Essentials of Crisis Counseling and Intervention

Crises occur when a person experiences a major loss or event. This can include life-threatening situations such as natural disasters as well as crime, mental and medical illness and sexual assault. Crises can be connected to problems that include suicide, homicide, sexual assault, substance use and loss of relationships. At such times, a person may lose her normal ability to cope. Mental and behavioral health clinicians use crisis counseling and intervention techniques to help.

Biopsychosocial Assessment

• A biopsychosocial assessment is a way to determine how a person is functioning and dealing with a crisis. Through interviewing the client, the clinician builds a picture of the person's mental functioning and mood. The clinician also asks about other areas that affect the client, including whether the person uses illegal substances, has support for problems with mental or behavioral health issues and the person's social and emotional resources. The clinician also might ask about the client's past history in these areas; however, the collection of historical information depends upon the nature of the crisis and may be assessed at a later time if needed.

Precipitants

• One of the primary roles of the crisis clinician is to determine what precipitated and led to the crisis. Crises do not happen in isolation but are the result of an individual's reaction to a specific event. To create treatment plans and interventions that are successful, the clinician needs to understand why the person is in crisis. Crisis clinicians use techniques such as talking in a soothing voice and showing a calm but firm demeanor to compel the client to tell her story and explain the events leading to the crisis.

Safety Assessment

• Assessing for safety is an essential part of crisis counseling. Crisis counselors assess for both risk and protective factors for suicide and homicide since people in crisis are at higher risk for both. Crisis clinicians understand that having suicidal or homicidal thoughts can occur during a crisis and are able to ask the individual specifics about these. For instance, risk factors for suicide include a personal and family history of suicide attempts, recent plans or attempts to harm one's self and access to weapons or other means of harming self. Other risk factors can include social isolation, mental illness and drug abuse or addiction.

Short-Term Goals

• Crisis clinicians use short-term goals or treatment plans to help resolve the crisis. These interventions depend on the type of crisis and how the client is functioning. Interventions can include the use of psychiatric medications and medical interventions as well as speaking with family, friends, therapists, social workers and others involved in the individual's life. Discussing different short-term options with the individual in crisis is an important intervention. For instance, a person who is in crisis because she is uncertain where to get help for an addiction may feel the immediate crisis lift if she is accepted into a detoxification facility.