Page:What is Crisis.pdf/10

Steps to Take During Crisis Intervention or Emergency

Crisis Intervention Steps	Emergency Intervention Steps
Crisis intervention done well may occur within the next 24 hours and over the next several weeks. Frequent use of stage 1. Stay in Rapport Building for much of the call.	Emergencies demand an immediate, personal and flexible type of interview if a tragedy is to be averted. Go pretty quickly to Stage 4, Plan of Action after careful assessment.
Engage the caller in telling his or her story. Use open-ended questions. Learn how and why things have built up. Obtain an understanding of the meaning of the crisis for the caller, prior attempts at coping, and availability of support systems Assess for the presence of a psychological emergency. If yes, suspend crisis intervention and conduct an emergency intervention. If no psychological emergency is present, resume crisis intervention. Assess functional impairment (activities of daily living) and impulse control, ego strength, quality of relationships, etc. Take a personal history. Has this ever happened before? How did you cope with this before? How do other earlier difficulties spill over into this one? Normalize that feelings are normal for an abnormal buildup of strain and stress. Focus on coping strategies, support systems, referrals, etc.	Contain and define the emotional turmoil of the caller. Use closed-ended questions, avoid reflection of feelings, and focus on facts. Determine the degree of risk: Assess lethality: ask about it in a direct and straightforward manner. What is the level of intent? For example, on a 1–10 scale…? What is the viability of the plan? For example, access to a method, etc. What is the likelihood that the client will act impulsively? (fuse builds up, a prior history of explosive conduct, etc.) Direct him or her to appropriate care and treatment, such as inpatient or outpatient medical care. Resolve problem and allay crisis.