As we evaluate the effectiveness of our intervention, we should ask ourselves, Are the critical symptoms going away?  Are things getting better?  If our answer is Yes, then we need only follow our hypothesis; our understanding of what is happening, what happened, and what might happen; and our understanding of the individual and his total situation.  If our intervention is not working, then either our definition of the crisis or our intervention hypothesis is wrong.  We need to develop either a better definition of the crisis or consider alternative intervention hypotheses.  The result of this rethinking should be the development of a new or modified intervention hypothesis.  That new hypothesis is then reevaluated in terms of its effectiveness.

Mr. H contacts us with what seems to be a fairly concrete problem.  He and his wife live on Social Security, and their check is a few days late.  He is very worried about how they are going to pay their bills and is concerned because they will not have any money to buy food.  You ask him if he has called the Social Security office to ask about his check.  Your initial hypothesis is that Mr. H needs some specific suggestions.  He says that he has called the Social Security office and in the next breath asks if you will take him to keep an appointment at his doctor’s the next afternoon.  You tell him that you will not be able to take him; you suggest that he call someone in his church.  Maybe they will give him a ride.  Your hypothesis suggests that you should try to help him think of a way to get to his doctor’s office to keep the appointment.  Instead of responding to your suggestion, he tells you that his wife is sick and may have to go to the hospital.  At that point, you reevaluate your initial hypothesis, which said that Mr. H wanted information and suggestions, and try a new hypothesis that Mr. H wants to talk with someone about his wife.  As you continue talking with Mr. H, developing and testing out various intervention hypotheses, you finally come to the conclusion that Mr. H is lonely and simply wants someone to talk with.  You say to him, You seem rather lonely and sound as if it is good to have someone to talk with.  He responds to this in a positive way, confirming your new intervention hypothesis. …

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