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Goals and Models of Crisis Intervention
Terms in this set (4)
Primary Goals of Crisis Intervention
depend on nature of crisis and client's reaction but include:
1) relieve current symptoms;
2) help identify, gain understanding of factors that led to crisis;
3) use remedial measures/resources to restore pre-crisis level of functioning;
4) help develop adaptive coping strategies for current and future situation;
5) help client connect stresses with past experience.
First three goals for all crises, last two if feasible or necessary.
Crisis Intervention Models
* Stress-Crisis Continuum (Burgess & Roberts, 2005)
* Seven-Stage Crisis Intervention Model (Roberts, 2000)
Stress-Crisis Continuum (Burgess & Roberts, 2005)
Level 1 - Somatic Distress: crisis due to somatic distress precipitated by biomedical disease (e.g., cancer, diabetes) or by depression, anxiety, or minor psychiatric state. Interventions: education about illness and treatments to address symptom reduction.
Level 2 - Transitional Crisis: caused by stressful events that may be anticipated but not controlled (e.g., adolescent pregnancy, job loss). Interventions: education, self-help groups, and individual therapy.
Level 3 - Traumatic Stress Crisis: precipitated by external stressor, unpredictable, sudden, life-threatening, overwhelming (e.g., natural disaster, assault, sudden death of a loved one). Interventions: crisis-oriented CBT, solution focused therapy, pharmacotherapy.
Level 4 - Family Crisis: precipitated by crisis with family or primary relationship or related to developmental issue (e.g., child abuse, domestic violence, parental abduction, homelessness). Intervention: "help restabilize lives, strengthen relationships, deter symptomatology" with psychoeducation, individual, couple, and family treatment.
Level 5 - Serious Mental Illness: dementia, psychosis, or serious mental illness increases likelihood of another problem precipitated by crisis. Immediate intervention: symptom reduction, enhancing problem-solving skills, environmental manipulation, pharmacotherapy. Hospitalization, long-term individual and group treatment.
Level 6 - Psychiatric Emergencies: severe impairment with threat/harm to self/others (e.g., suicide, homicide, drug overdose). Interventions: rapid assessment, mobilization of resources, emergency care.
Level 7 - Catastrophic Crisis: two or more level 3 crisis with a level 4, 5, or 6. Requires comprehensive multimodal intervention.
Seven-Stage Crisis Intervention Model (Roberts, 2000)
1. Crisis Assessment: Conduct assessment evaluating lethality, medical and psychosocial needs, risk (e.g., suicide, homicide, drugs, violence) and protective (e.g., supportive) factors.
2. Establish Rapport: develop therapeutic relationship with respect, genuineness, acceptance.
3. Identify Major Problems: prioritize problems by identifying precipitating events and nature of reactions including lethality and coping skills.
4. Explore Feelings and Emotions: encourage client to tell "story" and identify maladaptive beliefs underlying reactions, behaviors, and restore emotional balance.
5. Generate and Explore Alternatives: Identify solutions to problem (e.g., no-suicide/no-violence contracts, hospitalization, coping skills, sources of support)
6. Develop and Implement an Action Plan: Implement interventions to promote coping (e.g., what led to crisis, meaning of crisis, adaptive replacement of beliefs); resolve crisis.
7. Follow-Up: Check to see if action plan has been successful with post-crisis assessment (e.g., functioning, satisfaction with treatment, and coping of current stressors). Follow-up sessions (e.g., per month, per year/anniversary) or "boosters."
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