Ten Steps of Crisis Intervention
A General Model of Intervention and Crisis Counseling
Make Psychological Contact and Establish the Relationship.
Establish rapport by conveying genuine respect and acceptance of the client. The client also needs assurance and reinforcement that he or she may receive help. If this step is omitted, the client will not feel respected and will be resistant to counseling.
Examine the Dimensions of the Problem to Define the Problem.
Identify the precipitating event, previous coping methods, and lethality. Focus on the now and how, rather than the then and why. Use open-ended questions.
Explore Feelings and Emotions.
It is therapeutic for the client to vent and express feelings and emotions in an accepting, supportive, private, and non-judgmental setting. The crisis intervener must actively listen.
Explore and Assess Past Coping Attempts.
Identify and modify the client’s coping behaviors at both the preconscious and conscious levels. Coping responses must be brought to the conscious level and to educate the client in modifying maladaptive coping behaviors. Explore how certain situations are handled: intense anger, loss of a loved one, disappointment, failure, etc. Help the client understand how they have been coping and why it has not worked. If this step is omitted, the client may continue using maladaptive coping behaviors that continue not to work.
Generate and Explore Alternatives and Specific Solutions.
Clients need help conceptualizing more adaptive coping responses to the crisis. If the client has little introspection or personal insights, the clinician needs to take initiative and suggest coping methods.
Restore Cognitive Functioning Through Implementation of an Action Plan.
Help the client focus on why a specific event leads to a crisis state and, simultaneously, what the client can do to master the experience and be able to cope with future events. This is done in three stages:
- The client needs a realistic understanding of the crisis and what led to the event. Understand what happened, why it happened, who was involved, and the final outcome.
- Understand the specific meaning of the event, how it conflicts with expectations, life goals, and belief system. The clinician should note cognitive errors, distortions, irrational beliefs, and help the client discover them.
- Reconstructing, rebuilding, and replacing irrational beliefs with new cognition. Provide new info through homework assignments or referrals to others who have lived through and mastered a similar crisis, such as a support group.
Follow-Up
Clinician should leave her door for client to come back for future sessions. Often, unforeseen events conjure up images and old feelings surrounding (i.e. the anniversary of the event).
Additional Resources
This information was taken from lecture notes from J. Steinberg's graduate class in Crisis Intervention (1999). For related information, please read:
