Lesson 2: Crisis Intervention Skills
Attention
Learning Outcomes
Upon successful completion of this lesson's material students will be able to:
- Identify the skills needed to be an effective crisis worker.
- Describe the LAPC Model.
- Analyze the Empowerment-focused Crisis Intervention model.
- Write an effective crisis plan.
- Discuss individual needs in relation to the development of a crisis plan.
Teaching
The following video was created for police officers regarding mental health crisis. I liked the perspective and tips they offered so I wanted you to watch it as you learn more about crisis intervention.
Introduction to Crisis Intervention (Video 6:43 min): https://www.youtube.com/watch?v=-lYCwQ88-LE
Each person responds to a crisis situation differently. Also each of biological systems may be affected by the crisis situation. It can affect how we feel physically, emotionally and cognitively. It can affect an individuals mood, memory, physical wellbeing and so much more.
Read the following article: Crisis Reactions Handout (Read Page 1 - 7 of this handout)
Read about real life crisis situation that was dealt with effectively using empathy: http://www.goodtherapy.org/blog/practicing-empathy-in-crisis-learning-from-antoinette-tuff-0829137
Characteristics of Effective Crisis Counselors (From: http://work.chron.com/characteristics-good-crisis-counselor-7007.html)
Crisis counselors work with people who are in distress and often in need of medical, psychological or legal intervention. It takes a steady disposition and a calm demeanor to talk with people in crisis who may be very emotionally charged. Employers of crisis counselors include schools, substance abuse treatment centers, hospitals, crisis phone lines and social service agencies. Each setting requires special abilities and skills.
Some of those skills include:
Self Awareness - Many times, a client may stir up painful memories from your own past. Effective crisis counselors are aware of their own triggers and have spent time in counseling or other self-awareness programs to process personal experiences. A good crisis counselor can empathize with clients without becoming personally involved or emotional when subjects that have personal meaning come up.
Nonjudgmental - In the role of counselor, you will see clients who may have committed crimes or participated in lifestyles that you don’t approve of. Clients can gauge when you’re being judgmental and may shut down, leaving you helpless to offer assistance. Ideally, a good crisis counselor is willing to listen without casting judgment on those in crisis. As a nonjudgmental counselor, you can offer a more empathetic ear and support your clients in a safe environment.
Nonreactive - Clients coming to see you are in a highly emotional state, and you have to be able to remain calm through the chaos. An effective crisis counselor doesn’t react to clients’ outbursts or threats. When you witness strong emotions, you need to be able to be completely supportive without getting involved, or you risk furthering the unstable atmosphere and causing the client to refuse to reveal any more information to you.
High Tolerance - You need to have a high tolerance for chaos and dramatic situations because you inevitably will encounter them on a regular basis, perhaps even daily if you work in a busy crisis counseling center or answer phones for a suicide hotline. You’ll constantly be placed in tense, stressful situations, but you can’t allow the stress to build up in your own life or you won’t last long in the field.
Specific Training - While you may have briefly covered how to handle crises in your coursework to become a nurse, social worker or therapist, specific training in crisis counseling will prepare you react quickly during crisis intervention. That may include knowing how and when to call in police or medical first responders. In crisis counseling training, you’ll also learn how to deal with different cultural issues that may arise, how to develop boundaries and what ethical practices you need to follow. Organizations such as the American Institute of Health Care Professionals provide continuing education courses for crisis counselors.
Crisis Intervention Models
There are a variety of models on how to help someone in a crisis situation. We are going to explore three of those models in this lesson.
1) Empowerment-Focused Crisis Intervention
This model can be used with individuals of all ages. I found an article on its use with preschoolers that gives you idea of the basic framework and beliefs within the model: An empowering approach to crisis intervention and brief treatment
2) Roberts' Seven Stage Crisis Intervention Model
Read this article about the model: The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis
3) Crisis Intervention Techniques: The LAPC Model
The LAPC model was created by Cavaiola and Colford (2006) in their textbook Crisis Intervention Case Book. The advantage of the LAPC process is that it is easy to remember and apply, whether you are a degreed professional or a layman who has received a short amount of training. One of the difficulties of other crisis intervention models is that it can be difficult to recall the processes when they are needed most. A client who is at high risk of danger will need a very directive approach where the crisis worker directs the intervention, a client at a moderate risk of danger will work best with a collaborative approach where control is shared, and a client at a low risk of danger should have a very non-directive approach where they lead. The four steps of the LAPC Model are listed below:
- L = Listen
- A = Assess
- P = Plan
- C = Commit
1) LAPC Step 1 - Listen
The first step in the crisis intervention process is to listen! This seems obvious but in a crisis it can be very easy to fall into the trap of hearing what we think is happening, rather than what is actually happening. If we fail to understand what the person in crisis is actually experiencing we will respond inappropriately. Techniques used in the listening process include open-ended questions, paraphrasing and clarifying, and summarization. These are all primary counselling skills and are an inherent part of the active listening process. In addition to hearing what a client is actually telling you, you should work carefully to avoid facial expressions or reactions which could be seen as judgemental. This is especially important when disturbing or scary content like suicidal or homicidal thoughts, sexual abuse or others are covered.
2) LAPC Step 2 - Assess
Assessment is the next part of the process. This may be a structured and formal process (such as if you choose to use the CPR or DCIB Suicide Risk Assessments) or may be a much more informal process of synthesizing what you have learned in order to formulate an accurate picture of where needs are unmet or risk is present. If you have failed to listen correctly, your assessment will not target the correct areas the client will not feel heard. Additionally, if you’ve missed signs of suicide or homicide risk (or in children, neglect or abuse) you may place the client or others at risk.
3) LAPC Step 3 - Plan
The third step in the process is planning. In cases of suicide or homicide risk, safety planning will be the first order of business. For instance, someone who wants to overdose may give the pills to someone who can safeguard them, employ coping strategies to help ground themselves (watching their favourite movie or exercising for instance), or agreeing to call a crisis line if they can’t stay safe. Once immediate safety concerns have been taken care of, other planning can take place. This may involve referrals to organizations (an article on this will be published June 6) for longer-term support (like counselling or case management), or otherwise performing the first steps to restoring equilibrium. Planning should be a collaborative process between you and the client. If you simply take control and do everything for the client they will feel disempowered and dependency may result.
4) LAPC Step 4 - Commit
Finally it’s important for the client to commit to the plan. If they have been involved in the process up until now, they should have little concern with committing. In some situations (like child welfare) there will be no option for them to “opt out” and they may be upset but getting them involved is still required.
Bibliography - Cavaiola, A. & Colford, J.E. (2010). Crisis Intervention Case Book. Nelson: Toronto, ON.
Information on the LAPC Model from: MacDonald, D.K., (2016), "LAPC Model of Crisis Intervention," retrieved on September 5, 2016 from http://dustinkmacdonald.com/lapc-model-crisis-intervention/.
Assessment
Lesson 2 Quiz
- Describe, in detail, the skills needed to be an effective crisis worker. Describe your own skills and the strengths you have along with the challenges you may face. Pay particular attention to this section in the reading, and draw your vocabulary and analysis from this section of the book.
- Describe the LAPC model in detail. Go though each letter of the acronym and describe it in your own words. Discuss the importance of each aspect. Provide an explanation of your skills in each area and/or how you hope to improve your skills using the LAPC model.
- What are your thoughts about Empowerment-Focused Crisis Intervention? Be creative and thoughtful in your analysis- be sure to give enough detail to indicate that you understand this concept well. Include references to where you got your information.
Lesson 2 Assignment
Describe the physical, emotional (affective), cognitive and behavioral responses to a crisis situation. Complete a crisis plan for a person in your life. Identify the person's triggers, the interventions that help and hinder him/her through the initial stages of a crisis situation (trigger, escalation and crisis). Please include a title page with this assignment (APA Style with student name, Instructor Name, Assignment name and title, and date).
Purdue OWL APA resource page: https://owl.english.purdue.edu/owl/resource/560/01/
Lesson 2 Discussion (for online course only)
Share the details of the Crisis Plan you created in the Discussion Board (remove any identifying info, feel free to give person an alias). Discuss with the class your understanding of the process of identifying what is helpful during a crisis intervention.
This is supposed to be a lively conversation, but that is up to YOU!
I believe in intellectual alchemy and the melding of minds can be magical, but not as restrained, inert and unengaged object~ DISCUSS…. Ancient Greeks learned through lyceum talks- this online discussion forum is our philosophical arena! LEARN to ENGAGE:
Socratic Method: A pedagogical technique in which a teacher does not give information directly but instead asks a series of questions, with the result that the student comes either to the desired knowledge by answering the questions or to a deeper awareness of the limits of knowledge.
www.thefreedictionary.com