Crisis Intervention
Chapter 3: The ABC Model of Crisis Intervention
A – Developing and Maintaining Rapport
• Developing and maintaining contact
• Basic attending skills
• Follow the client and build rapport
Basic Attending Skills
Attending behaviors:
• Eye contact
• Warmth
• Body posture
• Vocal style
• Verbal following
• Overall empathy (focus on the client)
Questioning
• Open-ended questions encourage clients to explore more of what s/he just said
Begin with “what” and “how”
• Close-ended questions get facts
Begin with “do,” “does,” “are,” sometimes “what”- e.g., What is your daughter’s name?
• Avoid “why” questions
May make the client feel defensive
• Avoid “would you,” “could you,” “can you explain”
Ask a direct question
• Avoid interrogation style in which “yes” or “no” are the answers
• Don’t interpret in your questions
e.g., “Do you feel angry?”
Ask “How do you feel?” instead
Paraphrasing
• Restating in your own words what you heard a client say
• Don’t parrot – repeat what the client has stated
• Let the client know that you understand what was said
• Don’t add things or interpret
o e.g., don’t add “because” unless the client said it
Clarifying
• Close-ended question that clarifies what the client just said.
• Don’t add anything
• “So are you saying …?” NOT “Do you feel sad?”
Reflection
• Feelings
• Painful
• Positive
• Ambivalent
• Nonverbal
• Kiss
• Don’t add content or because
• Keep focus on the emotion
Summarization
• Ties together all that has been said
• Can be used to capture the essence of the crisis
• Precipitating event, perception, emotional distress, impairment in functioning
B- Identifying the Problem
• Follow the model using basic attending skills but adding therapeutic interactions
Climbing the Cognitive Tree
• Focus on thoughts and perceptions of the precipitating event
• Explore the many thoughts connected to the first answer
• Get to the root (or the top) of the problem
Precipitating Event
• Identify in detail what has happened within the past month
• Need to connect it with current distress and cognitions
Emotional Distress and Impairments in Functioning
• Identify feelings as related to cognition
• Identify how functioning has been impaired socially, occupationally, academically and behaviorally and relate to emotional distress
Ethical Checks
• Suicide
• Homicide
• Child abuse
• Elder abuse
• Disabled abuse
• Organic concerns
• Substance abuse issues
Therapeutic Interactions
• Validation
• Education
• Empowerment
• Reframes
C- Coping
• Explore client’s own attempts
• Encourage the client to develop new coping behaviors
• Present alternative coping
• Referrals
Support and 12-step groups
Long-term marital or family therapy
Shelters or other agencies
Medical or legal assistance
Journals, books, films
Stress management, assertive training
• Commitment and follow-up
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APA
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