crisis

Counseling Clients Through Crisis, Danger and Harm

Posted on by Mark Moran

In counseling, especially Trauma Informed Care counseling, counselors will not always discuss issues of the past.  Trauma from the past can scar emotionally and create many present issues, but many crisis situations exist also in the present.  Counselors or social workers or pastoral caregivers may discover clients that are in distress due to day to day threats and dangers.  This creates a difficult situation for counselors to discern legal and ethical obligations to protect someone from harm versus situations that while potential dangerous are not imminent and require the empathetic and therapeutic relationship to resolve.  New counselors have especially deeper concerns in this murky waters, while more seasoned counselors have a better understanding when and how to report, hospitalize or walk with a person in crisis that is facing danger or harm.  In this blog article, we will review various situations and how to deal with them, as well as important concepts in the therapeutic relationship that can help respect the autonomy and dignity of the person while also protecting the person.

Understanding how to help clients in potential or imminent danger and crisis. Please also review AIHCP’s Healthcare Certifications

Please also review AIHCP’s multiple certification programs in mental and behavioral health, including programs in Crisis Intervention, Grief Counseling, Christian Counseling and Trauma Informed Care.

The Importance of the Therapeutic Relationship in Resolving Crisis

Cochran points out that wrong decisions in counseling can have drastic consequences in helping those in crisis.  This means that following ethical and legal protocols are key, but assessing imminent danger and potential danger is a key skill.  Furthermore, even if as a counselor, one prescribes and writes down a plan for one to follow, there is never guarantee a client will listen. Many refuse to listen, or if feel coerced into doing something, fail to completely fulfill it because they do not believe in the course of action (2021, p. 222).  This is where not only discernment and assessment come into play but also understanding the dynamic role of the therapeutic relationship and how it can help a client in potential danger or even in some cases, imminent danger, a way to properly find safety without violating the person’s autonomy.  It is far more purposeful to help a person not only escape crisis and danger but understand how to progress and continue to heal and find better ways to to avoid it in the future.

Within the therapeutic relationship, Cochran emphasizes instilling within the client self responsibility that preserves dignity and integrity of the client with less restrictive interventions (2021, p. 222).  Why?  Simply because this allows the person to own the situation, understand the danger, be proactive in finding safety and share in the decision making process for finding that safety or care.  If this means convincing someone who is suicidal to admit oneself to a psych unit at a hospital, or help a person report an abuser, it is also best to guide and help the client make decisions with the counselor so the client can be fully on board.  When clients doubt, or question, or feel forced, they many times abandon the course of action and this is why the therapeutic relationship is so critical in helping clients escape danger.  Of course, unfortunately, there are cases where the client refuses to listen to reason, or refuses to report a crime, or puts oneself in harms way.  This is when a counselor reluctantly must obey legal obligations as a licensed counselor to protect a client.  Obviously these situations involve imminent danger, criminal activity, and a client unwilling to work with the counselor in a plan of action.  In addition to trying to utilize the counseling relationship to foster the best plans, it is also critical for the counselor to employ unconditional positive regard for the client and not just merely hear the situation, but to accept the person and the feelings behind it.  While one may be expressing self harm, or threat of being hurt by others, or hurting others, the counselor needs to employ empathy to help the person not only choose the best option but to also help the person heal.  Instead of judging, the counselor needs to hear the pain to better help the person correct the story (Cochran, 2021, p. 223).

Cochran points out that these situations of imminent threat to a client are some of the most difficult ones for counselors (2021, p. 249).   When dealing with suicidal clients, or domestic abuse victims, leave any counselors, much less new counselors feel a strong stress level when dealing with life and death.  Cochran points out that one of the biggest fears is never being 100 percent sure.  If a client completes a non-self harm agreement, a counselor can be left with a nervous feeling if the client will keep his or her word and not harm oneself.  In addition, Cochran points out that many times, counselors can be preoccupied with liability.  Rightfully so, liability is a key concern, and when necessary, legal actions need taken, but to focus solely on liability at the expense of the over-all situation and maintaining focus on the client, then larger errors can occur in the handling of a situation (2021, p. 252).  In addition to rookie jitters, lack of self confidence or experience, many new counselors sometimes also fear coordination with other counselors and professionals.  They may fear this may broach confidentiality but in many agencies, clients are seen by numerous other professionals and the seal of confidentiality is within the staff.  In addition, many times,  the discussions of imminent danger can be discussed with family, or other professionals due to legal laws (2021, p. 253-254).   If within the therapeutic relationship, family or other professional’s opinions can be inserted into the session without taking control away from the client.  These situations since they are so life altering sometimes need other minds and ideas and experiences to help provide the best outcome for the client.  When the client is working with the team and following a plan, instead of fighting against it and being forced into something, then these are the best situations.  Unfortunately sometimes, not all situations are ideal nor the existence of a therapeutic relationship’s existence.

Situations of Crisis that Can be Potentially or Imminent in Threat or Harm

Most situations of crisis that pose potential to imminent levels of harm include suicidal ideation, domestic violence and sexual abuse.  It is always best to utilize a therapeutic relationship in fostering the best play of action as opposed to arbitrary decisions, albeit sometimes when clients refuse to accept themselves, drastic decisions that may not fix the problem long term, but at least protect the client short term must be applied.

Helping those in distress can be difficult when trying to weight and balance legal duties as a counselor and also the autonomy of a client. The therapeutic relationship attempts to honor both

In all situations, it is best to help clients make the plan and be part of it.  Cochran points out that it may be tempting to take over and make it your plan for the client’s safety, but a counselor wants a client to have personal investment and ownership of a plan (2021, p. 225).   In planning, Cochran also calls for these situations to specifics in each plans that looks at all pitfalls or “what ifs” to help a client navigate the dangers of the crisis.  In addition, when a clients hint or speculate about things that may seem harmful, it is the duty of the counselor to error on the side of caution to broach the subject when necessary and even more so, say the words of “suicide”, or “abuse” if necessary to bring to the light the situation.  If a counselor feels a dangerous situation was implied, it should be saved for the end of the session to counter, but within the next few minutes to redirect to what was said to have a clear understanding of the danger the client is facing (2021, p. 226).

The Situation of Suicidal Threats

Suicide is nothing to ignore.  Many times, individuals dismiss these threats as attention seeking, or merely a state of momentary sadness.  While sometimes they may be benign statements, counselors, nor anyone should ever under estimate a possible suicidal threat.  Instead each needs to be taken seriously and with compassion and without judgement.  Each statement needs confronted and completely understood to see if it is merely a statement, or a wish that has potential or imminent harm intended.  Suicide assessment charts are common place in any counseling office.  These guides help counselors assess and discern situations but also help counselors better work with those who feel this way.

Counselors when broaching the subject of suicide, need to identify a plan of the person.  This plan entails why, when and how a person would kill oneself.  By discussing the details of each plan, counselors and trauma informed care specialists can better ascertain if the risk is minimal and requires therapeutic counseling or if it does pose a true and valid threat.  If it is a legitimate threat or desire, counselors need to determine the lethality of the plan.  The how of one wishes to kill oneself can be very revealing.  If one merely hopes to crash into a tree, or punch oneself, as opposed to shooting oneself, overdosing, or leaving a car running in a garage, then plans that involve less likely hood of death can be categorized as a lower risk level.   However, if more lethal methods are described, then the plan needs to be taken far more seriously.  Compounding the seriousness and lethality of the threat, counselors need to address if the means to carry out a plan is possible.  If a client owns a gun, or has a script that he or she could overdose on, then the level of imminent threat becomes a reality.

Counselors, however, can look for other clues to see the mindset of a client.  Clients may casually state I would like to kill myself, but it may hurt my family too much (Cochran, 2021, 229), or may state what would my baby do at home?  These types of clues are good ways to open the mind of the client to the counselor to better assess and determine.  In addition to preventative factors, counselors should look for future orientation (Cochran, 2021, p. 229).  If a client speaks of chores, events, or work schedules in the next coming weeks, then it is a good sign of no imminent threat, but if clients dismiss schedules, or events, or show no care these things, then a more imminent harm conclusion is warranted.   Another closely related clue to imminent threat is switch or sudden change in emotion about life.  If a client suddenly cares nothing about family, hobbies, or sports, or whatever interest that anchored to his or her reality, then this is a sign of danger that a counselor should take seriously (Cochran, 2021, p. 229).  In addition, a counselor should question the client on previous attempts of suicide.  Those with previous attempts pose a more serious threat to themselves.  Also, a counselor should discuss drug and alcohol abuse and the role it plays on inhibitions in regards to a person questioning life and whether to take it or not.

Through therapeutic counseling, the relationship in these conversations needs to end with some type of non-self harm contract.  The contract should include a time table of security, as well as persons to call if one feels sad or depressed or intrusive thoughts of harming oneself appear.  With this contract is safety planning, where the counselor attempts to receive from the client a promise of no self harm at least between sessions, as well as a call list of individuals that can help, as well as a promise to avoid substances that can limit inhibitions to prevent suicide (Cochran, 2021, p. 231).  One of the most important aspects of a plan is also removing any means that may exist.  If a person has access to a gun, then their is a promise to remove it, and if necessary facilitated through a family member.  If prescription medications are available, then the scripts are removed from the home or access of the person.

Some plans may not be able to be completed merely between the word of a counselor and client.  Some plans may need temporary hospitalization, or family intervention.  It is best that these plans are accepted by the client.  Hospitalization is important for individuals who cannot promise their own safety or commit to a plan.  It is good during this plan to discuss how the process will occur and the potential costs.  It may be helpful to to guide a client to the best facility to meet his or her needs.  It is also best to include family in this decision but also to not be afraid to ask for professional peer advice.   If a client is a threat to him or herself and refuses these measures, then unfortunately, the short term safety of the patient outweighs the therapeutic alliance (Cochran, 2021, p. 237).  It is always the best to have a client on board.  Good counseling and good relationships foster the trust for a client to follow the suggestion of a counselor he or she perceives as genuine and trustworthy.  Unfortunately, many in mental health may only see a client once or twice or in an emergency situation and may be forced making the tough but right decision on the spot.  It is however important to at least try to work with the client and empathetically guide them instead of stripping the person of all autonomy without conversation and empathy and respect.

Domestic Violence and Sexual Abuse

A client who discloses sexual abuse or domestic violence poses a real ethical issue for some counselors.  A counselor is ordered to report crimes of physical or sexual abuse.  How it is reported is another thing.  When joined together with the client in reporting physical abuse or sexual assault, a victim can retain autonomy and healing.  A victim may have a difficult time reporting in confidence this horrific trauma and may have conflicting feelings for the perpetrator, or remain in intense fear, or have shame about the story becoming public.  It is imperative to reflect these concerns with empathy and non-judgement but also reflect the imminent danger and legal responsibilities of the situation.  In previous blogs, we have discussed the importance of safety, security and trust in trauma informed care and this is especially important here.

Those facing potential harm need the ear of a good counselor to help guide them and protect them with an appropriate plan for the given situation. Please also review AIHCP’s Healthcare Certifications

Situations that do not denote reporting that lack physical violence or sexual assault can be more tricky.  There is definitely potential for harm and it may be imminent but has yet occurred.  In cases of emotional and verbal abuse, a very careful plan must be construed that utilizes the strengths of the therapeutic relationship.  Cochran points out that many relationships in crisis that carry emotional and verbal dysfunction may be unhappy but not necessarily imminent to harm (2021, p. 248).   It is important for counselors to understand the underlying causes for the dysfunction, approach ways to reduce triggers by both parties,  as well as ways to help them manage emotions.  Counselors should also seek to understand the past history of violence, if any physical violence occurred in the past to help ascertain the situation and its lethality.  Counselors may also suggest avoidance of high risk activities that lower inhibitions.  The use of drugs and drinking can correlate with violence.  Finally, whether, verbal or physical, anger in the home can be detrimental to children.  Special considerations need to be discussed regarding what children hear and what they feel regarding the uneasy tension (Cochran, 2021, p. 249).

If a situation does not warrant reporting yet has potential or imminent possible harm scenarios, a plan needs developed that guarantees the safety of the client.   Discussions on how to remove oneself from the situation, de-escalate, who to call, or where to possibly stay should all be highlighted.   Counselors are there in the therapeutic relationship to discuss the possible hardships and issues that surround all decisions (Cochran, 2021, p. 249).

In some cases, the counselor may speaking with the offender.  This may occur in solo sessions or couple counseling-The offender who admits to verbal or emotional abuse or to past incidents.  In this therapeutic setting, the counselor is to display unconditional positive regard despite any disgust or disapproval.  The point is this client or person has come for help.  They may at first make excuses but through empathy and good counseling skills, a person can start to see what he or she is doing is wrong in the situation.  This involves patience and no judgement to help facilitate the change necessary internally for the person to seek reform instead of being told to do something.  The counselor can help these individuals identify their own triggers, as well as circumstances, or situations that affect them.  The counselor can also identify if the client had been abused in the past and how to help the person heal and not pass on the same abuse.  Plans can involve identifying triggers, avoiding substances, and seeking the necessary help that may be beyond individual counseling sessions (Cochran, 2021, p. 243).

Conclusion

Counseling is not always about past trauma or issues that do not pertain to present potential or imminent harm.  Counselors need to understand their legal obligations when presented to report crimes or potential harm to a client or others, but they can also employ the therapeutic relationship which understands the pain of the individual and the distress of the entirety of the situation.  Sometimes this involves helping the person come to the conclusion that direct help beyond counseling is required, other times it may involve a plan for non imminent or criminal threats to a person’s safety.  The counselor in the therapeutic relationship manages the crisis with empathy but also respects the dignity and autonomy of the individual in coming to logical conclusions and safety plans that protect the individual and others.  When a client works with a plan instead of being coerced, then healing is more possible.  Unfortunately, some clients who are victims of crimes, or are a harm to themselves that refuse to work with a counselor, must be hospitalized, or the situation reported despite the pain it causes.  These are difficult times for counselors, especially new counselors.  Hence, it is important to employ a health therapeutic relationship when applicable, assess situations, consult with other professional peers and make the best decision for the welfare of the client.  It is not an immediate assessment but one that is made with many considerations, facts, and complications considered for the best outcome that respects the law but also safety of a client.

Please also review AIHCP’s healthcare certification programs in trauma informed care, crisis intervention and grief counseling

Always remember though

“The American Psychological Association (APA) offers ethical guidance through its “Ethical Principles of Psychologists and Code of Conduct.” Under these principles, therapists can disclose information without client consent if deemed necessary to protect the client or others from harm. This authorization for disclosure also extends to situations where the client has given permission, or when required by law, such as when providing professional services, seeking consultation from other professionals, or obtaining payment for services.” (Deibel, 2024).

Trauma Informed Care Specialists, those in crisis counseling, and any licensed mental and behavioral health professional, as well as healthcare professional can face these situations and must have a clear understanding what to do but also have the skills necessary to facilitate health client interaction that leads to joint conclusions when possible.

Please also review AIHCP’s multiple healthcare certifications and see which ones best meet your academic and professional goals.

Resource

Cochran, J & Cochran, N. (2021). “The Heart of Counseling: Practical Counseling Skills Through Therapeutic Relationships” 3rd Ed. Routledge

Additional AIHCP Blogs

Suicide Assessment. Click here

Suicide Lethality.  Click here

When Trauma Emerges in Counseling.  Click here

Additional Resources

Health Information Privacy. US Department of Health and Human Services.  Access here

Barsky, A. (2023). “Duty to Protect and the “Red Flag” Option”. Psychology Today.  Access here

“Guidelines for working with clients when there is a risk of serious harm to others” APS. Click here

Diebel, A. (2024). “What is a Therapist’s ‘Duty to Warn’ and Why is it so Important?” Grow Therapy. Click here

 

What is Trauma Informed Care?

Posted on by Mark Moran

Trauma is part of life.  As long one exists, trauma can occur.   Treating trauma acutely on the scene is important in crisis and mental health, but also recognizing it within a client or patient who has experienced it is key.   Being trauma informed and trauma aware can bring day light to many existing problems and prevent many future ones.  Mental health professionals must hence be trauma cognizant and alert for clues and possible issues within a client or patient.

Trauma informed care looks to help others that may have fallen through the cracks and never received trauma care. Please also review AIHCP’s Mental and behavioral health certifications

Again, the true reality is everyone grieves and loses someone or something.  The chance of one of those incidents to cause trauma at least once to some level in someone’s life is around 80 percent.  So understanding the fine line between experiencing something sad, or even bad, and how that translates subjectively to trauma is important since such a high percentage of people within the population will experience some type of traumatic reaction.  Identifying and helping individuals who are dealing with trauma can be a beautiful healing moment.

Please also review AIHCP’s Crisis Intervention Program, as well as its Trauma Informed Care Programs in 2026 for both clinical as well as pastoral disciplines.  Bear in mind, helping others with trauma and processing it, is not merely a clinical purpose, but it can fall into non clinical and pastoral settings.  So, it is important to help individuals face trauma within one’s scope of professional practice.  While this may be limiting for some, such as pastors or chaplains within the scope of their mental health training, other licensed professionals in social work, counseling or psychiatric nursing can help treat trauma at a much deeper level.  AIHCP’s certifications in behavioral health are aimed at giving professionals within all scopes of mental  health additional knowledge and skills to help those in trauma to process and identify it.  The idea of recognizing trauma across  a life span has only been recently introduced into the DSM-V.  This has opened the floodgates for many professionals to become certified within this field or utilize it within their practice.

What is Trauma

A person enters a state of crisis when something overwhelms his/her abilities to cope and handle the situation.  It de-stabilizes and disorientates them.  Like crisis, trauma is a severe stressful and impactful event in life that imprints itself upon the person.  Sometimes it is so horrible, the person is not even able to properly store it within the mind resulting later in PTSD.  Different levels of trauma exist.  In the article, “Advanced Method-Trauma Informed Framework” from SAMHSA (Substance Abuse and Mental Health Service Administration), the individual who suffers from trauma experiences what is referred to the 3 “E”s of trauma care.  The includes the event itself, the experience of it and the effects of it.

Trauma informed care looks to actively identify and recognize trauma in clients and be equipped to help those client heal from trauma across a life span

Within the event, what was the triggering occurrence that caused the initial trauma in a person’s life.  This is very subjective in nature.  What may negatively impact one person, may not hurt someone else based on numerous subjective, cultural, religious, emotional, mental and social support systems that make up the person’s ability to handle a crisis or horrible situation.  While an event may objectively be horrible, some individuals are able to recover and show resiliency to it and trauma is minimal or non existent.  Some soldiers can return home from war without trauma, while others cannot escape the trauma.   So while the event may be objectively dark, such as a tornado destroying one’s home, an individual may still respond to that event without long term trauma as opposed to someone else.

The experience of event is the second key element.  This is far more subjective in nature and determines if the individual will suffer trauma.  The experience at the mental, emotional, or physical level is so intense, it overtakes the individual to the point that the persons experience of the event is traumatic acutely as well as long term.  This again points back to a person’s emotional and mental build to particular events in life.  A person’s history, a person’s interior resiliency, or a person’s support systems can all play key roles in how a person handles a crisis or how a traumatic event imprints upon a person.  This in no way dismisses a person who experiences trauma as weaker than others because everyone is susceptible to trauma–it just matters what is one’s tipping point.

The effects of trauma play the third key element.  The effects of a traumatic event can be short term or long term.  They can be affect all aspects of the person.    Effects can include inability to cope with life and everyday stressors, or trust others, social withdraw and issues, or loss of purpose and life meaning, or properly utilize the cognitive process.  It can result in maladaptive coping practices, as well as manifest with symptoms associated with PTSD that include hyper vigilance, avoidance, dissociation, nightmares or emotional numbing.

Trauma across a life span and trauma informed care recognizes the imprint of trauma on human life and seeks to see if any trauma still lingers or was never discovered or at least discussed that may be haunting a client throughout his or her life.

SAMHSA and the Four “R”s and Key Assumptions in Trauma and Informed Care

SAMHSA’s article, “Advanced Method-Trauma Informed Framework” gives a detailed account about qualities and key assumptions in presenting a concise commitment to treating trauma across a life span and helping agencies, as well as individual practitioners a better way to proceed forward in creating a practice that gravitates around trauma informed care.  The four R’s are essential in addressing trauma within any agency.  A program or organization first needs to realize the impact of trauma as a universal human phenomenon that requires treatment in life.  Secondly, counselors, or agencies need to recognize the signs and symptoms of trauma that are either acute or manifesting across the span of one’s life time.  In many cases, one may have been living with trauma undetected through professional services or lack of visit.  Counselors need to be aware that some new clients may have trauma from ages ago that was never treated.  The agency or organization then needs to have the ability to respond to the needs of the client via fully integrated knowledge, training, policies and procedures to help the person.  Finally, the agency owes to to any client to resist re-traumatization of the person.

Trauma informed care realizes the existence of trauma and looks to recognize the symptoms of it within the population it looks to treat.

A trauma informed approach according to SAMHSA also applies six key principles to its application.  First and foremost, safety is key when working with trauma patients.  The client must feel safe physically, emotionally and mentally and the environment must facilitate that aura of safety.  Second, the agency and counselors or social workers need to present its operations in an open and trustworthy fashion.  Third, peer support is a key element in any healing.  Peer support or trauma survivors can supply their stories or support to others walking the healing journey.  Fourth, the entirety of the agency all plays a role in the healing process.  The entire agency has a clear and mutually defined role in application of trauma support.  Fifth, both staff and clients are given empowerment.  The client is able to share in the process of healing via choice and decisions in plans of action.  The staff as well is given empowerment via support of from the administration as well as the tools necessary to do their work.  The final principle involves removal of any bias based on culturally, religious or gender issues when dealing with and helping individuals deal with trauma.  In doing so, staff recognizes the trauma that can exist within certain groups and how that can manifest within individuals.

 

SAMHSA and Implementing a Trauma Informed Approach

Trauma informed care is an organizational decision that transforms the organization or agency or individual social worker or counselors paradigm of working with individuals.  To be successfully implemented, it takes more than principles and good philosophies but a pragmatic process that involves multiple levels of preparation, policies, training, finances and feed back.  SAMHSA lists ten core implementation domains that are essential to help agencies properly support individuals suffering from trauma.

Trauma informed care requires an organizational commitment from the counselor to the administration itself to ensure implementation of it at all levels

First, governance and leadership is essential.  There needs to be a conscious choice to implement trauma informed care and establish leadership and management of its implementation to oversee and work with peers and staff in that effort.  Second, the agency needs written policies established that outline the new mission as well as a blue print for procedure.  Third, the organization needs to create a physical environment that mirrors a safe harbor for the type of work trauma counseling requires.  Individuals must feel safe, secure and able to trust without fear of embarrassment, guilt, or repercussion of their story. Fourth, there needs to be within the agency an engagement and involvement across multiple lines of individuals not only between counselor and client, but also within the organization itself and the process of helping individuals through trauma at all levels.  In addition, fifth, an agency needs to be equipped with cross sector collaborations with other agencies at the local or state level that can help facilitate healing.  Sixth, the agency needs to utilize the best empirically and scientifically proven principles in screening, assessment and treatment.  Seventh, training and workforce development is essential to ensure counselors have the education and continuing education necessary in trauma informed care.  Education and training workshops are key in maintaining up to date skills and knowledge in helping others.  The training, however, is not just shared with counselors and social workers, but also at lower levels within staff in how to deal with trauma and understand the nature of trauma with potential patients who enter the actual facility.   Eighth, as with all training, monitoring and quality assurance is essential to confirm that principles, policies, procedures and trainings are carried out properly within the whole of the organization.   This involves trauma informed principles that are incorporated into hiring, supervision, evaluation of staff, as well as working with staff and their own vicarious trauma and self care needs.  Ninth, agencies obviously need the necessary financial budget to transform the facility to support the need of trauma clients, as well as paying for the necessary trainings.  Finally, evaluation and feed back is essential in how the mission is being carried out.  This involves evaluation from top to bottom and taking feed back from everyone to ensure the implementation of the program is successful or if needs any adjustments.

 

Conclusion

Many individuals unfortunately lack proper trauma care.  The initial trauma is untreated, or the trauma is allowed to persist without proper care.  Individuals feel like they become a number without a real advocate.  Many feel the pain of having to re-tell their story over and over without any true treatment.   Others feel they labeled and may flee any treatment, while others who seek treatment may not have access to quality care in trauma or not have access to it.  Hence many individuals feel as if they are unseen or not heard, or feel unrecognized within their social group and the traumas they collectively face.

Treating trauma is a social issue. Please also review AIHCP’s Behavioral Health Certifications

Trauma informed care looks to acknowledge the reality of trauma in life for individuals within all cultural, social, religious and ethnic groups.  It looks to implement mental health plans to help individuals heal from trauma and become healthy members of society.  The need for trauma informed care and spotting trauma is essential in our society.  So many suffer from trauma and when left untreated, these individuals can become a danger to themselves or others.  Recognizing the necessity of trauma informed care is an answer to our mental health crisis itself.

AIHCP recognizes this important issue and offers a variety of mental health certifications, including in 2026, a trauma informed care certification for healthcare professionals.  Please review AIHCP’s multiple certifications in behavioral health, as well as its Grief Counseling, Crisis Counseling, Stress Management and Anger Management programs.

 

Additional Blog

Sexual and Physical Abuse: Click here

Resource

SAMHSA. “Advanced Method-Trauma Informed Framework”. Access here

Additional Resources

AAP. “What is Trauma-Informed Care?” Access here

“Why Trauma-Informed Care Matters” Health Essentials.  Cleveland Clinic. Access here

“What is Trauma-Informed Care?”. University of Buffalo.  Access here

 

 

 

 

Healing Those in Crisis Video Blog

Posted on by Mark Moran

Helping those find stabilization and security is important helping those heal from crisis.  Crisis is an acute state but the losses endured after the crisis can cause multiple problems for a person in their healing process.  Crisis Intervention Specialist are trained to help those in crisis find stability

Please also review AIHCP’s Crisis Intervention Training Program and see if it meets your academic and professional goals.  To learn more, please click here

Pastoral Crisis Intervention Video

Posted on by Mark Moran

This video reviews the nature of crisis intervention from a pastoral perspective.  Please also review AIHCP’s Crisis Intervention Specialist Program as well as AIHCP’s Christian Counseling, Grief Counseling, Pastoral Thanatology and Stress Management Programs.  All programs are online and independent study with mentorship as needed for qualified professionals seeking a four year certification

 

Crisis Video Blog

Posted on by Mark Moran

Crisis is a state of emotional imbalance and in an inability to cope.  This short video takes a closer look at the nature of crisis and what it entails. Please also review AIHCP’s Crisis Intervention Specialist Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification.

Psychological Recovery After Crisis

Posted on by Mark Moran

Psychological recovery after a trauma and crisis event can take weeks, months, or even years depending on the damage of the event to the person’s mental, emotional, physical, financial and social modes of existence.  For some, pro long grief, or depression, or PTSD can become long term symptoms that require professional mental health services and long term care.  For some, the acute phase of crisis hovers over the person and the person requires assistance to again find firm grounding.  Most require basic psychological recovery that involves identifying the primary issues and needs of the person post disaster or traumatic event.  Many people are resilient and may not suffer long term mental issues, but most still require help and aid.  The National Child Traumatic Stress Network created an excellent CE course that discusses Psychological Recovery.   Much of the information supplied is based on general psychological and professional application but the Network did an excellent job of organizing it.   Bear in mind, like Psychological First Aid, Psychological Recovery services are not necessarily supplied by clinical licensed counselors or social workers, but can be given through unlicensed professionals who work in Human Services.  Low tier entry level professionals with some academic and professional training can handle numerous cases that do no have pathology and help coach and teach individuals with basic mental health techniques to recover from acute crisis.  This is the primary aim of Psychological Recovery within the area of Crisis Intervention.  It looks to help individuals after traumatic event to find the resources and skills to move forward weeks or months after an event.  It is less about pathology but more so about building resiliency and promoting teaching skills that can be taught by anyone in pastoral or unlicensed settings to help individuals grow after the event.

Individuals who survive a disaster or crisis need help sometimes refocusing and rebuilding with the help of crisis intervention workers

Helping individuals recover from a disaster or any traumatic event is key to a person’s resiliency to rebuild after the ashes and trauma.  According to the Network, it looks to protect mental health and maintain it, enhance abilities to address needs, teach skills to solve problems and prevent maladaptive coping by encouraging positive coping.  Like in Psychological First Aid, it focuses on the safety, calmness, self efficacy and connectedness the person possesses.  Does the person feel safe after the event?  Is the person calm and not exhibiting nervousness, or PTSD?  Does the person portray self resiliency and ability to cope?  Is the person connected to family or friends or have access to public and community resources?   These are important questions and are essential when meeting with a client who is a victim of a disaster.  Within any meeting though, it is important for the Crisis Intervention worker to understand nothing is a quick fix.  There will be multiple issues and each session represents a chance to help the person meet their needs.  It is not a mental health treatment but instead a mental coaching to help individuals get their lives back.  Hence each session should teach a particular skill, make a plan and receive reports how those plans work.

 

 

The National Child Traumatic Stress Network lays out various skills that are essential to help individuals get their lives back.  Within the critical phase of information gathering, the Crisis Intervention worker needs to identify current needs of an individual, prioritize them and make a plan of action.  Involved with this are skills that are taught to help meet each need and how to carry out that skill in everyday life.  Upon completion of skill utilization, the client reports back a week a later with how things have improved or not improved.  Upon this, plans can be troubleshot or retuned as well as other skills evaluated.  It is important when implementing plans and teaching skills not to overload an already stressed person.  Among some of the most important skills to help individuals includes rebuilding healthy connections, managing emotional reactions, promoting healthy thinking, encouraging positive activities and building problem skills.  The Network presents in-depth modules on all five basic skills that help train crisis intervention workers better help individuals manage crisis and issues.

Bear in mind, when in crisis intervention, one may be helping individuals with a myriad of problems from what appears small to large.  Some may be more emotionally distraught, physically hurt or others may be financially hurt, or still others may have lost a home.  Others may have temporary problems that are causing current stress, while others may have longer lingering issues that take more time to fix.  Some may be elderly with particular issues related to age, medication, or connection with others, while others may be children or adolescents who are suffering from trauma of the event, or even having issues reconnecting at school.  The combination of possible issues and problems faced by survivors of disaster or experienced trauma and crisis are endless and each one requires attention and rapport with the client.  We will take a closer look at the 5 helping skills emphasized by the Network.

Crisis Intervention workers help survivors formulate plans and develop skills that foster resiliency and rebuilding

One of the most basic and important skills in counseling is problem solving.  We have discussed in numerous blogs the importance of basic problem solving skills in counseling and how to implement them.  In Crisis Intervention work, problem solving while simple in theory is difficult in application because problems are very real and affect people in real life.  They just do not go away or vanish but have real affects on a person’s whole self and how they function.  Problems are not so much objectively the issue, but more so, how the person subjectively views them.  If the stressors of the problem seem overwhelming, then the Crisis Intervention worker needs to help the person discover the tools to make it less daunting.  With any problems, it is important to identify and label them.  This helps organize the issue and see how it is effecting the situation.  When discussing, it is important to weed out problems that are not the problem of the person or problems that the person cannot control.  In addition, it is important to set goals to counter the problem and brainstorm together some options to achieve that goal.  Together, best solutions are chosen and then they are implemented.  Upon return visit, crisis intervention worker and the survivor can discuss what worked, what did not and overall trouble shoot and analyze why something worked or did not work.  Ultimately it is important to instill hope into the person and grant them again power and control over the situation so that they can again become resilient forces in their own life.

Another skill, according to the Network, is rebuilding healthy connections.  Individuals or survivors after a crisis such as a hurricane or tornado or earthquake can lose many things in life including a home.  Those who are displaced need connections to find firm ground again.  It is hence important to help survivors review their connections and make a connection tree listing individuals they know and what each person means to them.  The crisis intervention worker can then help the person identify best suited individuals that can offer immediate help while also crossing off those who are unable to help or may not be the best influence in the given moment.  Helping the person reconnect with these resources can help individuals possibly find transportation, a place to temporarily stay, or find emotional support.  Sometimes, these connections may not be immediate but could also be fellow survivors or even agencies that can better alleviate the situation.

The Network also discusses the importance of the skill of managing emotions.  Numerous individuals after trauma have negative reactions and affective responses to triggers that may remind them about the disaster or traumatic event.  For example, a boy who experienced a tornado, may begin to feel uneasy, nervous, or fearful when a strong wind blows outside.  This can trigger a memory associated with strong winds of the tornado.  Or a small child may become fearful if the lights go out because the lights went out when the hurricane struck before.  The mind associates and ties together negative events with circumstances that by themselves are quite innocent.  This can trigger a response.  Of course, in PTSD, this trigger is far more extensive due to trauma and the inability of the brain to properly process and file the memory but many after an acute crisis experience initial negative affective responses to neutral occurrences that happened during the disaster.  It is important for the crisis worker to help these individuals label the emotions they feel with the trigger and cognitively reframe the situation.  This types of CBT can help individuals re-understand the emotion and where it is coming from and better react when the similar triggers appear.  In addition, sometimes, individuals may need to utilize meditation, breathing, or other grounding techniques to help calm themselves when a trigger appears that reminds them of the disaster.  For most survivors, overtime, the trigger becomes more and more numb as one perceives no negative consequences tied to the howl of the wind or lights going out.  In the meantime, it is important to help especially children how to cope, react and deal with triggers associated with disaster.

After a disaster, individuals need help forming proper connections and identifying necessary resources to help them again firm ground

While emotions can need managed, thoughts can also be an issue.  While some may deal with affective issues, others may walk away from the disaster with cognitive distortions and negative thinking.  The Network proposes instilling in individuals healthy thinking.  Healthy thinking is also a cognitive process where not only emotions are reanalyzed but also thoughts.  Healthy thinking looks at negative thoughts associated with the event. Many survivors may have negative thoughts about how they acted, what they did or did not do, or who they are blaming for the crisis.  These thoughts can derail the healing process because the thoughts are tied with anger, shame, guilt, or sadness.  Sometimes, the thoughts are totally untrue but perceived as true to the person.  Crisis Intervention workers need to weed through the multiple thoughts the person may have about the event and their participation in it.  Some may feel it is their fault, or if they did this or that, it would not have been so bad, or others may feel ashamed for not doing more.  It is important to identify unhealthy and untrue thoughts about the event and analyze them and reframe them with the reality of the situation.  This can help the person move forward and focus on more healthy thoughts that are conducive for the future.  Instead of thoughts of despair, thoughts are transformed into thoughts of hope that will focus on fixing the situation in the present instead of lamenting about it in the past.

The final skill that can be important for some individuals is helping them again live a normal life through positive activities that again give joy.  This does not mean one immediately celebrates after a house is destroyed but it means gradually, individuals plan to give self care, or find connections or positive things to do that take the mind off the trauma and event.  Many times children are also distraught because regular events no longer occur after the disaster due to limitations of recovery.  Helping children find a regular routine is key but also giving them, and oneself even, joy is also key.  As rebuilding one’s life continues, it is important to not only find silver linings and hope, but again to do something that was once fun, or even do something different.  Whether it is family game night, or going out to eat, or taking a brisk walk, or working less and spending more time with the family, it is important to find time to again live.  Crisis Intervention workers can help survivors find the importance in this and help them identify and schedule something within the week, even if one thing, to do within their means.

Conclusion

The National Child Traumatic Stress Network offers a various CE courses that can help those in Crisis.  AIHCP also offers a Crisis Intervention Specialist Certification and individual CE courses.  It is important to be trained, even at lower tier levels, to help survivors, victims and individuals in crisis again find firm ground. Not all cases will involve drastic mental health counseling or involve PTSD, but many will be merely individuals trying to find themselves again after a disaster with multiple basic needs and concerns but who are overwhelmed with the event and secondary stressors.  Crisis Intervention workers, counselors, social workers, chaplains and other Human Service Professionals can help individuals again find joy in life and the resiliency to rebuild what was lost.

Crisis Intervention helps individuals find balance. Please review AIHCP’s Crisis Intervention Specialist Certification

Please review AIHCP’s Crisis Intervention Specialist Certification.  Upon completion of the seven core courses, one can apply for certification.  The program is online and independent study with mentorship as needed and open to qualified professionals seeking a four year certification.

 

Additional Resources

The National Child Traumatic Stress Network.  Access here

Swaim, E (2022). “7 Reminders to Carry with You on Your Trauma Recovery Journey”.  Healthline.  Access here

“Resources on trauma and healing, including a guide inspired by ‘The Color Purple’”. APA.  Access here

“Recovering Emotionally After a Disaster”. American Red Cross.  Access here

 

 

Crisis and Grief: What is Psychological First Aid?

Posted on by Mark Moran

Individuals who experience traumatic events need help facing multiple issues.  Some individuals may cope better than others, while others require emotional stabilization.  The purpose of first responders and volunteers helping the scene though require abilities to meet the needs of individuals.  Sometimes, individuals may need only mere direction or information or basic supplies, while other times, individuals may need crisis intervention care to help stabilize themselves emotionally.

Psychological First Aid is immediate care for those affected by trauma or disaster at physical, affective, cognitive, behavioral or social levels

In many past blogs, we have discussed the importance of Crisis Intervention in helping individuals during a traumatic event.  Traumatic events such as natural disasters, terrorism, shootings, criminal assaults, suicide, or war zones all present deep rooted trauma to individuals who endure them.  Some may be better able to cope but when traumatic events occur they still present an abnormal level of surprise, pain, and loss.  Hence, someone on scene will have some type of need, whether physical, mental, emotional, social or all points.  First responders, volunteers, chaplains and other healthcare professionals are able to help everyone in the moment of a traumatic event by meeting whichever needs are present according to the person through basic psychological first aid.

Psychological First Aid is not long term therapy or looks to resolve the devastation that may take months and years to fix, but it does look to stop the emotional bleeding on the spot and meet the basic physical human needs of anyone in crisis, grief, trauma or loss.  Whether elderly, children, adults, or others of any cultural identity, bad things happen and when they do, people need trained professionals on site to help meet immediate needs.

PFA looks to ensure grant the person a feeling of safety in the chaos, help calm and stabilize those emotionally disturbed, find necessary persons of connection for the person, connect individuals with the necessary long term aid, and grant the person a sense of hope in the despair around them.  Chaplains, first responders, disaster volunteers, healthcare professionals, as well as social workers and counselors on scene are all trained in basic PFA and some at higher levels due to their training and licensures to help individuals at the level of help they need.  Whether it is simply offering water or giving shelter for a night, or helping someone find a loved one, or consoling a child, or directing a family to proper resources and federal assistance to rebuild a home, or referring something emotionally distraught to a mental health professional, or finally even helping ground a person in extreme disorientation and disequilibrium, the goals and duties of those in PFA are about helping the particular need in the moment.

Like any crisis or situation, those trained in PFA are expected to initiate contact with individuals on the scene.  Some may appear fine, others may appear disorientated.  Those in trained should focus on the most emotionally disturbed individuals that are displaying dis-equilibrium and immobility or those who seem out of place, especially elderly or children who are alone.  Crisis professionals should introduce themselves by name and the agency they work with and ask the name of the person.  Asking what them what the issue is or what is wrong is a good way to help.  Forcing oneself on the person, or asking detailed accounts of the event are not the best way to introduce and form a bond.  Introduction and making contact and forming a bond is a key in Crisis Intervention but also critical on scene when dealing with any victims or individuals faced with trauma.

Obviously helping the person feel secure is key.  Some may already feel safe, but others may feel the threat of danger still overbearing upon them.  PFA workers should help reassure a person that they are safe and address all fears without dismissing them.  Instead, they should help the person feel a sense of security through their presence.  Obviously someone who has been raped, assaulted, or a person who has just had their home flooded or destroyed by a tornado will require long term care, but the purpose of PFA is to help the person feel secure in the moment so that the individual can logically think without the presence of fear motivating them.

In certain cases, individuals suffering from trauma need help finding calmness.  They need help becoming stabilized emotionally.  They are unable to cope since their coping mechanisms have become overrun and their emotional equilibrium has become imbalanced.   Hence logical choices are removed and instead a state of affective, cognitive and behavioral dysfunction manifests.  The PFA worker depending on their level of training and experience can help these individuals find balance and coping.  Some times helping ground the person through breathing and focus techniques can bring a person back to the current event, while other times, discussing the issue and alternatives to the narrow options one faces when in crisis.   In many cases, individuals will suffer from mental issues such as disorientation, lack of concentration, memory loss, or poor cognitive reasoning, while in other cases, individuals may suffer affectively through various emotions.  Some emotions may be displayed such as anger or intense grief, or even guilt or shame about the event, while others may retreat from contact and suffer from disassociation, or become stuck in their own thoughts and look to flee human contact.  Others may display dangerous behavioral actions and will need controlled or helped to find calm to avoid danger to themselves, others and various workers at the scene.

After a person is calm, safe and stable, one can begin to access the person’s mental, physical and social needs.  Sometimes, the needs are affective, or physical, or cognitive or social, but it depends on identifying the clues and also talking to the person.  Some needs may be as simple as a blanket or a glass of water, while others may be concerns over a missing child or relative or friend.  Some may have minor injuries or headaches that need addressed due to the situation.  Others may have concerns where one will sleep for the night if a storm damaged the home.  Others may even have concerns beyond the immediate which can be addressed such as an event a person may have had the following day that will now have to be canceled.  In the mist of this, the PFA worker needs to offer assistance whether at the cognitive level or physical level.  This assistance may be in the form of advice, meeting physical needs, or helping the person organize what needs organized.  It can involve helping the person better understand the situation and supplying the person with the necessary information they need to deal with the issue at hand.

Those trained in PFA and Crisis Intervention can help individuals in distress due to trauma or natural disasters but certain steps must be followed albeit they can be adaptive and flexible depending on the person and situation

PFA workers can also help and offer assistance through connecting individuals to other people, friends and family.  Sometimes helping a person contact his friend or family helps the person find a place to stay or provides transportation.   Many individuals in crisis have support systems but they are unable at the moment to contact those persons and they need assistance in making those contacts.  In addition to immediate connections, later, PFA workers can help individuals find longer term help through social services, federal assistance and on a more individual note, references for mental health or healthcare services.  During this process, it is important for PFA workers to not promise things but to be as honest as possible about what can be done or not done.  Lying or making false promises to help alleviate a person’s mental state will not help the situation.

 

 

Throughout the process, the PFA worker also needs to address proper coping in the moment versus maladaptive coping.   Like a coach, a PFA worker can help the person face the immediate issue through productive coping strategies that involve reframing of the situation and putting energy into what can be done in a given moment.  This involves a variety of stress management and anger management concepts and helps the person focus on what can be done instead of utilizing maladaptive strategies that avoid or ignore the situation.  Obviously, longer term care reviews the necessity of healthy coping with any traumatic event.  It is unlikely that those who face traumatic events will have the same life.   Recovery from injuries or therapy still leaves scars and individuals need to have the tools to face those past traumas.  In addition, repairs and construction and family functions may be altered.   Things will change and the ability to be resilient and cope depends on multiple subjective and objective realities.  A person’s support system is key and this is why referrals and connections are so key in finding the person the help they need to create hope.  With hope a person can find resiliency and the ability to adapt and rebuild in the future with healthy coping strategies.

Conclusion

Psychological First Aid is a key component of crisis intervention and for those who work in it from a mental health, healthcare, law enforcement, first responder or chaplaincy component.   Knowing how to help a person in the moment and stabilize them and help meet the person’s physical, affective, cognitive and social needs are important to the recovery and adjustment of the person to the traumatic event.  These events can range from disasters to assault or war zones and suicide.  In all cases, crisis intervention looks to help the person find equilibrium and mobility to handle the situation,  PFA helps individuals with the core basics to help those with little needs to those with the greatest needs.

Psychological First Aid is necessary for those in immediate crisis. Please also review AIHCP’s Crisis Intervention Program

Please also review AIHCP’s Crisis Intervention Specialist Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Crisis Intervention.

Additional Resources

“Psychological First Aid”. National Child Traumatic Stress Network.  Access here

“Psychological First Aid (PFA).What is Psychological First Aid?”. Minnesota Department of Health.  Access here

“What is psychological first aid?” (2024). Doctors Without Borders.  Access here

Griffin, M. “Psychological First Aid: Addressing Mental: Health Distress During Disasters”(2022). SAMHSA. Access here

Crisis Intervention and the ABC Model

Posted on by Mark Moran

Crisis intervention is an important part of mental health services that seeks to help and stabilize people during times of serious emotional distress. When individuals face intense challenges, the need for quick and effective help becomes very important, as prompt support can change the outcome of a crisis. The ABC Model of crisis intervention provides a clear structure for professionals to understand and meet the immediate needs of those in crisis. This model involves three steps: A (Achieving contact), B (Boiling down the problem), and C (Coping). Each step is meant to help clarify the client’s situation and empower them to take back control. By using the ABC Model, professionals can assess the urgency of their client’s emotional distress and use strategies that build resilience and encourage positive coping methods, which can lead to better mental health results.

Crisis Intervention Specialists utilize the ABC model to help individuals find orientation after crisis

Please also review AIHCP’s Crisis Intervention Specialist Certification.

A.    Definition of crisis intervention

Crisis intervention is an important process meant to help people who are having severe emotional and psychological issues, so they can find their balance again. This method usually includes looking at the situation, understanding immediate needs, and checking available resources to provide support. Professionals use various techniques that fit the person’s needs, creating a feeling of safety and empowerment when times are tough. Since crises upset personal balance, quick intervention is important to prevent lasting psychological damage. The success of crisis intervention can be significant; it not only eases immediate pain but also lays the groundwork for further healing and strength. By using structured methods like the ABC model, professionals can assess the issue, find coping strategies, and help individuals move toward positive solutions. Ultimately, grasping the meaning and range of crisis intervention highlights its importance in maintaining mental health and improving quality of life during difficult situations.

B.    Importance of effective crisis intervention

During crises, the ability to act well can greatly affect both personal well-being and the stability of society. The need for quick response during crises is highlighted by the rise in childhood challenges impacting mental health, which can cause long-lasting harmful effects if not quickly addressed. The American Academy of Pediatrics notes that having safe, stable, and nurturing relationships (SSNRs) helps reduce toxic stress in children, promoting resilience and better coping with future challenges (Andrew S. Garner et al., 2021). In workplaces, especially in the hospitality sector, good crisis intervention is important for keeping employees safe and meeting health standards. Research shows that a clear psychological plan can improve compliance and protect both staff and the community during emergencies (Xiaowen Hu et al., 2020). Ultimately, effective crisis intervention is key to changing individual paths and building healthier, more resilient communities.

C.    Overview of the ABC model

The ABC model is an important framework in crisis help, focusing on a clear method to meet emotional and psychological needs during tough times. This model has three main parts: Activating Event, Beliefs, and Consequences. First, an activating event causes emotional reactions, which leads people to think about their beliefs regarding the situation. This belief system greatly affects the emotional and behavioral outcomes that come next. Knowing this link helps professionals help individuals change their thoughts for better coping methods. Also, using the ABC model in crisis help is vital, particularly in fields like hospitality, where following health and safety rules is very important. For instance, a study shows that good communication and management can lead to employees really following safety rules, demonstrating how the ABC model can improve how organizations handle crises ((Xiaowen Hu et al., 2020)).

II.  Understanding the ABC Model

In crisis help, the ABC Model gives a clear way to meet urgent needs and build strength. This model focuses on three main parts: feelings, actions, and thoughts that people have during a crisis. Knowing these parts helps workers to improve conversation, respond to feelings, and spot unhelpful behaviors that slow down recovery. For example, the use of artificial intelligence and large data sets to find and track the mental effects of crises is similar to how health markers show health levels in medicine. This shows that an in-depth understanding matters in both fields. By using new technologies, mental health workers can improve their responses, focusing on emotions and choices. In the end, using the ABC Model helps with quick crisis fixes and gives people tools for long-term coping, highlighting its important role in modern therapy.

A.    Explanation of the ABC model components

The ABC Model of crisis intervention has three main parts: Affection, Behavior, and Cognition. Affection means showing emotional support to people in crisis, creating a safe and understanding space for open talks. This emotional bond is important because it helps set the stage for the next steps in intervention. Behavior involves what both the person in crisis and the helper do; it looks at harmful actions that might make things worse and supports healthier choices. Lastly, cognition is about helping the person change how they think and see the crisis, which builds resilience and promotes positive problem-solving approaches. This complete method not only deals with current issues but also gives people skills for managing themselves in the future, with the goal of restoring their sense of control and well-being. All these parts together build a solid framework for good crisis intervention.

B.    Historical development of the ABC model

The ABC model’s history is important to know for its use in crisis help. It started in the 1970s by Albert Ellis and was later changed by people like Gerald Caplan, who focused on a methodical way to handle psychological crises. This model aimed to provide quick assistance to those in distress, concentrating on using resources and ways to cope. Over the years, the model has changed a lot, with its main ideas being updated to include new research and methods. For example, with climate change making mental health risks worse, there is a greater need for thorough plans that combine risk evaluation with crisis help, similar to what is proposed in studies of financial stability and sustainability (Simon Dikau et al., 2021). Additionally, the use of technology and data-driven strategies, as seen in responses to recent pandemics, shows that the ABC model remains important for addressing modern crises effectively (Israel Edem Agbehadji et al., 2020).

C.    Application of the ABC model in crisis situations

In crisis intervention, the ABC model is a key structure for grasping and addressing the needs of people in tough situations. This model focuses on three parts: Activating events, Beliefs, and Consequences, which help professionals respond to crises. For example, during the COVID-19 pandemic, health emergencies brought enormous stress and uncertainty, making the ABC model very useful. When hospitality workers faced health risks and operational issues, knowing their beliefs about safety protocols helped improve their compliance with these protocols ((Xiaowen Hu et al., 2020)). Likewise, stakeholders used advanced computing methods to predict and handle crises well, showing how belief systems are important for responses. Overall, the ABC model not only gives a clear method for crisis intervention but also builds resilience in challenging times, highlighting its importance in modern crisis management ((Israel Edem Agbehadji et al., 2020)).

III.             Phases of Crisis Intervention

Crisis specialists help individuals through the phases of crisis until at a pre crisis level

The crisis intervention process happens in separate steps, each important for dealing with the individual’s immediate issues and helping them recover. The first step focuses on figuring out the crisis, where the helper identifies what is happening and how serious it is. This step gives important details and makes sure the intervention is suited to the person’s specific situation. After this assessment, the next step is about building trust and creating a supportive space. This part is essential, as it helps the individual feel comfortable to communicate and be more open to the process. In the end, the intervention results in creating and putting into action a specific plan aimed at solving the crisis and encouraging long-term stability. By carefully going through these steps, crisis responders can really enhance results and support individuals in taking back control of their lives, highlighting the key ideas of the ABC model of crisis intervention.  These steps show how crucial a structured method is in crisis intervention. For example, as seen in healthcare studies, knowing patient histories and building trust are critical for effective help (Mitchell S.V. Elkind et al., 2020). Likewise, research from clinical studies shows that systematically evaluating patient needs can lead to meaningful improvements in health results, especially when dealing with crises (George W. Sledge et al., 2019).

A.    Assessment of the crisis situation

In dealing with a crisis situation, doing a full assessment is very important for good intervention. The first step is to find out the urgent needs and problems faced by people or groups affected by the crisis. For example, during the COVID-19 pandemic, the sudden school closures harmed more than one billion learners, causing major learning interruptions and access issues ((Edeh Michael Onyema et al., 2020)). This crisis not only slowed down learning but made existing inequalities worse, showing the need for specific responses. In health crises, advanced breast cancer (ABC) also brings big management challenges, with many patients facing a poor prognosis ((Fátima Cardoso et al., 2018)). Understanding these details helps practitioners focus on solutions that deal with both immediate and root issues, making sure that the responses are not just immediate but also aim to deal with the unique problems caused by the crisis in a lasting way. Therefore, a complete assessment is key to any good crisis intervention plan.

B.    Development of a crisis intervention plan

A complete crisis intervention plan is important for handling and reducing crises in different areas like healthcare, business, or communities. This plan should start with a careful look at the situation, figuring out the main causes of the crisis and checking the resources available for help. This step includes looking at market conditions and reviewing internal abilities, similar to anti-crisis financial management ideas that focus on prevention and managing risk (I. Zaichko et al., 2024). After the assessment, the plan should set out clear goals, using the ABC model to make interventions clear and often relying on evidence-based practices to shape the response. Since crises can grow quickly, acting promptly is vital, along with ongoing monitoring and feedback loops to adjust plans as needed. The end goal is not only to fix current problems but to build resilience, making sure organizations can learn from the crisis and set up systems to avoid future issues (Rifat Zahan et al., 2024).

C.    Implementation of intervention strategies

To make interventions work well, a clear and organized method must be used that looks at what each person in crisis needs. Using frameworks like the ABC model of crisis intervention—Assessment, Building rapport, and Coping strategies—can help professionals plan their actions. For example, during the COVID-19 pandemic, many families reported more stress in parenting and a drop in mental health, with two out of five parents showing signs of major depression (40.0%). This points to the need for focused support systems ((Shawna J. Lee et al., 2020)). By recognizing this situation, interventions can be adjusted to improve how parents manage stress while also looking after children’s emotional health. Additionally, teamwork among different professionals from various areas, as shown by researchers in global health, highlights the need to bring together diverse viewpoints in crisis intervention strategies ((Thomas Unger et al., 2020)). This all-encompassing method leads to better long-term results for people in crisis.

IV.            Effectiveness of the ABC Model in Crisis Intervention

In looking at how well the ABC Model works in crisis intervention, it is important to think about how it has a clear way to deal with immediate emotional and psychological needs. The ABC Model stands for Achieving Contact, Boiling the Problem Down, and Coping. It effectively helps practitioners set up a safe place for people who are having a tough time. This model focuses on understanding the specific situation of the crisis, which helps in creating a response that fits. For example, the ongoing issues from global crises like the COVID-19 pandemic have greatly affected mental health and access to resources. The ABC Model shows it can adapt to these complicated situations, focusing on communication and practical solutions (Edeh Michael Onyema et al., 2020). Additionally, as situations change, using technology in interventions allows for a wider reach and more involvement, showing the model’s relevance in today’s world, which is often unstable. This is similar to what is seen in Alzheimer’s disease, where early help can lessen long-lasting suffering (Michael DeTure et al., 2019).

Crisis Intervention Specialists are able to help others through crisis via the ABC Model

A.    Case studies demonstrating the ABC model’s success

Many case studies show how well the ABC model works in crisis intervention, proving it gives organized help in tough situations. A notable example is a case with COVID-19 patients, where the model improved communication and understanding of patients’ emotional and mental needs during the pandemic chaos (Israel Edem Agbehadji et al., 2020). In this case, clinicians used the ABC model to look at the triggers, actions, and results related to patients’ experiences, which led to specific interventions that enhanced patient cooperation and overall health. Moreover, another study pointed out how this model effectively dealt with the long-term impacts of COVID-19, emphasizing the need for ongoing support and adjustment to patients’ changing needs (Chen Chen et al., 2020). These results not only highlight the flexibility of the ABC model but also confirm its key role in providing caring, effective crisis intervention in different situations.

B.    Comparison with other crisis intervention models

When assessing how well the ABC model of crisis intervention works, it’s important to compare it to other well-known models like Psychological First Aid (PFA) and the Crisis Development Model (CDM). The ABC model focuses on looking at a person’s feelings, actions, and thoughts to help stabilize a crisis. In contrast, the PFA model puts more emphasis on providing emotional support and ensuring safety right after a traumatic event. This approach aims to give practical help while promoting a sense of connection and normal life. The CDM, on the other hand, highlights the importance of understanding how people behave in a crisis, providing a clear way to predict and manage situations as they escalate. These models showcase various methods for handling crisis intervention, yet the ABC model stands out for its focus on evaluating and addressing emotional and thinking processes. As seen in discussions about stress in parents and the well-being of children in crisis situations, knowing about different intervention models can improve practitioners’ ability to work effectively in various scenarios (Shawna J. Lee et al., 2020)(Chen Chen et al., 2020).

C.    Limitations and challenges of the ABC model

The ABC model is a basic framework in crisis intervention, but it has limits and problems. A major issue is that the model depends on how individuals in crisis are judged, which can lead to different views on what they need. This can be a big problem for people with serious mental health issues, like during the COVID-19 pandemic, when rising parental anxiety and depression changed how children’s wellbeing was seen (Shawna J. Lee et al., 2020). Moreover, the model might miss external factors that add to someone’s crisis, like economic difficulties, making intervention less effective. Recent research shows that there is a need for broader approaches that use new technologies, such as artificial intelligence and big data, to better spot and predict crises. These technologies could help fix some of the ABC model’s shortcomings (Israel Edem Agbehadji et al., 2020). If the model does not change, it may struggle to deal with the complicated nature of real-life crises.

V.  Conclusion

Please also review AIHCP’s Crisis Intervention Specialist Program

In summary, handling crises well is very important for dealing with the complex problems that come up in tough situations. The ABC model is a method that helps professionals look at, react to, and aid in recovery for people who are in distress. This model not only considers the urgent emotional and psychological needs of individuals but also includes key plans for long-term health. The recent disruptions in many fields due to the COVID-19 pandemic, such as the negative impacts on education and the hospitality industry noted in studies, show that quick and informed responses are essential ((Xiaowen Hu et al., 2020); (Edeh Michael Onyema et al., 2020)). Putting strong crisis plans and clear safety measures in place creates workplaces that encourage compliance and flexibility among employees and other stakeholders. Therefore, by using models like ABC, professionals can handle crises better, ensuring that those affected get the help they need to regain their balance and return to normal.

A.    Summary of key points discussed

When looking at crisis intervention, especially using the ABC model, several key discussions highlight its role in providing psychological support. The model focuses on how lab medicine and psychological tests have changed over time, enabling professionals to better address the pre- and post-intervention stages, which are often prone to mistakes (cite33). This change stresses the need for careful focus on assessment and intervention processes to ensure a well-informed approach to client care. Moreover, the guidelines for engaging with individuals with disabilities stress the importance of fairness and respect in assessment methods, fostering a more inclusive approach that improves intervention results (cite34). In summary, these points together confirm the ABC model’s position as an organized approach in crisis situations, promoting a thorough and caring method for intervention that emphasizes client well-being and informed choices.

B.    Future implications for crisis intervention practices

As society deals with challenges from global crises, it is important to look at and improve crisis intervention methods. The results related to the COVID-19 pandemic show a key future need: organizations must create a space that encourages strict adherence to health and safety rules among workers, which is especially important in fields like hospitality that depend on in-person interactions (Xiaowen Hu et al., 2020). Moreover, the education system’s experiences during the pandemic indicate that being able to adapt to technology will be essential for handling crises, which highlights the need for strong digital systems and training for teachers and students to enable effective distance learning (Edeh Michael Onyema et al., 2020). These points suggest that future crisis intervention methods should be adaptable, combining technology and mental preparedness to ensure resilience against unexpected issues. By focusing on these areas, organizations can better equip themselves for upcoming crises, protecting their employees and the communities they support.

C.    Final thoughts on the importance of the ABC model in crisis situations

In crisis intervention, the ABC model is an important framework that aids professionals in how they respond. It focuses on three steps: Achieving contact, Boiling down the problem, and Co-constructing a plan. This model offers a clear method that helps during confusing times. It helps interventionists build a connection quickly while understanding key parts of a person’s crisis, making sure the response fits their specific needs. Additionally, the ABC model encourages teamwork between the helper and the person in crisis, fostering a feeling of control and empowerment. The strength of this model lies in its organized approach and its ability to adapt, which makes it a crucial tool for dealing with the complex emotions and behaviors people face in difficult times.

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 and open to qualified professionals within human services, first responses, healthcare and chaplaincy.

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Emotional Flooding Video

Posted on by Mark Moran

Good review on emotional flooding and how emotions can sometimes overtake an individual.  It is important for those subject to emotional flooding to better understand how to control it as well as those around someone who may become emotional unstable.

Please also 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 seeking a four year certification in grief counseling.  In addition, please also review AIHCP’s other certifications in Stress Management as well as Crisis Intervention

Suicide and Crisis of Lethality

Posted on by Mark Moran

Crisis Intervention specialists deal with an array of issues.  Usually issues of self harm, harm of others and suicide are a very common theme.  In crisis, logical thinking and hope are erased and the person can sometimes do things out of character that are very lethal in nature.  Understanding suicide, suicide assessment, prevention and intervention are key components of helping individuals in crisis not make a permanent and fateful decision.

Suicide is rarely a conscious choice but one with emotional and mental implications that remove one from a state logical thinking

It is critical for crisis counselors, grief counselors, pastoral care givers and ministry, licensed mental health professionals, as well as those in healthcare to have a strong training and educational background in suicide and crises of lethality.  AIHCP offers certifications in Grief Counseling but also in Crisis Intervention to help train members in those fields with the additional knowledge and abilities to handle crisis of lethality.

Suicide

While in the past, AIHCP has offered blogs, as well as video content on the nature of suicide, this particular blog will focus on the crisis element of it.  It will identify suicidal signs, assessments, but also focus on intervention in particular.

James points out that a person in suicidal crisis is engaged in an expressive act of homicide where emotional state looks to reduce psychological pain (2017, p. 203).  According to statistics, James point out that 600, 000 to 100, 000 suicides are attempted each year in the United States and 30, 000 to 60, 000 die each year in those attempts, with 19, 000 permanently injured (2017, p. 204).  While different groups within the US  have different rates of suicide as compared to others, the leading group is older white males.

Theories surrounding suicide share many common features but also have different emphasis on certain reasons why one attempts to kill oneself.  Freud’s psychodynamic theories saw suicide as a reaction of some inner conflict with external stressors (James, 2017, p. 206).  Erickson saw reasons for suicide correlated with developmental issues that prevented the person from advancing and reaching certain goals in life.  Individuals who become stagnant and unable to develop sometimes choose suicide as an option to escape (James, 2017, p. 206).   Escapist theory views suicide as the only way out of a bad situation during fight or flight.  Within this theory, individuals feel they fell short, blame themselves, focus on narrow deficits only, and only see a view of perfectionism that if not met can only end in suicide due to the hopelessness perceived (James, 2017, p. 206).   Hopelessness remains a common theme in all situations where the person feels they have no power over the situation.

Another important theory was developed by Edwin Shneidman, the founder of suicidology.   In understanding suicide he measured one’s psycheache or pain in the mind, one’s perturbation or the degree of the pain, and the press or stress due to external factors (James, 2017, p. 206),   With the combination of these things, Shneidman saw how psycheache frustrates  or blocks psychological needs leading to hopelessness and suicide and reaching the state of critical mass to activate suicide.

Durkeim in the 19th Century proposed the sociological theory which looks at a person’s connections to society and how social norms and society based on a person’s integration with those norms plays a large role.  Egoistical suicide refers to one’s lack integration with any group.  Anomic suicide refers to when economic and financial systems of society break down all around the person.  Altruistic suicide refers when a person commits suicide for cultural reasons or the perceived better good according to the society.  Fatalistic suicide refers to if a person is an intolerable or unescapable situation such a concentration camp (James, 2017, p. 207).  According to Van Orden interpersonal states are also key in the mind of those contemplating suicide.  Suicidal individuals may acquire capability by decreasing innate fear of pain and death gradually.  In their personal views, they perceive themselves as burdensome to others as well as failing to belong to anyone or find attachment to anything (James, 2017. p. 207).   Existentialism and meaning also play an important role in suicide theory.  Ideas on death, existential isolation, meaning and meaningless in making sense of the world and the freedom of existentialist thought to make choices all play a role in the construction of existentialist thought.    When challenges to existence and death are overwhelmed and an existentialist anchor is lost, then many individuals can fall into hopelessness without any reason to exist (James, 2017, p. 208).

Another interesting theory follows a basic suicide trajectory model based on various risk factors that correlate with suicide.  This includes, biological, substance abuse history, genetic predispositions, gender, self esteem, psychological maladies, cognitive thinking and environmental stressors (James, 2017, p. 207).    Psychology also points to imbalances within the brain, neurochemical reactions that do not allow a person to better respond to a situation (James, 2017, 208).

From these theories and multiple other ones, one has a better understanding that suicide is rarely a free choice but is committed in a state of emotional turmoil without true cognitive reasoning.  This is why so many religious views on suicide as a choice or sin have been replaced with a better recognition that most if not all are victims of it.

Characteristics of Suicidal Individuals

For the most part, those thinking of suicide exist in an acute state of crisis or a chronic state of depression that leads to certain characteristics that manifest emotionally, socially, mentally and physically.

Many suicidal individuals suffer from depression or hopelessness. Please also review AIHCP’s Crisis Intervention Certification

Situationally, individuals face an endurable pain they cannot overcome.  A stressor frustrates the psychological need (James, 2017, p. 209).  Hence situations involving trauma, death, loss, finances, relationship or anything that creates a perceived unbearable loss appears.  Motivation wise, individuals look to seek a solution and that solution entails to remove the stressor via cessation of consciousness.  Accompanied with this are the affective emotions of hopelessness and helplessness.  Cognitively, individuals see solutions in a very narrow scope with out any alternatives to think their way out of the situation.  Relationally, an individual wishes to communicate intent and find mutual justification in it and acknowledgement of that right to do so.  Serially, characteristics reveal a long history of trying everything else but no other option remains (James, 2017,p. 209).

Within these characteristics of the suicidal mind, it important to dismiss certain myths that distort.  First, one needs to dismiss fears of discussing suicide as if it will cause it.  In fact, discussing suicide and being very upfront is key.  Second, one needs to dismiss the notion that those who say they will commit suicide rarely carry through with it.  In fact, many who say they are contemplating are very high risk of attempting it.  To the individual suicide is perceived as a very rational act.  Third, individuals who commit suicide are insane.  Most who commit or attempt suicide are only acutely affected with emotional issues.  Fourth, suicide is only impulsive.  In fact, most suicides are planned and plotted outside acute crisis.  Fifth, suicide is painless.  Many suicides can be very gruesome and some go awry and very wrong.  Sixth, suicidal thoughts are rare.  In fact, they are more common than one may think with 8.3 million have some type of suicidal ideation (James, 2017. p. 212).

Suicide Assessment is Key

Assessment is critical in saving a life.  While some crisis specialists deal with suicidal individuals in an acute and heated moment, many suicides are well planned and plotted.  Counselors need to be aware of the possibility and assess the lethality

James points out that there are a variety of verbal clues, statements and written letters.  As well as behavioral clues such as self harm or isolation.  Also situational clues that involve death of another person, financial woes, loss job, or divorce should be acknowledged.  In addition, syndromatic clues such as depression, hopelessness and unhappiness with life can play key indicators in possible suicidal.  This is why it is so important to also ask someone in assessment (2017, p. 212).

Another tool to utilize is PATHWARM.  This  is an acronym from the American Association of Suicidology.  It utilizes the letter within the acronym to better identify various warning signs.  Within the acronym is: Ideation, Substance Abuse, Purposefulness, Anxiety, Trapped, Hopelessness, Withdraw, Anger, Recklessness and Mood.

There are many, many assessment keys, questions, or triages one can utilize.  We will briefly go over a select few.

First, the basic clinical interview is essential in determining suicidal ideation.  Within it is a long laundry list of observations and questions.  Here are a few: Does the person exhibit suicidal intent or tendencies?  Does the person have a family history of suicide?  Does the person have past suicide attempts? Does the person have a specific plan?  Has the person experienced a death recently? Does the person have a history of drugs and substance abuse? Does the person display radical changes in mood and behavior?  Does the person display hopelessness?  Has the person experienced past trauma?  Has the person discontinued medication?  Does the person exhibit extreme emotions?  Has the person faced financial troubles or loss of job?  Does the person feel threatened?  Does the person see everything as all or nothing?  Does the person feel as if he or she does not belong? Does the person struggle with identity and self esteem?  Does the person have access to firearms?  Has the person explored suicide through online search or literature?  Has the person not seen a medical professional within the last 3 to 6 months? (James, 2017, p. 215).

SIMPLE STEPS is another acronym that can utilized in assessment during interview. Again it emphasizes the importance of asking the question are you thinking of killing oneself?  Within the acronym are the following points.  Suicidal? Ideation? Method? Pain? Loss? Earlier attempts? Substance abuse? Troubleshooting for alternatives? Emotions? Parental history? Stressors? (James, 2017, p. 216-17).  This triage captures the basic essence again of all assessment in that it asks the difficult question and looks to identify potential lethality and danger of a plan.  Not all cases may present an immediate acute threat while others may require immediate intervention and reference to medical professionals or notification of authorities and family.

Suicide Intervention

In intervention, whether in acute setting or discussing possible plans of a person to commit suicide, professionals need to not judge the person, or demean the person’s perceived tragic nature of life.  Instead, crisis professionals are encouraged to gain an understanding, form a bond and offer alternative options.

The Three “I”s are essential to know if looking to defuse suicidal situations.  The person feels the situation is inescapable, intolerable and interminable (James, 2017,p. 218).  Hence it is important to help the person feel secure, less painful, and offer hope with solid solutions.   When a person is facing crisis, they may feel there is no other way out and may need alternatives presented and applied to the situation.  In addition, the crisis counselor may try to help the person reframe the situation with attributes of CBT to see the situation from a different light.  The crisis counselor must also help the individual face the pain and discover that is not forever.  Helping focus on not so much the lethality but the perturbation of the person can help the person see more clearly, utilize problem solving abilities, and offer alternatives to the current issue.  Addressing stressors and helping the person see hope is the biggest key.  At this core, Crisis Management looks to help the person plan a response to suicidal issues (James, 2017, p. 222).

Those in suicidal ideation need alternatives and options. They need to know the there is escape and an end to the pain that involves not ceasing consciousness

In counseling, professionals should help clients reframe.  This involves not only a new line of thinking but also validating emotions and discussing future suicidal behaviors and how to counter them.  It is important to help the person learn real problem solving skills for issues but also address teaching individuals how to cope with pain and emotions in better ways.  In addition, counselors can help clients find better social connections to prevent isolation as well as play an important role in life coaching with positive thoughts, plans and goals.  Importantly as well, a counselor should obtain from the person a no harm commitment through a suicide “Do not Harm Contract” or “Stay Alive” contract which the individual signs.  It is important to let the person know he or she is not alone and can reach out or call when certain triggers may appear that seem unbearable (James, 2017, p. 227)>  In some cases, calls to the authorities may be needed, or a person may need observed for a period of time before the crisis has subsided.

Conclusion

Suicide is not simply a call for help but a true crisis situation that demands attention.  Through warning signs, assessment and proper intervention, crisis counselors can save lives.  It is also important to note that suicide is not something rationally chosen but one that is mentally and emotionally chosen when in a illogical state of mind.  Hence negative social stigmas need removed and professionals as well as society need to see these individuals who attempt or complete suicide as victims.  This is why it is so important to be educated on the subject and listening and observing with empathy for those who shows signs of suicidal ideation.

Please also review AIHCP’s Crisis Intervention Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification.  Counselors, first responders, clergy and other mental health professionals can play a key role crisis intervention and saving lives from suicide.

 

Resources

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

Additional Resources

Clay, R. (2022). “How to assess and intervene with patients at risk of suicide”. APA. Access here

Are you thinking about suicide? How to stay safe and find treatment. Mayo Clinic.  Access here

Ryan, E. & Oquendo, M. (2020). “Suicide Risk Assessment and Prevention: Challenges and Opportunities”. Psychiatry Online. Access here

Suicide and suicidal thoughts. Mayo Clinic.  Access here

Suicide Prevention Tools for Public Health Professionals. CDC.  Access here

988 Life Line  Access here