Overview
The crisis intervention model is a social work practice model of brief, intensive help for individuals or families in crisis. A crisis is not the hazardous event itself but a state in which a person cannot handle the event with their usual problem-solving methods and loses psychological balance. The same event may or may not become a crisis for different people. A crisis is seen as both a danger and an opportunity to learn new ways of coping.
Theoretical background
- Erich Lindemann studied relatives of victims of the 1942 Cocoanut Grove nightclub fire in Boston and described the symptoms of acute grief and the course of normal mourning (1944), showing that timely help could prevent pathological reactions.
- Gerald Caplan systematized crisis theory from the standpoint of preventive psychiatry. He held that a crisis is usually resolved one way or another within about four to six weeks, and that the help received in that period shapes later mental health.
- Ego psychology, stress and coping theory, and research on stress responses such as the general adaptation syndrome later broadened the model's foundations.
Types and stages of crisis
- Developmental crises: predictable transitions such as birth, adolescence, marriage or retirement.
- Situational crises: unforeseen events such as accidents, job loss, illness, crime or disasters.
- Existential crises: inner conflict over purpose, meaning and responsibility.
- Course of a crisis: often described as hazardous event → vulnerable state → precipitating factor → active crisis → reintegration. Adaptive reintegration restores or even raises functioning; maladaptive reintegration leaves it lower than before.
Roberts' seven-stage model
Albert R. Roberts organized crisis intervention into seven stages that are widely used in practice:
- Psychosocial and lethality assessment (risk of suicide or harm)
- Rapidly establishing rapport
- Identifying the major problems and crisis precipitants
- Dealing with feelings and emotions (active listening, validation)
- Generating and exploring alternatives and coping strategies
- Developing and carrying out an action plan
- Follow-up
Principles and limits
- Principles: immediate response, focus on the present problem and the here and now, limited goals, an active and directive worker, use of the client's strengths and support network, and instilling hope. If longer-term support is needed once the crisis eases, the client is linked to case management.
- Applications: suicide crisis counselling, support after disasters and accidents, protection of victims of domestic and sexual violence, bereavement and loss, and mental health emergencies. Grief models such as the five stages of grief are sometimes consulted alongside it.
- Limits: as a brief model it cannot resolve chronic or structural problems, and directive intervention may weaken client self-determination, so it is often combined afterwards with strengths-based approaches such as the empowerment model.
References
- Lindemann, E. (1944). Symptomatology and management of acute grief. American Journal of Psychiatry, 101(2), 141–148.
- Caplan, G. (1964). Principles of Preventive Psychiatry. New York: Basic Books.
- Roberts, A. R. (Ed.). (2005). Crisis Intervention Handbook: Assessment, Treatment, and Research (3rd ed.). New York: Oxford University Press.
- James, R. K., & Gilliland, B. E. (2017). Crisis Intervention Strategies (8th ed.). Boston: Cengage Learning.