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Kenneth Yeager, clinical psychiatry and social work

Posted on | February 16, 2011 | 1,389 views | 1 Comment

What is crisis intervention, and when and for whom is it necessary?
Crisis intervention is a process designed to assist anyone who is unable to function after  a life event that overwhelms their natural coping abilities. A crisis is an acute disruption of psychological homeostasis in which one’s usual coping mechanisms fail and there exists evidence of distress and functional impairment. Crisis intervention care is necessary for all of us. However, our ability to cope with stress, crisis and trauma varies greatly by person and is determined by individual character, temperament, protective factors, adaptability, past experience, support system and the stressors themselves.

What are the sources of crisis and how does a “crisis situation” affect the primary person’s family and friends?
Crisis-inducing events occur routinely and can originate from a number of sources, such as health issues, financial problems, grief, loss, victimization and exposure to natural disasters. Other events, such as emotional, physical and sexual abuse, may consist of multiple exposures over a long time period. The long-term impact of these stressors can cause psychological problems that are difficult to resolve and detrimental to the individual and their loved ones. Family and friends of the victim are often at a loss as to what action is most helpful and appropriate. These feelings of helplessness can leave family and friends feeling shaken and vulnerable. This concept is called vicarious traumatization. It is important for the victim’s supporters to be aware of the impact of vicarious traumatization, take steps to recognize it in themselves and seek help, if necessary.

What should someone do in a crisis situation?
There are three steps that anyone can do to assist a person experiencing a crisis-inducing event: Recognize, respond and rescue.

Recognize: While some crises may be obvious to others, events like financial or marital problems are much more difficult to see. When we ask, “How are you?” more often than not the answer is “fine.” If something causes you to think that the person is not “fine,” then the best intervention is to ask,  “Are you sure?” Follow this question with a statement about why you are concerned.

Respond: Once you have established a caring rapport, be prepared to listen to the story. Take note of what the person needs and where they are in their attempts to resolve the situation. You will almost always hear statements such as, “I just don’t know what to do“ or “I am at my wits’ end.” Talk about past coping strategies and consider different approaches. Finally, find out what supports are available to the person and if they have accessed this support.

Rescue: In crisis, life savers are around us but frequently are not readily identifiable or accessible. First consider the level of individual risk — a trip to a crisis center or emergency department may be in order. More frequently, offering to help the person to access local services may be all that is needed. Good resources include employee assistance programs, outpatient therapists or a primary care physician. These providers can help the victim establish an individualized approach to resolve the crisis.

What are the goals/outcomes of an intervention?
The goal of crisis intervention is to return the individual to a state of psychological equilibrium by providing the support and strategies necessary for stabilization and enhanced coping skills. While it is never easy to have to go through a crisis, many victims who have successfully worked through a crisis event eventually report that their experience has left them feeling psychologically stronger than they were before the event occurred.

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