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Crisis Intervention: Assessment & Practical Strategies
Crisis Intervention: Assessment & Practical Strategies - 10 CEUs

Section 28
Appendix: Reproducible Client Worksheets

CEU Answer Booklet | Table of Contents | Crisis
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

Techniques for the client in crisis

The ‘Differential Relaxation’ Technique
Review CD track 7 for more information regarding this technique.
Client reviews and utilizes the following procedures to address somatic challenges related to the client’s crisis state.
1. Keep a diary for a week of what muscles and body areas you are aware of using during your typical daily activities.
2. Remain in an attentive sitting posture and focus on what the teacher is saying.  While maintaining your focus, tune in on breathing with an emphasis on relaxation.
3.  Notice the areas that are involved in the activity, your shoulder, neck, arm, and hand.  Now, shift your focus to the parts of your body not in use. 
4.  Suggest to yourself letting go of all tension, sinking down in the chair, feeling heaviness and the pull of gravity on the parts of your body in rest.
5.  Once you have released your tension, return your full focus to the lecture.  Periodically scan your body for tension.  If you detect any tension in the parts of your body at rest, slowly breathe this tension away.

The ‘Small Control’ Technique
Review CD Track 9 for more information regarding this technique.
Clients reviews and utilizes the following procedures to focus on reestablishing coping mechanisms during a crisis.

#1. Impose order in your life where you can.  Set as a priority easily achievable goals to order your life, such as being on time for appointments, eating regular meals, and adhering to a healthy bedtime.  Create a detailed daily schedule.  Sticking to the schedule allows you to feel a daily sense of achievement and control.
#2. Look after your appearance.  By neglecting your appearance, you may be reinforcing to yourself that there is no reason to  be at your best.  Make your old grooming habits a part of your daily schedule.
#3. Take note of the good moments.  You might try keeping a small notebook with you at all times.  When something good happens, write it down.  That way you can constantly remind yourself that positive things are happening in your life.

The ‘Overnight Care’ Technique
Review CD Track 10 for more information regarding this technique
Client reviews and utilizes the following procedures to help provide structured situational support for a partner in a rape crisis.
1. If your partner agrees, spend the night at her or his apartment.
2. If your partner gives permission, hold, touch, and reaffirm your love for her or him.
3. Speak with your partner about your future as a couple, and any plans you have, so she or he knows your intentions are still the same
4. Do not under any circumstances attempt to initiate sexual intercourse unless your partner specifically asks.

The ‘Carbonated Thoughts’ Visualization Technique
Review CD Track 11 for more information regarding this technique
Client reviews and utilizes this visualization technique as an immediate coping mechanism for dealing with stress in a crisis state.

Imagine a glass of carbonated water with lots and lots of bubbles. See the bubbles float to the surface and burst.  As the bubbles burst, let go of any thoughts bouncing around your mind along with them.  As you continued watching the carbonated water, see the bubbles slowly declining in frequency, getting fewer and fewer, slowly, very slowly, until the water becomes very clear and calm.  As the bubbles burst and disappear, continue seeing your thoughts flow from your mind, gradually and slowly becoming less and less, and feel your mind becoming calmer and clearer, coming to a place of complete rest in quiet peacefulness.  See yourself drifting into a deep, calming relaxation as you continue to breathe very slowly.

Techniques for the Therapist

The ‘Common Denominators Assessment’ Technique
Review CD Track 1 for more information regarding this technique
1. The time factor: general consensus among therapists is that a crisis is acute rather than chronic.
2. Marked changes in behavior: the individual or group therapy is obviously less effective than usual.  Client activity is mainly related to attempts to discharge inner tensions, there are successive trial and error abortive attempts to solve the problem without apparent success.  Constructive behavior decreases, and frustration mounts.  It is usually at this time that scapegoating and excuse giving occurs.
3. Subjective aspects: The person experiences feelings of helplessness and ineffectiveness in the face of what appears to be insoluble problems.  There is a perception of threat or danger to important life goals the client has and this is accompanied frequently by anxiety, fear, guilt, or defensive reactions.
4. Relativistic Aspects: Although there are common crisis situations, such as the death of a loved one, the loss of a job, or a sudden disabling accident, the individual’s perception of threat and of a crisis is of course unique to her or him.  What may constitute a crisis for your client may not constitute a crisis for another individual or group.
5.  Organismic tension.  The client in crisis will experience generalized physical tension which may be expressed in a variety of symptoms, including those commonly associated with anxiety.  These reactions may be immediate or temporary, or they may constitute a long-term adjustment to the crisis situation itself.

Focus Questions for the Initial Crisis Interview
Review CD Track 2 for more information regarding this technique

• What prompted the client to seek help now?
• What happened to cause this crisis?
• How is the client trying to solve the crisis?  What is working?  What is not working?
• How was the client behaving before the crisis?
• How is the client behaving now?
• Has anything like this happened to the client before?  How was it handled?
• What is the client’s history of handling other crises?  What was successful?  What was not successful?
• What are the client’s psychological strengths?
• What are the client’s environmental strengths?
• What does the client see as the two or three most important problems to be worked on immediately?
• How much immediate success is the client likely to have in these or other problem areas?
• How life threatening is this situation? Immediately?  In the near future?
• What things are likely to stand in the way of successful crisis resolution?
• What is the client’s mental status?

 
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CEU Answer Booklet for this course | Crisis
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