Crisis Intervention

Table of Contents

A loved one in crisis may struggle with a high degree of confusion, anxiety, and frustration. Coping mechanisms may go out the window, and the person’s life may start to revolve around that crisis state. In a severe state of crisis, the individual may become violent, self-harm, or engage in reckless or dangerous behaviors.

Healthy Life Recovery can offer assistance with crisis intervention and treatment for mental health or substance abuse. Crisis intervention techniques can help support a loved one in crisis. These techniques can generally be applied if their crisis relates to substance use or mental health conditions.

Crisis Intervention: What to Keep in Mind

During a crisis intervention, several critical factors may need to be considered.

1. Evaluate the situation

Before an outside party can offer any crisis intervention, they must evaluate the situation and identify potential problems. The goal during the intervention process is to determine what the crisis is and what support intervention can offer. 

Someone planning to intervene must ensure they understand what is happening and whether there is any immediate threat. If they are engaging with others, they may want to work together to answer critical questions about the situation. 

They may ask:

Amid a  crisis, it can be easy to get caught up in fear and panic. By clearly identifying the situation, the person intervening can more effectively determine what is needed in a specific case.

2. Make safety the top priority.

In any crisis, it’s critical to evaluate the safety of the person responding and that of others around them. This includes the person directly in crisis. Anyone intervening in a crisis must make safety the top priority at all times. 

Sometimes, that may mean they need to remove themselves from the situation or bring in help from the outside. In an extreme crisis, they may need to contact the police and get additional support.

3. Indicate presence and support.

The intervening person should let the person in crisis know they are there to assist them. Often, that means letting the person in crisis know they are cared for and that they’re there to help them solve the problems they may face. 

Establishing that relationship and those critical lines of communication can prove essential to letting the other party know they are not alone. Stability and support are important when someone is in a personal crisis. 

An indication of presence and connection can also aid in calming the other party. Sometimes, the spiraling emotions of a crisis moment can make it very difficult to reach out or break the cycle. By notifying the other party of that presence, the person responding can make it easier to achieve their goals.

4. Work through a plan together.

It can be challenging to see a way out when someone is in a crisis. Working together to create a plan may be necessary as part of an intervention strategy. This plan can help support the person to find stability and hope.

Get creative and think together as a unit. Examine solutions. If outside parties or professionals are contributing to the process, they can help guide loved ones.

Often, crises are brought about by extreme circumstances. A crisis intervention might occur when drug or alcohol addiction has reached a tipping point or when a loss has pushed someone into distress. It can be challenging to see a way out during those circumstances. 

Spiraling anxiety and other emotional challenges can make it increasingly difficult to deal with those scenarios 5. By working together to develop a plan, the person responding can help alleviate those spiraling emotions and provide tools that are more likely to be genuinely helpful.

Crisis Intervention Techniques

Several crisis intervention techniques are commonly used to help bring crises under control. The method used may depend on the individual responder’s strengths and the situation faced at the moment. People may be responding to a person in the depths of substance abuse or a mental health crisis. 

There are also some treatment centers or interventionists that provide crisis intervention services. These resources are meant to help support people experiencing a mental health or substance use emergency. They should be trained professionals who are well-versed in diffusing situations and preventing life-threatening consequences.

ABC Crisis Intervention

The ABC model of crisis intervention is designed to help alleviate immediate crisis challenges 1. It follows the “ABC” method for describing how to address a potential crisis. This may make it more memorable at the moment. While also making it easier for the person handling the crisis to deal with those challenges and provide a comprehensive solution.

A: Achieve Contact

These endorphins are created in the pituitary gland and released into the bloodstream. They function similarly to the central nervous system—blocking pain signals throughout the body. These endorphins, for instance, may block pain sensations within muscles.

Both hormones and neurotransmitters carry messages to either start or stop something from happening within the body. The only difference is that neurotransmitters stay within the nervous system while hormones travel through the bloodstream. Both types of endorphins (neurotransmitters and hormones) block pain signals.

B: Boil Down the Problem

Take the time to clarify the problem that has sent the victim into crisis. Generally, a crisis occurs because of some external stimulus. The victim usually feels overwhelmed and does not know what to do next. 

Ask them to describe the situation that sent them into that crisis spiral. What just happened? How did it impact them? 

Encourage them to talk about the here and now. Ask what they think the most significant current problem is and why they feel strongly about it. 

When responding to a crisis, it can be beneficial to avoid judgment. A sense of judgment can interfere with the response of the person in trouble. They may want to repeat what they have heard to clarify anything they don’t understand.  Through this process, they may get a better overall feeling of precisely what the victim might be dealing with.

C: Cope with the Problem

Once the responder has identified the problem the victim is dealing with, they may need to take some time to work through solutions. For example, a patient suffering from a drug or alcohol addiction crisis might seek rehabilitation facilities. 

Providing comprehensive support can often help the victim obtain a more future-focused attitude and a more positive overall outlook.

It’s essential to ensure the responder involves the victim in coping. They might ask them to identify what resources they might need to solve the problem. For example, someone who has recently lost a job or suffered immense financial challenges might benefit from immediate provisions. However, long-term support is also essential for long-term stabilization.

D: Determine the Meaning of the Event

The responder should take the time to work through the event’s meaning and how it might have impacted the victim. Often, problems can bring up significant thoughts about faith, religion, or spiritual concerns, as well as anger or anxiety. Discuss the situation with the victim and help them identify immediate challenges that they may be dealing with.

ACT Intervention Model for Acute Crisis and Trauma Treatment

The ACT Intervention Model identifies seven steps to trauma and crisis intervention 2.

1. Assess Lethality

In many crises, it is critical to start by assessing the danger posed by the person in crisis. Is that person likely to turn lethal or display other signs of dangerous behavior? The responder’s reactions to that crisis, and the steps they can take safely, may depend on the danger posed.

2. Establish Rapport

The Roberts method, or ACT model, encourages establishing rapport. If the responder has never met the person in crisis, they may need to introduce themselves. If the responder knows the other person, they may want to work carefully with them to identify the current situation and what help they need.

3. Identify Problems

A crisis does not usually occur without reason. The ACT method encourages the person responding to identify the problems with the current situation. They may need to identify issues from the perspective of the person in crisis and the perspective of others around them. Often, the impact of someone’s crisis will spill over far beyond its initial circumstances.

4. Deal with Emotions

Ask the other person to name the emotions they’re feeling and the challenges they are facing. What caused them to spiral into crisis mode? The responder may need to work through those emotions with them. Continue to maintain empathy and rapport.

5. Explore Alternatives

When a person is in crisis, they often do not know what to do next. The anxiety and fear spiral can interfere with the ability to think through solutions logically. It is difficult for the person in the middle of a crisis to deal with those challenges. Help identify solutions. 

The responder may want to identify multiple alternatives or provide various supports to determine which one best fits the needs of the person. Remember that the goal is to address their problems, not necessarily just to throw out solutions.

6. Develop an Action Plan

Once the responder and the person in crisis have arrived at a solution that works, they can develop an action plan. The responder may want a signed contract that the other party will not engage in dangerous behavior. 

The action plan should include clear, actionable steps. These steps may consist of resources that both parties intend to take advantage of or the specific steps that will be taken to support the person in crisis.

7. Follow Up

Immediate crisis intervention helps address the current situation and come up with solutions. If the person responding to the crisis fails to follow through, the other party could end up in more trouble. The ACT method reminds them to engage in follow-up meetings and interventions after the crisis to arrive at a more satisfactory resolution and help get the person’s life back on track.

Critical Incident Stress Management

Critical Incident Stress Management was initially developed to help first responders deal with traumatic incidents 3. Often, CISM is designed to help vent emotions and manage trauma  before the party experiencing that trauma spirals out of control. These services can help many people deal with potential crises or the aftermath of an emergency.

Debriefing

A debriefing occurs after any potentially traumatic event. It is a formal crisis management strategy that encourages people who have been through trauma to share information openly6. This critical information includes any potential dangers suffered during the event. 

Most of the time, the debriefing process occurs 24-72 hours after a traumatic event. Though in some cases, it may need to be pushed later. Debriefing helps mitigate a traumatic event’s physical and emotional impact and provides essential support.

Defusing

During the defusing process, people involved in the situation can share their immediate reactions to a crisis, vent about potential challenges, and share their emotions. The defusing process typically lasts 30 to 60 minutes and occurs immediately after the crisis. A defusing session can help avoid potential troubles by allowing the victims or responders to eliminate some pressure and steam.

Grief and Loss Session

A grief and loss session allows the opportunity to explore grief reactions and dialogue about any challenges surrounding the circumstances of the death or event. A grief and loss session is the chance to process the loss. While also discussing any questions that may come up and sharing emotions. Often, sharing grief can help with overall processing.

Crisis Management Briefing

During the crisis management briefing, facilitators will have the chance to review immediate coping tools. Often, these sessions will help provide insight into what is expected to happen during the crisis management process. This briefing can help loved ones, and responders understand the situation and ensure that people have the right intervention tools.

Critical Incident Adjustment Support

During a critical incident adjustment support meeting, those involved in an incident will be provided with long-term resources to help them deal with that ongoing impact. These sessions can prove critical for addressing challenges for individuals and families involved in a crisis. 

The solution is likely some treatment in the context of people struggling with a mental health crisis or addiction. For people amid a crisis, accepting residential treatment is one of the first steps they can take towards stability.

Pre-Crisis Education

Pre-crisis education can be critical in helping someone deal with a loved one suffering from drug or alcohol addiction. Loved ones can feel reassured since they will already have the tools on hand to help the person struggling. Pre-crisis training can provide insight into what tools and resources are available for someone in crisis. 

Pre-crisis education can also be critical for preparing responders to deal with the trauma that often emerges after a crisis. Coping with traumatic situations can prove incredibly traumatic. Unprepared responders may end up with PTSD or other devastating responses due to their involvement 4. On the other hand, pre-crisis education often puts them in a better position to deal with potential situations as they arise.

Treatment & Support for Loved Ones in Crisis

Whether you have a loved one in crisis due to drug and alcohol addiction or a loved one who has spiraled into crisis due to mental health problems, loss, or outside circumstances, having the right tools at your disposal to deal with that crisis can prove essential. Seeking behavioral or mental health services can be crucial in finding stability for the person in crisis.

At Healthy Life Recovery, we help offer support to individuals suffering from addiction. We can guide the intervention process and crisis intervention. Our mental health and treatment professionals team has extensive experience walking patients and their family members through challenging times.

Sources

1: Young S. D. (2020). The Adaptive Behavioral Components (ABC) Model for Planning Longitudinal Behavioral Technology-Based Health Interventions: A Theoretical Framework. Journal of medical Internet research, 22(6), e15563. https://doi.org/10.2196/15563 

2: Roberts, Allen R, PhD. (2002.) Assessment, Crisis Intervention, and Trauma Treatment: The Integrative ACT Intervention Model. e Interdisciplinary Program in Criminal Justice at Rutgers University. https://triggered.edina.clockss.org/ServeContent?rft_id=info%3Adoi/10.1093/brief-treatment/2.1.1 

3: CISM International. What is CISM? Understanding CISM. https://www.criticalincidentstress.com/what_is_cism_ 

4: Mann, S. K., & Marwaha, R. (2022). Posttraumatic Stress Disorder. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/32644555/ 

5: Van der Velden, P. G., Contino, C., Das, M., van Loon, P., & Bosmans, M. (2020). Anxiety and depression symptoms, and lack of emotional support among the general population before and during the COVID-19 pandemic. A prospective national study on prevalence and risk factors. Journal of affective disorders, 277, 540–548. https://doi.org/10.1016/j.jad.2020.08.026

6: Everly, Jr., G. S., & Mitchell, C. T. S. and J. T. (n.d.). A primer on Critical Incident Stress Management (CISM). ICISF. Retrieved September 29, 2022, from https://icisf.org/a-primer-on-critical-incident-stress-management-cism/

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