A Hybrid Model of Crisis Intervention

Perhaps the biggest change in the seventh edition of this book is our notion of how a model for crisis intervention operates. There are numerous models for crisis intervention (Aguilera, 1998;

Kanel, 1999; Kleespies, 2009; Lester, 2002; Roberts, 2005; Slaikeu, 1990). All of these models

depict crisis intervention in some linear, stepwise fashion. Indeed, through 20-plus years of

publishing this book we did much the same, with the admonition that changing conditions might well

mean that the interventionist would have to recycle and move back to earlier steps. In our earlier

model we depicted crisis intervention as starting with problem exploration, examining safety

concerns, looking for support, examining alternatives to present behaving, planning how to restore

equilibrium, and finally gaining a commitment to take action. We no longer believe that a stage or

purely step model captures the way crisis intervention works, and here’s why.
The problem that we have struggled with as we try to teach students like you about crisis

intervention is that at times crisis is anything but linear. A lot of the times crisis intervention

absolutely epitomizes chaos theory—with starts, stops, do-overs, and U-turns. At times doing crisis

work is a lot like being a smoke jumper, controlling a psychological brush fire on this side of the

mountain only to be faced with a new one on the other side of the valley. Fighting those

psychological fires according to a neat, progressive, linear plan is easily said but not so easily

done. Therefore, we have combined our former linear model with a systems model we helped develop

(Myer, James, & Moulton, 2011), resulting in what could more appropriately be called a hybrid model

for individual crisis intervention that is generally linear in its progression but can also be seen

in terms of tasks that need to be accomplished. While certainly some of these tasks would usually

be done in the beginning, middle, or end of a crisis, changing conditions may mean you have to

accomplish some task you would normally do later, first. Or indeed, a task you thought was already

accomplished comes apart and has to be done over not once, but multiple times.
A further problem with a strict linear model is that each step should be discrete, following from

step one to step two and so on, with particular techniques to employ in each of those steps. In

crisis intervention, issues suddenly erupt that defy discrete, stepwise techniques. Focus on

getting a commitment from a person to do something, which would normally come at the end of a

crisis session, may need to happen immediately if that person is standing out in the middle of a

busy intersection at rush hour! Likewise, gaining that commitment to get out of the street may call

for assertion techniques that are anything but what we might normally do when making initial

contact with a client. Consider the following analogy.
Picture yourself as a linesperson on the cross arm of a power pole, hard hat on, heavy insulated

clothing, leather over insulated gloves, dug in with your climbing spikes, attempting to repair a

high-voltage (crisis) transmission line in North Dakota in January with the wind blowing sleet in

your face at 20 miles an hour. On your utility belt are a variety of tools. You know the steps

required to get the transformer hooked back up and the sequential manner in which you will employ

the tools on your belt to get the job done. The problem is, Mother Nature is not happy and the wind

picks up and a coupling breaks loose or a new fuse you just put in blows and you have to start all

over again! If you can picture this analogy in your mind’s eye, you are well on the way to

understanding how crisis intervention works. As we describe the model, we will give you some

examples of when you have to change tools to meet the changing conditions up on that pole.
The model you are about to examine is the hub around which the crisis intervention strategies in

this

book revolve, and the tasks/steps are designed to operate as an integrated problem-solving process.

It is not complex, but rather is designed to be simple to implement, easy to use, and adaptable to

just about any crisis we can think of you would likely encounter.
Task 1. Predispositioning/Engaging/Initiating Contact
Predispostioning may be seen as first and foremost getting ready to do something. It is usually the

first step in a crisis model: placing oneself, or something, in a position to be of use in some

future occurrence. Typically, systems such as the armed forces and government agencies such as FEMA

use predispositioning to get supplies, equipment, and personnel ready to meet some future

emergency. Indeed, in Chapter 17, Disaster Response, you will see predispositioning in operation on

a very large scale. In the counseling literature, predisposition was originally studied by

Prochaska, DiClemente, and Norcross (1992) in regard to what motivated people who were suffering

from addiction to decide to change. Since their seminal work, the concept of predisposing clients

to get them ready for counseling has become widespread.
In crisis intervention, predisposition is somewhat different. It means predisposing individuals to

be receptive to our intervention when, in many instances, they may not be at all enthused about our

presence or be so out-of-control that they are only vaguely aware of us. Therefore, predisposition

has a lot to do with the attitudinal set and predisposition of how the crisis worker enters the

situation. A number of clients the crisis worker will meet do not act, talk, look, or even smell

nice! The ability to convey empathy and be authentic as to who and what you are doing without

pretense is critical (Kleespies & Richmond, 2009).
Particularly with a first contact, predispositioning the client as to what to expect is critical.

Along with letting the client know what is going to occur, it is important to make contact in such

a way that the client can see the interventionist as an immediate ally and support, and not another

in a long line of people, representative of bureaucracies and institutional authorities, who have

been anything but helpful in resolving their problems. One of the most critical initiating

components of crisis intervention is how the worker introduces him- or herself to a client who has

never met the crisis interventionist—which is a fairly common occurrence in this business. It is

not just to fill time that our practicum training with aspiring crisis intervention team police

officers now devotes an initial session specifically to how the officer introduces him- or herself

to a recipient of services (Memphis Police Department, 2010). Our primary objectives in

predisposing an individual to accept crisis intervention are twofold: (1) to establish a

psychological connection and create a line of communication and (2) to clarify intentions with

regard as to what is going to happen.
Establishing Psychological Connection.
First and foremost, you need to introduce yourself in a way that is nonthreatening, helpful, and

assumes a problem-solving as opposed to an adversarial approach.
Leron: (standing in the middle of a main city street in five o’clock rush

hour traffic waving two broken whiskey bottles) The God damned house authority. NO place to live.

Kicked me out, the rotten bastards. Everybody needs to know them for the crooks they are. CIT

officer: (slowly approaching the subject from a distance with hands visible, empty, and open) Man!

You really are angry with them to make this kind of statement out in the middle of Union Avenue

during rush hour. My name’s Scott Lewis, a CIT officer with the Memphis Police Department. I didn’t

catch your name. Mind telling me?
One of the most important elements in making first contact is getting the client’s name and

introducing yourself in a nonthreatening manner. Note that Scott approaches the subject slowly, not

only because he is armed with two whiskey bottles (which has to do with another task that is pretty

important here, providing for the client’s safety and your own), and responds to his current

affective and behavioral state of being. Before he ever asks a question about why this has

happened, he immediately states his name and asks for the client’s. Also note that his full name,

not his rank or the police department, comes first.
Another advantage with the approach used by Scott is that he allows Leron to maintain some control

over the situation. The housing authority has already taken his home and barred him from his

belongings. Imagine if Scott rolled onto the scene and immediately began demanding Leron get out of

the street and put down the whiskey bottles. Scott would likely get the response “screw you, cop.”

Scott would be seen as just another authority figure who doesn’t listen. By establishing a

problem-solving, helpful connection, Scott allows Leron to maintain momentary control of the

situation. By reflecting Leron’s anger, the crisis worker immediately attempts to convey empathic

understanding of the

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