Crisis Intervention: Models, History, and Social Impact

Introduction to Crisis Intervention

Crisis situations are usually sudden, unexpected, life-threatening, time-restricted incidents that may overpower a person's ability to react adaptively. During these critical incidents, extreme events may contribute to individual crises, traumatic stress, and even Posttraumatic Stress Disorder (PTSD). Generally, a crisis can be described as an incident that occurs when people are confronted with problems or situations that cannot be resolved. These irresolvable incidents contribute to increased anxiety, tension, an inability to function for extended periods, and a successive state of emotional unrest. In the past few decades, various major events have impacted the development and growth of crisis intervention, contributing significantly to its evolution as a field of practice.

Defining a Crisis

As noted above, a crisis can be described as an incident that occurs when people are confronted with problems or situations that cannot be resolved. These problems or situations are usually accompanied by emotional unrest, anxiety, tension, and a seeming inability to function effectively (Dass-Brailsford, 2007, p. 94). In other cases, a crisis is defined as an event considered so unbearably difficult that it exceeds a person's available resources and coping techniques. This period is characterized by psychological disequilibrium that cannot be resolved using common coping mechanisms.

Crisis events share several characteristics: perception of the precipitating event as threatening, seeming difficulty in changing or lessening the effect of stressful conditions, and increased tension, fear, and confusion. Additional characteristics include a high level of subjective discomfort and a rapid shift from a state of discomfort to an active crisis state. Some of the most common examples of crises include the death or loss of a loved one, unemployment, natural disasters, financial hardship, physical illness, an accident, unexpected pregnancy, and divorce or separation.

Historical Development of Crisis Intervention

Crisis intervention can be defined as the provision of emergency psychological attention and care to people affected by sudden, stressful situations. The main goal of crisis intervention is to help victims return to adaptive levels of functioning and to lessen or prevent the probable negative effects of psychological trauma. Crisis intervention primarily creates opportunities for affected individuals to learn new coping methods by identifying, organizing, and strengthening their existing coping mechanisms.

Crisis intervention has developed largely from disaster response and military literature of the early 20th century. The field begins immediately upon a crisis, aiming to restore traumatized individuals to normal operating levels, stabilize them, and help mobilize resources and support networks. The procedures used in crisis intervention evolved from research on grief in 1944, military literature in 1947, and a focus on community mental health programs oriented toward primary and secondary prevention (Flannery & Everly, 2000, p. 120). The field of psychological crisis intervention has been in existence since the early 1900s. The 1944 grief studies were carried out by Erich Lindemann following a major nightclub fire, while military literature from 1947 examined three basic principles in crisis work: immediacy of intervention, proximity to the event's occurrence, and expectation that victims would return to normal operations. In 1964, Gerald Caplan turned attention to community mental health initiatives based on primary and secondary prevention.

Notably, intervention is a natural consequence of the specific nature of the critical event and should be parallel to conceptualization of that incident. Drawing on concepts developed by Caplan in 1964, crisis intervention has primarily been understood as urgent, acute psychological response to a sudden, stressful situation. Early crisis intervention strategies were based on the principles of immediacy, proximity, expectancy, and brevity, and were adopted to achieve four major goals: stabilization, mitigation, and restoration. Stabilization focuses on halting escalating suffering; mitigation on lessening acute signs or symptoms; and restoration on promoting autonomous adaptive functioning or facilitating access to higher levels of care.

Since the early 1900s, the field of crisis intervention has developed concepts and practices serving both civilian populations and individuals in high-risk occupations such as the military. Disaster mental health targeting first responders has emerged as a distinct area of practice during the same period. Its development was influenced by recognition of the occupational risks first responders face, the emergence of critical incident stress management, and the global rise in terrorism (Castellano & Plionis, 2006, p. 327).

Conclusion

Crisis intervention has evolved alongside the evolution of critical incidents in society. The focus of and processes used in crisis intervention have continued to change as crises themselves change in nature and extent of impact. Following major events of the past 30 years, crisis intervention has developed to incorporate a psychological and mental health perspective. This shift led to the development of the Psychological First Aid model, which consists of five stages used to meet the psychological needs of individuals and first responders exposed to critical incidents. Moreover, crisis intervention has impacted society broadly by contributing to increased peer support, greater recognition of the need and value of talking about traumatic experiences, improved emergency planning, and enhanced institutional safety programs.

References

Castellano, C. & Plionis, E. (2006, November). Comparative analysis of three crisis intervention models applied to law enforcement first responders during 9/11 and Hurricane Katrina. Brief Treatment and Crisis Intervention, 6(4), 326–336.

Clark, D. W. & Haley, M. (2007, August). Crisis response tools for law enforcement. The Police Chief: The Professional Voice of Law Enforcement.

Dass-Brailsford, P. (2007). Crisis interventions. In A practical approach to trauma: Empowering interventions (chap. 5, pp. 93–114). SAGE Publications.

Flannery, R. B. & Everly, G. S. (2000). Crisis intervention: A review. International Journal of Emergency Mental Health, 2(2), 119–125.