Crisis Intervention Strategies

673 Pages·2007·4.336 MB·English

by  Richard K. James

Crisis Intervention
Strategies
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S I X T H E D I T I O N
Crisis Intervention
Strategies
Richard K. James
University of Memphis
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Crisis Intervention Strategies,Sixth Edition
Richard K. James
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DEDICATION
The sixth edition of this book is dedicated to the hundreds of thousands of survivors of
Hurricane Katrina—such as my daughter, Shannon James, and her fiancé, William
Wygul—who lost just about everything but the shirts on their backs and what they were
able to load in their cars. Yet they persevered and came out on the other side of the crisis
stronger and more resilient.
This book is also dedicated to my friends and colleagues—Dr. Le Anne Wyrick-Morgan,
licensed professional counselor of Colorado; Dr. Holly Moore, Assistant Professor of
Counseling, Indiana University of Pennsylvania; and CITofficer Scott Davis, Montgomery
County Maryland Police Department—and to all of the thousands of other professionals and
volunteers who dropped what they were doing and went to the gulf coast after Hurricane
Katrina, because they cared about their fellow Americans. If these people do not give one
hope for the tenacity, spirit, and goodness of humanity, I don’t know what does.
Lastly, this sixth edition is dedicated to the students and faculty at Virginia Tech—to
both the living and the dead—that the tragedy there shall not have been in vain, but will
cause the federal and state governments to make and change laws that will halt the carnage
that now assails our schools.
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C O N T E N T S
P A R T O N E
BASIC TRAINING: CRISIS INTERVENTION THEORY
AND APPLICATION 1
C H A P T E R O N E
Approaching Crisis Intervention 3
Definitions of Crisis 3
Characteristics of Crisis 3
Presence of Both Danger and Opportunity 3
Complicated Symptomology 4
Seeds of Growth and Change 4
No Panaceas or Quick Fixes 4
The Necessity of Choice 4
Universality and Idiosyncrasy 4
Transcrisis States 5
Transcrisis Differentiated From Posttraumatic
Stress Disorder 5
Transcrisis Points 6
ABrief History of Crisis Intervention 7
Grassroots Movements 7
The Importance of Volunteerism 8
The Need for Institutionalization 9
The Societal Impetus for Crisis Intervention 9
Theories of Crisis and Crisis Intervention 10
Basic Crisis Intervention Theory 10
Expanded Crisis Theory 11
Applied Crisis Theory 13
Crisis Intervention Models 14
The Equilibrium Model 14
The Cognitive Model 14
The Psychosocial Transition Model 15
vii
viii Contents
Developmental-Ecological Model 15
Contextual-Ecological Model 15
Eclectic Crisis Intervention Theory 16
Characteristics of Effective Crisis Workers 17
Life Experiences 17
Poise 17
Creativity and Flexibility 18
Energy and Resiliency 18
Quick Mental Reflexes 18
Other Characteristics 18
Rewards 18
Summary 19
References 19
CHAPTER TWO
Culturally Effective Helping 22
Multicultural Perspectives in Crisis Intervention 22
Culturally Biased Assumptions 22
Shortcomings of a Multiculturalist Approach to Crisis Intervention 23
Universal Versus Focused Views 25
Culturally Effective Helping 25
Positive Aspects of an Effective Multicultural Counselor 26
Working on the Individualist/Collectivist–High/Low Context Continuum 27
Awareness of Both Ecology and Multicultural Competencies 28
Multicultural Issues in Outreach 29
The Case Against Too Much “Helping” 30
Trauma Tourism 30
Occupation as a Cultural Barrier 31
Geographic Locale as a Cultural Barrier 32
The Dilemma of Local Consultation 32
Necessity of Acting 33
Training 34
Summary 34
References 34
CHAPTER THREE
Basic Crisis Intervention Skills 37
Introduction 37
The Six-Step Model of Crisis Intervention 37
Assessing 37
Listening 39
Psychological First Aid 39
Step 1:Defining the Problem 39
Step 2:Ensuring Client Safety 39
Step 3:Providing Support 39
Contents ix
Acting 40
Step 4:Examining Alternatives 40
Step 5:Making Plans 40
Step 6:Obtaining Commitment 40
Assessment in Crisis Intervention 41
Assessing Client Functioning 41
The ABC’s of Assessing in Crisis Intervention 42
Assessing the Severity of Crisis 42
The Triage Assessment System 43
Psychobiological Assessment 49
Assessing the Client’s Current Emotional Functioning 50
Client’s Current Acute or Chronic State 50
Client’s Reservoir of Emotional Strength 51
Strategies for Assessing Emotional Status 51
Assessing Alternatives, Coping Mechanisms, and Support Systems 51
Assessing for Suicide/Homicide Potential 52
Summary of Assessment 52
Listening in Crisis Intervention 52
Open-Ended Questions 53
Closed-Ended Questions 53
Restatement and Summary Clarification 54
Owning Feelings 54
Facilitative Listening 56
Basic Strategies of Crisis Intervention 58
Climate of Human Growth 60
Communicating Empathy 60
Communicating Genuineness 64
Communicating Acceptance 65
Acting in Crisis Intervention 66
Nondirective Counseling 66
Collaborative Counseling 66
Directive Counseling 67
Action Strategies for Crisis Workers 67
Summary 72
References 72
CHAPTER FOUR
Crisis Case Handling 75
Handling Crisis Cases Versus Long-Term Cases 75
Comparison of Principles,Objectives,Client Functioning,and Assessment 76
Case Handling at Walk-In Crisis Facilities 76
Types of Presenting Crises 76
Case Handling at a Community Mental Health Clinic 79
Police and Crisis Intervention 81
Police and the Mentally Ill/Mentally Disturbed 82
The Crisis Intervention Team (CIT) Program 82