At my last job, I was fortunate to be trained in crisis intervention and treatment, an extremely useful skill in the world of clinical practice. Regardless of where you work or what population you work with, encountering a client in crisis is inevitable. It’s also inevitable on the licensure exam – it’s important for licensing bodies and test administrators to ensure that you know the basics of crisis intervention so that you can keep clients safe and help them through this critical juncture. Here’s how it might come up in a test item:
A 19 year-old male arrives at a community mental health clinic in a state of agitation. He reports to the intake social worker that both of his parents were killed in an automobile accident a week ago, and he has been unable to sleep since then. He has no siblings or extended family in the area and is overwhelmed by the prospect of planning funerals for both of his parents. He reports that the funeral home has been contacting him, but he has been avoiding the calls because he cannot make a decision about what to do. What should the social worker do FIRST?
A. Refer the client to a psychiatrist for a medication evaluation
B. Teach the client relaxation skills to help him sleep
C. Conduct a brief assessment and begin crisis intervention
D. Assist the client in contacting the funeral home to discuss arrangements
According to the Social Work Dictionary, a crisis is defined as “a term social workers use in two ways: (1) an internal experience of emotional change and distress and (2) a social event in which a disastrous event disrupts some essential functions of existing social institutions,” (Barker, 2003). In a basic sense, it may be helpful to think of a crisis as any event in which a person’s typical methods of coping are inadequate. So, what are the essential steps in crisis intervention? Roberts provides a seven-stage crisis intervention model: lethality assessment, establish rapport, identify problems, deal with feelings, explore alternatives, develop action plan, and follow up (Roberts, 1991). As therapists, our goal is to assist the client in “mobilizing resources and developing plans to overcome the temporary situation,” (Eaton & Roberts, 2002). It is not long-term treatment and does involve lengthy explorations into the client’s past.
The best answer choice is, in this case, C, since the client appears to be experiencing a crisis. Answers A, B, and D may all be part of the action plan associated with the crisis intervention, but would not be the social worker’s best FIRST step.
Coming up next week: Substance Use/Abuse/Dependence
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