There are a variety of crisis theory and crisis intervention models used to explain how crises develop and what it means for an individual to need crisis intervention. Some explanations of crisis theory are more academic in nature, while others are considered more applied or practical.
Before reviewing the three types of crisis, it’s important to review basic crisis theory. While there are dozens of models – James (2008) lists 7 theories and 5 models of crisis intervention only a few will be covered below. These ar the most important.
James (2008, p.3) lists several definitions of crisis, which are an important precursor to understanding crisis theory. The core element in each of them is that an individual is overwhelmed. Three of the 6 definitions are listed below:
“People are in a state of crisis when they face an obstacle to important life goals–an obstacle that is, for a time, insurmountable by the use of customary methods of problem solving. A period of disorganization ensues, a period of upset, during which many abortive attempts at a solution are made.” (Caplan, 1961, p.18)
- “Crisis results from impediments to life goals that people believe they cannot overcome through customary choices and behaviors” (Caplan, 1964, p.40)
- Crisis is a crisis because the individual knows no response to deal with a situation (Carkhuff & Berenson, 1977, p.165)
- A negative event occurs which leading to a feeling of subjective distress
- This distress leads to an impairment in functioning
- Coping skills fail to improve functioning
The term “cognitive key” refers to your belief about the negative event, which influences how well you will be able to cope with the event. Changing your perspective and help improve your ability to cope.
Basic Formula for Crisis Intervention
- Alter the perception of the negative event and offer coping strategies
- Distress is lowered
- Functioning returns to pre-crisis levels
Crisis as Danger and Opportunity
Crisis can be thought of as both of a danger or an opportunity. There’s a myth that says that the Chinese word for “crisis” means both danger and opportunity. While this is not exactly accurate (any more than the word “opportunity” contains the word port), the sentiment is true
If an individual in crisis is able to muster their coping skills, supports, and resources, they will find themselves able to come through the crisis and be more prepared to work through future crises. On the other hand, if they don’t seek that support their functioning will decline further and they will find it harder to deal with things.
Historical Crisis Theory
Erich Lindemann, a German psychiatrist authored the first papers in the field of crisis intervention, relating to bereavement in the aftermath of the Cocoanut Grove nightclub fire which killed nearly 500 people. (Wright, 2014) His paper, Symptomatology and Management of Acute Grief noted that crises tended to share a similar features and progression and most did not require formal intervention. (1944)
Lindemann’s colleague Gerald Caplan extended the field of crisis intervention to look at all kinds of traumatic events. Both Lindemann and Caplan saw crisis as developing from a state of disequilibrium, with Lindemann identifying four stages of crisis (James, 2008; p.10):
- Disturbed equilibrium
- Brief therapy or grief work
- Working through the problem or grief
- Restroation of equilibrium
With Caplan extending this crisis theory to identify affective, behavioural and cognitive impacts.
Modern Applied Crisis Theory
While Caplan and Lindemann’s work has been influential and is important in understanding the development of crisis intervention it is insufficient for describing modern mental health crises that may develop without a single precipitating event or pre-existing mental health issues.
Lawrence Brammer’s 1985 book “The Helping Relationship: Process and Skills” (as cited in Miller, 2011) identifies three types of crisis that make up his theory of applied crisis.
These domains are:
- Developmental Crisis
- Situational Crisis
- Existential Crisis
A developmental crisis is the result of a normal life event (like a pregnancy or graduation) that causes stress and strain on an individual. (James, 2008, p. 13) While developmental crises are normal they may need close monitoring to ensure that a client returns to normal functioning.
One useful way of conceptualizing a developmental crisis is to consider the concept of grief and loss. Because all changes in a person’s life result in loss and loss requires grief work to process, an individual will need to take the time to process their life changes.
A situational crisis is the most common kind of event when we consider crisis intervention. This is an event that is so overwhelming and sudden (Schottke, 2001, p.236) that it overwhelms normal coping. Examples of situational crises include sexual assault, a motor vehicle accident or sudden loss or grief.
This is the most common form of crisis that emergency responders and other crisis intervention workers (hotline workers, social workers) are likely to encounter.
Existential crises are based on larger concepts of a person’s purpose and attainment of actualization, a deep sense of personal fulfillment (Olson, 2013) Often existential crises are related to situations of regret or belief that life has passed them by (Price, 2011) or realization that one will not reach goals they had set for themselves at a certain age (James, 2008, p. 13)
Existential crises are particularly common at life transition points like 30, 40, and 50 when people “take stock” of their life. A significant existential crisis can predispose suicide and may be linked to the markedly high suicide rate among men and women between 45 and 54. (MacDonald, 2015)
Other Theories of Crisis and Crisis Intervention
There are a variety of other resources identified in James (2008) that are not covered here. They are:
- Psychoanalytic Theory
- Systems Theory
- Ecosystems Theory
- Adaptational Theory
- Interpersonal Theory
- Chaos Theory
- Developmental Theory
Other Models of Crisis Intervention
- Equilibrium Model
- Cognitive Model
- Psychosocial Transition Model
- Developmental Ecological Model
- Contextual-Ecological Model
Caplan, G. (1964) Principles of Preventive Psychiatry. Basic Books: New York, N
Brammer, L.M. (1985) The Helping Relationship: Process and Skills. Prentice Hall: Upper Saddle River, NJ
James, R.K. (2008) Crisis Intervention Strategies. Brooks/Cole: Belmont, CA.
Lindemann, E. (1944) Symptomatology and Management of Acute Grief. American Journal of Psychiatry, 101.141-148. Accessed electronically on May 28, 2016 from http://www.nyu.edu/classes/gmoran/LINDEMANN.pdf
MacDonald, D.K. (2015) Understanding and Preventing Male Suicide. Accessed electronically on May 29, 2016 from http://dustinkmacdonald.com/understanding-and-preventing-male-suicide/
Miller, G. (2011) Fundamentals of Crisis Counseling. John Wiley & Sons: Hoboken, N
Olson, A. (2013) The Theory of Self-Actualization: Mental illness, creativity and art. Psychology Today. Accessed electronically on May 29, 2016 from https://www.psychologytoday.com/blog/theory-and-psychopathology/201308/the-theory-self-actualization
Price M. (2011) Searching for meaning. Monitor on Psychology. 42(10). 58.
Schottke, D., Pollak, A.N. (Ed.) (2001) Emergency Medical Responder: Your First Response in Emergency Care. American Association of Orthopaedic Surgeons. Jones & Bartlett: Suffolk, MA
Wright, B. (2014) “The Cocoanut Grove Nightclub Fire Happened 72 Years Ago in Boston”, Boston.com. Accessed electronically on May 29, 2016 from http://www.boston.com/news/local-news/2014/11/28/the-cocoanut-grove-nightclub-fire-happened-72-years-ago-in-boston