Table of Contents
Crises refer to a state of emotional turmoil and/ or cute emotional reactions to powerful stimuli or demands. Crises manifest through three characteristics: the distortion of the balance between the thinking and emotions of an individual; the failing of the usual mechanisms of coping; and impairment being evident in a group or an individual. Crises tend to occur when people face actual or threatened death to their physical integrity. Individuals may undergo victimization following experiences such as witnessing the occurrence of these events on other people. Crises can also be caused by deeply held beliefs being contradicted. This paper seeks to give an insight to crisis intervention management from the perspective of a public safety officer.
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Crises can be defined as acute disruptions of psychological homeostasis where the usual coping mechanisms of individuals fail, and where there also exists the evidence of distress and functional impairment. Crises can also be defined as the subjective reactions to the stresses of life experiences that undermine the stability and ability of an individual to cope or function. The main causes for crises are stressful, traumatic, and or events deemed as hazardous events. These are coupled by other necessary conditions. These are the perceptions of the individuals of the event as being the cause of significant upset and/ or disruption, and also the ability of the individual to resolve the resultant disruption through the use of previously applied coping mechanisms. Crises can also be defined as a disruption of a state of steadiness. This has five aspects: hazardous or traumatic events; a state of vulnerability of unbalance; precipitating factor; active crises on the basis of the perception of an individual; and the resolution of the crises. Crises intervention is most often provided by firefighters, emergency medical, police officers, and/ or search or rescue personnel, nurses, and community members.
Crisis intervention is guided by three basics: mitigation of the impact of an event, facilitation of normal process of recovery, and the restoration of the adaptive function of an individual. Techniques of crisis intervention adhere to several principles. These are: simplicity: people’s responses in crisis situations are facilitated by the adoption of simple procedures to ensure best chances of positive impact. Brevity in the sense that psychological first aid should take a short time, for instance they should range from minutes to an hour. Innovativeness through the use of creativity since certain instructions may not hold for every scenario. Pragmatism is also essential through keeping things practical since impractical suggestions could result in more frustrations which can be undesirable given the crisis situation. Support serves provided should also be close to an individual’s functioning areas. The proximity is also bound to the idea of a safe zone (Polk, Mitchell & Gulli, 2008). Crisis management should also be guided by immediacy in the provision of services, since addressing them requires rapid interaction, otherwise delays could result in the effectiveness of the support services can be undermined. Crises management should also be guided by the expectancy of reasonable positive results. The people or groups in crises ought to be encouraged to acknowledge that help is available, that there is hope and that the situation can be managed.
Crisis Intervention Models
There are two major models of crisis intervention. These are the Seven-stage Crisis Intervention Model by albert Robert, and the Critical Incident Stress Management intervention system by Mitchell. Other include Psychological First Aid, Stress First Aid and Mental Health First Aid
Robert’s Seven Stage Crises Intervention Model
Seven critical states are identified by Robert, and are experienced in the process of stabilization of crises, their resolution and mastery. These are the planning and conducting assessments of biopsychological and lethality/ imminent danger. Biopsychological assessment should include the environmental supports and stressors, medications and medical needs, current drug and alcohol usage, as well as the external methods and resources for coping used by the clients. Lethality assessment should determine whether suicide attempt have been made, and imminent danger should establish whether the person faces the risk of domestic violence and sexual abuse (Roberts & Ottens, 2005).
Psychological contact should be made while also establishing collaborative relationship. Violence and mental illness to instill trust; identification of the major problems such as the cause of the crises; encouragement and exploration of the extent of the feelings and emotions; generation and exploration of alternative ways and new strategies to cope with the situation; the restoration of the victim, patient or client’s normal functioning through the implementation of an action plan; and planning of follow-up and booster sessions with regard to intermediate in the crises.
Critical Incident Stress Management (CISM)
This is a comprehensive intervention system for crises that is applicable to individuals, small functional groups, organizations families and/ or entire communities. CISM is entails seven core components. These are pre-crisis preparation that entails education on stress management, stress resistance and mitigation of crises; disaster/ large scale incident and also support programs for schools and communities in general that include demobilization, informal briefings and advice to various staff; defusings-which are discussions by small groups offered within hours of the assessment of crisis, triaging and the mitigation of acute symptoms; longer discussions by small groups known as Critical Incident Stress Debriefing (CISD) that are offered days after a crisis aimed at the mitigation of acute symptoms, assessment of follow-up needs, and where possible offer post-crises psychological closure (Everly, Flannery & Mitchell, 2000)
CISM also features a one-on-one intervention or counseling or psychological support through the entire spectrum range of the crisis; crises intervention for families and organizational consultation bases on individual needs; and also follow-up and mechanisms for referral for treatment and further assessment when applicable (Everly, Flannery & Mitchell, 2000)
Recent research finding have gone against the stigmatization of mentally ill individuals as being violent. Despite this, mentally ill individuals are still perceived to be violent, as evidenced in their portrayal in various media. Studies show that mental illness does not necessarily lead to violence. On the other hand psychosis and suicidal thoughts among other behaviors considered as anti-social and violent can be induced by drug and alcohol abuse. The management of such cases requires proper preparation and training to enable officers to sufficiently address these situations, and to ensure that these situations do not escalate into personal complaints of the officers owing to the use of excessive force and suicide (Tully & Smith, 2015). For instance the confrontation of emotionally disturbed persons (EDPs) by police in a scene with evidence of drug or alcohol abuse has a high likelihood of violence. Violent mentally ill offenders are also highly likely to attack family members and/ or caretakers. Strangers or people outside their social network are hardly targets of violence (Tully & Smith, 2015).
Public safety officers need to receive specialized training to more effectively deal with the violence risks of the EDPs in effective crisis intervention training. This aims at making them be able to identify the signs and symptoms mental illness, learning the de-escalation of situations of crisis as well as for the development and understanding the resource options available for officers who might need to seek treatment on EDP in lieu of arrests. Consumer involvement has been an essential aspect of crisis management with regard to the cases of mental illness, both from the training and practice. It was noted that incorporating the views of consumers (the public) with regard to mental illness was instrumental in the dispelling the existing myths as well as stigma about persons with mental illness and in the provision of content in training.
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Differentiating Crisis Intervention from Disaster Management
Where applicable, crisis intervention is usually the third phase of response to disasters. It usually begins 1-4 weeks after the unfolding of a disaster/ phase one is the Impact while phase two is the Rescue. These two phases encompass the management of disaster and services of emergency relief medical technicians among other agencies. These agencies focus on public safety which entails; the location shelters for disasters, temporary units of housing, provision of food and clean water, transportation, medical care and clothing for survivors and their family members. Survivors are also helped to reconnect and reunite with family members and friends.
Phase three: Crisis intervention then begins after the 1-4 weeks, upon request. It is more of a voluntary process that is quickly delivered and provided on-need basis. Crises are personal and dependent on the perceptions of an individual of the potential of the factors that induced the crises, their personality, life experiences, temperament, and their coping skills that vary from one individual to the other. This requires surface skills to differential since they may appear the same on face value. Reactions to such as crises may be normal or specific, and tend to include numbness, shock, sadness, frustration, anxiety, anger, exhaustion, impulsiveness and/ or fear.
To measure the effectiveness of the resolution of crises, and for the facilitation of accountability and quality improvement, it is essential for outcome measures to be clearly explained on behavioral and in terms that are quantifiable. The performance indicators applied in intervention programs for crises include the duration of the intervention that encompasses the average length of crises services during the period of reporting for the people receiving the services at each of the intervention levels; follow-ups; initiation for crises intervention for people who have or develop problems of mental health; and treatment engagement for people with mental health.
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- Everly, G., Flannery, R., & Mitchell, J. (2000). Critical incident stress management (Cism). Aggression And Violent Behavior, 5(1), 23-40. http://dx.doi.org/10.1016/s1359-1789(98)00026-3
- Polk, D., Mitchell, J., & Gulli, B. (2008). Prehospital behavioral emergencies and crisis response. Sudbury: Jones and Bartlett.
- Roberts, A., & Ottens, A. (2005). The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis Resolution. Brief Treatment And Crisis Intervention, 5(4), 329-339. http://dx.doi.org/10.1093/brief-treatment/mhi030
- Tully, T., & Smith, M. (2015). Officer perceptions of crisis intervention team training effectiveness. The Police Journal, 88(1), 51-64. http://dx.doi.org/10.1177/0032258×15570558