Identify how functioning has been impaired socially, occupationally, academically and behaviorally and relate to emotional distress

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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Identify how functioning has been impaired socially occupationally academically and behaviorally and relate to emotional distress

APA

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