A crisis occurs when a stressful life event overwhelms an individual’s ability to cope effectively with a real or perceived threat (Auerbach & Klimann, 1997; Everly & Mitchell, 1999; Sandoval, 1985) A crisis may be further broken down as a response condition wherein:
- An individual’s internal balance or homeostasis has been disrupted
- An individual’s usual coping mechanisms have failed to reestablish this balance
- The individual experiences some evidence of functional impairment due to the stress caused by the crisis (Caplan, 1961, 1964; Everly & Mitchesl, 1999).
The term “critical incident” is used to describe the stimulus or stressor event that preceded the crisis response. Some examples of extreme stresses are natural disasters, war, torture, rape, and other human acts of violence. These can result in psychological trauma and PTSD (post traumatic stress disorder) (American Psychiatric Association, 1994). Other critical incidents that may occur are facing actual or threatened death, serious bodily injury, or witnessing the events occurring to others. Crisis may also emerge as the result of a contradiction to some deeply held belief (Everly & Lating, 1995).
As individuals mature and develop, they continually meet new demands and stressors. These challenges could be intellectual, job-related, economic, or relationship problems. As an individuals meets these challenge they acquire practice resolving them. As this occurs they develop healthy coping mechanisms. However when an individual has to confront events they have not encountered in the past, they may not have developed adequate coping skills to deal with the new stressor. These critical incidents leave the individual feeling overwhelmed and powerless. To compound their distress, these incidents cause their heightened emotions and adrenaline to impair their ability to think rationally and cope effectively. The crisis response then overrides their normal psychological and biological coping mechanisms. The anxiety this causes further serves to disrupt their ability to think and cope effectively in an already incomprehensible circumstance for them.
Over the years, crisis intervention has proven to be an effective tool in assisting victims of all types of critical incidents, especially the extreme stressors that may result in psychological trauma (Everly, Flannery, & Mitchel, 2000). Crisis intervention is the administering of emergency psychological care to individuals to assist them return to a healthy manner of coping and to prevent prolonged negative long term impact of the trauma.
Teens in need of intervention are teens that develop high risk factors and behaviors that create negative consequences in their lives. Not all crisis responses are caused by single or one-time events. Many are the result of months or years of problems and issues that went unaddressed. In teens, the result is they often exhibit problems with drug and alcohol use, violence and suicide threats.
There is a wide range of potential teen interventions possible depending on the severity of the situation. The following is a list of interventions.
- Psycho education
- Therapy (individual, family or group)
- Family therapy
- Increased parental involvement and meaningful connection
- Increased supervision
- Change schools or move to new area
- Outdoor or wilderness adventure programs
- Parenting by other family members
- Foster care
- Private or Boarding school
- Day treatment program
- Therapeutic Boarding School
- Residential treatment program
- Psychiatric hospitalization
- Law enforcement involvement
The intervention should match the level of need. A teen skipping class could possibly use tutoring or increased parental involvement as opposed to wilderness camp or a drug detox center. Likewise a teen using drugs and alcohol may benefit from residential drug treatment more than a self help book or just moving and hoping the problem goes away.
Principles of Intervention
Whether the intervention is for an adult or a child/teen, there is agreement on some common principles that seem to alleviate the acute stress being experienced by the individual. Although there is not one model of crisis intervention, the following is a list of general principles to that are commonly followed;
Urgency – Intervene immediately if the crisis is emotionally traumatizing and can immobilize the person.
Stabilize – Mobilize resources, community and support networks to recreate some semblance of routine.
Provide Understanding – The goal is to restore the individual to their pre-crisis level of function. This is established by debriefing or gathering facts about what has happened, listening to the individual recount the event, and encouraging the expression of difficult emotions that relate to the event. This will begin to help the individual understand the impact the crisis has had on them.
Problem Solving – Individuals in crisis may be immobilized or in a state of “learned helplessness” and despair. They may need instruction and assistance in assessing the problems at hand and strategies to address the immediate issues. This enhances their independent functioning in the long run.
Encourage independent functioning – Self reliance is ultimately a goal. Along with problem solving, the emphasis should be placed on restoring their self reliance and ability to cope independently.
Drug and Alcohol Intervention
The greatest problem with drug or alcohol abusers is denial. They usually do not know or will not admit that they have a problem with drugs or alcohol. They argue that they are normal or are at least in control. Receiving honest and objective feedback from a skilled interventionist and the support of family and friends can assist them in realizing the gravity of the situation. The drug intervention process helps an abuser recognize the impact of their use on those around them and to hear of consequences should they refuse help or drug addiction treatment. People used to believe that a drug abuser could only get better if he was self-motivated to change. This is an outdated idea. Almost every addict that gets sober is mandated by some external force to stop using whether it is the liver, spouse, job, legal trouble or any wide variety of causes. Therefore an experienced professional can help motivate an abuser toward recovery at any stage of addiction.