Crisis Intervention Counseling

A crisis occurs when an individual feels overwhelmed by events. The crisis may be precipitated by events which bring about sudden change to the person's environment . It may also be linked to factors unrelated to any mental health issues such as a tragedy such as a school shooting or work place incident, which in turn precipitates a crisis requiring intervention. Usual coping mechanisms fail and new strategies may be tried but, if these also fail, an increasing state of anxiety and poor morale develops. Maladaptive coping strategies, such as substance abuse, deliberate self-harm or violent behaviour, may also be applied. Further escalation leads to a state of decompensation in which normal psychological functioning breaks down, most commonly causing panic attacks and disabling anxiety, suicidal intent or psychosis.

Crisis therapy aims to intervene as soon as possible after the onset of the crisis in order to enable the individual to overcome it, minimise the usage of maladaptive coping strategies and avoid complete psychological breakdown. It is a short-term intervention, which may require intensive involvement of the therapist with the patient and sometimes also members of their family.​

Key elements of management

  • Management will depend on the severity and cause of the crisis, as well as the individual circumstances of the patient.

  • Many relatively minor crises can be managed by providing friendly support in primary care, without referral.

  • More severe crises will require referral to counselors or the local Mental Health Team.

  • Crisis therapy includes short-term behavioural/cognitive therapy and counseling.  Involvement of family and other key social networks is very important.

  • Therapy should be relatively intense over a short period and discontinued before dependence on the therapist develops.

  • The risk of suicide and self-harm must be assessed at presentation and at each review.

  • The aims of treatment are to:

    • Reduce distress.

    • Help to solve problems.

    • Avoid maladaptive coping strategies - eg, self-harm.

    • Improve problem-solving strategie

Batten down the Hatches