Crisis Intervention For Psychological Care: Analysis And 7-Task Model

Explanation of Crisis

Discuss about the Crisis Intervention for Psychological Care.

Crisis intervention is a short-term and immediate psychological care, which is implemented for helping people, who are in a crisis situation and seeking help to restore their normal biopsychological functioning and for reducing the occurrence of long-term psychological trauma (Kanel, 2014). In this assignment, the key focus is on the analysis of a crisis situation and how it is affecting a person’s functioning. Moreover, this assignment would also include the analysis of the crisis and possible intervention through the implementation of 7-task hybrid model of crisis intervention. In the next phase, the challenges faced by the psychotherapists to implement this framework in the crisis intervention plan will be discussed. Finally, the ways through which the crisis intervention related challenged might be overwhelmed, would be discussed here.   

Crisis is referred to an event, which is defined as individual’s experience of a situation or event in which the victim perceives to have exhausted his or her coping skill, social support, self-esteem and power. These kinds of situation can be referred to the status, when a person is making suicidal threats, experiencing personal loss, experiencing threat or witnessing suicide. When the person is going through a crisis on the individual level, the counsellor or psychotherapist should assess his safety aspects initially. For example, professional burnout is a significant crisis for an employee or health care staff, as the status includes the signs of crisis (Camille-McKiness & Wickman, 2013). It is a type of psychological stress. It is characterized as exhaustion, lack of enthusiasm, lack of motivation, ineffectiveness in workplace, frustration and reduced efficacy in work.  

Burnout can be categorized in three levels, i.e. activity, state and trait. At the activity level, burnout can be reduced, only when the routine is change. At the state level, burnout might be situational or periodic. On the other hand, at trait level, it is all-pervasive, surrounding every facet of the worker’s life. This level of burnout is serious and immediate intervention is required (Hendricks & Hendricks, 2014).

Burnout has a significant negative impact upon a person’s daily functioning. Symptoms of burnout involve dysfunctional attitude towards work, loss of motivation, exhaustion, poor coping mechanism, distress and feeling of ineffectiveness. The effect of burnout upon a person’s functioning can be discussed with the help of ABC model. The ABC model has been established by Dr. Albert Ellis for understanding the meaning to the reactions to adversity. A stands for adversity, indicating the situation or event. B is for the victim’s belief, i.e. the explanation about why the situation happened and C is about consequences, the feelings and behaviour caused by the belief (Heyns & McCormack, 2014). The burnout signs are the reaction, which are based on the thoughts about the situation. The impact of an adverse situation may among person to person. For instance, professional burnout is the result of negative consequences and work pressure upon the employees. However, similar incident can be perceived by two employees different, as a result, two staffs would handle the same situation differently, thus the intensity of stress would be different for two staffs. The negative consequences of perception or belief might lead to burn out development in one person, but other one might not lead to the same issue. Thus, assessing the status of burnout is very important before making the crisis intervention plan.   On the other hand, ABC can stand for the followings:

Crisis Impact on a Person’s Functioning

A- Affective state – Impaired affect is one of the initial states of crisis. The person might unable to control emotion or severely withdrawn. The counsellor might assist the client to regain control, by helping him to express feelings and thoughts in a proper way (Humphries et al., 2014).

B- Behavioural functioning – Assessing the client’s behaviour is crucial for understanding the status of crisis. This process may involve asking client to be breath slowly with the counsellor, leading through a grounding exercise.

C- Cognitive state – Assessing the cognitive thinking pattern is essential to understand whether it is coherent or logical.

The impact of person’s crisis can modify individual’s behaviour, thought, feelings and cognitive functioning. For instance, behavioural change is often seen in a person, undergoing burnout; especially in health care staffs. Burnout makes the person anxious, depressed, frustrated, dysfunctional attitude towards work, agitated and negative in kind of work. On the other hand, the person will feel restless, less confident, accident prone and frustrated. Moreover, the person’s thought process as well as cognitive functioning is significantly affected (Kraus & Stein, 2013). For instance, the person become unable to control the expression of his stress related behaviour and feelings, negativity and withdrawal is significant signs of stress-related burnout. Poor cognitive functioning, impaired judgement, muddled thinking and worry are also significant effects of professional burnout. In addition, burn out also affects person’s functioning by affecting his health; for instance, headache, skin irritation, breathlessness, fatigue, muscle cramp and frequent infection are the symptoms, indicating stress related burnout (Vered et al., 2014).

The Hybrid model of crisis intervention is used for addressing all the necessary aspects, while developing a crisis intervention plan for a person undergoing a crisis. This model helps the counsellor to design a linear approach to crisis intervention. As a crisis is studies consistently, the incidents do not occur systematically. The hybrid model attempts to consider the crisis in a realistic fashion and allows the crisis intervention team to move forward in more systematic and effective manner, resulting in therapeutic innovation and enhanced effectiveness (Shin et al., 2014). The model consists of 7 tasks in an ordered format. The first task is predisposing, engaging and initiating contact. For instance, the counsellor would initially establish a connection with the person experiencing burnout and then build a relationship of communication. However, as the person is in crisis, it is difficult to build a positive relationship. A positive relationship will help to clarify the understanding of the person’s needs and counsellor’s intention to support and help him.

7-Task Hybrid Model of Crisis Intervention

The second task is problem exploration. Here, the counsellor explores the problem by defining the crisis, its cause and the factors contributing to the crisis occurrence. For instance, the crisis of a person experiencing professional burnout might be due to organization of the context through the professional stress, work pressure, lack of support in organization, discrimination, organizational bullying, financial loss or other causes related to profession (Baril et al., 2016). 

The third phase is providing support. It can be psychological, social, logistical and informational. It is difficult to support a person undergoing a crisis, due to his negative feelings. However, through the establishment of a positive therapeutic alliance, the feeling should be understood. This phase will help to discover the person’s needs.

The fourth task is examining alternative. Instead of supporting the patient, what other alternatives can be implemented for the client, would be assessed in this task. For instance, during this task, the client would be asked about how he is feeling and asked for additional support, including medication, therapy, reference of other support group and treatment resources may be provided (Baril et al., 2016)..

The fifth task is planning in order to re-establish control over the chaotic situation. In this state, the client will be assisted to adopt the coping mechanisms to overcome obstacles.  This phase will help the client to be empowered with resiliency for the next time.

The sixth task is obtaining a commitment from the client for continuing forward ad accepting support, if needed. At this phase, the client becomes familiar and feels free to share his thoughts and perceptions to the counsellor. It will also ensure that the person would become able to cope with the future crisis (Shin et al., 2014).

The final task is follow up with the person. It ensures client’s adherence to the communication and support from the counsellor, thereby ensuring that upcoming difficulties in client’s life will be addressed and noted if cannot be managed by the client himself, prior the consequences becomes severe challenge for living.

As the crisis intervention is for people undergoing a significant crisis, dealing with such people is difficult and challenging, while applying 7-task hybrid model for mitigating the crisis issues. One of such challenge is related to problem callers. These kinds of people are usually severely disturbed and use the crisis line for some reasons other than it should e used for.  However, it should be remembered that the people regularly using crisis line is using the same as a part of their coping mechanism. Sometimes, abusive callers seek help for irrelevant reasons and the situation becomes difficult to be handled by the counsellor (Baril et al., 2016).

Another problem of crisis intervention with the help of the 7-task hybrid model of crisis intervention is following each step of the crisis intervention model in a systematic framework. It is mostly overviewed while handling a patient with severe disturbance due to crisis and the crisis intervention is done on an emergency basis. For a client at a severe stage of crisis, an immediate action is needed for his well being. Thus, it becomes difficult to follow all the steps in the same manner. In these kinds of situation, the counsellors tend to jump to the relevant stage suitable for the crisis of that person, thereby reducing the time of crisis intervention (Humphries et al., 2014).

Another challenge of implementing this crisis intervention model is dealing with clients over phone. Sometimes, after resolving a problem in a systematic manner, client attempt to address another different issue to the counsellor. However, for the counsellor it becomes difficult to avoid the client’s need, thus the care provider has to start the intervention steps from the beginning. It is difficult to handle such situations due to professional and ethical concerns. However, it has been argued by (Heyns & McCormack, 2014). that crisis intervention over phone with severely disturbed people is not meant to be curative, rather it is a process designed for helping people to revert back to their normal lives.

Through a number of ways the above mentioned problems can be handled. These ways are described below:

• Setting time limit over phone: Setting time limit and incorporating a system that will monitor the time of calling and automatically end the call after the required tine will be helpful for the counsellor to handle the problem caller (Heyns & McCormack, 2014).
• Imposing open-ended questions: Imposing open-ended question will attempt to focus on the problem back to the caller, which will reduce the inappropriate conversation from the caller and help the workers to resolve problem caller’s related issues.
• Terminating abuse: Instead of the ethical issues, while handling clients with crisis, the crisis line system should involve time limits and termination of abuse (Kraus & Stein, 2013). The caller should be informed that he or she is being terminated the call and can provide them with an option that he or she can call again, when he can communicate appropriately.
• Switching care providers: When there will be an option to switch worker, the frequency of abuse will also be reduced. The facility of switching call to another worker, while having a difficult call from a caller, would help to reduce work pressure of the care providers and make them able to handle the other calls effectively.

Conclusion

In conclusion, it can be revealed that crisis interventions are helpful for the people undergoing crisis like professional burnout. The professional burnout is a problem through which a person undergoes behavioural and cognitive impairment, which may also affect the mental and physical status. In this assignment, the implementation of a crisis intervention model, known as 7 task hybrid model for crisis intervention has been discussed along with the description and analysis of its each steps. Then the challenges faced by the counsellor, while implementing this intervention has also been described. Finally, the ways through which these issues could be overwhelmed has also been discussed in this assignment. This assignment revealed the effectiveness of 7 task hybrid model in crisis intervention.

Reference List

Baril, C., Gascon, V., Miller, J., & Bounhol, C. (2016). The importance of considering resource’s tasks when modeling healthcare services with discrete-event simulation: an approach using work sampling method. Journal of Simulation.

Camille-McKiness, K., & Wickman, S. A. (2013). Crisis Intervention Teams and Mental Health Advocacy. JCI, 13.

Hendricks, J. E., & Hendricks, C. S. (2014). Crisis intervention in criminal justice/social service. Charles C Thomas Publisher.

Heyns, T., & McCormack, B. (2014). Moving from crisis intervention towards person?centredness. Nursing in critical care, 19(4), 162-163.

Humphries, N., Morgan, K., Catherine Conry, M., McGowan, Y., Montgomery, A., & McGee, H. (2014). Quality of care and health professional burnout: narrative literature review. International journal of health care quality assurance, 27(4), 293-307.

Kanel, K. (2014). A guide to crisis intervention. Cengage Learning.

Kraus, S. W., & Stein, C. H. (2013). Recovery-oriented services for individuals with mental illness and case managers’ experience of professional burnout. Community mental health journal, 49(1), 7-13.

Shin, H., Park, Y. M., Ying, J. Y., Kim, B., Noh, H., & Lee, S. M. (2014). Relationships between coping strategies and burnout symptoms: A meta-analytic approach. Professional Psychology: Research and Practice, 45(1), 44.

Vered, Y., Zaken, Y., Ovadia-Gonen, H., Mann, J., & Zini, A. (2014). Professional burnout: Its relevance and implications for the general dental community. Quintessence International, 45(1).