Crisis Intervention




A Definition

Crisis is a perception of an event or situation as an intolerable difficulty that exceeds the person's resources and coping mechanisms (Gilliland and James, 1997)

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A conceptual model for understanding tragedy and pain

CHANGE (Tragedy)--------------LOSS-------------PAIN--------------Stress (perception) (resistance) (anticipation)

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Goal of Crisis Counseling

Crisis Counseling differs from other forms of counseling in the following terms:

1. Primary goal to restore the client to equilibrium (may be brief)
2. A second goal of taking action (may be directive and allow temporary client dependency)
3. The counselor takes more active role in giving information and teaching coping strategies

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Role of the Crisis Counselor

1. Remove distractors and other stressors
2. Avoid impulsive action
3. Delegate authority
4. Model calmness
5. Be prepared

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Crisis Intervention Principles

1. Begin counseling immediately
2. Be concerned and competent
3. Listen to the facts of the situation
4. Reflect the individuals feelings
5. Help the child realize that the crisis event has occurred
6. Do not encourage or support blaming
7. Do not give false reassurance
8. Recognize the primacy of taking action

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Crisis Worker's Assessment

Assessing client mental statues and functioning
Assessing severity of crisis (cognitive, affective, psychomotor)
Assessing the client's current emotional status (acute or chronic, client's reservoir of emotional strength)
Assessing alternatives, coping mechanisms, support systems and other resources
Assessing for suicide potential
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Crisis Worker's Action Strategies

Recognize individual differences
Assess crisis worker's self (values, readiness, physical and emotional limitations)
Show regard for client's safety
Provide client support
Define the problem clearly
Consider the alternatives
Plan action steps
Use the client's coping strengths
Attend to client's immediate needs
Use referral resources
Develop and use networks
Get a commitment
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Steps of Crisis Counseling

1. Defining the Problem
2. Ensuring Client Safety
3. Providing Support
4. Examing Alternatives
5. Making Plans
6. Obtaining Commitment

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Crisis Counseling the Children: Don'ts and Dos

Do Not:

* underestimate children's' ability to feel like adults

* say "everything will be all right. Let's be brave."
*say "stop crying, it can not change things"
*refuse to answer questions
*diverting conversations
*make advice to escape or speed up grief processes

DO

* Let the young children know they are not alone. I am here for you and with you." to balance the magical and ego-centered thinking and restore some sense of control through outside help

* watch for their physical reactions/symptoms

* communicate creatively (body, tone, eye, touch, play, art, music, etc.)

* understand the children's immature, self centered ways of thinking

* Permit the children to confront (face) losses.

* grief counseling creatively and translate grief reactions and stages into child-appropriate language. For example:
Denial: I did not want this to happen.
Anger: Why me? It is not fair.
Bargaining: Only if----, may be it would have happened.
Depression: I am not worth living. XXX was such a good student and he died anyway.
Panic: I must do--- in order to survive.
Guilt: I would rather it was me who died.
Worry: I want to do what ever I can to prevent this from happening again.
* help them understand what happened and how they are involved in causing them, and most importantly, how the are feeling

* understand children react differently in different development stages

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More tips for counselors/teachers/schools

*Provide honest information and help children master the facts of their existence
*Develop/teach a vocabulary of feelings and thoughts about loss and its resolution
*Parents/teachers should examine their own ideas and unresolved issues related to death and loss
*Provide/discuss adult perspective on the facts of loss
*Help children to anticipate difficult times like (100 days after the death according to the Taiwanese custom, holidays like Chinese New Year, birthdays and the anniversary of the tragedy.
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Tips for parents

* try all of the above
* Help your child understand what happened
* Talk with the child about the damages, deaths, and traumatic reactions she/her witnessed or sees in TV
* accept and teach your child express feelings
* listen to your children if he/she shares concerns of her/his peers in the classroom or school.
* keep lines of communication open with your child-even when it is difficult.
* Be involved in your child's school life and understand/request appropriate supports offered by the school and teachers
* work with your child's school to make it more responsive to students in a time of rehabilitation.
* volunteer to work with school based support groups concerned about the adjustments
* find out what is available in your community for psychological help
* talk with the parents of your child's friends. Discuss how you could form a team to mutually support the children.
* be aware when you need to seek help for your self

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Tips for the students who have new students in their class due to the earthquake

* work with teachers and make the classroom an "warm home" to welcome the new students
* listen to your them if they share troubling feelings or thoughts. Encourage them to talk to teachers and counselors.
* volunteer to be a helper for the new students (tutoring the school works the new student has missed in the past weeks, ease their homesickness if they are away from home and their parents)
* express care, warmth and love for the new students. Be careful about asking too many questions about their sad situations, teasing and intimidating them

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Tips for training school personnel (for both counselors and non counselors)

* Provide a written small pamphlet to inform them about the do's and don'ts in responding the children needs
* provide in-service to help them deal with their reactions and coping
* Provide training to better help the children survivors for re-entering the school environment
* For junior high and high schools, training on watching early singes of suicide
* establish a referral resources in the immediate community

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