Therapeutic Crisis Intervention
Edition 6
Residential Child Care Project Cornell University 2009
A Crisis Occurs When
A young person’s inability to cope
results in a change in behaviour
THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 9
The Goals of Crisis Intervention Are To
Support: environmentally and emotionally to reduce stress
and risk.
Teach: children better ways to cope with stress
THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 10
Stress Model of Crisis
THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS11
Recovery Phase
THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 12
Skills Building Pyramid:LSI
THE LIFE SPACE INTERVIEW 63
Stress Model of Crisis
PROTECTIVE INTERVENTION 50
Elements of Potentially Violent
Situation
A potential trigger to violence
A target
A weapon
Level of stress of motivation
PROTECTIVE INTERVENTION 51
Remove the Potential Trigger to
Violence By
Never touching an angry and potentially violent person
Avoiding any aggressive moves and provocative
statements
Avoiding the conflict cycle and counter aggression
Removing others who might trigger the violence
_ Body language is critical _
PROTECTIVE INTERVENTION 52
Remove the Target By
Asking the targeted person to leave
If it’s you, reminding they young person of
your relationship or leaving the situation
and asking a “neutral” staff to mange the
incident
- The target may shift during the episode -
PROTECTIVE INTERVENTION 53
Avoid the Weapon By
Discreetly removing objects
Manoeuvring away from weapons
Staying a safe distance away
PROTECTIVE INTERVENTION 54
Decrease the Level of stress or
Motivation By
Using your relationship
Actively listening to identify feelings
Removing the audience
Using co – regulation strategies (reactive
aggression)
Offering alternative, nonaggressive ways to
achieve goals( proactive aggression)
PROTECTIVE INTERVENTION 55
Skills Building Pyramid: Crisis
Co-Regulation
HELP ME HELP MYSELF CRISIS CO-REGULATION 56
Stress Model of Crisis
HELP ME HELP MYSELF CRISIS CO-REGULATION 57
Objective of Crisis Co- Regulation
To provide support in a way that reduces
stress and risk
HELP ME HELP MYSELF CRISIS CO-REGULATION 58
What to think (Self Awareness)
Ask yourself the four questions
Use positive self talk.
HELP ME HELP MYSELF CRISIS CO-REGULATION 59
What To Do (Nonverbal Strategies)
Take a deep breath
Use protective stance
Step back
Give the situation time
Sit sown if appropriate
Remember the importance of body
language and facial expression
HELP ME HELP MYSELF CRISIS CO-REGULATION 60
What to say (Verbal Strategies)
Very little
Understanding responses
“ I can see….”(validate feelings)
“ When you …”(encourage positive behaviour)
“ I know we….” ( emphasise desirable outcomes)
“ I am sorry….” (offer an apology)
Remember the importance for tone of voice
HELP ME HELP MYSEL: CRISIS CO-REGULATION 61
What to Do When It is Over
It’s over when the …………….
Prepare to discuss the situation in a LSI
HELP ME HELP MYSELF CRISIS CO-REGULATION 62
Skills Building Pyramid: LSI
THE LIFE SPACE INTERVIEW 63
THE LIFE SPACE INTERVIEW 64
The Life Space Interview ( LSI) Is
A therapeutic, verbal strategy for intervening
with a young person
“ The clinical exploitation of life events”
- Fritz Redl
THE LIFE SPACE INTERVIEW 65
Goals of the LSI
1. Return the young person to normal
functioning
2. Clarify events
3. Repair and restore the relationship
4. Teach new coping skills
5. Reintegrate the young person back into
the programme
THE LIFE SPACE INTERVIEW 66
Steps to the LSI
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Isolate the conversation
Explore the young person’s point of view
Summaries the feelings and content
Connect feelings to behaviour
Alternative behaviours discussed
Plan developed / Practice new behaviour
Enter young person back into the routine
THE LIFE SPACE INTERVIEW 67
Caveat (Warning)
Participate only if physically and medically able
Offer no resistance in the role of the young person
(unless the trainers instruct you otherwise)
Remove objects that might cause injury
Be appropriately dressed
Practice only the techniques demonstrated
PROTECTIVE INTERVENTIONS 49