By – James M. Katz, BA

In moments of acute stress and upheaval, the deployment of an effective crisis intervention model can mark the difference between escalation and resolution. Within the framework of mental health and emergency response, such models serve as structured approaches for professionals, including members of a crisis intervention team, to provide immediate emotional support and mitigate the impact of the crisis. Recognizing the importance of these models is paramount in addressing a mental health crisis efficiently, ensuring individuals receive the necessary support during their most vulnerable moments.

This article navigates through various crisis intervention models, delving into their structures, methodologies, and applications. From the ABC Model of Crisis Intervention, which lays out a straightforward approach to crisis response, to Roberts’ Seven-Stage Crisis Intervention Model and the newer SAFER-R Model, the discussion extends to Lerner and Shelton’s 10 Step Acute Stress & Trauma Management Protocol. Each model offers unique perspectives and strategies on managing crisis interventions effectively. By exploring these different frameworks, the piece aims to guide professionals in choosing the right model to apply in diverse scenarios, fortifying their crisis intervention and response capabilities.

Key Takeaways

• Crisis intervention models offer structured approaches for helping individuals in acute distress.
• Different models, such as the ABC Model, Roberts’ Seven-Stage Model, and SAFER-R, provide unique strategies and frameworks.
• Training and proper implementation of these models are crucial for their effectiveness in real-world scenarios.
• Understanding the strengths and limitations of each model helps in selecting the most appropriate intervention for specific situations.
• Integration of multiple models can enhance the overall effectiveness of crisis intervention efforts.

Understanding Crisis Intervention Models

Definition and Purpose

Crisis intervention is a short-term management technique employed to reduce the risk of long-term damage to individuals experiencing acute mental health crises. These crises can range from the trauma of losing a loved one to the stress of a severe illness. The primary aim is to stabilize the individual, provide immediate support, and prevent potential psychological trauma. By obtaining background information, establishing a relationship, and facilitating understanding and coping strategies, professionals can help individuals return to their mental baseline and avoid lasting harm.

Importance in Mental Health

The role of crisis intervention in mental health cannot be overstated. It serves as a critical response mechanism that can prevent the escalation of a crisis into a more severe mental health condition, such as major depressive disorder. Studies have shown that interventions can lead to reduced hospital return visits and shorter stays, which underscores their effectiveness compared to standard care. Furthermore, community mental health centers and local government agencies often employ crisis intervention teams that play a pivotal role in community support during natural or man-made emergencies, enhancing overall psychiatric outcomes.

These teams are equipped to assess and manage crisis situations promptly, providing essential support and referrals to further mental health resources. Their ability to intervene effectively can be crucial in preventing the development of more severe mental health issues and in supporting individuals in regaining control over their lives.

Types of Crisis Intervention Models

ABC Model

The ABC Model of Crisis Intervention is a streamlined approach that combines various methods from crisis counseling experts. Developed further by Kristi Kanel in 2014, this model focuses on three critical stages: establishing and maintaining rapport (A), identifying the problem (B), and coping (C). It emphasizes building trust with the client, understanding the crisis event and its impact, and developing strategies for coping with the situation.

Roberts’ Seven-Stage Crisis Intervention Model

Albert Roberts developed his Seven-Stage Crisis Intervention Model over many years, drawing on foundational crisis theory work by Caplan, Golan, and Lindeman. Published in 2005,  the model outlines a systematic process starting with a thorough assessment of the client’s emotional, cognitive, and behavioral reactions, rapidly establishing rapport, identifying key problems, exploring feelings, developing alternative coping strategies, implementing an action plan, and concluding with follow-up sessions to ensure the client’s recovery.

SAFER-R Model

The SAFER-R Model, created by Dr. George Everly in 1996,  is structured around the biopsychosocial needs of individuals during a crisis. It includes steps such as Stabilize, Acknowledge, Facilitate understanding, Encourage coping, and Recovery or Referral. This model is particularly noted for addressing immediate health and psychological needs, encouraging effective coping mechanisms, and ensuring social support systems are in place to aid recovery.
Lerner and Shelton’s 10 Step Acute Stress & Trauma Management Protocol

Developed by the American Academy of Experts in Traumatic Stress, Lerner and Shelton’s protocol provides a comprehensive 10-step approach to manage acute stress and trauma. Key steps include assessing safety, understanding the mechanism of injury, evaluating responsiveness, addressing medical needs, and providing support. This protocol is designed to help emergency responders effectively manage traumatic events and support individuals in navigating through trauma.

ABC Model of Crisis Intervention

Establishing Rapport

The initial stage of the ABC Model of Crisis Intervention focuses on developing and maintaining rapport, which is crucial for building a trusting relationship between the counselor and the individual in crisis. Effective rapport is achieved through both physical and emotional connections. Physically, counselors ensure there are no barriers such as tables or chairs between themselves and the individual, maintain solid eye contact, and orient their bodies towards the person, indicating positive regard. Emotionally, establishing safety and comfort involves validating the individual’s feelings, using empathetic statements, and maintaining a calm, even tone of voice. These attending behaviors demonstrate to the client that the counselor is genuinely engaged and listening, which encourages the individual to communicate more openly and freely.

Identifying the Problem

Once rapport is established, the next step involves identifying the problem. This phase is critical as it helps to clarify the nature of the crisis and the individual’s perceptions and emotions related to it. Counselors use a mix of open and closed questions to delve into the underlying issues that have led to the crisis. By understanding the precipitating events and the individual’s emotional responses, counselors can better address the specific needs and concerns of the person. This process includes recognizing any impairments in functioning, such as difficulties at work or school, and assessing the individual’s pre-crisis level of functioning. Ethical considerations are also crucial at this stage, ensuring that issues like potential harm to oneself or others are addressed.

Coping Strategies

The final stage of the ABC Model is focused on coping and adaptation. Here, counselors work with the individual to develop effective coping strategies that can help manage and mitigate the crisis. This involves exploring past coping behaviors to understand what has been effective or ineffective. Counselors encourage the development of new, healthier coping mechanisms and may suggest additional support such as therapy, support groups, or other community resources. The goal is to empower the individual to handle similar situations in the future more effectively and to establish a plan that includes follow-through on the coping strategies discussed. This stage is crucial for helping the individual regain a sense of control and moving towards recovery.

Roberts’ Seven-Stage Crisis Intervention Model

Stages Overview

The Roberts’ Seven-Stage Crisis Intervention Model, developed by Albert Roberts in 1991, is a comprehensive framework used to guide clinicians in systematically addressing and managing crisis situations. The model emphasizes a structured planning and implementation of interventions to ensure effective crisis resolution. It involves the following stages:

1. Plan and Conduct Crisis and Biopsychosocial Assessment: This stage includes assessing the risks of suicide, medical needs, and identifying protection and persistence resources such as family and other support systems.
2. Establish Rapport and Psychological Relationship: Clinicians focus on building trust and acceptance with clients, ensuring a therapeutic relationship is formed without judgment.
3. Identify Dimensions of the Problem or Crisis: Evaluating the issues and challenges faced by the clients, this stage shines a light on potential coping mechanisms.
4. Explore Feelings and Emotions: Active listening and empathetic responses are key to understanding the emotional state of the clients, enhancing the helping process.
5. Explore Alternative Coping Strategies: This involves assessing previously used methods and creatively finding new solutions that suit the client’s situation.
6. Develop an Action Plan: Clinicians work with clients to identify support networks and reference sources that can aid in the execution of the coping strategies.
7. Follow-Up Plan: Planning follow-ups is crucial to evaluate the client’s progress and ensure they are managing the crisis effectively post-intervention.

Implementing Each Stage

Implementation of each stage in the Roberts’ Seven-Stage Crisis Intervention Model requires a careful and tailored approach to each client’s unique situation. Clinicians begin with a thorough biopsychosocial assessment, including lethality measures, to grasp the full scope of the crisis. Establishing a rapid, collaborative relationship is crucial for effective intervention and client comfort.

As they move through the stages, clinicians explore the client’s feelings and the dimensions of their problems, including crisis precipitants or the “last straw” events. This exploration is supported by active listening, validation of the client’s emotions, and an avoidance of victim-blaming.
Generating and exploring alternatives is a collaborative process, where clinicians empower clients to generate their own solutions and provide access to untapped resources. The development of an action plan is a participatory process, ensuring clients are involved in every step and have various options for organizing and recording their plans.

The follow-up stage is flexible but structured, aimed at maintaining client safety and integrating trauma-specific services if necessary. Clinicians remain sensitive to the potential for re-traumatization and ensure that any necessary adjustments to autonomy are transparent and minimal.
By adhering to these stages, clinicians can provide a trauma-informed, effective response to clients in crisis, supporting them in navigating through and ultimately overcoming the crisis.

SAFER-R Model

Principles of the Model

The SAFER-R Model, developed by Dr. George Everly, is rooted in the biopsychosocial model and addresses the immediate needs of individuals in a crisis. This model is designed not as a therapy substitute but as a method for stabilizing and mitigating acute crisis reactions. It is widely recognized for its effectiveness in crisis intervention, especially in fields requiring quick and efficient psychological first aid, such as emergency services and military operations.

Steps to Implement the Model

1. Stabilize: The first step involves ensuring the individual’s basic needs are met. This includes assessing their safety, health status, and immediate physical needs like food or drink to help stabilize their condition.
2. Acknowledge: This step focuses on acknowledging the crisis event and the individual’s reactions to it. It involves listening to the details of the event without judgment and understanding the emotional impact on the individual.
3. Facilitate Understanding: At this stage, the responder helps the individual understand and normalize their reactions to the crisis. This involves encouraging the expression of difficult emotions and providing reassurance as they move towards recovery.
4. Encourage Effective Coping: This involves identifying and reinforcing the individual’s personal coping mechanisms. It also includes discussing physical self-care practices such as diet, hydration, and sleep, alongside exploring available social support to aid in stress reduction and return to normalcy.
5. Recovery or Referral: The final step assesses the individual’s recovery progress and determines the need for further care. If the individual’s condition is not adequately stabilized, referrals to mental health professionals are considered to ensure continued support and care.

By following these steps, practitioners can provide immediate and effective support to individuals experiencing a crisis, helping them navigate through their immediate challenges and commence the recovery process.

Lerner and Shelton’s 10 Step Acute Stress & Trauma Management Protocol

Steps Overview

Lerner and Shelton’s 10 Step Acute Stress & Trauma Management Protocol, developed by the American Academy of Experts in Traumatic Stress, offers a structured approach for emergency responders handling traumatic events. The protocol includes the following steps:

1. Assess for danger/safety of self and others: Ensure the safety of the patient, those around them, and the responder.
2. Consider the mechanism of injury: Determine how the trauma has affected the individual physically or mentally.
3. Evaluate the level of responsiveness: Check if the individual is under the influence of substances or otherwise impaired.
4. Address medical needs: Provide immediate medical care as necessary.
5. Observe and identify: Recognize signs of traumatic stress in the patient.
6. Connect with the individual: Establish rapport and begin to communicate with the patient.
7. Ground the individual: Encourage the patient to discuss the traumatic event and ground their experience in reality.
8. Provide support: Offer empathy and actively listen to the patient’s concerns.
9. Normalize the response: Validate the patient’s reactions to the trauma and reassure them that recovery is possible.
10. Prepare for the future: Help the patient anticipate future challenges and provide referrals for ongoing support.

Application in Crisis Situations

In crisis situations, the protocol provides practical tools to address a wide spectrum of traumatic experiences, from mild to severe. It aims to “jump-start” an individual’s coping and problem-solving abilities, stabilize acute symptoms of traumatic stress, and stimulate healthy, adaptive functioning. The protocol is particularly effective in connecting with emotionally distraught individuals, offering strategies to engage and support them through challenging emotional states.
For instance, emergency responders might use techniques such as Distraction, Disruption, and Diffusion to engage individuals who are displaying intense emotional reactions. These techniques help break through emotional barriers by matching or redirecting the individual’s emotional and physical state, thereby facilitating a more controlled and supportive intervention.

Overall, the Lerner and Shelton’s protocol is designed not only to manage the immediate effects of trauma but also to enhance the long-term well-being of those affected, increasing the likelihood of seeking further mental health intervention if needed.

Choosing the Right Model

When selecting a crisis intervention model, several critical factors should be considered to ensure the chosen approach aligns with both the practitioner’s capabilities and the specific needs of the client.

Factors to Consider

1. Philosophical and Professional Alignment:  Professionals should choose a crisis intervention model that resonates with their personal philosophy and professional style. It’s also vital to consider the requirements and protocols of the organizations they are affiliated with, as these often dictate the specific models and approaches to be employed.
2. Model Suitability and Goals: Each crisis intervention model, from the ABCD Model to Psychological First Aid, aims to stabilize, reduce symptoms, and restore adaptive functioning. Selecting the right model involves understanding the specific goals of each and matching these with the crisis at hand.
3. Client’s Needs and Crisis Type: The nature of the crisis—  whether it is acute, chronic, developmental, or situational—significantly influences the choice of an intervention model. A model that provides immediate problem-solving may be suitable for acute crises, whereas others that offer more emotional support may be better for chronic conditions.
4. Cultural and Contextual Sensitivity: The chosen model must be adaptable to the cultural context and sensitive to the unique circumstances of the client. This includes considering the client’s background, existing support systems, and risk factors.

Tailoring to Individual Needs

The effectiveness of a crisis intervention greatly depends on how well the model is tailored to meet the individual needs of the client. This includes:

1. Assessment of Immediate Needs:  Identifying the immediate needs of the client is crucial. This involves a rapid assessment of their physical and emotional safety and determining the most pressing concerns to address.
2. Building Rapport: Establishing a strong rapport is foundational in crisis intervention. The chosen model should facilitate a connection that makes the client feel understood and supported, enhancing the effectiveness of the intervention.
3. Empowerment and Participation: Engaging clients in the intervention process empowers them and can lead to more effective outcomes. The model should encourage clients to participate actively in developing coping strategies and making decisions about their care.
4. Adaptability and Flexibility: The model must be flexible enough to adapt to the changing dynamics of the crisis. This includes being able to shift strategies as the client’s needs evolve during the intervention process.

By carefully considering these factors and tailoring the intervention to the individual needs of the client, crisis intervention professionals can enhance their effectiveness, leading to better outcomes for those they serve.

Best Practices in Crisis Response

Strategic Crisis Response planning is necessary for developing a comprehensive crisis intervention plan before deployment and providing services. Knowing what sequence of crisis intervention processes to use for which individuals or groups, at what times, and under what circumstances is crucial to all effective early intervention programs. An effective strategic plan identifies and assesses target populations and determines the types of interventions, when to apply the interventions, and the resources required.

Ethical Considerations

Numerous crisis response programs, services, approaches, and methods have been developed to prevent, mitigate, and recover from the natural human stress reactions in the aftermath of tragic events. All crisis intervention modalities have the same goals: to stabilize, reduce symptoms, and return to adaptive functioning or to facilitate access to continued care. Ethical considerations are paramount in ensuring that interventions are both effective and respectful of the individuals’ rights and needs.

Case Management Strategies

Observe the signs and symptoms of distress and use appropriate crisis intervention tactics in response to those symptoms. Differentiate which signs and symptoms of acute stress have the potential for long-term effects and address those. Consider the needs of the individual and tailor crisis intervention to those needs. Time the crisis intervention based on the readiness of the individual rather than the actual passage of time.

Psychological First Aid (PFA)

Basic Elements

Psychological First Aid (PFA) is a supportive intervention designed to help individuals in the immediate aftermath of a disaster or traumatic event. It focuses on providing practical care and support, assessing needs and concerns, and helping people address basic needs. PFA is not about diagnosing or treating mental health conditions but about promoting a sense of safety, calm, and hope.

Use in Disaster Response

PFA is widely used in disaster response scenarios to provide immediate emotional and psychological support to affected individuals. It is designed to be simple and pragmatic, ensuring that responders can offer effective assistance without needing extensive mental health training. The approach is flexible and can be adapted to various cultural contexts and specific disaster situations.

Training and Certification

Training in PFA equips responders with the skills to offer immediate support and identify those who may need more intensive mental health care. Certification programs are available to ensure that individuals are adequately prepared to deliver PFA in crisis situations. These programs often include modules on active listening, empathy, and practical problem-solving skills.

Theories Underpinning Crisis Intervention Models

Crisis intervention is a relatively new field compared to other forms of therapy, and as such, crisis theory is still being developed. Most forms of therapies have an underlying theory based on research that provides a framework for treatment. The crisis intervention models were developed by experts in the field who provide crisis intervention and are based on both their experiences and research. Foundational theories by Caplan, Golan, and Lindemann have significantly influenced modern crisis intervention models. Intervention specialists have begun to make connections between the underlying emotions and circumstances common in crisis intervention, regardless of the type of trauma causing the crisis.

Conclusion

Throughout this discourse on crisis intervention models, we’ve traversed a panoramic landscape of methodologies, from the ABC Model’s structured simplicity to the depth of Roberts’ Seven-Stage Crisis Intervention Model and the biopsychosocial groundedness of the SAFER-R Model, signaling the cornerstones of crisis response. The essence captured within each model illuminates the imperative of tailored interventions, underscoring the diversity and complexity inherent in crisis situations. By distilling these models to their core principles, we’ve aimed to furnish professionals with the insights necessary to navigate the multifaceted realms of crisis intervention, highlighting the quintessential goal: stabilizing, supporting, and steering individuals through their most tumultuous times toward a semblance of their pre-crisis equilibrium.

Significantly, our journey through the various models reiterates the broader implications these methodologies bear on the fields of mental health and emergency response—emphasizing the need for an adept, compassionate, and informed approach to crisis intervention. As we culminate our exploration, the call to action extends beyond the confines of theory into the practical realms where these models find their application. It enjoins professionals to continuously refine their skills, advance their understanding, and remain agile in their methodologies, thus ensuring that individuals in crisis receive not just immediate relief but a pathway to recovery rooted in understanding, empathy, and effective intervention strategies. The commitment to adopting and adapting these models according to individual needs and crisis contexts consequently positions professionals to make a substantive difference in the lives of those they aim to serve.

If you’re a mental health counselor or in the healthcare, Mental healthcare, or emergency service industries and would like to learn more about crisis intervention counseling please consider reviewing the rest of our website. We offer an online Crisis Intervention Counseling program as well as Crisis Intervention Counseling courses for professional CE credits. For more information about our Certification in Crisis Intervention Counseling please visit our program’s webpage here. 

FAQs

What are crisis intervention models?

Crisis intervention models are structured approaches used by counselors to help individuals in crisis. They represent the clinical processes that can be used individually or in combination to meet the needs of a person in crisis.

Why is it important to choose the right crisis intervention model?

Choosing the right crisis intervention model is crucial because it should align with the counselor’s philosophy, personality, and professional style. Additionally, organizations may require specific protocols to ensure that volunteers are properly trained and can work well with other team responders.

What are some examples of crisis intervention models?

Some examples of crisis intervention models include the ABC Model, Roberts’ Seven-Stage Crisis Intervention Model, Lerner and Shelton’s 10-Step Acute Stress & Trauma Management Protocol, the SAFER-R Model, and the ACT Model.

What are the six steps involved in crisis intervention? Crisis intervention consists of six key steps:

• Step One: Define the Problem. This step involves identifying the specific problem that needs to be addressed.
• Step Two: Ensure Safety. The priority in this step is to secure the safety of all individuals involved.
• Step Three: Provide Support. Offering emotional and practical support is crucial at this stage.
• Step Four: Examine Alternatives. This involves exploring different solutions to the problem.
• Step Five: Make a Plan. Develop a clear plan of action to tackle the crisis.
• Step Six: Obtain Commitment. Secure a commitment to the plan from all parties involved.

What are the five phases of the crisis management model? The crisis management model includes five distinct phases:

• Phase 1: Early Warning and Signal Detection. Recognizing the signs that a crisis may be imminent.
• Phase 2: Preparation and Prevention. Taking steps to prepare and prevent the crisis.
• Phase 3: Damage Containment. Efforts to limit the impact and spread of the crisis.
• Phase 4: Recovery. Working towards normalcy and repairing damage.
• Phase 5: Learning and Reflection. Analyzing the crisis to improve future responses.

What are the four stages of crisis response? The response to a crisis can be broken down into four stages:

• Pre-crisis: The phase before the crisis occurs.
• Crisis: The actual occurrence of the crisis.
• Response: Actions taken to deal with the crisis.
• Recovery: Efforts to return to normalcy and learn from the crisis.

What are the three steps of the ABC model of crisis intervention? The ABC model of crisis intervention includes three primary steps:

• A: Developing and maintaining rapport. Establish a connection with the individual in crisis.
• B: Helping the individual identify and process their feelings and perceptions related to the crisis.
• C: Encouraging focus on coping and adaptation strategies. Assist the individual in finding ways to manage and adapt to their situation.

What is Psychological First Aid (PFA)?

Psychological First Aid (PFA) is a crisis intervention model used in disaster response. It aims to reduce initial distress and foster short- and long-term adaptive functioning and coping.

Why is ongoing training important in crisis intervention?

Ongoing training is essential in crisis intervention to ensure that counselors are up-to-date with the latest techniques and best practices. Proper training also ensures that they can effectively implement the chosen crisis intervention models and work well within their organizations.

What is Critical Incident Stress Management (CISM)?

Critical Incident Stress Management (CISM) is a crisis intervention model that focuses on providing support to individuals who have experienced traumatic events. It is often used in organizational settings and has a significant impact on first responders.

Additional Resources:

The Impact of Organizational Culture on Leadership Strategies in Crisis Management. Niña A. Martinez, Et Al. Excellencia: International Multi-Disciplinary Journal of Education (2994-9521), Vol. 1 No. 5 (2023). ARTICLES Published 2023-11-29

Access link here 

Review: Crisis responses for children and young people – a systematic review of effectiveness, experiences and service organisation (CAMH-Crisis). Deborah Edwards, Judith Carrier, Et Al. The Association for Child and Adolescent Mental Health. First published: 14 February 2023

Access link here

Solution Focused Brief Therapy Telemental Health Suicide Intervention. Finlayson, B.T., Jones, E. & Pickens, J.C. Contemp Fam Ther 45, 49–60 (2023).
Access link here

The spatial (in)stability of mental health calls for police service. Jacek Koziarski. (2022). Criminology & Public Policy 22:2, pages 293-322.

Access link here