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Crisis Intervention

Crisis Intervention Crisis intervention is emergency first aid for mental health (Ehly, 1986). In this paper, I intend to show you a brief overview of what crisis intervention is, describe what school psychologists do and summarize the steps they may use to identify, assess, and intervene with an individual experiencing crisis. Crisis intervention involves three components: 1) the crisis, the perception of an unmanageable situation; 2) the individual or group in crisis; and 3) the helper, or mental health worker who provides aid. Crisis intervention requires that the person experiencing crisis receive timely and skillful support to help cope with his/her situation before future physical or emotional deterioration occurs. A crisis may occur when an individual is unable to deal effectively with stressful changes in the environment. A stressful event alone does not constitute a crisis; rather, crisis is determined by the individual's view of the event and response to it. If the individual sees the event as significant and threatening, has exhausted all his/her usual coping strategies without effect, and is unaware or unable to pursue other alternatives, then the precipitating event may push the individual toward psychological disequilibrium, a state of crisis (Smead, 1988). Psychological disequilibrium may be characterized by feelings of anxiety, helplessness, fear, inadequacy, confusion, agitation, and disorganization (Smead, 1988). At this point, the individual experiencing this disequilibrium may be most receptive to outside assistance, thus providing an opportunity for behavioral change and a return to balance. To summarize, a crisis results from a person's negative perception of a situation. Psychologists, counselors, social workers, mental health personnel, and therapists are trained to provide services to individuals in crisis. These workers can assist an individual or group in crisis by providing direct intervention, by identifying alternative coping skills, or by consulting with others. A helper's primary goals in a crisis are to identify, assess, and intervene; to return the individual to his/her prior level of functioning as quickly as possible; and to lessen any negative impact on future mental health. Sometimes during this process, new skills and coping mechanisms are acquired, resulting in change (Sandoval, 1988). School Psychology is a general practice and health service provider specialty of professional psychology that is deals with the practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a large range of diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families, and other systems (Ehly, 1986). School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. To do this, they perform valid assessments and intervene to promote positive learning environments which children and youth from diverse backgrounds have equal access to effective educational and psychological services to promote healthy development. School psychology has evolved as a specialty area with core knowledge rooted in psychology and education. School psychologists have advanced knowledge of theories and empirical findings in developmental and social psychology, and in the areas of learning and effective instruction, effective schools, and family and parenting processes. School psychologists concentrate on children’s development from multiple theoretical perspectives and translate current scientific findings to alleviate cognitive, behavioral, social, and emotional problems encountered in schooling (Zins, 1990). School psychologists are accountable for the integrity of their practice. They protect the rights of children and their families in research, psychological assessment, and intervention. Their work reflects knowledge of federal law and regulations, case law, and state statutes and regulations for schools and psychological services. They appreciate the importance of the historical influences of educational, community, state, federal, and organizational dynamics on academic, social, and emotional functioning of children and youth in educational settings (Ehly, 1986). School psychological services are provided in a broad array of settings (e.g., schools, workplace, school-based and school-linked health centers, as well as medical, social service, or correctional facilities). School psychologists recognize schools as a crucial context for development. They know effective instructional processes; understand classroom and school environments; understand the organization and operation of schools and agencies; apply principles of learning to the development of competence both within and outside school; consult with educators and other professionals regarding cognitive, affective, social, and behavioral performance; assess developmental needs and develop educational environments that meet those diverse needs; coordinate educational, psychological, and behavioral health services by working at the interface of these systems; intervene to improve organizations and develop effective partnerships between parents and educators and other caretakers (Smead, 1988). An essential role of the school psychologist is create information on developmental mechanisms and contexts and translating it for adults who are responsible for promoting the healthy growth and development of children and youth in a wide range of educational contexts (Caplan, 1964). The mission of the National Association of School Psychologists (NASP) is to promote educationally and psychologically healthy environments for all children and youth by implementing research-based, effective programs that prevent problems, enhance independence, and promote optimal learning. This is accomplished through state-of-the-art research and training, advocacy, ongoing program evaluation, and caring professional service (www.nasponline.org) What kinds of crises do school psychologists deal with? The kind of crisis that a school psychologist deals with depends on the age range of the children they are working with. Let’s just say, for this paper’s sake, that we are dealing with adolescents and teenagers. Some of the major crises teenagers face are eating disorders, depression, anxiety/stress, suicide, drugs and/or alcohol, and death/loss, although there are many others. The early signs of a crisis can be subtle. In order to intervene parents and family members must recognize there may be a problem and they must know how to communicate this not only among themselves, but also with others who can or should help. The following is a list of signs that are ranked approximately in terms of warning signs and critical signs. ü Changes in routine and healthy sleep habits ü Joining new group of friends who are unacceptable to parents ü Recent and dramatic drop in schoolwork, attendance or grades ü Abrupt failure or refusal to contribute to the family in terms of work ü Deception, lying and keeping their activities a secret ü Dramatic disregard for self-care and hygiene ü Abrupt change in personality, attitude and emotional stability ü Reckless, destructive and threatening behavior ü Violent, self-harming or suicidal statements or behavior What are some of the causes of these crises? In most cases it takes time for a crisis to become critical, life threatening or intolerable. Patterns of crises have usually taken place before yet another crisis quickly becomes dangerous. At some point, one can trace the cause to one or more factors. Identifying these factors can help characterize the evolution of the crisis, the appropriate response and the duration of intervention that may be necessary. ü "Brittle" or fragile emotional temperament ü Untreated parental alcoholism, drug abuse or mental disorder ü Failure to provide rules, discipline and a bonded relationship with a child Understanding the potential cause of a crisis is only useful if there are potential interventions that are comprehensive and have sufficient duration and intensity to contain and redirect the situation. There exist a range of potential interventions. The following is a comprehensive list of interventions. ü Education and training for parents and teenagers ü Individual counseling and therapy ü Increased parental involvement and supervision ü Parenting by other family members ü Police or law enforcement response The choice of intervention, the duration and the competence of those involved are critical factors to insure success. More than anything, the intervention must be appropriate to the level of risk and responsive to the underlying problem or potential cause. The key is to determine the level of risk and likelihood that problems will continue or escalate. The most reliable and systematic methods are the first and best approach in assessing risk. The "Youth At Risk Screening Questionnaire" is a method to obtain an overall measure of risk (Sandoval, 1988). The results of this questionnaire approximate the level of certainty that without an intervention, further problem behavior on the part of a teenager will continue. Higher scores are associated with higher risk or certainty of continued or worsening problems. While stabilization and symptom relief are necessary as the first step in many interventions, there must be sufficient structure and follow-up in order to prevent further crisis and to prevent relapse. Parents and family members must keep in mind that an inappropriate intervention may potentially make matters worse and can not only undermine their relationship with their child, but also could create another crisis. An inadequate response prolongs the problem and may reduce the likelihood of future intervention succeeding. Finally, there is often a cycle to the crisis that teenagers, parents and families experience. The crisis tends to grow, escalate, subside and resurface in a pattern of increasing emotional, psychological and behavior problems. Brief periods of normalcy are typical in crises involving teenagers. During these periods, teenagers can become more cautious, reflective or sincerely remorseful. Whether the crisis represents a turning point or not will depend on whether or not the appropriate intervention is designed and followed through with. In summary, crisis intervention provides the opportunity and mechanisms for change to those who are experiencing psychological disequilibrium, who are feeling overwhelmed by their current situation, who have exhausted their skills for coping, and who are experiencing personal discomfort. School psychologists identify, assess, and intervene with the individual in crisis so as to restore balance and reduce the effects of the crisis in his/her life. The individual is then connected with a resource network to reinforce the change. Bibliography:

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