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Crisis Intervention
| Question | Answer |
|---|---|
| SAFETY | 1. ensure physical/emotional safety 2. ask “What do you need right now to feel safe?” , connect to ER resources if needed 3. use Attending behavior, empathic listening, clear and concrete communication. |
| SAFETY | 1. ensure physical/emotional safety 2. ask “What do you need right now to feel safe?” , connect to ER resources if needed 3. use Attending behavior, empathic listening, clear and concrete communication. |
| CALMING & CARING | 1. establish emotional stability/convey geuine care 2. stay calm/centered, avoid minimizing langauge "It will be okay." Instead "You are not alone" or "What do you need right now?" 3. refelction of feeling, empathetic stmts, verbal/nonverbal immediacy |
| NORMALIZING | 1. help them understand actions normal/valid/expected 2. Reframe distress responses as natural human reactions to abnormal situations 3. Paraphrasing, strength-spotting, reframing. |
| DEBRIEFING THE STORY | 1. invite to share experience in own words 2. may need to tell several times, your job to listen, reflect, affirm, NOT fix 3. Open-ended questions, reflection of content, summarizing. |
| ASSESSING STRENGTHS & RESOURCES | 1. identify what is helping them cope & what else might help 2. explore internal strengths & external resources "What has helped you get through hard times before?" 3. Scaling questions, strengths-based questioning, collaborative dialogue. |
| ACTION & ADVOCACY | 1. develop plan meet immediate needs/reduce harm 2. what need, make happen, advocate (involve making calls, arranging shelter, or walking the client through a resource referral) 3. Goal setting, planning, assertive communication, problem-solving. |
| The 7 Stages of Crisis Intervention | 1. Safety 2. Calming & Caring 3. Normalizing 4. Debriefing the Story 5. Assessing Strengths & Resources 6. Action & Advocacy 7. Follow-up |
| Suicide is often the result of multiple intersecting factors—not just mental illness, but ... | 1. social isolation 2. loss 3. trauma 4. systemic injustice 5. access to lethal means. |
| Key Risk Factors | Severe depression, anxiety, Alcohol/drug misuse, Hopelessness sleep disturbance/difficulty concentrating, Loss of employment, housing, elationships, Abuse history, Serious health condition, Past self-harm/past suicide attempts ,Access to lethal means |
| Protective Factors and Strengths | Strong social support networks, Spiritual beliefs/religious practice, Sense of responsibility to family or children, Life satisfaction/sense of purpose, Problem-solving/oping skills, Positive therapeutic relationships, Limited access to lethal means |
| Warning Signs of Imminent Suicide Risk | Expresses thoughts of wanting to die or hurt themselves Has a specific plan and access to lethal means Talks about death, dying, or suicide, or gives away personal items |
| How to Ask About Suicide | “Some people in your situation have told me they’ve had thoughts of ending their life. Have you had similar thoughts?” |
| Once ask about suicide, follow up with... | “Do you have a plan?” “When did you last feel this way?” “Have you ever attempted suicide before?” “Is there anything or anyone keeping you going right now?” (show care, not fear or alarm) |
| FOLLOW-UP | 1. ensure client supported beyond crisis 2. offer future session, refer to long-term providers, arrange for warm hand -off, ensure not along 3. Contracting, summarizing, affirming next steps. |
| The 7 Stages of Crisis Intervention | 1. Safety 2. Calming & Caring 3. Normalizing 4. Debriefing the Story 5. Assessing Strengths & Resources 6. Action & Advocacy 7. Follow-up |
| Suicide is often the result of multiple intersecting factors—not just mental illness, but ... | 1. social isolation 2. loss 3. trauma 4. systemic injustice 5. access to lethal means. |
| Key Risk Factors | Severe depression, anxiety, Alcohol/drug misuse, Hopelessness sleep disturbance/difficulty concentrating, Loss of employment, housing, elationships, Abuse history, Serious health condition, Past self-harm/past suicide attempts ,Access to lethal means |
| Protective Factors and Strengths | Strong social support networks, Spiritual beliefs/religious practice, Sense of responsibility to family or children, Life satisfaction/sense of purpose, Problem-solving/oping skills, Positive therapeutic relationships, Limited access to lethal means |
| Warning Signs of Imminent Suicide Risk | Expresses thoughts of wanting to die or hurt themselves Has a specific plan and access to lethal means Talks about death, dying, or suicide, or gives away personal items |
| How to Ask About Suicide | “Some people in your situation have told me they’ve had thoughts of ending their life. Have you had similar thoughts?” |
| Once ask about suicide, follow up with... | “Do you have a plan?” “When did you last feel this way?” “Have you ever attempted suicide before?” “Is there anything or anyone keeping you going right now?” (show care, not fear or alarm) |
| Ethics, Safety, and Referral | If you believe a client is at imminent risk, safety overrides confidentiality. Let the client know you may need to take steps to ensure their wellbeing. You are ethically and legally obligated to |
| Use resources such as: | The VA Suicide Risk Assessment Guide (DOC, 75KB) Local mobile crisis units or suicide prevention lines The 988 Suicide & Crisis Lifeline (U.S.) |
| Secondary traum is sometimes called... | vicarious trauma |
| secondary trauma | s the emotional residue that remains after hearing clients’ stories of suffering. |
| Signs of secondary trauma and burnout | Emotional exhaustion or numbness Difficulty sleeping or concentrating Hypervigilance or anxiety Cynicism or loss of empathy Avoidance of certain client stories or topics |
| cynicism | a negative outlook on life characterized by a distrust of human motives |
| Hypervigilience | a state of heightened alertness and increased awareness of one's surroundings, often accompanied by a sense of anxiety or fear |
| Burnout | arises from systemic overload—too many demands, too few resources, and chronic stress without relief. |
| Debriefing & Peer support | Following a crisis, debriefing with trusted colleagues can be a powerful tool for resilience. This isn’t gossip or venting—it’s a structured process of reflection, validation, and support. |
| Resilience | doesn’t mean being unaffected. It means having tools to recover and remain grounded |
| Resilience strategies | Regular physical activity or movement Creative outlets or hobbies Connection to supportive friends, family, or faith Therapy or peer support groups Mindfulness, meditation, or spiritual practice |
| Crisis/Trauma Counseling involves 2 major phases: | (1) working through the initial trauma and (2) appropriate follow-up and further counseling. |
| Key strategies for working with those who experience trauma: | 1. safety 2. calming & caring 3. normalizing 4. Debriefing the Story 5. Assess strengths & resources 6. Action/Advocacy 7. Follow-up |
| Key CBT Propositions | • Cognitive activity affects behavior. • Cognitive activity may be monitored and altered. • Desired behavior change may be effected through cognitive change. (Dobson & Dozois,2021, p. 4) |
Created by:
hdemerly