C RISIS I NTERVENTION Community Health Worker Course Rogue Community College 1

W HAT DO WE MEAN BY CRISIS ? A disruption in an individual (or their family’s) normal or usual level of functioning. Typically cannot be resolved within the persons usual problem-solving skills, or they may not have the resources. Is different from a problem or an emergency. Can be either acute or chronic. 2

S ITUATIONS THAT CAN LEAD TO A CRISIS Family situations Economic situations Community situations Significant life events Natural elements 3

H OW DOES OUR BRAIN RESPOND TO CRISIS ? 4

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R ESPONSES TO C RISES Fight = High arousal response, anxiety and rage; approach threat Flight = Similar to fight (need to move), anxiety and fear; avoid threat Freeze = Body remains immobile while deciding what to do – while taking in information about the threat Submit = Body’s active defense is shut down; dissociate 6

O VER A ROUSAL VS U NDER A ROUSAL Over arousal symptoms Anxiety and fear Intrusive memories Triggered reactions Concentration problems Nightmares Hyper vigilance Under arousal symptoms Emotional numbing Social avoidance Hypersomnia Fatigue and low energy Dissociation Note: when this occurs our threat response system may be underactive which could lead us to miss signs of potential danger. 7

S O WHAT DO WE DO ? 8

T HE F IRST S TEP I S : 9

S ECONDLY Know your role. Know your limits. Know your resources. 10

S HORT V IDEO Introduction to Crisis Intervention 11

I NTRODUCTION TO 6 S TEP C RISIS I NTERVENTION M ODEL 12

6 S TEP C RISIS I NTERVENTION M ODEL Define the ProblemEnsure SafetyProvide SupportFind AlternativesMake a Plan Obtain Commitment 13

D EFINE THE PROBLEM This step relies on listening. Define the issue from your client’s point of view. Utilize listening skills: Empathy Genuineness Acceptance Positive Regard Listen without judgment. Ask open-ended questions. Listen without pressuring them to talk. 14

E NSURE S AFETY Safety should be at the forefront of all the steps. Find any natural supports and elicit their help. If client already has a safety plan, help them use it. Help ensure that basic needs are met (food, information, water). Make sure that you are within your role as a CHW and call in the “experts” when necessary. 15

P ROVIDE S UPPORT Communicate to your client that you care for them. Provide information about and connection to resources. Help with the connection to resources, don’t just give them a list and expect them to be able to call. 16

F IND A LTERNATIVES Keep client’s strengths and needs at the forefront. Look at situation resources. Find any supporters he or she may have. Help identify coping mechanisms, actions, behaviors, or other resources to help them get through the crisis. 17

M AKE A P LAN Outline the people, groups, or referral resources for immediate support. Discuss ways that they can cope and how they can use them. Help the individual to define positive, concrete steps that they can take in the moment. Always ensure that the individual feels they are in power, independent, and treat them with respect. Planning is to get through the short-term. 18

O BTAIN C OMMITMENT Have the person verbalize the plan. Enable the individual to commit to the plan. Commitment needs to be both voluntary and realistic. Plans developed only by staff will be ineffective. 19

F URTHER T RAINING AND R ESOURCES Mental Health First Aid ASIST (Applied Suicide Intervention Skills Training) Dunn House Trainings 20

R EMEMBER “The Chinese use two brush strokes to write the word 'crisis.' One brush stroke stands for danger; the other for opportunity. In a crisis, be aware of the danger--but recognize the opportunity.” ― John F. KennedyJohn F. Kennedy 21

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