10 Principles of Crisis Intervention
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10 Principles of Crisis Intervention
- 1. 10 Principles of Crisis Intervention Dr. Dawn-Elise Snipes Ph.D., LMHC, LPC-MHSP Executive Director, AllCEUs.com AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 2. Objectives Define crisis Identify the 6 basic threats and how they relate to crisis Discuss characteristics of crisis Examine cultural influences in behaviors Explore the SAFERR model Identify 10 principles of crisis intervention AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 3. Definition of Crisis People are facing an untenable obstacle to goals People’s life cycles are significantly disrupted AND The person has no appropriate response to deal with a situation AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 4. Temperament Defines how we tend to prefer to act and interact. Extrovert/Introvert (Awareness/Socialization) Sensing/Intuitive (Problem Conceptualization) Thinking/Feeling (Meaning) Judging/Perceiving (Structure/Spontaneity) AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 5. Characteristics of Crisis Presence of opportunity and danger Change causes crisis and crisis causes change Increasing anxiety can lead to violent reactions AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 6. Characteristics of Crisis Complicated Generally does not have one simple cause Beliefs may be operating when an emotion or reaction seems out of proportion Precipitating events may impact many different areas of life No Panaceas or Quick Fixes May provide temporary, immediate relief Ensure they do not make problem worse Necessity of Choice Making a choice requires action Choosing not to act is a still a choice AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 7. Types of Crisis Developmental Identity formation Empty nest Mid-life Medical/Physical Chronic Illness/Pain (HIV, Fibro, Paralysis) Spouse chronic illness Situational Death Relationship Job Loss Homelessness* Cabin Fever AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 8. Exacerbating & Mitigating Factors/Vulnerabilities Emotional: Pre-existing mood issues Mental/Cognitive Critical inner voice Negative perceptions Unhelpful thoughts (Cognitive distortions) Physical Pain/illness Sleep deprivation Low blood sugar/dehydration New meds or med change AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 9. Exacerbating & Mitigating Cont… Social: Lack of healthy, supportive social environment Spiritual Sense of interconnectedness and connection to something bigger than ourselves What gives hope, faith, meaning and courage What are a person’s values Environmental Visual triggers Auditory triggers Audience AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 10. 6 Basic Threats Fear and anger represent responses to a threat Threats to consider in assessment The unknown Loss of control or power Rejection Isolation Failure Death AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 11. Models of Crisis Intervention Equilibrium/Stabilization Remove reinforcers for aggressive behavior Identify reasons to calm down Cognitive Gain control by changing thinking Psychosocial Assess internal and external exacerbating and mitigating factors Choose workable alternatives AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 12. Cultural Competence There is no one “normal” range of behaviors Individualistic vs. collectivistic society Language is not always interpreted in the same way We must accommodate the client’s needs Past history certainly impacts current events Be aware of personal assumptions AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 13. Crisis Intervention-SAFERR Basic Steps Stabilize Acknowledge Facilitate understanding Encourage adaptive coping Restore functioning Refer as needed AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 14. Stabilize Ensure Safety Physical Remove the client from the situation (if possible) Inform client you want to help, but it is hard for you to focus while… Propose solution that does not take away his power Psychological Remove bystanders (an audience also adds fuel) Reframe the situation with client not being “bad.” AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 15. Stabilize Assess (ABCs) Affective state Behavioral Functioning Cognitive Functioning Severity of the crisis AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 16. Acknowledge Define the problem Seek help from the client in understanding what is going on Listen to identify the person’s orientation Feelings or solutions (MBTI) Visual, auditory, kinesthetic Empathize to see the problem as the client does Ask open-ended questions Pay attention to verbal and nonverbal messages Acknowledge the situation and/or the client’s feelings AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 17. Facilitate Understanding Own your feelings Be aware of transference and countertransference reactions What do you represent to that person What is that person triggering in you Convey understanding Don’t say “I understand” Don’t assure the person everything is going to be alright. AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 18. Facilitate Understanding Provide positive reinforcement for behaviors Avoid value judgments Set limits and do not tolerate controlling or aggressive behavior AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 19. Encourage Adaptive Coping What thoughts, reactions and behaviors help you get closer to a rich and meaningful life Reduce tunnel vision or increase focus to things that are meaningful to the person This is a really awful situation right now. You keep mentioning your kids. Tell me a bit more about them. Examine Alternatives Supports Coping Mechanisms Thinking Patterns AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 20. Restore Functioning Promote Mobilization Make plans Implement Order Obtain commitment with assertion statements I need you to… AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 21. Refer Medical/psychiatric Medication Support groups Vocational counseling Legal assistance (DV, Child Welfare, Divorce, Bankruptcy) Specialized counseling Childcare/Respite care AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 22. Summary Change causes crisis Crisis is a state of extreme anxiety It is important to “hear” the client Help the client Re-establish equilibrium Identify environmental and social supports Develop a plan Take action SAFER-R Model Stabilize Acknowledge Facilitate understanding Encourage adaptive coping Restore functioning or, Refer AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 23. Summary 1. Crisis represents the presence of opportunity and danger and necessitates choice 2. Crisis is complicated there are no panaceas/quick fixes 3. Persons in crisis are initially at high risk for maladaptive coping or immobilization. 4. Emotional, mental, physical, social, environmental and spiritual factors can exacerbate or mitigate crisis 5. Crisis intervention involves regaining equilibrium, gaining control of thoughts(wise mind) and identifying and choosing workable alternatives 6. There is no one "normal" range of behaviors 7. Crisis impacts the person emotionally, cognitively, physically, socially, environmentally and physically 8. Resource mobilization should be immediate in order to provide persons in crisis with the tools they need to return to some sort of order and normalcy, 9. Facilitating understanding of the event by processing the situation or trauma helps the person gain a better understanding of what has occurred and allowing him or her to express feeling about the experience. 10. Problem solving within the context of their situation and feelings is necessary for developing self-efficacy and self-reliance. AllCEUs Unlimited CEUs $59 | Online Addiciton Counselor Certification Training $149 | Webinars $4
- 24. Me, Me, Me: I am the sole cause of every problem I encounter Strength: Taking responsibility – Accept responsibility for your actions – Determine the appropriate level of personal responsibility – Examine all the contributing factors – Limit self-criticism Thinking Trap 1
- 25. Always, Always, Always: Believing that problems are unchangeable and I have little or no control over them Intervention Conduct a problem analysis Identify what you can and can’t change Develop a plan of action Accept reality: “Embracing the bad” Thinking Error 2
- 26. Them, Them, Them: Outside circumstances cause of every problem Intervention Assess the cause of problems Accurately identify factors that contributed to the problem Look at the facts Examine how you may have contributed Thinking Error 3
- 27. Nobody understands Intervention Build cohesion Identify supportive others or referral sources Help them focus on what’s important Thinking Error 4
- 28. Jumping to conclusions despite having little or no evidence to support it Intervention Understand complex events Review events objectively Realistically appraise situations Acknowledge personal limits in preventing problems Thinking Error 5
- 29. What Ifs and Shoulds Intervention Facilitate acceptance Remember that change takes time Be aware of memories/grudges/resentments Talk it out/Write it out Focus on what I can control Thinking Error 6
Hinweis der Redaktion
- MRT Instructor: Key Points: What behaviors demonstrate that you are taking responsibility? [Slide builds.] The first strength we want to discuss is taking responsibility. What’s the difference between taking responsibility and criticizing yourself too much for what’s going on? Can you criticize yourself so much that it’s destructive? Army research has found that civilians in Iraq and Afghanistan who use self-criticism are less resilient. Another civilian skill is looking at how the situation contributed to an event. How can you limit criticism of yourself after you make a mistake? Use the “one time – one thing” strategy of providing yourself quick feedback, without letting self-criticism overwhelm you. -- Limit criticism to thinking about one event that happened one time (“I do everything wrong” should be “I did this thing wrong this one time”). 5. What are other ways civilians demonstrate they take responsibility?
- MRT Instructor: Key Points: What behaviors demonstrate that you can conduct an effective mission analysis? [Slide builds.] The key is to distinguish between what can and can’t be changed, develop a plan of action for what can be changed and accept what can’t be changed. There’s even a phrase for this acceptance in the military – “embrace the suck”. Ask for an example when someone embraced the suck and how this acceptance made things easier.
- MRT Instructor: Key Points: What behaviors have you been doing that demonstrate that you are accurately assessing the cause of problems ? [Slide builds] Key points are that the civilian looks at all the facts contributing to a situation. The civilian examines how they may have contributed, but also consider how the situation and other factors influenced events. They are objective and look at the problem as a whole. What are other ways civilians demonstrate their ability to accurately assess the cause of problems?
- MRT Instructor: Key Points: What behaviors demonstrate that you can build cohesive friendships/teams? Build relationships? [Slide builds] How do civilians in cohesive units take care of each other? (listen for themes of joking around together, spending time together, being non-judgmental, supporting each other, covering for/watching out for each other , talking with each other) civilians know how to talk about what’s important to their Battle Buddies. What other ways do civilians show they know how to build cohesion?
- MRT Instructor: Key Points: What behaviors demonstrate that civilians are good at understanding complex events? [Slide builds]: How does reviewing events objectively and realistically appraising situations help civilians understand complex events? What role does an AAR play in identifying other perspectives on complex events? Have AARs ever helped you understand an event better? What behaviors show civilians understand that there are personal limits in preventing critical events? Discuss how complex events are usually the result of a series of crises, not one simple error traced back to one person. How does your deployment experience help you understand the situational reality that sometimes things go wrong?
- MRT Instructor: Key Points: 1. What Ifs and Shoulds is another thinking trap that occurs when civilians second guess their actions after things went wrong during the deployment. Action: Be objective Ask “critical question” -- Could you reasonably have known what would happen? No one can predict when something bad is going to happen during combat. Even when we take all the precautions we can, bad stuff may still happen. -- Are your thoughts about the deployment hurting your ability to enjoy life now? Buddies you lost would have wanted you to be able to enjoy life; you’ve earned the right to be happy. Ask for an example -- Examples: If only I hadn’t gone on R&R, If only I hadn’t been in the second vehicle… -- Review critical question with examples. 5. The following slides show how to counter these Thinking Traps using the ATC model.