Table of Contents
Introduction
The following is the last in a series of articles (posted once a week) where I began to fill in basic crisis intervention skills in order to make this website a more comprehensive and useful resource to beginning crisis workers as well as experienced ones.
Basic strategies for crisis intervention have been identified by Myer and James (2005) in the book “Crisis Intervention Strategies, 6th Edition.” These nine strategies are used to help stabilize the client and can be used at any time in the crisis intervention process. These strategies are listed below:
Crisis Intervention Strategy 1: Creating Awareness
The crisis worker can promote an awareness of the feelings underlying a client’s behaviour. For instance, someone who is suicidal may have not considered their reasons for living or dying. The worker can help them get awareness of these thoughts and feelings which helps give them new perspective.
Crisis Intervention Strategy 2: Allowing Catharsis
Catharsis is the expression of emotion, for therapeutic purposes. Clients may experience a range of emotions and behaviours, including crying, yelling, swearing, and so on as they vent about what they’re going through. As a client describes what’s going on in their life they may find themselves brought right back to the same emotional intensity when they originally experienced the situation, or even worse.
Someone who talks about a situation that made them powerless or angry will find their blood pressure rising, sweating, and all the other physiological responses from the first time. Keep in mind that if a client is getting too elevated it may be more helpful to practice deep breathing and grounding exercises to bring the client back to the present.
Crisis Intervention Strategy 3: Providing Support
This strategy involves naturalizing the client’s response to what they’ve been going through. Often times clients will think that they are crazy or that they are overreacting. Note I didn’t use the word “normal”, because their suspended coping skills are not effective or even typical in someone who is not experiencing a crisis. They are however common, and we need to point out that they are natural given people who are so overwhelmed.
As an example of providing support, many people see suicidal behaviour or an inability to cope as a sign of weakness, which can impair their ability to respond effectively. Pointing out that reaching out for help, the behaviour that brought them into contact with the crisis worker in the first place, is itself a good response, and working with them to build a plan will help them feel less overwhelmed.
Crisis Intervention Strategy 4: Increasing Expansion
Increasing expansion involves helping clients get out of their tunnel vision. This is very common with suicidal individuals who are totally unable to see anything but hopelessness in their situation. By providing alternative perspectives, the client will begin to see that their situation can be different.
Reframing in general is a very common strategy throughout crisis intervention and in therapy, especially cognitive behavioural therapy (CBT), where distorted thoughts are the cause of depression and suicidal thoughts.
Crisis Intervention Strategy 5: Emphasizing Focus
When clients have the opposite of tunnel vision and their cognitions are all over the place with no basis in reality, emphasizing focus becomes more important. This helps the client to focus on the specific causes of the crisis and break solutions down into manageable steps that help clients work through these things.
Crisis Intervention Strategy 6: Providing Guidance
Guidance involves providing information and referral services to clients, to help them fix specific issues in their life. This is more commonly achieved by case management in the long-term, but in the short-term may be performed by telephone or in-person crisis workers.
Crisis Intervention Strategy 7: Promoting Mobilization
Mobilization involves helping crisis workers access external supports. Because individuals in crisis have difficulty accessing their internal coping skills external and peripheral supports become more important. These include the people around them that they can trust and be supported by, and professional supports like counsellors and therapists.
Crisis Intervention Strategy 8: Implementing Order
Implementing order helps clients break their problem down into manageable pieces and decide which ones are the most important. By dealing with the most important issues first, they’ll be able to get a sense of control and begin to take advantage of internal coping strategies.
Crisis Intervention Strategy 9: Providing Protection
Finally, providing protection (which is Step 2 of the Six Step Model of Crisis Intervention) involves protecting the client from their own self-injurious behaviour and potentially harmful behaviour towards others. Suicide and homicide risk assessment is an important part of this strategy, which is demonstrated throughout the crisis intervention process.
Other Resources
If you’re a Durham College student enrolled in SSW2506 Crisis Intervention then you’ll want A Guide to Crisis Intervention, 4th + Helping Professions Learning Center 2-Semester Printed Access Card instead.
Bibliography
Myer, R.A. & James, R.K. (2005) Crisis intervention workbook and CD-ROM. Belmont, CA: Thomson Brooks/Cole.