Crisis Interventions

Crisis interventions: Emergency & Urgent First-Aid for Your Loved Ones

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We live in a society where crises are everywhere we turn. 

Those who live with extreme and undue stress may have a moment in their lives where they start to break down — the tools that once helped them cope no longer work. 

The signs of this may be extremely out of character for your loved one and may shock you and your family. This is when crisis intervention should be seriously considered.

Definition of Crisis

Crisis is defined as “An acute disruption of psychological homeostasis in which one’s usual coping mechanisms fail and there exists evidence of distress and functional impairment.” 

Whatever tools your loved one used to deal with enormous stressors in the past aren’t working anymore. 

The stress of the crisis has taken a huge toll on their mental, emotional, and in some cases physical, strength and they can no longer cope in a healthy way. In short they have broken down and must rebuild. 

Crisis intervention is a sort of emergency first aid for your loved one. This disturbance has caused immense emotional, mental, or physical distress and has every opportunity to destroy their life if it continues. This intervention will be the first step in their recovery.

The crisis worker assesses the level of destruction, insists that your loved one enters a form of treatment, and attempts to prevent any negative behavior or actions to affect your loved one’s mental health in the future. 

The treatment will allow your loved one the opportunity and time to work through the stress and pain of the crisis in a safe environment. They will be educated, coached, and supported by experts and professionals in the mental health field. 

Do crisis interventions work?

Crisis interventions are considered the most important part of the treatment process by many professionals. If there was no intervention, millions of people would not be in treatment, rehab, or free from their crisis.

Crisis intervention is a broad term and so covers all sorts of interventions. Crises can be anything that causes extreme distress or emotional upheaval, such as returning home from war, abuse, alcohol addiction, and so on. 

Psychologists, therapists, counselors, mediators, and all licensed mental health professionals are specifically trained on crisis and finding the cause and level of destruction it has caused.

Each crisis intervention case is unique and many require a professional expert in that specific area in order to get the best results. 

These professionals ensure that your loved one gets the best possible care during the most difficult part of their life.

Signs that it’s time for an intervention

Below are some signs that your loved one may need an intervention. Please note that these are not all the signs – crisis does not look the same for everyone.

Increased tension & fatigue

Extreme stress makes us all severely tired and uptight. Constantly thinking about the situation will make your loved one’s health worse – they most likely won’t sleep or eat much and this will affect their mood, interactions with people, and their job.

Changes in temperament

The constant preoccupation with the crisis mixed with the lack of sleep will make for an irritable person. They won’t be the same – the stress will change them. They may have angry outbursts or go through a state of depression.

Inability to concentrate

They will always be concentrated on the crisis. They won’t give a moment’s thought to anything else until their problem is solved. 

Preoccupied with ideas 

They are always preoccupied with the issue or making new plans that will “change” it. They don’t think of anything else – their job, family, hobbies, pets, etc. Nothing you say distracts them and they can’t pull themselves away from the problem. It seems like an addiction.

Social withdrawal

They withdraw from others, even their family. They know that they’re not fun to be around because they’re always thinking about the problem and so choose to stay away from family and friends. 

Substance use/abuse

The sudden use of drugs or alcohol may be used to numb their feelings about the crisis. These substances may seem to “help” the situation by making your loved one forget the issue at hand. But because they are depressants they only make their irritability, depression, anger, and stress worse. 

Denial

Your loved one may be in total denial about their crisis. If they don’t show up to a family gathering, they may say they’re sick. If they’re angry or depressed, work is stressful. Admitting that the crisis is a big problem is tough for them – it may be hard for them to face reality.

Apathy

The opposite of empathy – a lack of interest, motivation, or concern for themselves or others – is extremely difficult to live with but is a defense mechanism for those going through a hard time. Instead of feeling, they shut themselves off and feel nothing for anyone. 

This can make it difficult to approach your loved one with the idea of getting help or treatment. But if your loved one has shut themselves off in this way, chances are high that they would be more than willing to accept help after some convincing.

How Do You Perform A Crisis Intervention?

Crisis intervention is a broad term for all interventions that require immediate help. If you wish to have an intervention for your loved one, it is highly advised that a crisis worker is present, whether they are a psychologist, therapist, or counselor. They conduct an assessment of your loved one to understand the crisis, assess how bad the crisis has affected your loved one, and create a plan to prevent any more negative situations from impacting their mental or physical health. 

Assessment

This assessment allows the professional to gain insight into the life of your loved one. It’s in the form of an interview, during which your loved one answers questions about their life, the crisis, and what brought them to the stage where the crisis took hold.

There are three steps to the assessment: 

  1. Triage: Your loved one’s condition and treatment options are looked at during this stage.
  2. Experience: The professional will gather general information about what happened during the crisis.
  3. Social and cultural: Stress levels, the severity of the crisis, how well the crisis was managed are all taken into account here. 

All these steps gather pertinent information about the experience your loved one went through. This information will help create a unique treatment plan for them and help them rebuild their life. 

Procedures

There are many procedures that help produce stability in people who have suffered from crises. These three, the ACT, SAFER-R, and the ATSM, create the most comprehensive model that can be used in nearly all crisis situations. 

7-Stage Crisis Intervention Model (ACT)

This model is designed to be followed to resolve crisis situations and to return things to how they were. They were built to ensure that your loved one relearns stability, resolution, and mastery

  1. Plan and conduct a thorough biopsychosocial and lethality/imminent danger assessment: This step goes over the patient’s stressors and supports. Are they on any medication? Do they take any alcohol or drugs? How do they deal with stress on a day-to-day basis? Are they a risk to themselves or others? If so, the crisis worker will ask for more information. 
  2. Make psychological contact and rapidly establish the collaborative relationship: It’s all about the rapport. If there’s no trust at the very beginning, there will be no healing. Genuineness, respect, and acceptance of the patient is vital. 
  3. Identify the major problems, including crisis precipitants: Once the professional has established the past information, it’s time to understand what has brought the patient in now. What happened in their life to make them seek help at this time rather than earlier, or later? This is essential – this is the turning point in the patient’s life and in their healing process. 
  4. Encourage an exploration of feelings and emotions: Expressing feelings and venting is an important part of the healing process. The crisis worker also begins to direct the patient in their thought processes by reframing, giving information, new interpretations or perspectives, or playing the devil’s advocate in order to help the patient open their mind. 
  5. Generate and explore alternatives and new coping strategies: This can be a stressful part of the model because it’s often the most difficult for patients. It requires them to understand the “bigger picture,” and loosen their hold on their old ways of coping. It will often end with them making a “deal” with their crisis worker, often a no-suicide contract or something similar. It is essential that this contract come from the client themselves and not anyone else. 
  6. Restore functioning through implementation of an action plan: The strategies come together to create a plan for the patient. Whether that is joining a support group, temporary hospitalization, a treatment program or something else entirely is up to your loved one and their crisis worker.
  7. Plan follow-up and booster sessions: The follow-up ensures that the crisis work is continuing after your loved one exits treatment and is in post-crisis status. The follow-up is to make sure that they’re still on track for healing and are doing well in their life. 

These steps do not need to be followed in order, and they can overlap each other. The goal is to finish the model and to make sure that your loved one has the tools needed to go through life. 

SAFER-R Model 

This model is intended to return your loved one back to a state of functionality similar to the one they were at before the crisis. Its main focus is on their stability in life.

The 6 Stages of SAFE-R:

  1. Stabilize
  2. Acknowledge
  3. Facilitate understanding
  4. Encourage adaptive coping
  5. Restore functioning
  6. Refer 

10 Stages of Acute Traumatic Stress Management (ATSM)

These steps focus on restoring balance and the mental stability of your loved one.

The 10 Stages of ATSM:

  1. Assess for danger/safety for self and others 
  2. Consider the mechanism of injury
  3. Evaluate the level of responsiveness 
  4. Address medical needs
  5. Observe and identify
  6. Connect with the individual 
  7. Ground the individual
  8. Provide support
  9. Normalize the response
  10. Prepare for the future

These 3 different models are both separate and connected. They can be used on their own but do the most good when they are used together for those suffering from crisis. 

The Cost

There is no concrete amount on the cost of a crisis intervention. However, according to a report put out by SAMSHA in 2014, they found the total average cost per case for the mobile crisis programs, and for police interventions. The mobile crisis program’s average cost totaled $1,520, and the police interventions totaled $1,890

The costs also differ from state to state and from health facility to hospital, depending on where you are and where you look for treatment. Please also note that these are the prices in 2014. 

The Services

There are many services for those in need of a crisis intervention. If you believe that you or your loved one is in need of an intervention, please consult your doctor or talk to a mental health professional for more information. 

There are many ways to get help, including hotlines. If you are in need of immediate help and don’t have access to a doctor or mental health professional, please seek out information from a crisis intervention hotline. There are many different categories under crisis intervention so you or your loved one can decide where to get the most specific help. 

Universal Crisis Intervention

Universal Crisis Intervention (U.C.I.) specializes in complex interventions. When you hire U.C.I., you’re retaining a team of certified interventionists, retired law enforcement agents, licensed PI’s & psychologists who work together seamlessly toward one common goal – to protect your loved ones and keep hope alive.

Embrace hope & call today: 1-855-202-1278 (24/7 Service)

National Suicide Prevention Lifeline

They help and support those who are having suicidal thoughts, or family members or friends who know someone who is. Call 1-800-273-8255

Crisis Text Line 

This helpline aids those in any crisis: anxiety, depression, bullying, suicide, etc. They are across North America, the UK, and Ireland. Text “Home” to 741741 (US)

YouthLine

YouthLine focuses on children and young adults age 11-21 and aids in any crisis: peer pressure, bullying, eating disorders, suicide, anxiety, etc. It is run by both teens and adults. Text “teen2teen” or call 1-877-968-8491

ChildHelp National Child Abuse Hotline

This hotline deals specifically in child abuse crises.They offer information and immediately direct you to a counselor for your case. If you or someone else is in such a crisis, please call this hotline for more information. Call 1-800-422-4453

National Domestic Violence Hotline

They are available 24/7 for domestic violence/abuse cases or anyone concerned about family members or friends who are dealing with such a crisis. Call 1-800-799-7233

National Deaf Domestic Violence Hotline

This is a spinoff of the NDVH but made specifically for Deaf and Hard of Hearing individuals in need of help. They provide exceptional support and information. Please email [email protected]

RAINN

This organization and hotline was made specifically for anyone who has experienced sexual abuse or assault. You will be directed to a local organization and to additional resources. Call 1-800-656-4673

The Trevor Project

LGBTQIA+ kids and teens can look here for support and understanding for any issue during a crisis. Text “START” to 678678 or call 1-866-488-7386

Trans Lifeline

Trans Lifeline provides support specifically for transgender and questioning callers. THey also provide support for those in a crisis and offer support and guidance for those who are questioning their gender. Call 1-877-565-8860

SAMHSA National Helpline

They are specifically dedicated to drug and alcohol abuse. They offer support and information about these addictions, as well as helpful treatments and recovery options. Call 1-800-662-4357

There are also services within communities that play a huge role in crisis intervention. One of these is the Crisis Intervention Team. Read more below. 

CIT 

The Crisis Intervention Team (CIT) is a community based approach to improve the outcomes of crises across the US. Because there are so many crises across the nation and so few services, crisis cases most often fall to law enforcement and first responders. There are over 2700 communities nationwide in which the CIT creates connections between law enforcement, mental health providers, emergency services, and those with mental illness and their families. 

Final Thoughts

Any crisis should be noticed and taken seriously. Whether the victim is a child, teenager, or adult, everyone is susceptible to an unforgiving amount of stress and pain. 

Treatment for crisis is no easy feat, nor is it cheap or easy to re-assimilate into normal life. But to those who can do the work and want a better life for themselves and their families, it is worth it. 

If anyone you know is suffering from a crisis, call a hotline, doctor, or mental health professional. It is paramount that they get the help and support they deserve so they are able to return to their lives as easily and comfortably as possible. 

 

References

Stevens, Brenda A. & Lynette Ellerbrock. Crisis Intervention: An Opportunity to Change. Eric Digest. 1995.

What Is A Crisis Intervention?. AddictionCampuses. 2020.

Crisis Intervention Team (CIT) Programs. NAMI. 2020. 

Roberts, Albert R, PhD. & Allen J Ottens,PhD. The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis Resolution — Roberts and Ottens 5 (4): 329 — Brief Treatment and Crisis Intervention. Stanford University Libraries. 2005.

Crisis intervention. Wikipedia. 2020.

Substance Abuse and Mental Health Services Administration. Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies. HHS Publication No. (SMA)-14-4848. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. https://www.nasmhpd.org/sites/default/files/SAMSHA%20Publication%20on%20Effectiveness%20%26%20Cost-Effectiveness%20of%2C%20and%20Funding%20Strategies%20for%2C%20Crisis%20Services%206-5-14_8.pdf

Suicide Prevention Hotline. https://ccrinfo.org/national-suicide-prevention-lifelife-regional-call-center/

Crisis Text LIne. https://www.citywatchla.com/index.php/cw/los-angeles/15718-wanna-help-save-lives

YouthLine. http://www.volunteercentraloregon.org/agency/detail/?agency_id=104199

ChildHelp. https://www.facebook.com/childhelp/

National Domestic Violence Hotline. https://twitter.com/ndvh/status/1276993708861214721

National Deaf Domestic Violence Hotline. https://www.adwas.org/hotline/national/

RAINN https://www.linkedin.com/checkpoint/challengesV2/AQEjoZHGHcaE6QAAAXN3mJSQUDsS7hNfRmwHU9zwFenksTvwaFwn4_F-F6O6mir0sB_1btx_Qizf5IKsAkAnT_baxknLD2_9wQ

The Trevor Project. https://www.facebook.com/TheTrevorProject/

Trans Lifeline. https://www.pinterest.com/pin/473792823300323157/

SAMHSA National Helpline. https://www.samhsa.gov/find-help/national-helpline

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