What about a crisis?

There are times when we hit a crisis or, indeed, one crisis after another. At these times when we might most need help, therapy might not be the best ‘help’ available.

Therapy, to be effective, requires some stability and a few moments within which we can reflect. It needs us to do small safe experiments to foster our own chosen changes. We will need time to collect the results and make sense of them.

When I am in crisis, I am not very well equipped to take a long trip lasting days. There are urgent things to do this morning, and a place of safety may well feel a long way away.

This is perverse, is it not? At a time when I may most need help, the service of well-trained therapists, able to listen and guide, seems less suitable!

There is good news: helping others in a crisis is only about good people doing something or even just being there. Great expertise and insights into the human condition are not required.

So what can us ordinary folk do when a pal finds themselves in trouble?

BE there

BE practical …………..

BUT listening may be more helpful than fixing.

BE a temporary anchor. A reliable, sensible and available person – a ”port in a storm’. Notice, if you would, how it easy for ‘temporary’ to become ‘permanent.’

ATTEND to what your pal is doing to take care of themselves. Make sure they can see what needs to be done for themselves.

Find ways to see things done day-by-day, and one after the other, so they can take even better care of themselves or others in their world.

Find ways to sort out the URGENT, the IMPORTANT and sort it from the URGENT AND IMPORTANT.

THAT MAY BE ENOUGH, but here are a few other thoughts based on my experience of doing this kind of work on many occasions. When I did this work, I believe it was my training and experience as a probation officer and social worker that helped me rather more than my skills as a psychologist. Some of the goals of crisis intervention are:

To mitigate the impact of event, e.g. to ensure a safe place is found. To promote early recovery from crisis by being there and doing practical things.

To restore our adaptive abilities by helping others to do things differently. This can be a slow process, and care is needed when some-one freezes into immobility.

To restore our day-to-day functioning, when we that is possible.

Crisis intervention techniques may be better if they follow these seven principles:

Simplicity: In a crisis, I respond best to simple procedures and instructions. Simple things have the best chance of having a positive effect on me. It is not that I am ‘simple’ but my abilities to change are impaired in a crisis. That said, it is a time when we can find the necessary energy to focus on desired change.

Brevity: Psychological first aid needs to be available for short periods, from minutes up to one hour in most cases. Long group work and intense individual therapy is counter-productive.

Innovation: Use creativity; there are no specific instructions for any one case or circumstance.

Pragmatism: Keep it practical; impractical suggestions can foster even more frustration and foster the feeling that things are even more out of control.

Proximity: keeping effective support services close by can promote a better sense of safety.

Immediacy: Crises demand rapid interaction so acting quickly is needed. Even so, too much haste can generate too little speed and undermine the impact of support services.

Expectancy: Set up expectations of a reasonable outcome and foster a sense of hope – the situation is manageable. There are do-able things that can be found.

Follow-up: to monitor the:

  • changed physical conditions – accommodation, work and important relationships.
  • changes in the understanding of the precipitating event, if any.
  • any continuing stressors and how those are being handled.
  • considerations for longer term support, including therapy.

Some other leads

Crisis, Anxiety or both

Problem Solving Therapy (PST)

Taking action

Action isn’t everything

Blind Spots

The Johari Window

The Discount Matrix

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