotline number and called it.

After briefly speaking with Mary, the accessor quickly jotted down some of the general issues in tabular format:

Issue/Indication

Precursors, Therapeutic Interventions

Crisis Stage

2, 3, 4, 6 (See Below)

Repetitive nature of issues causes additional stressors

Crisis Prone

Triggers, but not enough information about other events in her life to indicate if prone or not.

Triggers are abandonment, child rearing, responsibilities of motherhood, fear of abandonment, lonlieness.

Overall Issue

Seems to pick inappropriate partners; in long-term, one must ask, are there issues Mary engenders over time with romantic relationships?

Substantive emotional stability; lack of intimacy; feelings of rejection.

Initial Steps

Clearly -- initial steps are to work through the feelings of suicide and find a way to get Mary on a treatment program with a professional.

Mary needs to either seek immediate help from a psychiatrist; perhaps who can prescribe either anti-anxiety medication or screen for anti-depression. Mary may be in enough of a crisis that emergency psychiatric treatment may be needed; checking herself in to a local hospital or at the very least finding a medical assessment as quickly as possible.

Potential

Crisis intervention -- critical that Mary get help; initial issues to cover are: self-esteem, that suicide is not a solution, find ties to the world that Mary can actualize; distract Mary from the negative by asking about the positive; emphasize the future can hold a great deal of motherhood, etc.

There are a number of variables -- first, trust and empathy must be established; Mary is suffering but needs to know that there are steps that can be taken to help the pain end. Something in the brain chemistry MUST change for Mary to feel better. Patience, perserverence are necessary -- compassionate intervention (see below).

Mary's Perception

Mary perceives that she has little choice, and that she is on the brink -- her money situation is dire, her relationships are all but naught, and her physical health is deteriorating along with her mental health.