Chapter 2
Crisis Intervention
TWO KEY FIGURES IN CRISIS
INTERVENTION
• Gerald Caplan
• Eric Lindemann
• Created the Wellesley Project as a result of
the Coconut Grove fire in Boston, 1942
• Preventive psychiatry emphasized early
intervention to minimize psychological
impairment
1950’s through the 1960’s
• Introduction of psychotropic medications
such as thorazine and lithium began the
process of the deinstitutionalization of the
state hospital mentally ill patients.
• Short-Doyle Act funded community mental
health centers throughout the country
1960’s through 1970’s
• Suicide prevention
• Journals and scientific research about
crisis intervention and suicide
• Grass roots movements lead to the
creation of non-profit agencies and use of
paraprofessionals
• Colleges created counseling programs
1980’s through the 1990’s
• Managed care
• Brief therapy was more cost effective
• Emphasis on crisis intervention, all mental
health workers would provide case
management and short term care
21st Century
• Bills still pending in congress about the rights of
the mentally ill.
• Funding at federal level is minimal
• California trend is to create new programs for
mental health care (Proposition 63 has passed)
this creates thousands of jobs and facilities for
mentally ill
• Crisis intervention still the preferred mode by all
funding sources.
Timeline in the Development of
Crisis Intervention
1942
1946 - 1964
1950’s
Coconut Grove Fire / Use of
Non-Professionals to counsel
grief reactions.
Baby boom / Grief reactions to
stillbirths and miscarriages.
Discovery of Psychotropics/
deinstitutionalization of the
Mentally Ill.
1957
Short / Doyle Act
1963
Community Mental Health Act
/ JFK Assassination
Timeline in the Development of
Crisis Intervention (Continue)
1960’s
1960 - 1970
1970 - 1980
1980 - 2000
Journals about suicide prevention
and crisis intervention, increase in
professional studies in counseling
Grassroots movements,
non-profit agencies, use of
paraprofessionals.
Increase in college counseling
programs, professionalization of
mental health, movement toward
longer mental health counseling.
Managed Care takes over the
medical field, including mental
health, return to crisis intervention in
private and public mental health
services.
Contributions from other
Modalities
Psychoanalytic Approach:
• Psychic energy is finite and limited. We can only handle so
much stress and then something gives for a period of time until
coping skills are learned or defense mechanisms are utilized.
• An individual’s past experiences will determine how current
experiences are dealt with and how a crisis will be resolved.
Existential Approach:
• Humans are responsible for decisions and capable of selfawareness and choice.
• Anxiety is a normal part of the human condition and impetus for
growth.
Contributions from other
Modalities (Continue)
Humanistic Approach:
• Humans are capable of self-directed growth and there is
hope and optimism about life struggles being manageable.
• A genuine relationship with a counselor where empathy is
shown is vital to therapeutic change.
Cognitive Approach:
• Human emotions and behavior is related to cognitions and
perceptions about our experiences.
• Helping an individual to alter cognitions when in a crisis
state is therapeutic.
Contributions from other
Modalities (Continue)
Behavioral Approach:
• Brief, goal oriented counseling which is directed at
changing behaviors which are maladaptive to normal
functioning.
Family Systems Approach:
• Runaways in a family is analogous to a crisis in an individual
in that normal counteractive mechanisms don’t work to
return to homeostasis.
• Solution oriented therapy aimed at helping families adjust
to transitions in family member’s development cycle.
BRIEF THERAPY
• Not the same as crisis intervention
• Clients explore past patterns of behavior
and how these prevent successful
lifestyles and choices.
• More explorative rather than structured
• Time limited, but not focused solely on the
crisis
THE ABC MODEL OF CRISIS
INTERVENTION
• A: Developing strong rapport
• B: Identifying the nature of the crisis and
altering perceptions
• C: Offering coping skills