Crisis Counseling

Crisis counseling helps a person in the immediate aftermath of a traumatic event. Learn more about the types of crisis counseling and how to help a person in crisis.

When people experience traumatic events, they may need help coping with the emotional burden that occurs in the aftermath. Crisis counseling helps individuals deal with overwhelmingly stressful situations that they feel they cannot cope with on their own. The traumatic event could include experiencing a natural disaster, going through dramatic life changes, being thevictim of sexual or domestic abuseor experiencing the death of a loved one.

A person needing crisis counseling has usually exhausted their ability to handle a situation themselves and will need help to avoid further mental or physical harm. Crisisinterventionis designed to help the individual realize that the situation they are going through is temporary and that they will be able to return to a sense of normalcy eventually. It is designed to give the individual the tools needed to cope with their current situation and better handle situations that might cause crises in the future.

What Is Crisis Counseling?

Crisis counseling is a short-term therapy that aims to help an individual deal with a traumatic situation during the immediate aftermath of the event. It is not the same as traditional psychotherapy, as it has a specific goal of dealing with one event that is presently bothering a person, rather than focusing on a person’s entire history. A typical crisis counseling session can last anywhere from 15 minutes to two hours and the individual usually attends between one and three sessions.

History of Crisis Counseling

Crisis counseling was developed from observations made of soldiers during World War I and II. At that time, if a soldier was dealing with psychological issues in the aftermath of going to war, the soldier was considered weak. However, psychologists observed that soldiers who received immediate counseling to address the traumatic events they witnessed managed much better than soldiers who did not.

Since then, crisis counseling has developed into several different models, all of which include the same basic principles, but can be tailored to an individual’s specific situation.

Theories of Crisis Intervention

Most forms oftherapieshave an underlying theory based on the research of what works to treat the condition that provides a framework for treatment. Crisis intervention is relatively new compared to other forms of therapy. Therefore, crisis theory is still being developed.

Intervention specialists have begun to make connections between the underlying emotions and circumstances that are common in crisis intervention, no matter what kind of trauma is causing the crisis. Some of the theories that are developing include:

• Systems crisis theory,which states that all crises have to do with the relationships people have with one another or their relationship to a traumatic event
• Adaptational theory,which implies that a person who can change their negative attitude toward a situation can overcome their crisis
• Interpersonal theory,which encourages people to gain personal control of a situation rather than relying on others for support or validation
• Ecological theory,which deals with crises on a massive scale, usually resulting from a natural disaster, and considers the impact of the crisis on people as well as their environment

Elements of Crisis Counseling

There are several ways to deal with crises that vary depending on the traumatic event. However, there are elements of crisis counseling that are common no matter what method is used. These include:

1. Assessmentof the individual’s current situation. This involves asking the person questions and actively listening to their responses to define their problem. The counselor is empathetic, accepting and supportive during this time to determine what the individual needs to cope with their crisis.
2. Educationto allow the individual to understand their situation and realize that what they are going through is normal. The counselor emphasizes that the individual’s reaction is temporary and that the individual will eventually be able to return to normal functioning.
3. Developingan action plan for the individual to deal with the crisis. This involves developing a set of skills, including stress relief and positive thinking, that the person can use to cope with the crisis now and in the future.
4. Offering supportto the individual that is non-judgmental. This is the most important part of crisis intervention. The individual needs to know they are accepted and feel reassured that they can get the help they need, whether it be directly from the counselor or through referral to other resources.

Principles of Crisis Intervention

In addition to these common elements, there are several basic principles of crisis intervention that are recommended when helping someone through a crisis. Theprinciples of crisis interventionare to:

• Observe the signs and symptoms of distress and use appropriate crisis intervention tactics in response to those symptoms
• Differentiate which signs and symptoms of acute stress have the potential for long-term effects and address those
• Consider the needs of the individual and tailor crisis intervention to those needs
• Time the crisis intervention based on the readiness of the individual rather than the actual passage of time
• Select the best crisis intervention tactics for the specific event and population affected

Crisis Intervention Models

There are several different types of crisis counseling that can be used individually or in combination with each other to meet the needs of a person in crisis. The types of crisis counseling can be categorized into several crisis intervention models. These models represent the clinical process a counselor can use to help their patient through a crisis.

The crisis intervention models were developed by experts in the field who provide crisis intervention and are based on both their experiences and research in the field. These models include the ABC model, Roberts’ seven-stage crisis intervention model, Lerner and Shelton’s 10 step acute stress & trauma management protocol, the SAFER-R model and the ACT model.

ABC Model

The ABC model of crisis intervention is a combination of various crisis counseling experts’ methods of intervention. It was refined and expanded by Kristi Kanel, who published abookdescribing the model in 2014. The ABC model includes:

• A) Establishing and maintaining rapport.The counselor makes an effort to build a state of trust with the client that allows them to open up and tell the truth about how they are feeling.
• B) Identifying the problem.The counselor uses a series of questions to understand how the crisis event occurred, the client’s perception of the event, what emotional distress the client is experiencing in response and how the client is presently functioning.
• C) Coping.The counselor develops a plan with the client to help them cope with their situation. This includes assessing how they are currently coping and what they can do to better cope in the future.

Roberts’ Seven-Stage Crisis Intervention Model

Roberts’ seven-stage crisis intervention modelwas developed by Albert Roberts over the course of many years. Roberts based his model on the seminal work of Caplan, Golan, and Lindeman, who were founders of the crisis theory.

In 2005, Roberts published his model as a blueprint for dealing with a wide variety of crisis situations. He developed a series of seven stages that must be completed for successful crisis intervention. The seven stages of this intervention model are:

1. Conduct a thorough survey of the person’s emotional, cognitive and behavioral reactions to the crisis and assess their risk of suicide or imminent danger
2. Rapidly establish rapport with the client
3. Identify major problems, including crisis precipitants
4. Encourage exploration of feelings and emotions
5. Develop a list of alternative resources and coping strategies
6. Implement an action plan to restore functioning
7. Agree on follow-up and booster sessions

Lerner and Shelton’s 10 Step Acute Stress & Trauma Management Protocol

The American Academy of Experts in Traumatic Stress (ATSM) is a group of professionals who provide emergency responders with protocols on how to deal with traumatic events. In 2001, the president of ATSM, Dr. Mark Lerner, and the director of emergency medical training at a police academy, Dr. Raymond Shelton, developed a10 Step Acute Stress & Trauma Management Protocolfor emergency responders to use. The ten steps are:

1. Assess for danger/safety of self and others.Assess if the patient affected by the trauma, people in the patient’s life or the counselor themselves are in danger.
2. Consider the mechanism of injury.Determine how the trauma physically or mentally caused harm to the person.
3. Evaluate the level of responsiveness.Consider if the person is under the influence of any substance.
4. Address medical needs.Tend to any medical needs present.
5. Observe and identify.Identify the signs of the patient’s traumatic stress.
6. Connect with the individual.After the assessment is complete, the counselor introduces themselves and begins to build rapport with the patient.
7. Ground the individual.Discuss the facts and have the client tell their story of the trauma.
8. Provide support.Be empathetic and actively listen.
9. Normalize the response.Validate their response to the trauma and assure them that a return to normalcy is possible.
10. Prepare for the future.Review the event, anticipate events in the future and provide referrals.

SAFER-R Model

The SAFER-R model of crisis intervention is one of the most commonly used. It relies on the same principles as the other models but outlines them in a more concise manner. The acronym SAFER-R stands for:

• S) Stabilize
• A) Acknowledge
• F) Facilitate understanding
• E) Encourage adaptive coping
• R) Restore functioning
• R) Refer

ACT model

TheACT crisis intervention modelwas also developed by Albert Roberts. He established the model in response to the September 11th tragedy to offer a framework for crisis intervention specialists to improve the service they provide patients experiencing trauma.

The ACT model of crisis intervention combines Robert’s seven-step method and the ten-step method of Lerner and Shelton. It uses three steps to identify and address an individual’s crisis:

• A) Assessment
• C) Crisis Intervention
• T) Trauma Treatment

Crisis Counseling for Trauma

There are many different types of trauma that a person can experience that would lead them to require crisis counseling. The type of intervention a person receives will depend on the event that triggered the person to feel emotionally burdened. Some examples of crisis interventions include:

• Suicide crisis intervention,which provides support for individuals who are in severe emotional stress andcontemplating suicide
• Crisis intervention for domestic violence victims,which offers individuals resources to help them leave abusive relationships and provides the emotional support needed to accomplish this goal
• PTSD crisis intervention,which helps a person withPTSDrealize that their reaction to the traumatic event is normal and gives them the tools to cope with their experience
• Crisis intervention during natural disasters,which provides people with support for the extreme emotional stress that a natural disaster can cause, including financial burdens, health concerns or grief
• Sexual assault crisis intervention,which offers support to recover from sexual trauma and cope with its emotional aftermath

How to Help Someone Experiencing a Crisis

When someone is experiencing a mental health crisis, there are several things that can be done to support that person and help them regain a sense of normalcy. To temporarily help someone going through a mental health crisis, a person can use the steps ofmental health first aid. However, individuals experiencing mental health crises should also seek professional help.

If you or a loved one are experiencing a crisis in response to a mental health disorder that involves addiction, The Recovery Village can help. To learn more about our comprehensive treatment plans,call The Recovery Villageto speak with a representative.