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Focusing on Immediate or Crisis Intervention

Focusing on Immediate or Crisis Intervention

Clients will come to therapy with a wide variety of needs, some may need long-term work after suffering years of abuse or mental illness, while other may be in a tight spot and want someone to listen while they talk things out. They also come from a wide variety of economic backgrounds as well, and some may not be able to afford seeing someone for months or years. If you have someone that may have financial difficulties, and there is work you want to do with them, a focus on the immediate needs, or even crisis intervention may be beneficial. Here is a brief framework to use when employing a very brief or crisis-oriented model; consider this like a drop-in model, do what you normally do as per your theory or orientation of preference but build it around these steps. 

Before anything, be upfront with the focus of the treatment based on the financial realities they face. What is vital is to present this as a valid treatment option, which it is, but the client must have hope and must believe in it. If they do not, then likely nothing you do will make an impact. The caveat is that it must be reasonable to do so, obviously do not present brief intervention as a cure for schizophrenia, but you could present it as a way to help someone with schizophrenia manage negative interactions at work. Framing it as something specific is a way to help keep the intervention targeted and brief. 

Empathy.  This one does not need to be explained, but empathy is the key and the primary tool to use. Empathy as well as warm, genuineness and respect will help establish a strong rapport, which will allow you to work quickly and do intervention over the course of three or four sessions that the client will follow and accept. A motivated client that is accepting of treatment is worth a lot. 

Understanding is another tool to use. Where does this feel familiar? When have you felt this way before? Pretty standard questions, but it helps the client to see the broader context of their life and the patterns they have. The other trick to this is that it is building the framework to utilize coping skills to manage distress and also explore other options when they see or feel themselves at a similar point in their lives. 

What exactly do they want to have happen? The magic wand question is used with quite a bit of effectiveness to help guide counseling and set treatment goals, and for an immediate or crisis intervention can be used with the same efficacy. Both the therapist and the client need to have an idea of where they are going to make sure they can actually get there. Without this, it is literally like trying to get somewhere you have never been without a map. There is also a power in having the client say out loud and own what it is they really want and what they want to change in their lives. It gives a sense of ownership and responsibility that can be subverted all too easily when we go off in directions the client does not actually want to go. 

Explore options. What else could you have done? What could you differently net time to meet you goal of ______? What ways would you sabotage that? Again, these are standard questions that are used frequently already, but bring them in with the focus of helping the client find immediate ways to take steps to change their lives. Mindfulness based approaches do well here by helping the client open themselves up to possibilities they would not normally think about. 

Coping skills, coping skills, coping skills. These are almost therapy 101, but they cannot be talked about enough. Helping clients learn to manage distress, when to use those techniques, and have them practice it will be imperative to success for them. It is even useful to have a coping skill plan written out for them, so they do not have to try to remember what to do when they are already under stress and their minds are not the clearest. Give them a tool and have them put it on the refrigerator of what their triggers are, what the warning signs are, what to do, who they can call, and emergency contacts if necessary so all they have to do is look at their tool and it brings them back and focuses them on coping. 

A brief intervention can give clients the skills and options they need for a more economical cost. It can work very well with clients that have low or moderate level problems, or for those who can have a very tight focus on one or two specific areas. Above all it can give clients hope when they feel like the help they need is beyond their reach. 

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Jason Simpkins
Posted on 05/25/2018 by Jason Simpkins

Jason Simpkins is a writer at Open Counseling. He is a clinical social worker in Michigan and is dedicated to having quality mental health care available to everyone. And as a University of Michigan graduate, he says a hearty, Go Blue!



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