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Crisis Intervention: A Social Interaction Approach (4)
Chapter 4 - The Assessment Set
Crises are not always what they seem to be. For example, Michelle is in what might be considered a suicidal crisis, that is, she might kill herself if something is not done. To the casual observer, it may seem that the “possible suicide” is the crisis. Of course, Michelle’s killing herself is the “potential” of the crisis. But it is not the crisis itself. The crisis exists in the temporary and serious interaction problem between Michelle and her situation.
Wanda’s anger is almost rage like. “That bastard—my husband—can’t think that he can treat me that way and that I’ll just sit around and do nothing. He’ll find out that I’m not just that quiet little mouse he thinks he married. I’m going to do it this time. I won’t stand for it. He can’t do that and get away with it.”
What did Wanda’s husband do? What is she going to do? From her initial angry comments, we are unable to answer either question. Nonetheless, considering how angry she is, we get a sense that her actions may not work out very well. Within those actions lies the now potential of the crisis. Whatever her husband did seems to have precipitated the crisis. We can see, then, that Wanda is between the precipitating event and acting out the now potential. For her, though, the crisis is now. Her present interaction (with you) is the first focal point. Your assessment of her crisis will expand to include both the precipitating event and the now potential. You will look at possible causes and possible cumulative effects. Gradually, you can develop a picture of her crisis in a careful and caring way. Nonetheless, starting where Wanda is now and expanding your understanding from there allows you to assess her crisis effectively, gives emphasis to your “now” relationship with her, avoids the possibility of oversimplifying the crisis, on the one hand, or seeing it as more complex than it really is, on the other. You can help Wanda both understand and deal with her crisis as it really is. …
CRISIS FOCUS
Thus far, we have located the conflict within the interaction between the individual and his total situation. We have determined that it has a high now potential and a low self-resolution factor, justifying our intervention. We have asked, “What happened,” and are developing an understanding of the precipitating event. Our picture of the crisis is taking on form and content. We are ready to consider the assessment set. From this point on, crisis intervention is unlike more traditional forms of counseling and therapy. Traditionally, we want to know as much as possible about the person; his total situation; his “now,” “then,” and “when”; and as many other related factors, situations, conditions, circumstances, and events that possibly concern the individual and his situation now. Our “picture” needs to be as complete and as detailed as possible. To achieve this level of understanding requires long-term interaction between therapist and “patient” as well as a high level of skill and training on the part of the “therapist.”
In crisis intervention, our focus is considerably more narrow, centering sharply and clearly on the crisis itself. This point can hardly be overemphasized, and as a test of crisis focus, we should always consider these questions.
1. Specifically, what is likely to get worse?
2. How bad might it get?
3. If things get worse, what is the potential effect and on whom?
4. Why do we think the individual or someone else in the crisis will not be able to deal with it?
If we can adequately and clearly answer these four questions, we may conclude that we have clear crisis focus. Crucial to effective intervention, then, is maintaining that clear focus throughout the crisis intervention process. Establishing and maintaining this crisis focus enab...
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By Gary CrowChapter 4 - The Assessment Set
Crises are not always what they seem to be. For example, Michelle is in what might be considered a suicidal crisis, that is, she might kill herself if something is not done. To the casual observer, it may seem that the “possible suicide” is the crisis. Of course, Michelle’s killing herself is the “potential” of the crisis. But it is not the crisis itself. The crisis exists in the temporary and serious interaction problem between Michelle and her situation.
Wanda’s anger is almost rage like. “That bastard—my husband—can’t think that he can treat me that way and that I’ll just sit around and do nothing. He’ll find out that I’m not just that quiet little mouse he thinks he married. I’m going to do it this time. I won’t stand for it. He can’t do that and get away with it.”
What did Wanda’s husband do? What is she going to do? From her initial angry comments, we are unable to answer either question. Nonetheless, considering how angry she is, we get a sense that her actions may not work out very well. Within those actions lies the now potential of the crisis. Whatever her husband did seems to have precipitated the crisis. We can see, then, that Wanda is between the precipitating event and acting out the now potential. For her, though, the crisis is now. Her present interaction (with you) is the first focal point. Your assessment of her crisis will expand to include both the precipitating event and the now potential. You will look at possible causes and possible cumulative effects. Gradually, you can develop a picture of her crisis in a careful and caring way. Nonetheless, starting where Wanda is now and expanding your understanding from there allows you to assess her crisis effectively, gives emphasis to your “now” relationship with her, avoids the possibility of oversimplifying the crisis, on the one hand, or seeing it as more complex than it really is, on the other. You can help Wanda both understand and deal with her crisis as it really is. …
CRISIS FOCUS
Thus far, we have located the conflict within the interaction between the individual and his total situation. We have determined that it has a high now potential and a low self-resolution factor, justifying our intervention. We have asked, “What happened,” and are developing an understanding of the precipitating event. Our picture of the crisis is taking on form and content. We are ready to consider the assessment set. From this point on, crisis intervention is unlike more traditional forms of counseling and therapy. Traditionally, we want to know as much as possible about the person; his total situation; his “now,” “then,” and “when”; and as many other related factors, situations, conditions, circumstances, and events that possibly concern the individual and his situation now. Our “picture” needs to be as complete and as detailed as possible. To achieve this level of understanding requires long-term interaction between therapist and “patient” as well as a high level of skill and training on the part of the “therapist.”
In crisis intervention, our focus is considerably more narrow, centering sharply and clearly on the crisis itself. This point can hardly be overemphasized, and as a test of crisis focus, we should always consider these questions.
1. Specifically, what is likely to get worse?
2. How bad might it get?
3. If things get worse, what is the potential effect and on whom?
4. Why do we think the individual or someone else in the crisis will not be able to deal with it?
If we can adequately and clearly answer these four questions, we may conclude that we have clear crisis focus. Crucial to effective intervention, then, is maintaining that clear focus throughout the crisis intervention process. Establishing and maintaining this crisis focus enab...