Analysis of a crisis intervention session

Introduction

An individual is considered to be in a crisis when they are faced with an event or situation that they deem too big for them to handle due to personal inadequacies and/or limited resources and it exceeds their tolerance capabilities (James & Gilliland 2005, p. 19). Crisis intervention is therefore the immediate help offered by a professional with the objective of helping the persons in crisis – client – to reestablish pre-crisis situation or achieve equilibrium (Echterling et al., 2005). To achieve this objective, there are a number of strategies and models available for counselors to use during a counseling session. This essay will analyze a presented case as per the guidelines of James & Gilliland (2005) and reflect on the same from a clients as well as the counselor’s stand point.

Case overview

The case study in focus is a crisis intervention session involving Louise – the client – and Elaine the counselor. The client is a first year student who is facing difficulties with her course work and the counselor is the university counselor for students’ affairs. The client is finding it difficult to coup with the course requirements, in particular, this one assignment she is supposed to write therefore; she is in a crisis. She seeks help from the university counselor who offers to hear her out, hence crisis intervention. The session according to the counselor is meant to run for twenty minutes and it is effectively within that time frame, with two spillover minutes.

Case analysis

James and Gilliland (2005, p. 19) proposes the assessing six-step model for counseling. The assessing model is a pervasive strategy that is action-oriented and situation-based. This model is founded on the six steps involved in a crisis intervention session namely; problem definition, ensuring client safety, providing support, examining alternatives, making plans, and obtaining commitment to action from the clients. These steps can be grouped into two categories of listening, step one to three and action from step four to step six. The case study is determined to follow this six step model. Additionally, the counselor seems to combine the non-directive and collaborative technique. In the better part of the session, the counselor allows the client to come up with the way forward even though in some parts, the counselor provides some solutions by saying “I would do…” but then she makes it clear it is the responsibility of the client to make the final decision.

1. Defining the problem

According to James and Gilliland (2005, p. 20) unless the counselor perceives the problem the same way the client does, then all the crisis intervention efforts might miss out and be of no importance to the client. To define the problem, the counselor has to listen effective and affording to Kim (2008, p. 108), effective listening by a social worker can be attained through training in the core listening skills. These core listening skills require the counselor to employ empathy, genuineness, and positive regard. To establish the problem from the client’s point of view, the counselor has to listen and allow the client to speak. In the provided case session, the counselor has used this step effectively. Within the first one two minutes of the session, the client has used the largest chunk of time alone. From 00:45 to 1:44, the client is speaking with the counselor intently listening. The client uses this time to bring to the fore her problem.

According to Echterling et al. (2005), this step should also provide for a relation building between the client and the counselor. The intention to visit the counselor by the client might be based on situation, for example in the case study, it is between a student and the students counselor therefore the educational-setting facilities the session. However, for a client to open up fully concerning the problem depends on the relationship between the two involved. In the case file, the counselor has sought to build a strong relationship with the client though empathy and positive regard.

2. Ensuring client safety

Safety is a core part of the crisis intervention process for the client, the counselor, and other (James & Gilliland 2005, p. 21). It is the responsibility of the counselor to see to it that the requisite safety measures are observed throughout the session. The client can be a danger to other and self, or might be facing some danger from someone else. To help such a client it is important to control them and bring them to constraint, or make them safe from the impending danger. Among the crisis intervention cases that will require heightened safety measures include suicidal attempts, homicide, and fear of the safety of a loved one from a third party among others (Echterling et al. 2005).

In the provided case study, even though the client doesn’t seem to pose danger to self or other, the counselor has used various methods all through the session to ensure the client is not only safe, but also comfortable. In 00:26, the counselor asks “do you find the place okay?” to find if the client is comfortable. The counselor is keen to quote the confidentiality terms for the session. When the issue of the client’s father comes up from 8:05 to 8:10, the counselor is interested to establish more about the father.

3. Providing support

The counselor should make the client feel valued, prioritized, and cared for. To achieve this, the counselor should communicate this to the client and not assume the client will figure it out (James & Gilliland 2005, p. 21). In the case study crisis intervention session, within the 25 seconds of the session, the counselor appreciates the client and thanks her for taking considering and taking the time to visit the counselor.

4. Examining alternatives

One of the characteristics of persons in crisis is that that they think there are no options available for them (Cuijpers et al. 2007, p. 10). This step is critical in opening up clients to the wide array of option available to them. According to James & Gilliland (2005, p. 21), this is part of the action phase of a session and the alternatives available can be situational support, coping mechanisms, or adoption of positive and constructive thinking patterns.

Throughout the case study crisis intervention session, the client is able to independently explore various solutions on how to deal with the crisis. Even though in some occasions the counselor helps in proposing the possible solutions, it is the client who makes the final decisions through exploring ways trough which she has previously death with other difficult situations measuring to the magnitude of the crisis at hand. The better part of the crisis intervention is spent on this part. After the problem has been identified, the counselor helps the client to brainstorm and establish the possible solution to dealing with the crisis.

5. Making plans

The fifth step in the crisis intervention model is to come up with an elaborate plan on how the client will restore the pre-crisis situation or achieve equilibrium (James & Gilliland 2005, p. 22). The plan should identify and involve other resources for example, friends which the client has identified in the case study, and coping mechanisms. According to Sheldon & Macdonald (2009), the plan should be practical and realistic and provide a systemic problem solving strategy and coping strategy. In addition, the plan should be made at least in collaboration, if not nondirective, with the client for the purpose of making the client identify and own the plan as theirs.

In the reference crisis intervention case, an elaborate action plan has been established to help the client deal with the difficulties in her studies. The plan has three actions; the client to contact, go out to a movie or visit the gym, and share the problem with her friends, to seek additional help for example from the lecturer, reflect on how she wrote previous report at work, and reflect on how personal stuff connects with the content to the paper she has to write (21:05-22:15). The plan should take effect from the following day when she has to meet her friends. According to Cuijpers et al (2007, p. 13), physiological therapy through exercises is one of the way to relax the brain by refocusing on other issues and it has been shown to help in increasing productivity of the brain.

6. Obtaining commitment to action

The final step of the six-stem crisis intervention model is to gain commitment from the client. According to James & Gilliland (2005, p. 22), this step flows easily from step five for an effective crisis intervention process. This is done through a number of way for example, asking the client to summarize the action plan.

In the case study, the counselor asks the client, “What is the most important thing in the last 15-20 minutes…” (19:55-20:02). In addition, commitment is evident when the client is able to give a start time for the implementation of the plan even before the counselor can ask. Moreover, the willingness of the client to schedule an appointment for follow-up purposes is an indication of the commitment she has.

Conclusion

The crisis intervention session referenced in the essay, is between student in crisis due to difficulties in managing course work – in particular a writing task and the student counselor. The student is the client and the student counselor the counselor. The crisis intervention takes the James & Gilliland six-step model. The first step is to identify the problem which the counselor does by listening to the client and asking questions to find out more until she is able to establish that the client is faced with difficulties in writing the assignment paper due to personal stuff. The second step is ensuring client safety, but because the client is not in a danger situation to self or others, all the counselor does is to make the client comfortable. The third step is providing support and the client does so through empathy and positive regard. The fourth step is to examine the possible alternatives and the counselor nondirective and collaboratively helps the client to identify the possible solutions. First, they make a plan how to go about solving the crisis and lastly, a commitment to the established plan is obtained from the client. Therefore, the case crisis intervention session is considered a success because it was able to achieve the objective of crisis intervention: to restore the client to the pre-crisis situation or achieve equilibrium.

References

1. Cuijpers, P., van Strated, A., & Warmerda, L. 2007. ‘Problem solving therapies for depression: A meta-analysis.’ European Psychiatry, 22, 9-15.
2. Echterling, L. G., Presbury, J. H. & McKee, J. E. 2005. Crisis intervention: Promoting resilience and resolution in troubled times. Upper Saddle River, NJ: Merrill/Prentice Hall.
3. James, R.K. & Gilliland, B.E. 2005, ‘Basic Crisis Intervention Skills’, in Crisis Intervention Strategies, 4th edn, Wadsworth/Thomson Learning, USA, pp. 19–50.
4. Kim, J.S. 2008. ‘Examining the Effectiveness of Solution-Focused Brief Therapy: A Meta-Analysis.’ Research on Social Work Practice, 18(2), 107-116
5. Sheldon, B. and Macdonald, G. 2009, A Textbook of Social Work. Abingdon, Routledge.