Crisis Intervention Counseling

Crisis Counseling Vs Traditional Counseling Settings

Posted on by Mark Moran

Obviously crisis counseling is sometimes on the scene of the event.  It is emotional first aid that attempts to restore equilibrium and mobility to the person.  It is short term in its plan and it briefs the individual and carries through necessary tasks to help the person return to pre-crisis state.  It also looks to help the person find orientation and resources to help avoid future crisis and find resolution to what caused the crisis reaction.

Crisis specialists who arrive on scene have an entirely different approach to counseling than long term counselors in mental health

In this blog, we will look at crisis counseling in settings where intake occurs and how counselors work to help individuals leave the state of crisis.  In these cases, the individual is brought in by the police, or rescue and the person requires mental care until able to be released.  These types of counseling sessions differ greatly from traditional counseling settings.  They still are not long term but they do look to alleviate crisis as much as any work on the scene itself.  In addition to reviewing these types of crisis counseling settings, we will look at the efforts to better concert the police with mental health professionals in ensuring mutual safety of first responders and those in crisis.

Please also review AIHCP’s Crisis Intervention Specialist Program, as well as its Substance Abuse Specialist Program for qualified professionals in Human Services and first response.

Crisis Counseling in Facilities

Many mental health community centers are equipped to handle walk-ins, police escorted individuals in crisis, family admitted or social service recommended cases (James, 2017, p. 100).  Like the crisis specialist in the field and on the scene, these professionals provide the same type of de-escalation model to help the person find equilibrium and mobility.  They can also keep the person a few days if necessary and later coordinate with case managers to ensure the person receives continued observation, medication, or future counseling.  Some facilities are 24 hour facilities, while others have emergency call centers beyond the regular hours (James, 2017, p. 102).

Upon entry into a facility, a person is assessed across the range of the triage scale to determine if someone is mildly or severely impaired.  For more severe cases, a senior technician is called upon to help the person.  Crisis specialists will also try to receive a case history of the person to better determine the onset of crisis.  If mental pathology is present, a psychiatrist may be called to better meet the needs of the person (James, 2017, p. 100).   James also references that those who face more severe mental fragmentation will be committed until safe to self and others (2017, p. 100).

The initial intake interview is a key process where questions and basic crisis intervention tasks can be completed.  If the person is appraised negatively with a high level of lethality as well as drug use, then the person will need to stay longer.  The clinician or team following the intake interview, prepares a disposition that describes the case as well as suggestions for treatment.  In some cases, the facility will supply the person with a psychological anchor.  This refers to a professional who will serve as their case worker, advocate or contact person (James, 2017, p. 101).  In some cases, the individual will need short term disposition which meets the immediate physical needs of food, water or shelter.  The Department of Family Services plays a big role with social workers to ensure the proper government entities meet the needs of the person.  However, sometimes, long term disposition occur where the person needs long term care plan which includes counseling abd  medication to help the person deal with future issues and crisis (James, 2017, p. 101).

Crisis and Short Term Vs Counseling and Long Term Cases

Since crisis is about mental and emotional first aid that looks to stop emotional bleeding, its goals and procedures to reach those goals differ greatly from long term counseling and cases.  James lists numerous differences between these two types of mental health models.  In regards to the initial tasks themselves, there is a large difference.  Crisis counseling looks to ensure client safety and assess lethality initially, while long term looks to prevent future problems.  Where crisis counselors look in the first task to form a bond with the person in crisis, long term counselors look to correct issues with sound and tested evidence based treatments.  Where crisis counselors help the person define the immediate problem, long term counselors help provide systematic support for that problem.  Where crisis counselors provides support to help calm the person in crisis, long term counselors help facilitate growth in the healing process.  Where crisis counselors look to help those in crisis see alternate options and develop a plan, long term counselors look to re-educate and help clients express and clarify emotions.  Where crisis counselors resolve with commitment to plan and follow up, long term care counselor continue treatment with resolving issues, accepting realities, reorganizing attitudes and working on maximizing intellectual resources to deal with issues (2017, p. 98).

Those admitted into crisis centers are facing affective, behavioral and cognitive issues that are preventing proper emotional balance and coping. These facilities face different types of intake individuals who face acute crisis

Crisis intervention specialists utilize diagnosis via the triage method looking at the affective, behavioral and cognitive issues on the spot and face to face, while long term counselors work with a detailed case history as well as observation throughout a period of time with most patients not experiencing a state of acute crisis.  Where crisis specialists treat acute trauma and help to stabilize, long term counselors look at the underlying causes for issues over an extended period of time.  Where a crisis specialist’s plan is to meet the immediate physical and emotional needs to stabilize a person, a long term counselor’s plan is a comprehensive effort that covers time and numerous personal and social environments that looks to help alleviate a non acute issue. (James, 2017, p. 98). Hence crisis intervention specialists deal with individuals who are affectively in an impaired state, cognitively unable to think logically and behaviorally out of control and pose a threat to themselves and others, while a long term counselor deals with individuals not in impairment emotionally and is able to think and socially behave (James, 2017, p. 99). This means that crisis professionals whether on the scene, or in a facility helping a person in crisis are working at a mental emergency level where decisions and observations must be quicker and plans may need be adjusted quickly due to safety issues (James, 2017, p. 99)

Types of Issues with Crisis

Obviously dealing with those in crisis requires quick thinking and assessment but it also entails dealing with individuals who are a lethal threat to self and others, as well as many times on multiple types of drugs.  Crisis professionals deal with chronic mental illness, acute interpersonal problems due to relationships and other social factors, and combinations of both (James, 2017, p. 97).  While long term care counselors deal with these type of issues, usually the person is not actually intoxicated, or in a state of mania, or suicidal with gun in hand during a session.  Many crisis counselors deal with an array of acute issues that include those who are constantly in a transcrisis state that can be activated at any moment.  Those facing multiple stressors or anxiety or depression can easily fall into a state of acute crisis in these cases.  In addition to transcrisis, many individuals in chronic crisis will face regression and fall back into old issues that led to crisis.  Others may face issues with possible termination of future sessions with counselor since the counselor has become an anchor (James, 2017, p. 108).  In addition to dealing with those in transcrisis, many counselors deal with individuals with addiction issues and psychotic breaks with reality.  One common type of malady that corresponds with crisis in Borderline Personality Disorder.  This disorder prevents the person from past trauma to achieve stable moods from hour to hour, day to day or month to month.  They can erupt into anger or sadness over minor things they perceive as slights.  Many are also impulsive, self destructive, confused with goals, unable to maintain self esteem, possess suicidal ideation, and have destructive choices in relationships (James, 2017, p. 111). Obviously this type of disorder is a chaotic recipe for crisis calls for the police and later mental health intervention.

These types of issues can lead to big problems with counselors and those in crisis as well as those who offer long term counseling.  It can lead an array of issues where the client is suicidal, deals with abuse, or problems with finances or the law, as well as one who frequently misinterprets a therapist’s statements, reacts strongly to advice, fears resistance and follow through of treatments, as well as transgressing professional boundaries with calls and insults (James, 2017, p. 111).   James points out that when dealing with individuals in chronic crisis or facing other mental maladies, one needs to set ground rules that apply for everyone.  Sessions need to start and end on time. Sessions need to be void of threats.  Everyone speaks for oneself and is fully heard.  Everyone faces all issues discussed and does not have the option to abruptly leave.  The session will not include gaslighting or avoiding the subject.  No one is to arrive drunk or intoxicated.  The crisis counselor or counselor will not take sides.  Time will be respected outside the office and the needs of other clients will not be dismissed for another’s immediate demands (James, 2017, p. 114).  Obviously dealing with those that face multiple issues and chronic crisis is a heavy task.  It involves professionalism, boundaries and sometimes a place to vent for the counselor afterwards.

Crisis Facilities and Law Enforcement

Since the closing of mental asylums in 1963, law enforcement and prisons have picked up the slack of dealing with those in mental crisis.  This has led to many unfortunate incidents of police shootings, or police brutality cases.  While most police officers and law enforcement are good people, the job of dealing with those in mental crisis is exhausting and can trigger a sane individual into actions not normal for fear of safety of self or frustration.  Most police historically have dealt with criminals in the true sense.  Upon apprehending of a thief, the thief understands to drop the weapon or the stop.  Unfortunately in heated situations of mental crisis, people sometimes cannot emotionally understand or comprehend orders.  Due to equilibrium and immobility of a person in crisis, an officer has to show constraint and avoid authoritative and aggressive commands or he/she may escalate the situation.   Some officers are not able to handle this type of mental health interaction but modern policing requires it.  As more and more unfortunate death by cop whether intentional or intentional occurs, the more police need trained in crisis intervention and de-escalation.  Police officers who cannot handle this adjustment either need to find a new profession or soon risk the chance of ending up in prison, sued, or fired themselves.

Police are responding more and more to crisis calls than merely criminal calls. They need to be trained in how to help individuals face crisis to avoid future fatalities

James mentioned the change in policing from instrumental crimes to more expressive crimes where officers are required to adjust their approach in dealing with the person in crisis (2017, p. 102).  James illustrated one of the first joint task teams of law enforcement and mental health and crisis centers with the Memphis Police Department in 1987 (James, 2017. p. 103).   The Crisis Intervention Team or CIT was designed to train police when dealing with those in crisis as well as to coordinate with mental facilities instead of prisons.  James pointed out that the model was not just about training police but also to help create better coordination with the mental health community and consumer advocates promoting mental health awareness (2017, p. 104).  James pointed out that the program covered 40 hours of CIT training that covered cultural awareness of mental illness, substance abuse, developmental disabilities, treatment strategies and mental health resources, patient and legal rights in crisis intervention, suicide intervention, use of mobile crisis teams, education on psychotic meditations and effects, verbal defusing and de-escalating techniques and education on borderline personality disorder and other mental issues (2017, P. 105).

According to James, the program has been a success and a model for other law enforcement agencies in other communities and cities.  Within its first 16 months of operation in 1987 to 1988, Memphis CIT trained officers responded to 5, 831 mental disturbance calls, transported 3, 424 cases to proper mental health facilities without patient fatality (2017, p. 106).   In the 20 and more years since, more calls are received to the hotline differentiating crime and mental crisis and there has been a reduction in the use of force and more individuals being sent to mental facilities instead of jail (James, 2017, p. 106).

This is an important issue and the success shows that modern policing can meet the needs of mental crisis.  Some departments also receive additional aid from social workers, chaplains and other crisis professionals on calls related to mental disturbance.  This does not mean that danger and risk exists both for the person in crisis as well as the first responders but it does reduce the chance for unnecessary and tragic fatality.  This should be an issue every person cares about because anyone can become a victim of crisis and police when called need to be able to de-escalate and not escalate.

Conclusion

Crisis intervention care is not for the faint of heart.  It requires quick thinking and decisions which need to be adjusted on the fly as danger and possible death loom with every call.  Crisis cases whether on scene or in a facility deal with acute crisis.  Individuals are facing dis equilibrium and immobility.  They are affected emotionally, behaviorally and cognitively.  This leads to a different type of response than long term care.  Crisis counselors understand the different nature of their calling and profession. In addition, mental health facilities, the public, and police are all beginning to incorporate better crisis response to negate police brutality or illegal shootings of those in crisis.  This involves understanding that modern policing is more about arresting bad guys but also helping sick people find balance and the proper treatment.

Please also review AIHCP’s Crisis Intervention and Substance Abuse Specialist Programs

Please also review AIHCP’s Crisis Intervention Specialist Certification as well as its Substance Abuse Specialist Certification.  Both programs are online and independent study with mentorship as needed.  The program is open to qualified professionals in law enforcement, healthcare, mental health, human services and chaplaincy.

 

 

 

 

 

 

 

 

Source

James, R. & Gilliland, B. (2017). “Crisis intervention Strategies” (8th).  Cengage

Additional Resources

Crisis Centers by State and U.S. Territory.  Access here

Crisis Text Line. Access here

If You or Someone You Know is in Crisis and Needs Immediate Help.  National Institute of Mental Health.  Access here

National Hotline for Mental Health Crises and Suicide Prevention.  NAMI.  Access here

988 Suicide & Crisis Lifeline. Mental Health America.  Access here

Tich, B. (2023). “What Works in De-Escalation Training”. National Institute of Justice. Access here

Zeller, S. & Kircher, E.  (2020).  “Understanding Crisis Services: What They Are and When to Access Them”. Psychiatric Times.  Access here

 

 

 

 

 

Crisis Intervention and Assessment of Those in Crisis

Posted on by Mark Moran

Those in crisis require different kinds of counseling than those in short and long term care counseling.  Those in crisis have emotional and mental wounds that are intensely bleeding from within leading to sometimes lethal and dangerous decision making.  Individuals feel lost and without purpose with no light at the end of the tunnel.  Hence those in crisis lose cognitive and mental capabilities to make safe and logical decisions.  This requires on site mental first aid and de-escalation.  Those in EMT, police, FEMA, as well as chaplains and social workers who work with law enforcement approach those in crisis as mental first responders.  One does not know what to expect and the job can definitely be dangerous due to the unexpected behavior of those in crisis.  Individuals trained in crisis hence provide emotional and mental first aid and look to stabilize individuals from a mental and emotional way.  This blog will look at the basic steps of Crisis Intervention and the role of assessing individuals in crisis.

Crisis Intervention professionals assess and implement plans to stabilize the person in crisis

Please also review AIHCP’s Crisis Intervention Specialist Certification and see if it meets your academic and professional goals

Hybrid Model of Crisis Intervention and Steps

Various models of Crisis Intervention look to examine the best psychological way to understand the state of crisis and how to help an individual reach pre-crisis state.  Crisis professionals all agree that those in crisis experience disequilibrium  as opposed to equilibrium and immobility as opposed to mobility (James, 2017, p. 48).  Disequilibrium refers to lack of emotional stability, balance or poise within an individual (James, 2017, p.48) and immobility refers to the state of a being that is unable to autonomously change or cope or respond to different moods, feelings needs, conditions that require adaptation (James, 2017. p. 48).  Hence it is the duty and vocation of the crisis professional to help individuals again find balance and ability to cope with the crisis inducing situation.  The crisis professional is not again present to help resolve the issues causing the crisis itself but only present to help the person again find ability to cope with the situation in the heat of the moment.  The crisis professional can then guide the person to appropriate resources and support to face the problems that created the conditions for crisis to occur.  This involves various steps and procedures to help a person in crisis stabilize and find balance again.  However, James warns that those in crisis are ones to follow steps but in reality are far more chaotic.  With this in mind, these steps serve as a checklist or guidebook that can be adapted, or repeated, or reused as necessary within the process until the person again finds state of mind.

The Hybrid Model serves as a way for crisis professionals to help de-escalate the situation and help a person find pre-crisis state through seven steps.  The first step is predispositioning/engaging and initiating contact (James, 2017, p. 50).  This essential task sets the table and emotional response between anyone in crisis, whether one is facing little impairment or facing extreme emotional impairment.  This step involves the crisis professional introducing him/herself and attempting to form some type of bond or understanding.   When a person is in intense crisis, approach is key.  An aggressive approach can turn the person to self harm or harm of others or also increase agitation within the mind.  Trained police officers who approach someone in a mental breakdown who approach with more calmness and articulation are far better able to de-escalate as opposed to officers who approach as angry, aggressive or authoritarian.  Many times, police escalate the situation of a person in crisis by challenging, commanding, or threatening.  A person in crisis will not respond logically or calmly to these types of approaches.  The best way is to introduce oneself calmly without threatening (James, 2017, p. 50).  Within this initiation of contact, police or crisis professionals should attempt to learn the name of the person and also clarify one’s intentions in what the person in crisis should expect to happen next.  Calm, clear and precise articulation can help break the ice and begin the process of de-escalation as opposed to making the situation worst.

The second task involves exploring the problem.  This involves understanding the problem from the current context of the individual in crisis (James, 2017, p. 51).  Key to helping and understanding requires core listening skills that encompass empathy and genuineness (James, 2017, p. 51).  In this way,  the crisis specialist examines the situation as a detective.  H/she not only assesses the person (which we will review in the second part of the blog), but he/she also looks for clues about the current problem and addresses the person’s issue as how he/she is experiencing it.  If a person is experiencing a breakdown, the crisis professional will discuss why the person is upset and reinforce understanding of why the situation is bad but also why it can be fixed.  In addition to the person, the crisis professional will also see all the other issues surrounding the current issue, such as interpersonal issues, or other environmental issues and understanding how they fuel the current crisis.

The third task involves providing support.  The crisis specialist, police or chaplain on the scene can provide support via continued empathetic dialogue.  This includes letting the person know he/she is not alone and that the crisis specialist is a person who cares about he or she and that the crisis professional is present to help the person receive the support necessary (James, 2017, p. 52).  This type of reassurance can help a person find some stability.  Many individuals facing natural disasters will need those simply initial words of support to help them find some peace and calm after being completely overwhelmed.  The crisis professional can supply psychological support, logistical support which leads the person to basic survival needs, such as food or water or shelter, social support which includes activating and discovering family, friends, coworkers or church, and information support which can include resources the person can access to find help (James, 2017, p. 53).   Sometimes a person in crisis will need to be reassured that there is support before he/she will accept help from someone or leave a potentially dangerous situation.  A crisis professional can help alleviate the hopelessness by asking and promising the help one needs.  Of course, safety is a huge concern during these discussions.  When weapons or erratic behavior exist, crisis specialists are at risk.  Whether its a violent person in the street, a person threatening to shoot oneself with a gun in hand, the crisis specialist needs to assess, utilize the proper safety guidelines and also the backup present when hoping to diffuse and talk to individuals in a state of crisis.

The fourth task involves helping the person find alternatives to the current mode of thinking (James, 2017, p. 54).  Sometimes rational ideas or different ways of viewing a crisis can help a person find some logic or some hope in finding pre-crisis state.  This involves asking about situational supports the client has had in the past involving family or friends who can help, as well as offering coping mechanisms that include actions, behaviors or resources that can help the client in the temporary crisis.   In addition, offering positive reframing of the current and temporary situation can help the client or person in crisis think more clearly.  A crisis professional can offer a variety of solutions or alternative to the one in crisis to view the situation differently (James, 2017, p. 54).   This ultimately involves a serious examination of the person’s realistic options within the current crisis situation.

Crisis Intervention counselors and specialists on scene look to help the person find emotional balance and mobility to cope with the short term problem through a series of tasks

The fifth task is to create a plan.  Usually these plans are short goal but they offer order in the chaos for the person in crisis.  The crisis professional offers certain ways of proceeding forward and meeting immediate and short term needs of the person.  This type of grounding helps the person find some anchor in the chaos and that there are plans available to escape the crisis.  This is important for individuals who may have lost a home to hurricane or a person who lost his or her job, or a person who is going through a divorce and lost his or her children. The crisis professional helps the person find order and some control (James, 2017. p. 55).  The person should feel part of the plan and have autonomy within it.

The sixth and seventh tasks involve obtaining commitment on part of the person to follow through on the plan and then following up with the client within a few hours, or even days to ensure the person is still on the right path (James, 2017, p. 55-57).  Commitment shows the person understands and comprehends the plan and also gives the person a sense of empowerment.  Follow up is key to ensure the person still understands the plan and is meeting with the necessary agencies or persons to permit the plan to blossom.   This also shows that the crisis professional cares and wants the person to be able to find permanent success following a crisis.  This is important for anyone who lost a job or home and needs to contact certain groups, as well as those who were suicidal are committing to the plan of getting the help they need.

A similar model is referred to as the Robert Model.  This involves assessment of the situation and person regarding lethality.  Following assessment, involves rapport with the individual as found in the Hybrid model.  Following rapport, identifying the problem and crisis and then exploring the emotions is addressed.  Alternative options and plans are then addressed with follow up.  As one can see, most models share a similar 7 step procedure that involves assessments, making contact, understanding the situation and giving options to de-escalate and help the person return to precrisis state with followup.

Interaction with Those in Crisis

Within the first task of initiating contact, it is crucial to establish trust and a bond with those experiencing crisis.  Whether a person is brought to a mental health facility in a state of crisis, or arriving upon a scene, basic interaction with communication and listening skills are important.  As they are in any counseling, particular ways crisis counselors speak and listen can play a big role in de-escalating a situation.  Open ended questions are important that request descriptions of the situation such as “Please tell me” or “Show me” can help a person open up and communicate the crisis.  In addition open ended questions that focus on plans of the person such as “What will you do?” can help make the person in crisis think.  Expansion questions can help broaden the story by simply stating, “Tell me more” or questions that look to assess the situation.  For most cases, “why” questions should be avoided since they provide opening for illogical defense.  While it may attempt to allow one to understand, it also allows the person to intellectualize and defend why one is doing something that one should not do (James, 2017, p. 74).  Close ended questions are used for more focus and quicker responses.  They can obtain specifics, obtain commitments, and help focus on the issue at hand. Crisis counselors can also apply basic counseling skills that involve restatements of what the person feels as well as summaries of how the person is acting.  Sometimes, restating and summarizing can allow a person in crisis to see the insanity of his/her state of mind.

In crisis, crisis professionals many time utilize owning or owning of feelings (James, 2017, p. 75).    Utilizing “It” statements in what is to be done, or how one feels can help the conversation become more intimate and less confrontational as “we”.  The person in crisis has only the professional to discuss, when “I” is utilized.  Such as examples of ” I understand” . It is important not to falsely understand when one does not. In these cases, one should ask for clarification.  Assertion statements are also useful when telling the individual what you expect and how you want someone to do something for one’s own safety.  In these statements, specific actions are asked in the particular moment with “I” statements.  In addition, it is important to offer positive reinforcement when applicable while working a person through crisis.  Compliment the person who is able to breathe smoothly or who is starting to show control of emotions (James, 2017, p. 77).

In addition to various statements that can help create bonds and trust, as well as de-escalation, counselors need to listen with empathy and genuineness (James, 2017, p. 78).  This involves empathetic listening for clues and acknowledging what the person is saying, but also understanding it while helping to guide the person to better options.  It is not patronizing but serious listening and response to what is being related by the person in crisis.  If the person in crisis understands that the counselor is acknowledging fears and taking what the person feels as serious, then respect can exist and the person in crisis will be more listening to reason and statements from the counselor.  Through this, sometimes, a counselor can help create awareness of the situation during reflection of what the person in crisis is stating.  Sometimes, restating the problem via good listening and offering a clear awareness of the difficult situation can be a great aid for the person.  Sometimes, it is also important to allow the person in crisis to talk.  One needs to allow sometimes for the person to talk, express, swear, curse, rant or mourn before reason can be restored (James, 2017, p. 80). In crisis intervention counseling this is referred to as catharsis.  Ultimately, listening and communicating involves empathy with the client in crisis.  It involves proper attending, verbal communication, reflecting feelings, and utilizing nonverbal cues and silence as a way to show empathy (James, 2017, p. 82).

Throughout the tasks, especially when discussing emotions, alternatives and plans, the crisis specialist needs to also promote expansion of the client’s tunnel vision of the temporary moment and open possibilities.  This helps the client see the overall picture (James, 2017, p. 81).   Sometimes during these phases and tasks, crisis counselors can also help individuals focus on the immediate issue.  Many times individuals in crisis will spiral out of control and discuss multiple stressors that are not present.  The crisis counselor can help partition, decompartmentalize and downsize client’s fears and stressors (James, 2017, p. 81).   In addition, counselors during interaction need to know how to supply guidance and help implement order.  Those in crisis and chaos depending on their level of impairment need direction and guidance.  Finally, crisis counselors need to assure those they are working with that they are safe.  “I” statements that assure safety and meeting of physical needs can help a person in crisis become more secure and open to de-escalation (James, 2017, p. 81).

Again, simplified, the basic ABC’s of Crisis Counseling merely involves achieving a relationship, breaking down the problem and committing to a plan of action.  Identifying what activated the event, understanding the beliefs associated with it and the consequences surrounding it.  This involves helping the person again find mobility and equilibrium throughout that process and utilizing the skills listed above in that process and also understanding the affective, behavioral and cognitive states of the person.

 

Assessment in Crisis Intervention

The tasks in helping a person find balance and mobility again are essential in crisis intervention.  One of the initial observations during the first contact with a person in crisis is assessment of the person.  Crisis Intervention offers a variety of assessment tools and charts to help EMT, police, chaplains and social workers to better able assess a person’s threat to oneself and others.  Most assessment covers affective and emotional states, behavioral states and cognitive states.  It is also important to assess whether a client has been in crisis before or if this is merely an isolated acute situation or if the person is chronic crisis with common re-entry (James, 2017, p. 69).  Chronic, long term and transcrisis can all play roles in the persons limitations on resources and resiliency.

Affective states refer to one’s current mood.  Hence any abnormal or impaired mood can show signs of crisis upon the scene.  A person may seem over emotional  or severely withdrawn.  The behavioral functioning can also be important in assessing.  The crisis professional observes the doing, acting and behavior of the person on scene (James, 2017, p. 58).  Finally the cognitive state of the person in crisis in important in crisis.  The crisis professional reviews the thinking patterns and thoughts of the person in crisis.

These three observations detail the ABC model of affective, behavioral and cognitive states (James, 2017, p.58).   The Triage Assessment system and chart lists a series of questions that look at affective, behavioral and cognitive issues as well as supplying a chart to access severity of crisis (James, 2017. p. 59-64).  A person’s affective state will include observing if the person is on medication or not, under a substance, experiencing psychosis or paranoid or any other mood related or physical appearances.  A person’s behavioral state is ranked based on if the person is defiant, aggressive, reckless, suicidal, or violent.  From a cognitive state, observations include if a person is uncooperative, impulsive, hysterical, confused or unresponsive (James, 2017, p. 60 & 68).

The Affective, Behavioral, and Cognitive scales help assessment with the worst score totaling 30.   Important labels include  no impairment and minimal to low, moderate, marked and severe.  Stable moods are contrasted moods devoid of feeling, behaviors are rated from socially appropriate to behaviors that intensify crisis, and decisions are ranked from considerate of others to decisions that are clear and present danger to self and others (James, 2017, p. 61-62).  Ratings are based off of a 1 to 10 model of each facet of affective, behavioral and cognitive.   Within affective, one rates anger, fear and sadness.  Within behavioral, one rates approach, avoidance and immobility.  Within cognitive, one ranks current transgression, perceived future threat and past reflection on loss.  In addition, there exists observation questions regarding the person that looks at if the person is on or off medication.  Individuals who rate within 3 to 10 total points within assessment are considered minimal impairment and need little direction and can self direct.   Those with ratings of 11-15 require some guidance and direction.  Those with a score of 16 to 19 are indicative of a person losing more and more control of the situation.   Those with scores at 20 are potentially entering into harms way and need intense direction to avoid a lethal range, while those in the upper 20 scores have entered into a lethal range and lethality is present (James, 2017. p. 66).

Conclusion

Please also review AIHCP’s Crisis Intervention Specialist Program and see if it meets your academic and professional goals

Crisis Intervention is a structured response to pure and utter chaos.  It is mental first aid.  While structured it is adaptable and adjustable.  Those who are experienced and talented utilize the core concepts and adjust and adapt in the moment.  The seven tasks to help a person find balance and mobility are key as well as assessing low impairment and high impairment cases within one’s affective, behavioral and cognitive abilities.  Those in crisis intervention whether in police, EMT, social work, mental health, and chaplaincy require empathy, patience and skill to safely deal with those who are harmful to self and others.

Please also review AIHCP’s Crisis Intervention Specialist Program.  Qualified professionals can earn a four year certification to help them within this field.  Whether working at a crisis center or trained professionals on the scene, the certification can help give academic and core information that can aid others attempting to work in this high stress but high rewarding field.  The program is online and independent study with mentorship as needed

 

 

 

Resources

Bengelsdorf, H., Levy, L. E., Emerson, R. L., & Barile, F. A. (1984). A crisis triage rating scale: Brief dispositional assessment of patients at risk for hospitalization. Journal of Nervous and Mental Disease, 172(7), 424–430. Access here

James, R & Gilliand, B. (2017). “Crisis Intervention and Strategies” (8th). Cengage.

Marschall, A. (2023). “How a Crisis Intervention Provides Mental Health Support”. Very Well Mind. Access here

Myer, R. A., Lewis, J. S., & James, R. K. (2013). The introduction of a task model for crisis intervention. Journal of Mental Health Counseling, 35(2), 95–107.  Access here

Roberts, A. & Ottens, A. (2005). “The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis Resolution”. Brief Treatment and Crisis Intervention. Access here

 

 

 

 

 

A Closer Look at Crisis Intervention

Posted on by Mark Moran

Crisis Intervention is a specialty field that is on the battlefield itself.  It is the first aid of those in initial emotional pain and mental disorientation.  It involves emergency workers, fire, police, paramedics, but also trained professionals in social work, chaplaincy and mental health.  These individuals go to the distressed whether the situation is individual or collective at a local or state level.  They meet the emotionally distressed at their home, whether it is due to violent crime, rape, murder, suicide, or sudden death, or to sites where national disasters such as hurricanes have wiped out a person’s home, or to terrorist or shooting sites where communities are left without meaning.  Crisis Intervention Specialists look to help individuals find sanity in the insanity and help equip them with the necessary immediate physical, mental, emotional and spiritual care needed to access and find direction.  They are not long term specialists for trauma but the first mental health responders to crisis itself.

Those in crisis intervention look to stabilize the person and help them regain emotional balance and the ability to cope when things personal or local disaster strikes

Crisis Intervention stems back the very first Suicide phone line in 1906 and the need for it was escalated with the infamous Coconut Grove Nightclub fire of 1942 (James, 2017, p. 3).   The crisis emergency became more apparent with the Community Mental Health Act of 1963 that closed asylums and referred those with mental issues to local mental health services (James, 2017. p. 3-4).  Unfortunately, without observation, most suffering from mental trauma, addiction, or minor mental health became the problem of law enforcement and many now find themselves in prisons.  The constant and sometimes fatal interactions with mentally unstable individuals with police have led to multiple unfortunate deaths which have called for better mental health accountability by society as well as police training in crisis intervention.  With the awakening of post Vietnam PTSD among veterans, addiction, as well as women rights and abuse, the need for crisis intervention grew even more.  Today it is a must in a society with many mental maladies that lead to acute instance of crisis.

AIHCP offers a four year certification for those interested in a Crisis Intervention Specialist Certification

What is Crisis?

Crisis definition while sharing key qualities is defined by many mental health professionals.  According to James there are a variety of instances that constitute crisis.  People can face crisis when obstacle to life goals seems to insurmountable that it leads to despair and disorganization in life.  People can face crisis when a traumatic event occurs that totally usurps one’s life and life narrative.  People face crisis when a person has no response for the problem or immobilizes them and prevents them from moving forward.  People face crisis when fall into anxiety, fear, shock and distress about a disruption in life.  People face crisis a loss of psychological equilibrium and emotional instability and imbalance result.  People face crisis when they enter into an acute emotional situation arising from external sources that one has temporary inability to cope with or deal with.  People face crisis with extraordinary events of disaster and terror or rapidly building stressors that upset the homeostatic balance of the person’s life creating a vulnerable state (2017, p. 9).

James  also gives a more precise definition accumulating the above ideas of crisis.  He refers to crisis  as the “perception or experiencing of an event or situation as intolerable difficulty that exceeds the person’s current resources and coping mechanisms.  Unless the person obtains relief, the crisis has the potential to cause severe affective, behavioral, cognitive malfunctioning up to the point of instigating injurious or lethal behavior to oneself or others (2017, p. 9)”.

Types of Emergencies

Behavioral emergencies when situations escalate to a point of immediate intervention to avoid death or injury (James, 2017. p. 9).  This can include suicide intervention, homicides , lethal situations, abuse, rape, or any type of violent interpersonal behavior.  It can be direct or indirect. Sometimes these emergencies occur due to accidents without intent of injury but injury or life risk occurs.  In other cases, they can be a product of emotional reaction

Another type of emergency is referred to systemic emergencies that affect organizations, communities or nations.  James defines a systemic emergency as a “when a traumatic event occurs such that people, institutions, communities and ecologies are overwhelmed and response systems are unable to effectively contain and control the event in regard to both physical and psychological reactions to it (2017, p.11)”.  These can include natural disasters such as hurricanes, tsunamis, earthquakes or tornadoes, as well as terrorist actions, or public shootings.  Within all crisis is the possible of it spreading.  The term metastasizing crisis is utilized to explain how crisis can outgrow one person and spread to another or how one local crisis can spread to a larger reason.  Crisis Intervention teams and emergency response units look to contain crisis through primary prevention as well as secondary intervention policies to prevent as well as minimize.

In all of these cases, the presence of danger exists. Things can change quickly and there are no quick fixes  In most of these crises, individuals are faced with choice or no choice.  Many are unable to make a choice without help but choosing to do something shows ability to respond and react.  Whether an individual is negatively effected by a crisis depends on their individual makeup.  Any human being can be victim of a crisis but how one responds depends on interior and exterior characteristics of both the person and the the type of emergency.  Resiliency plays a key role in whether one in crisis events and emergencies will go numb, or emotionally instable and uncapable of response.  Ultimately beyond exterior and interior sources of a person, it is ultimately one’s perception of the crisis that has a stronger influence than the actual event itself (James, 2017, p. 11-12).

 Types of Crisis and Transcrisis States

Within these types of emergencies, there exist numerous types of crisis to the individual.  Individuals can suffer from developmental crisis as a result of change throughout life that produces abnormal responses of crisis.  Such examples can include the birth of a child, college, a midlife crisis, or even aging (James, 2017, p. 18).  In addition to developmental crisis, individuals also face situational crises that are uncommon or extraordinary as to result in inability to respond or cope.  Existential crises are far deeper reaching and reach the core of the person’s belief system.  Finally, ecosystemic crises involve acts of nature, or human causes evils or disasters that affect individuals or communities (James, 2017. p. 18).

Individuals can experience many different types of crises.

While it is the job of the Crisis Intervention Specialist to help individuals again find balance during crisis, sometimes individuals carry baggage of unresolved issues and current stressors can trigger past unresolved trauma.  This is referred to as transcrisis states that can emerge.  These states can also occur due to a variety of mental issues ranging from development and unfilled duties, to repressed trauma,  as well as addiction which can lead one into crisis when faced with other issues.

James  notes however that transcrisis state should not be confused with PTSD which is an identifiable disorder linked to a specific trauma (2017, p. 13). While those with PTSD may be in a transcrisis situation, transcrisis by itself is more vague and due to multiple issues and stressors.  The state is one that is residual and reoccurring and always capable of catching fire with a stressor that overflows the cup of the person’s mental abilities.

Basic Crisis Intervention Theories

Lindermann introduced the first basic concepts of Crisis Intervention with his research from survivors from the Coconut Grove Nightclub fire but he focused more solely on normal grief reactions and adjustments to the loss.  Caplan, later would view the whole of the traumatic event as crisis beyond grief and loss.  Caplan listed the the basic qualities of crisis and adjustment to crisis involving disturbed equilibrium, grief therapy, grief work and restoration of equilibrium (James, 2017, p. 14-15).

Other systems would expand on this basic theory and address certain aspects of psychology of one or more over the other.  This included various systems.  First, psychoanalytic theory applied the idea of expanded crisis theory beyond general systems that surround the person to also include the individual’s subconscious thoughts and past emotional experiences and how they relate to the current crisis (James, 2017, p. 15).   Systems theory instead of looking within the person, emphasized analyzing the interrelationships and interdependence of individuals in crisis or the event and how needs were met within those systems.  Via aid and assistance, one can lessen the crisis to the individual or family (James, 2017, p. 16).  Ecosystems theory places more emphasis on the macrosystem involving the person, family or community and the interrelated  elements and how change to one aspect can lead to disarray for the whole (James, 2017, p. 16).   Adaptational Theory focuses on a persons adaptive or maladaptive coping strategies and how good coping will alleviate the crisis sooner than maladaptive reactions. Hence the focus is on how one copes with the issue in a healthy way (James, 2017, p. 16).  Interpersonal theory focus on internal locus of the person and the ability to reshape and reframe and find optimism.  It is based on empathy and listening as well as the ability to help individuals find confidence that will ultimately defeat the crisis state (James, 2017, p. 17-18).  Finally, Developmental theory analyzes how ones development in life has prepared or not prepared an individual for future crisis (James, 2017, p. 18)

Crisis Intervention Models

The three primary models in crisis intervention are the equilibrium model, the cognitive model and psychosocial transition model.

Different models approach crisis from different angles. Please also review AIHCP’s Crisis Intervention Specialist Certification

The Equilibrium model is based off Caplan and identifies crisis state as an emotional and mental imbalance.  Their abilities to cope and meet the needs of the crisis are overwhelmed and require assistance in finding equilibrium as opposed to disequilibrium.  The goal is to help individuals find balance (James, 2017, p. 19).

The Cognitive model looks to correct faulty thinking in crisis regarding the events surrounding the crisis.   The goal is to help the individual become aware of their faulty thinking, reframe and change their views or beliefs about the situation.  They are very much connected with CBT (James, 2017, p. 19).

The Psychosocial model states that individuals are a product of their genes, social influences and social environment.  When crisis arrives, professionals look to help individuals identify internal behaviors and moods as well external factors which are preventing the individual from utilizing resources or workable alternatives to the crisis at hand (James, 2017, p. 19).

A large part of all models is helping individuals again be able to cope with the problem at hand.  Hence the term Psychological First Aid was coined for crisis intervention (James, 2017, p. 20-21).  Like stopping the bleeding of the wound, crisis intervention specialists, first responders, emergency relief, social workers, and chaplains are trained to help individuals by meeting basic needs so the person can regain pre-crisis state. US Department of Veteran Affairs, among many, list the most important steps in psychological first aid.  Some of these issues also deal with supplying basic safety and security, including shelter and food when necessary as part of basic Maslov needs.  Basic Psychological First Aid includes proper contact and engagement which is non-intrusive and compassionate.  It should include a sense of safety and comfort.  It needs to help stabilize if needed the individual from a mental perspective.  It needs to gather information for the needs of the individual and then giving practical assistance for those needs.  Furthermore, it entails connecting the individual with social supports such as family, friends as well as informing the individual how to cope with stress and help the person continue to function.  Finally, it involves securing for the individual future contacts for aid and help with various services for their particular issue or mental health. (James , 2017, p. 21).

Within this first aid model, the ACT model can play as key guide.  One needs to access the problem and understand the needs of the person, connect the person to social support systems and to identify any traumatic reactions or possible future disorders.

Conclusion

Crisis comes in many forms and is universal to all humanity but different people react differently to crisis.  Some may lose emotional balance and equilibrium and need immediate care.  Those in emergency services, chaplaincy, social work, or disaster relief need to understand the nature of crisis and how to help individuals in the moment regain that emotional equilibrium.  While different crisis range and different models exist to help others, crisis intervention is similar to emotional first aid in that it looks to stop the immediate emotional bleeding and help the person again regain control of the situation and be able to cope.  While this only deals with the first phase of a long recovery, like all emergency and acute situations, it is vital for many to be able to survive the initial blast of crisis at during different times.

Please also review AIHCP’s Crisis Intervention Specialist Program

Please also review AIHCP’s Crisis Intervention Specialist Program and see if it meets your academic and professional goals.  The program is online and independent study with mentorship as needed.  The program is and to qualified professionals seeking a four year certification who work in human services,  mental health and healthcare professionals, social work, chaplaincy, nursing,  emergency call centers, first responders, and disaster relief teams.

Resource

James, R. & Gilliland, B. (2017). Crisis Intervention Strategies (8th)”. Cengage

Additional Resources

Boscarino, J. (2015). “Community Disasters, Psychological Trauma, and Crisis Intervention”. Published in final edited form as: Int J Emerg Ment Health. 2015. National Library of Medicine. Access here

Ford, J. D. (2021). Essential elements of crisis intervention. In J. D. Ford, Crises in the psychotherapy session: Transforming critical moments into turning points (pp. 63–79). American Psychological Association. Access here 

Valeii, K. (2024). “Psychological First Aid: How It’s Used”. Very Well Health.  Access here

Wang, D & Gupta, V. (2023). “Crisis Intervention”. National Library of Medicine. Access here

“What to Do In a Crisis”. NAMI. Access here

 

 

 

Pastoral Crisis Intervention

Posted on by Mark Moran

While AIHCP offers a Pastoral Thanatology Certification which aims at end of life and death counseling and spiritual care, pastoral care goes beyond merely helping individuals face the crisis of death, but it also stretches out throughout life where multiple pastoral and crisis events occur.  Grief counseling, Christian counseling, as well as Stress Management and Anger Management are all key tools to help individuals face the problems of life, but crisis itself involves bandaging the bleeding wound and stabilizing the person emotionally and mentally.  A person is crisis is facing a confusing and emotional imbalance that one’s coping strategies temporarily are unable to handle.   The following can lead to immediate disorientation, loss of sense, and intense emotional outbreaks associated with sadness, anger, or hopelessness.   In essence, ” for an individual, crisis is the perception or experiencing of an event or situation as intolerable difficulty that exceeds a person’s current resources and coping mechanisms (James, 2017, p. 9) “. For some in crisis, foolish decisions can be made, while others, inaction or inability to act can occur.  Whether insanity and foolishness or numbness ensue, the person is in dire need of intervention to restore balance, reason and hope.  The purpose of the pastoral counselor specialized in crisis intervention is to not only help the person restore that balance but also to give spiritual aid if needed.  Chaplains and other on the scene professionals look to help these individuals in crisis find clarity and hope.

Chaplaincy plays a big role in pastoral crisis intervention.

Please also review AIHCP’s Crisis Intervention Specialist Program as well as its Pastoral Thanatology Program

Basic Crisis Intervention

Secular crisis intervention serves the most basic needs of those experiencing trauma or sudden loss.  Whether a sudden deceased family member, a violent crime, a national tragedy, or act of nature, individuals need immediate care and assistance in these dark moments. Everly points out that traditional mechanisms of crisis intervention including early intervention, social support, cathartic ventilation, problem solving and cognitive reinterpretation are all essential basics for helpers in crisis (2000, p. 139).   In addition, Mitchell looks at some of the most basic needs for those in crisis need through the acronym ASSISTANCE.  Mitchell lists the need for Assurance of individuals that individuals, or the government will help in severe crisis.  In addition, he lists Security is present and that children and families are safe if they follow directions and guides.  Structure refers to order in chaos and the structure provided by others to help again restore order.  Information refers to giving individuals in crisis, or part of disaster, the best knowledge and resources for a given crisis or disaster. Support refers to not only financial and guidance, but also mental and emotional support through crisis intervention as well as pastoral guidance.  Truth refers to not hiding important information to those victims of disaster or terrorist action but letting them know everything pertinent to a situation to avoid further panic.  Action refers to not merely thinking but also helping others in distress, whether it is the crisis counselor working with someone, or others helping a neighbor in need during disaster.  Neutralize refers to negating pessimism but pushing forward with optimism and plans.  Courage refers the inner resolve of those in crisis, disaster, or terrorist attack to move forward with renewed strength.   Crisis and Pastoral counselors can play a key role in implanting this within individuals with words of encouragement.  And finally this leads to Encouragement and being positive and pushing positive emotions and ideas with those in crisis but also fellow neighbors. (Mitchell).

Pastoral Crisis Intervention

These basic elements of helping others in crisis are core elements.  It is important to help individuals by offering hope but also helping individuals find balance and restoring pre-crisis mental and physical health to help the person find logic and reinterpretation of the event to avoid insanity and inaction.  Chaplains and other pastoral care givers who work in disaster sites, or work with police and fire can also offer another element of crisis care referred to as pastoral crisis intervention.   When individuals in crisis of a particular faith are receptive, pastoral crisis interventionists whether at a death bed, hospice, sites of violent crimes, accidents, disasters, shootings or other terrorist acts can look to help sooth the soul as well.  Everly illustrates various ways chaplains or other pastoral crisis interventionalists can apply pastoral care in crisis.  He lists scriptural education, individual and conjoint prayer, intercessory prayer, explaining worldviews, offering ventilative confession, providing faith based support, supplying ritual and sacraments, and discussion of Divine forgiveness and discussions about life and death and the afterlife (2000, p. 140).  Within this model it is also important to emphasize perceive reception for utilization of these strategies, which include receptive expectations from the person in crisis for spiritual care, or at least a receptive state of mind that is open to spiritual care, and finally not limiting it only to the person in direct crisis, but being there for other family members, police and rescue, as well as physicians, nurses and other healthcare professionals (Everly, 2000, p. 140).

Potential issues can erupt those for chaplains or other pastoral care givers.  It is essential first and foremost not to see oneself as a spreader of the particular faith one adheres to.  One is bringing spiritual comfort to those in crisis.  Chaplains in hospice or on staff for hospitals, or even prisons, or those who appear on crisis sites are there to serve all people of all faiths.  This is why they must be equipped with basic knowledges different religions, ranging from Christianity to Islam to Hinduism and Buddhism, as well as Judaism to even Taoism.  In some cases, individuals may be merely receptive to hear a caring voice.  Chaplains or those in pastoral care in crisis need to be aware of their role as bringers of peace.  If a patient or victim of crisis shares the same faith values, then such issues of universal speech of spirituality can be narrowed down theologically to the faith shared, but when not, some victims may request someone else who shares the same faith, or even wish not to discuss spirituality.  Sometimes, it is the duty of the chaplain to find a rabbi, iman or priest for a particular individual if one cannot meet the spiritual needs itself. When reception is not open, chaplains and other pastoral care givers in crisis must respect these wishes to avoid further stress and frustration within the individual.  A person who is dying, or in crisis does not need further agitation if spirituality is discussed.  Furthermore, chaplains, while present to give peace, are not equipped to offer certain faith based services to other individuals.  For example, a minister is not able to offer Last Rites but must find priest, or in other cases, chaplains should not delve into religious practices they are not trained in or go against their personal beliefs.  Such subjects should be left avoided or referred to other clergy capable and willing.

Pastoral Crisis Intervention works with receptive individuals looking for spiritual care during crisis.

Everly lists a few issues that can occur in application of pastoral crisis intervention that are important keys for chaplains and other crisis givers need to remember.  Among them, he lists failure to listen to the secular needs of an individual.  He further lists lack of a proper or structured plan when arriving upon a crisis or death scene.  He also points out the the dangers of debating religious and spiritual issues with those in crisis, or attempting to explain theological issues, or preaching to a unreceptive individual, as well as trying to convert someone (2000, p. 141).   Obviously these issues are addressed in chaplaincy training and crisis response.  Chaplains learn in CPE training that they are present to offer peace not agitation.  They are not their to convert but to help with whatever spiritual or emotional need is within the person who is in crisis or dying.   Many who are strong within their faith may feel an inner obligation to bring their faith to the individual, but this impulse must be controlled for those who do not seek it or receptive to it.  Not everyone will share the same faith, but one is called to serve all individuals and meet the unique needs of those individuals.  One does not merely serve one’s own, but serves all common humanity.

In addition, Everly lists some diagnosis mistakes that can be made with individuals in acute crisis that should be avoided.  Many times, individuals in crisis can be mistaken as depressed when it is merely grief reaction to loss.  Also, chaplains and pastoral crisis interventionists need to be aware of brief psychotic reaction vs intrusive ideation, dissociation vs intrusive ideation as well as acute cognitive impairment vs severe incapacitation (2000, p. 141).   Ultimately, many individuals need to be referred later to licensed counselors to deal with longer term issues after crisis.  In some cases, the counseling may only need to be at pastoral levels but in other cases, clinical counseling may be required.  Chaplains and crisis interventionists are again present to supply immediate emotional and spiritual first aid, much like an EMT who physically stops the bleeding or acute issues, while the nurses and physicians repair the long term damage.  Likewise, chaplains and crisis intervention counselors later refer those who have stabilized to the appropriate behavioral health and human service professionals.

Conclusion

According to Evenly “Pastoral Crisis Intervention is the functional integration of pastoral activities with traditional crisis intervention/emergency health services (2000, p. 141)”. With this definition, one can see the important role chaplains play in helping individuals in crisis, whether due to terrorist action, natural disaster, violent crime, sudden death, or even near death in hospice or hospital settings.  Chaplains are not to evangelize the Gospel but grant peace and spiritual presence.  In some cases, they may be called to find a representative of the person’s faith, other times, they may be working with one of the same faith, but ultimately the goal is to treat all of humanity not only one of a particular faith.  In this regard, chaplains must be trained in multi faiths and multicultural counseling competencies to better speak and help others in different faiths.  In addition, chaplains are sometimes not even called to discuss spirituality because secular individuals in crisis may not wish to speak about it.  Chaplains, especially those on crisis scenes are called to respect the wishes of others and bring calm and restoration of pre-crisis state of mind.

Please also review AIHCP’s Crisis Intervention Specialist Certification and also AIHCP’s Pastoral Thanatology Certification

 

 

 

 

 

 

 

 

 

Please also review AIHCP’s Crisis Intervention Program, as well as AIHCP’s Pastoral Thanatology Program.  Both AIHCP’s Crisis Intervention Specialist Certification and Pastoral Thanatology Certification are online and independent study with mentorship as needed.  The programs lead to four year certifications for qualified professionals.

Resources

Evenly, G. (2000) “The Role of Pastoral Crisis Intervention in Disasters, Terrorism, Violence and Other Community Crises”. International Journal of Emergency Mental Health.

James, R. & Gilliland, B. (2017). Crisis Intervention Strategies (8th). Cengage

Mitchell, J. “The Meaning of Assistance”.

Additional Resources

“National Hotline for Mental Health Crises and Suicide Prevention”. Naomi. Access here

Davies, B. (2023). “Crisis Intervention: Techniques and Strategies”.  NWA Crisis Center. Access here

Cherry, K. (2022). “How Crisis Counselors Help People Coping With Trauma”. VeryWellMind. Access here

“A Chaplain’s Role in Times of Crisis”. (2019). Christian Reformed Church” The Network.  Access here

 

 

Grief and Counseling with Asian Americans

Posted on by Mark Moran

Asian Americans, as well as those who immigrate from Asia to the West are a multicultural group that cannot be categorized completely as one group.  In many cases, the general assumption of Asian equates to those of the Orient, but Asia encompasses far more than the mere Orient Japanese, Chinese and Korean cultures, but also India and many other locations throughout the massive continent.  Hence when referring to Asian Americans, it is to be understood as Asia as a whole and not merely those of Oriental descent.  Regardless, Asian Americans share many similar traits, religious ideals and cultural and family structures.  In addition, they have also faced there own oppression at home as well as within the West and United States.  Grief counselors who wish to help Asian clients need to have a full understanding of their culture and ways of expression, in addition to understanding historical oppressions.

Please also review AIHCP’s Grief Counseling Certification and see if it matches your academic and professional goals.

The Asian American and Migrant

Asian Americans are a diverse group of individuals who share many common family structure norms. This plays a large role in their mental health and adjustment to Western culture

Like any migrant group, Asian Americans face unique challenges during acculturation, as well as unique challenges from their homeland.  Many Asians immigrated to the United States via the west coast in the 19th Century, as well as those who have fled communist and tyrannical regimes in the 20th Century.  There are numerous migrants from China, Vietnam and Korea since the mid century who fled oppressive regimes, as well as government persecution of minorities in India and Southeast Asia.   Within the West, Asian Americans have met there own discrimination especially within the United States.  In the 19th Century, many Asians were commonly mocked and ridiculed and left isolated within their own districts.  During the World War II, many Asian Americans were collected into determent camps by the US government.  Many Oriental Americans, especially of Japanese descent had to prove their American values and were treated as traitors or spies.   Even today, various racist slurs or attributed to Asian Americans of different descent and most recently, many were unjustly targeted for the spread of Covid19.

Ironically, many Asians also receive “positive” stereotypes that can also be damaging, such as the assumption all Asians are smart and receive good grades.  While education is key driving force within Asian culture, these reinforced stereotypes when applied can cause confusion and distress to the particular individual.

In addition, Asian Americans and migrants face acculturation issues within their own unique family structures  and Western society.   Asian American cultural structures place greater value on collectiveness and needs of the family.  It submits to a stronger hierarchal structure that places the individual at the need of the family. Many personal and individual decisions made by Westerners are considered family business in Asian families.  Hence obligation to family, obedience, and arrangements even in marriage are considered social necessities (Pederson, 2018. p. 122).  In addition, Asian culture emphasizes humility and modesty when speaking of self and are far less lenient with outsiders than family members in these regards.  In addition, self restraint and harmony are prized more than self disclosure and independent choices (Pederson, 2018, p. 122). With this higher respect of authority, many Asian Americans have difficult times understanding American and Western culture and its demand of freedom, pride, rebellion and personal choice.

Hence within this group, there can be a struggle between first and second generation family members as well as integration with less traditional Asian families via marriage.  This can lead to depression and anxiety for members who need their family structure and support but wish to express themselves outside the cultural norm of their family.

Counseling the Asian American

Many Asian Americans who experience better acculturation seek counseling more so than those with worst experiences.  Of course tradition, language barriers and other cultural factors can play a role in willingness to seek mental health help. Overall, Asian Americans are considered to under utilize health services (Pederson, 2018, p. 129).   Asian Americans, however, experience the same general mental issues all human beings experience despite the “model minority” stereotype (Pederson, 2018, p. 130).   Like many cultures, Asian Americans sometimes prefer a counselor of their own culture and race to help foster understanding of cultural issues.  Pederson points out that racial matches in counseling do equate to increased utilization and duration of therapy (2018, P. 134).  Racial match while able to grant better credibility within the counseling relationship is not always ideal or available and this again leads to the importance of counselors to be multicultural aware.  Of course with so much discussion about racism, many sometimes wish to turn a blind eye to race itself but turning one’s eye to race and culture ignores the fabric of the client sometimes him or herself.  Ignoring hate and removing it is the key, not denying differences that are integral to who someone is.  Hence counselors need to be aware of the differences and through this understanding be competent to bridge the cultural difference between counselor and client.  This will ultimately help population groups, such as Asian Americans, become more comfortable with a non-Asian counselor.  This involves Western counselors having a stronger understanding of authority and family structures within Asian American homes and better apply that knowledge to the counseling dynamic.  Interesting enough, it is important to discuss the counseling outcome and dynamic with Asian Americans.  Normally, Asian Americans expect answers from experts.  They wish to be told what to do and how to follow through.   The overall view for many is that counseling is directive and authoritarian. Many expect more directness in what to do (Pederson, 2018, p. 128).    This is why is it important to review expectations of mental therapy and the importance of the process of self discovery and healing instead of the counselor taking upon a role of authority.

Grief Counselors need to have multicultural competencies in Asian culture to best help clients with grief

Again noting that no two people are alike, counselors can still have a base understanding of Asian culture when working with a Asian client.  First, it is important to note that many Asians communicate in a high context style without direct or specific references (Pederson, 2018, p. 125).   In addition, many Asians do not express or communicate emotion as freely as Westerners (Pederson, 2018, p. 125).  It is important to understand this because if analyzed from a Western lens only, this may appear to be hiding feelings or pathological but in reality is merely cultural.  Other misconceptions can occur as well if a Western lens is utilized in call cases.  If an Asian client seeks parental and family advice on every issue from employment to relationships is judged as a Westerner, then diagnosis may present a maladaptive issue, while in reality, the Asian client is performing well within his or her cultural norms.  Hence it is important to have a strong understanding of the cultural emphasis of family and authority within Asian communities and how this comes into play during counseling.

One key cultural expressions within Asian communities is the issue of shame and loss of face.  The fear of shame or failure or losing face and disappointing the family can be a large motivational pull for Asian clients (Pederson, 2018, p. 124).   Feelings of shame upon one’s name and family is a large fear in collectivist cultures (Pederson, 2018, p. 124).  Hence shame can play a role in loss, grief, as well as decisions.  One may live an unhappy personal life at the expense of a living a life that spares shame upon the family name. In addition to shame and loss of face, many individuals within Asian cultures are pushed to perfection and fear failure.  The more perfectionist the family structure, the far greater stressors for the individual to succeed at all costs (Pederson, 2018, p. 127). In addition to fear of shame, or depression and anxiety associated with perfectionist model families, counseling with Asians must also take into context high contextual communication styles versus lower contextual communication styles. Most Asians associate with non-verbal cues to express ideas.  This helps avoid confrontation or disrespect.  On the contrary, most Westerners communicate with more direct communication or low contextual communication where words are purposely used to state and communicate an issue.  This can across to an Asian as direct, aggressive, or rude (Pedersen, p. 125).

Within grief, various family structures and inner frictions can cause unresolved issues during loss and death.  Anytime a person exists within a culture that has expectations of the group over the self, as well as a restraint of emotion, one can expect possible grief reactions.  The individual may experience depression or anxiety with one’s own life choices and then when family death occurs and  also possibly feel multiple guilts if one did not do as one was told to do by the deceased.  These issues need addressed in counseling to allow for proper grieving and resolution of the loss.  When dealing with Asian clients, these issues may exist during grief and loss and may need addressed or at least explored to discover if the client’s family had such cultural norms.

Conclusion

Asian Americans or migrants are more than just South East Asia but also include India and outlaying areas.   The culture for the most part is very family and collectivist orientated with emphasis on respect of authority.  Family plays a key role in decisions.  Shame also plays a key role in keeping members of the culture to performing their duties to the family.  Counselors need to be aware of the cultural dynamics when working with individual clients.  Pending on acculturation and family dynamics, different Asian clients will vary in how they respond to Western ideals.  Regardless, grief and loss can still be impacted within family structures that dismiss emotional expression and individual freedom.  Resentment and anger can build up and play a role later in loss and grief.

Helping different cultures acculturate yet maintain identity is key. Please also review AIHCP’s Grief Counseling Certification

Please also review AIHCP’s Behavioral Therapy Certifications for Human Service Professionals as well as Healthcare Professionals. In particular, please review AIHCP’s Grief Counseling Certification and see if it matches your academic and professional goals.  The program is online and independent study and open to qualified professionals.   In particular, for those who are already certified grief counselors, please review AIHCP’s specialty Grief Diversity Counseling Program.

 

 

 

 

 

 

 

 

Reference

Pederson, P. et al. (2018) “Counseling Across Cultures” Cengage

Additional Resources

Huizen, J. (2021). “Asian American mental health stigma: Why does it exist?”. Medical News Today.  Access here

Nagayama Hall, G. et al. (2011). “Culturally-Competent Treatments for Asian Americans: The Relevance of Mindfulness and Acceptance-Based Psychotherapies”. Clin Psychol (New York). Author manuscript; available in PMC 2012 Sep 1.  National Library of Medicine.  Access here

Cherry, K. (2023). “17 Mental Health Resources For Asian Americans and Pacific Islanders” Very Well Mind.  Access here

Misun Kormendi, N. (2021). “Asian American mental health during COVID-19: A call for task-sharing interventions” SSM Ment Health. 2021 Dec; 1: 100006.. National Library of Medicine. Access here

 

 

 

 

 

Grief Counseling and Immigration: Needs of the Migrant

Posted on by Mark Moran

Migrant populations are becoming more and more increasing in the West and this has had a large impact on Grief Counseling as well as other forms of mental therapy.  Throughout numerous blogs, we have discussed the immigration factor for population groups of Asian, African, and Hispanic groups, but the general and universal need of the immigrant and the acculturation process is a unique process within itself.  Whether from Eastern Europe or South East Asia, there are general considerations to take into account for counseling migrants.  Of course, for some population groups, the cultural shock and change are far greater as the cultures differ, but there still remains a general shared story for any traveler in a foreign land.

While some may paint the immigration story to America as perfect, the reality is somewhere in between

Please also review AIHCP’s multiple behavioral health and counseling certifications for Human Service and Healthcare professionals in the areas of Grief Counseling, Stress Management, Crisis Intervention, Anger Management, Life Coaching and Christian or Spiritual Counseling.

The Immigrant

For a nation that prides itself upon taking upon the world’s ragged and poor, the welcoming arms of the Statue of Liberty has not always been so welcoming.  As a nation built upon migrants and the concept of social melting pot, there ironically has existed a counter effort to maintain its Anglo-roots.   WASP and Nativist movements have existed within the US since the early 19th Century as an attempt to keep America White, Anglo, Saxon and Protestant.  Social agitation to Irish immigration, Italian immigration, Asian immigration and African freedom, as well as discounting of the rights of the original inhabitants, the Native Americans, have always been a priority for these racist groups.   Whether in regards to restriction of rights, rewriting history, or national intimidation tactics, the Nativist Movement within the United States has always had a minor audience that wished to keep America Anglo Saxon, or at least European.   This has led to countless cases of intimidation and hate against migrants.  This was especially true in the 19th Century at the hands of the Know Nothing Party and its attempts to suppress Irish Catholics.  Later, the KKK would take up the effort to intimidate not only African Americans recently freed from slavery, but also to all immigrants ranging from Jews and Asians to Catholics and Irish.  Unfortunately, even today, the anti-immigration rhetoric is powerful.  In 2024, our nation still exhibits racist tactics against migrants at the border as well as against Haitians accused of eating pets in Ohio.

Dehumanizing is the key part of any rhetoric.  Hispanics at the border are labeled as cartel thugs, rapists and criminals or Haitians are accused of eating pets.  These dehumanizing attempts are part of the play book of the racist.  It was done to the Jewish people in Europe and to the African American peoples during slavery.  The moment the individual is dehumanized, one is able to rationalize and justify their horrendous activity.   Downplaying the migrant is also key in the playbook of the Nativist.  Pederson points out that migrant faces various myths that attempt to make them appear as threats to the average American.  First, he points out the myth migrants have low education and little skills.  On the contrary, most migrants consist of 47 percent of the US. top academic positions within doctorate levels.  Secondly, Pederson points out that migrants are painted as threats to taking American jobs.  The reality is migrants make up about 15 percent of the American workforce. As for the jobs taken, many are low level entry positions or farming.  In fact, migrants make up 75 percent of farming jobs for fruit and vegetables, contributing to 9 billion in federal taxes and 75 billion in earnings.  Third, many label migrants as undocumented, but the reality is two-thirds of all migrants are documented.  Finally, many push the myth that a stronger border is needed to prevent invasion.  This has been suggested due to the terror attacks and security issues but while this is important, most migrants are not a threat and more focus should be to making those who are illegal into becoming legal and productive individuals, especially since so many are actually born here as children or existing on expiring visas (2018, P. 324-325).  Again, the Nativist myth that migrants are invaders are the larger myth at play here.  Border security is crucial but if the reason is due to fear of migrants, then the wrong emphasis on the wrong security issue is being emphasized to the detriment of a population group.  Unfortunately, the Nativist Movement is strong and alive again in the United States and it is something that must be addressed in the future years.

Migrant Issues in the United States

Acculturation varies upon the culture extremes between the country of origin and the host nation but also upon not just the culture but the individual.  So again, issues for one, may not exist for another.  One cannot in counseling assume one thing exists and another does not but must investigate each individual’s unique situation.  With that understood, one can still give a general and likely list of issues that can exist for a migrant during acculturation.

Migrants face different stories in their immigration and also face additional stressors within the host nation

First it is important to note that some migrants are here voluntarily, while others have had no choice.   One migrant may arrive for a better life and education or job chances, while others may be fleeing persecution, revolution or famine and disaster (Pederson, 2018, p. 323).  Obviously these two extremes present different mindsets when counseling a migrant. Hence the refugee migrant will have a far more traumatic experience than someone who has travelled to the United States or the West for opportunity.  The refugee faces various cases of potential PTSD, subjugation to relocation, detention facilities, lost family members as well as trying to adjust to a new culture, language and basic survival itself (Pederson, 2018, p. 326).  Some prior to arrival to the United States may have been tortured, abused, raped, falsely imprisoned or during time in refugee camps faced unclean sanitary conditions resulting in health issues and malnutrition (Pederson, 2018, p. 326).  Some may also experience survivors guilt issues along with PTSD.

Merely the psychosocial adjustment for forced migrant or voluntary migrant is difficult.  New schooling, or new jobs or new homes can all take time to adjust for anyone.  Merely relocate to another house across town and one is merely stressed, much less moving from an entirely different culture and nation to a new and foreign place.  The first 1 to 2 years constitute a crucial period for migrants as they attempt to find a foundation in life with basic survival (Pederson, 2018. p. 329).  This involves finding stable income and food, housing and jobs.  Many migrants who are refugees do no have the luxury as well as those who immigrated voluntarily to choose a destination.

During acculturation, migrants will experience the phenomenon of culture shock.  Some may integrate, others may not, others may gradually adjust, but the stresses of one culture clashing with another can have big affects on the individual as well as one’s family dynamics.  Pederson lists four phases that exist within culture shock.  The first is likened to a tourist who sees different and new things about a place and finds excitement regarding the differences.  The second phase can be a turning point, where the individual becomes dissatisfied or even disorientated to the change.  The third phase involves adjustment or re-orientation.  Finally, one reflects a degree of adaptation in managing cross cultural transitions (2018, p. 306-307).  Culture shock itself can manifest also in various physical ailments such as headaches, cognitive impairment, stomach issues, reduced energy and fatigue (Pederson, 2018, p. 307).  Mentally, it can lead to anxiety, depression and overall stress (Pederson, 2018. p. 307). Culture shock is a big part of acculturation depending on the culture and the person.  It is in essence an objective and subjective balance that varies from person to person, yet it is something that many migrants face due language barriers, challenges within the family due to external pressures, and racism within the host nation.

Counseling the Migrant

Whether a international student, a refugee, forced or chosen visitor, the migrant faces issues that sometimes are dismissed from the behavioral and mental health aspect.  Many migrants do not understand or wish to partake in the mental health services available due to cultural differences regarding counseling and expressions.  Pederson points out that many migrants will first seek what is comfortable and familiar to them when facing emotional issues.  Many turn to traditional forms of medication or services from their home culture.  In addition, many migrants feel the Western system of care is incapable of addressing their issues due to cultural barriers.  They also feel uncomfortable due to various language barriers that can make it difficult to communicate issues.  Finally, many are unable to find locations where services are provided due to their relocation itself (2018, p. 328-329).

Counselors need to be multi cultural proficient to help migrants from different places

Due to the wide variety of migrant cultures, counselors are called to multicultural proficiencies and practices (Pederson, 2018. p. 336).  In helping migrants, there is a multi model phased process to help migrant clients.  The first phase should involve education regarding mental health practices and interventions.  This will help eliminate any misconceived notions about the process and help the client and migrant understand the process.  Many cultures may have different ways of expressing and discussing issues.  This is why it is so pivotal to address how mental health works, however this does not mean the client’s cultural ideas and methods of healing are dismissed.  Within the second phase, traditional healing and other cultural aspects are taken into account.  The counselor learns and understands how the migrant from a particular culture expresses and migrant’s needs of family or traditional healing methods. In the third phase, counselors help migrants regain cultural empowerment within their environment.  This not only involves discussing mental issues with the migrants, but also focusing on daily issues and helping the migrant find services that meet everyday needs.  It is sometimes critical to focus on helping stabilize the migrant’s daily life before helping the migrant with his/her mental issues.  Part of this not only involves discussing daily problems but also addressing issues of racism and micro aggressions.   The final phase, it not only final, but also incorporated throughout the counseling process.  This phase involves the counselor as acting as a social advocate and as one pushing for basic human rights of the migrant (Pederson, 2018, p. 337-339).

Hence, counselors are not only helping migrants with grief, loss, relocation, but also a host of other adjustments that occur within the transitional period.  Many of the issues related to the immigration can sometimes become secondary to the new acculturation process itself.  The numerous stressors to change of environment can become overbearing to anyone, much less someone who may be fleeing a war torn nation.  Hence counseling migrants presents a whole new level of complications than the basic citizen.

Grief Counselors may be working on the pain and loss of home, family and way of life with a migrant, but also have to deal with an array of stressors arising from the acculturation process and its many demands.  This can lead to complications within grief as well.  In fact, many migrants may be dealing with traumatic grief itself.

Conclusion

Migrants face a unique challenge than other target groups.  First, they are not born within the host nation and face a more drastic change and acculturation process.  Second, they face greater discrimination and third, many are refugees and are forced into relocation due to famine, disaster or war.  Many face mental issues from the relocation and in addition face acculturation issues in the host nation.  Grief Counselors, Licensed Counselors, Social Workers or pastors need to understand not only the culture of origin but also the general pain of the migrant.  There obviously will be objective and subjective elements to each story, but counseling is definitely needed for many migrants who have faced atrocity and now face new discriminations within the host nation.  Unfortunately for many migrants, counseling can be a difficult process due to cultural differences, language and lack of access to it.

Please also review AIHCP’s multiple behavioral health certifications, especially, the Grief Counseling Certification.  The program is online and independent study and open to qualified professionals in both behavioral health as well as healthcare itself.  Please review and see if the Grief Counseling Program meets your academic and professional goals.

Reference

Pederson, P. et. al. (2018). “Counseling Across Cultures”. Cengage

Additional Resources

Line, A. (2022). “Considerations When Counseling Immigrants and Refugees” NBCC. Access here

Hodges, H. (2020). “Going To Therapy Can Be Hard, Especially For Immigrants — Here’s How To Start”. NPR. Access here

Tan. J. & Allen, C. (2021). “Cultural Considerations in Caring for Refugees and Immigrants”. National Library of Medicine. Access here

Moncrieffe, M. (2023). “Specialized care for immigrants experiencing trauma is vital. Psychologists are breaking down the mental health barriers”. APA. Access here

 

 

Multicultural Counseling Video Blog

Posted on by Mark Moran

 

Multicultural counseling competency is important in counseling.  Counselors need to be diverse in understanding how culture, race , creed, age and gender play a role in how a client will respond to them.  Counselors need to be also aware of their own internal biases.  With good cultural understanding, the counseling relationship can become enhanced and help the client heal and grow.  Please review the video above to learn more about multicultural counseling,

It is important to have a strong grasp of multicultural counseling skills when helping clients from diverse backgrounds. Please also review AIHCP’s many behavioral health certification programs

Please also review AIHCP’s Grief Counseling Certification, as well as its numerous behavioral health certifications in Christian Counseling, Spiritual Counseling, Anger Management, Crisis Intervention and Stress Management, as well as Life Coaching, ADHD Consulting and Meditation Instructor.

 

Stress and Anger Management: Helping Others with Emotional Flooding

Posted on by Mark Moran

Sometimes emotions get the best of individuals.  Individuals may be overwhelmed, dealing with multiple stressors or losses, overworked, or dealing with anxiety and stress.  These individuals may finally hit the final straw and face an occurrence known as emotional flooding.  First coined by John Gottman, this phenomenon can occur in workplaces, at home between couples and also between parents and children.

 

Emotional Flooding can occur when someone is overworked, over stressed and not getting enough self care. Please also review AIHCP’s Anger Management and Stress Management programs

Emotional Flooding can lead to an outburst or even a withdraw.  The individual loses ability to communicate rationally and becomes emotionally overcome.  This is quite similar to Fight or Flight responses, where the individual is put into a survival mode situation.  Obviously, emotional flooding can lead to drastic problems in relationships, mental health and legal situations especially in cases of anger.  It is hence important to utilize both Stress Management and Anger Management skills to help one face emotional flooding situations and hopefully prevent it.

Who is More at Risk for Emotional Flooding Situations?

Individuals who already have high levels of stress and anxiety or various anxiety disorders. PTSD or depression have a higher risk of emotional flooding occurring, as well as those with border line personality disorders as well as attachment disorders.  Traditionally, males more so than females also have greater chances of outbursts, but many females still experience the problem.   Those with higher sensitivity issues are also more prone to becoming overcome with emotional flooding.

Emotional Flooding, like any stress response, is a fight or flight response that will either push the person to emotional react without rationale or retreat.  With higher level of stress, the body will pump cortisol into the blood stream and one’s blood pressure and heart rate will increase, muscles will tighten  to prepare the body for fight or flight moments.   In addition, rapid breathing and shortness of breath may occur, with loss of focus and increased anxious states.

These types of lapses are obviously huge problems at work places, arguments between couples and when parents are dealing with unruly children.  It is important to identify the triggers and symptoms, as well as understand one’s current level of stress to better prepare for a total flooding moment.  Emotional Flooding hence has huge negative impacts on mental health, physical health and social life.  This in turn leads to worst anxiety, poor decisions, broken relationships, legal issues, lost jobs and physical break down of health.

Dealing with Emotional Flooding

When facing and dealing with stress and anxiety, the first step is a good defense.  Individuals need to identify stress loads and mental health issues.  These need addressed and treated as needed to prevent a flooding moment.  Those who sense burnout is approaching, need to address mental and physical health issues to better address stressors.  In addition, individuals need to identify triggers that can set them off.  Those who see life as all or nothing or catastrophize things also need to readdress and realign their mental outlook on life.  Reframing can be a huge help to maintain a reasonable outlook when things go wrong or when one is over flooding with emotion.

Individuals who are facing emotional stress at a larger level hence need to take a good inventory of their life and their emotions.  They need to practice self care and give themselves time to reflect.  They need to set boundaries with others if too many things are overtaking them and they also need to find time to meditate, breath, or rest.  In addition, when facing an outburst, it may be helpful to practice breathing exercises, or grounding techniques seen in PTSD where the individual uses physical touch or grabbing of an item to help keep connection to reality.  It is important to identify triggers and emotions beforehand and to see how they can suddenly sabotage a person’s day.  Thinking about reactions and practicing reactions when in a peaceful situation can also help reframe reactions.  This is usually conducted in therapy.

When individuals lives begin to spiral out of control due to outbursts, then it is time to seek professional help.  Individuals may begin to isolate, lose sleep, lose appetite, become depressed, or lose important relationships.  Higher levels of anxiety may begin to creep into the person’s life and professional help may be required to help not only manage anger and stress but to also cognitively reframe reality.  In addition, if dealing with higher levels of anxiety or depression, certain medications may be temporarily needed to help a person again find balance in life.

According to therapist Maggie Holland, “Emotional flooding can be an extremely overwhelming and intense experience, but help is available. By working through your triggers, learning to self-regulate, making healthy lifestyle changes, or working with a therapist, you can feel more confident when navigating difficult situations and emotions (2024)”.

Helping a Loved One through Emotional Flooding

Of course no-one should ever permit themselves to be emotionally and physically abused.  It may sometimes be important to remove oneself from the situation.  While trying to help others through emotional flooding issues, one can help the other person cognitively through supporting the person and understanding the condition and triggers.    Focus, listening and empathy can help the person face the emotional surge. Avoiding quick judgement and feeding the anxiety is also key.  One can help the loved one breathe and calm down by presenting a calm and caring voice.

Conclusion

Selfcare, identifying triggers and grounding can help one deal with emotional flooding. Please also review AIHCP’s Stress and Anger Management programs

Obviously Emotional Flooding can be acute or chronic with an individual.  Some individuals are dealing with immediate stressors and overloaded while others may have anxiety, depression, PTSD, or Borderline Personality issues which would make the emotional breakdowns more common.  Regardless, it is important to practice good Stress Management skills and Anger Management skills to avoid worse breakdowns during flooding.  This involves identifying triggers, understanding one’s mental state and emotions, and grounding oneself.  One can also practice self care, meditation, and set greater boundaries to prevent overload.  With work, family life, partners and children at risk, it is critical to regain control of one’s life.

Please also review AIHCP’s Stress Management and Anger Management Certifications.  The programs are online and independent study and open to qualified professionals seeking a four year certification.  Many healthcare as well as behavioral healthcare professionals seek these additional certifications to enhance their work resume and specialty practices.

 

 

 

 

Reference

Holland, M. (2024) “Emotional Flooding: Definition, Symptoms, & How to Cope”. Choosing Therapy.  Access here

Additional Resources

Gould, R. (2023) “How to Navigate the Storm of Emotional Flooding”. VeryWellMind.  Access here

Romanelll, A. (2020). “Flooding: The State That Ruins Relationships”. Psychology Today.  Access here

Malik. J. et., al. (2021). “Emotional Flooding in Response to Negative Affect in Couple Conflicts: Individual Differences and Correlates”. J Fam Psychol. 2020 Mar; 34(2): 145–154.  Library of Medicine.  Access here

“Expert Tips: How To Navigate And Overcome Emotional Flooding”. Mind Help.  Access here

The Problem Management Model Video

Posted on by Mark Moran

A key part of counseling involves helping the client identify the problem, propose solutions and execute those plans into action with assessment of progress.  This is the core of the Problem Management Model in counseling and is key in helping track a client’s progress.

Counselors can help clients learn to find solutions for their issues through the Problem Management Model

Please also review AIHCP’s multiple behavioral health certifications ranging from Grief Counseling and Christian Counseling to Crisis, Stress, Life Coaching and Anger Management Programs.  The programs are online and independent study and open to qualified professionals in both the behavioral health and health field areas.

 

 

 

 

 

 

 

 

 

Please review the video below

Counseling and Attending the Client Video

Posted on by Mark Moran

Counselors study psychology, various therapies and devote themselves to understanding the science of the mind and behavior, but if the counselor is unable to communicate and attend the client properly, then the knowledge is useless.  Counseling hence is also an art.  Counselors must possess interpersonal skills that allow them to help their clients.  Various micro skills help the counselor attend the client.  Basic fundamentals of attending include empathetic listening, observation skills, and appropriate responses.  This forms the foundation of the counselor and client relationship and allows therapy to flourish.

Attending the client refers to basic skills involving listening and observing. Please also review AIHCP’s behavioral health certifications, as well as AIHCP’s Grief Counseling Certification

Please also review AIHCP’s numerous behavioral health and healthcare certifications in Grief Counseling, Crisis Counseling, Christian Counseling, Spiritual Counseling, Anger Management, Life Coaching and Stress Management.  The programs are online and independent study and open to qualified professionals seeking a four year certification.

 

 

 

 

 

 

 

 

Please review the video below