The nature of crisis is as defined byKanel (2014) “as a person’s emotional and psychological imbalance” and occurswhen a precipitation event arises follow by the perception of a person to theevent as threatening or damaging and then this type of perception leads to aperson’s emotional distress that will then leads to impairment of theirequilibrium and disruptions of their usual or normal activities. And if thecrisis is not intervened, the person’s behaviours can be threatening tothemselves or others. There are a couple of different types of crisis and Iwill be explaining some. Being bullied in school or workplace, maritalseparation, loss of significant others can cause a great deal of emotionaldistress.
Being hurt physically can also lead to emotional distress and thencontribute to a person’s crisis such as physical accident from work ormotorcycle accident. The effect of crisis can affect a personin many ways. The ABC model of attitude consist of Affective(feelings),Behaviour(behaviour) and Cognition(thoughts). Affective component involves aperson’s feelings about the attitude object. For example, “I am scared ofcockroaches”. Behaviour component involves the attitude we have influences howwe react, act or behave.
For example, “I will avoid and scream when I see acockroach”. Cognitive component involves a person’s thoughts/belief about anattitude object. For example, “I believe cockroach are dangerous and dirty”(McLeod, 2014). When a person is in crisis, we can measure the impact of crisison ABC model of attitude it will instil to the person by using the TriageAssessment Form(TAF).
It can be grouped to three categories; minimalimpairment, moderate impairment and severe impairment. When a person is underminimal impairment, the person’s Affective component are somewhat appropriatebut there is some noticeable negativity and liability, Emotions are generallystill under control but is primarily focused on the crisis event, theirresponses may vary from agitated to slow and subdued and the person could havelonger periods of negative mood that is slightly more intense than thesituation warrants. Their Behaviour component of how they behave will beineffective but not dangerous, Behaviours could still be controlled by self orrequest by others even with some resistance from the person, the person couldneglect some necessary tasks for daily living and functioning is somewhatcompromised. The Cognitive component are increasingly irrational but post nopotential harm to self or others but the person is somewhat inconsiderate ofothers, their thinking is focused on the crisis but not extremely consuming,the person still have the ability to have reasonable dialogue but is restrictedby the failure to see other perspectives, they might have recurrentdifficulties with problem solving and decision making and their perception arediffered in some aspect from reality.
Moving on, when a person is under moderateimpairment, the person’s Affective component are primarily negative and areexaggerated, interventionist considerable efforts to control and subdue liableemotions are not always successful, the person’s response are highly emotionalbut is somewhat appropriate and could be controlled with effort. Theirbehavioural component are maladaptive but not immediately destructive, theperson’s behaviour are very difficult to control even with efforts from othersand their behaviour is becoming more of a threat to themselves and others. TheCognitive component are irrational and might potentially post a threat to selfor others, the person’s thoughts, feelings and well-being is increasinglydisregarded, their thoughts on the crisis situation are becoming consuming,their problem solving and decision-making abilities are adversely affected andtheir perception is differed noticeably from reality. Lastly when a person isunder severe impairment, the person’s Affective component are extremelypronounced in a negative way, they have no ability to control feelings andcannot respond to questions because of the severe disturbance of emotions andthey might be Depersonalized from themselves. Their Behaviour are totallyineffective, erratic and highly dangerous that could cause harm to self andothers.
The Cognitive component is severely shut down and their thoughts becamechaotic, their ability to understand and respond is non-existent and they mightstart to have severe paranoia and have hallucinations bouts (James &Gilliland, 2017). As crisis are constantly studied, it hasbecome more apparent that crisis occurs chaotically and disorganized and willalways transact from one state of crisis to another. Upon knowing, the HybridModel is then designed to enhance the earlier linear method to crisisintervention (James & Gilliland, 2017). The Hybrid model consist of 7 tasksand this section will explain the reason for the tasks follow by an example ofhow each task is illustrated. But before we go into the first task, one of atask is not within the 7 task as it is a should to include it at every taskwhich is Ensuring Client’s Safety.
This task should always be the priorityevery time and always make sure the client is safe from hurting themselves. Thefirst task is predisposition (engaging and initiating contact). Establishing apositive connection to the person in crisis is an important aspect to build agood relationship of communication that will help to understand the needs ofthe client and the intention of the worker to help the client. An example ofthis task is “What brings you here today?”, “Can you tell me more about thesituation?”. These questions show that the counsellor is interested in findingout what the crisis situation is about that propels the client to feel he/sheis with people who are sensitive to the issue and is willing to hear andunderstand the client’s feelings. The second task is problem exploration.
Thistask opens up discussion of how the client is feeling from their point of view.Finding out how the client had been affected, what they need and theirfeelings. It can be access by using who, why, when, where questions. An exampleof this task is to ask questions consistently for instance “I understand youare screwed over this incident, so tell me what got you so mad andfrustrated?”. The third task is Providing Support. It cannot be emphasizedenough that when a person is going through a traumatic crisis to talk, to beheard and to have someone to understand their feelings without judgement.Discovering their needs and assist them is the best support for the client incrisis and it can also be classified into 3 different types of support;Psychological, Logistical and Social support. An example of this task is “I cantell you are very upset and frustrated and a lot of it comes from the constantbullying you are experiencing.
“, “How can I help with your situation?”. Thefourth task is Examining Alternatives. What other option or support couldbenefit the client or what does the client actually want.
These supports canspan from Medications, therapies or social supports. It is significant tounderstand that these alternatives are better when they are madecollaboratively and when the alternatives selected are preferred by the client.An example of this task is “So, what steps do you think we can take from here,to make this a better situation?”.
This question is intended to find a possiblesolution to the situation. The fifth task is Planning in Order to Re-establishControl. This step involves making concrete plans together with the client inorder to mobilize them to help them gain some control over the situation and itcould also empowers them with improved life skills and resiliency for thefuture. A good plan should have two objective in mind, first objective being isto identify groups of social support or resources that can be contacted forsupport. Second objective is to provide coping mechanisms and the plans shouldbe realistic in terms of the client’s coping ability. An example of this taskis “Ok, well maybe we could seek help from the care centre first and proceedfrom there”. The sixth task is to Obtain Commitment from the client to continueto move forward to improve the situation.
This step also clarifies the role ofthe counsellor and client and instil knowledge to what responsibility is heldby themselves and allows for both control and autonomy. Commitment can beobtained by; “So tell me what we are going to do?”, “Maybe we can come out withan agreement of the said plan”. The seventh and last task is to Follow Up withthe client after the initial intervention to warrant that the client’s crisisis on the way to being resolute and client’s equilibrium is on the pre-crisislevel. Counsellors can ask question like “Do you have a better understanding onthe situation now? And how are you going to handle it differently?” And it isalso good to provide information to client on how to contact you if needed inthe future (James & Gilliland, 2017).
There are some challenges that could befaced while applying the 7 tasks model. In this section I will criticized someof the personal flaws as a counsellor I feel I might have or other superficialproblems during counselling and come up with a possible solution to thechallenges in the following section. It is important to stay Poised throughoutthe whole intervention process because crisis can be out of control and mightchange drastically that could catch us off guard.
By being Poised is to staycalm, stable, rational and in control during crisis for the client, becausewhen clients are in crisis they could be out of control and present danger tothemselves or others. I feel that I am lacking “Poise” when I am overwhelmedwith crisis that is constantly changing and I might panic and lose confidencein myself that could render me unable to make rational decisions and it isextremely dangerous for the client in crisis that is already out of control.Silence in counselling most of the time isinevitable.
Although Silence is not necessary a bad thing, it could beunhealthy when it is handled or interpreted wrongly for example awkward silenceis not a good process. Sometimes I might get stuck with words and not know whatto say in response to the client’s speech. I also feel that the anxiety for meto perform as a counsellor will utter me to speak words that is illogical tothe situation and that might lead the conversation to go off track or confusingpossibly resulting in awkward silence.
Also as a person myself, I also dislikesilence because I interpret silence as uncomfortable and awkward even though itis not necessarily true all the time and I do find myself trying not to fill asilence, but I just can’t seem to help it to always break silence even thoughthe silence might be therapeutic and helpful. It could be a misconception frommy part that because counselling is about ‘talking’ then silences mean that Iam not helping the client. I could also misinterpret silence, for example theclient is actually feeling stuck and that I should “break the ice” whennecessary after a moment, instead I misinterpret it as the client isexperiencing emotions.Humour can be a good skill to implementwhenever appropriate. But it could misfire or fall flat and become counterproductiveand waste of therapeutic time when it is used ineffectively.
The client, in thepresence of such counterproductive humour may feel that I am taking his problemlightly or assume that I am a superficial person whose seriousness andcapacities cannot be trusted. Implementing effective humour is mostly due tothe tones, facial expression and changes of body tone also the words used inthe humour. Knowing myself personally, I tend to have a “dry” personality. Alittle aloof and humourless and kind of have little change in my tone andfacial expression when speaking most of the time.
I feel that I am unable toimplement humour in session productively and it is a challenge for me. Counsellor burnout could be an issue forme, there could be a lot of factors contributing to the burnout. It could bemental and emotional exhaustion caused by long-term involvement in an emotionaldemanding workplace. Feeling of helplessness and hopelessness that could bederive by my counselling does not seem to help my client despite my utmosteffort, or client is resistant/reluctant to change. Compassion fatigue due tomyself being in a prolonged and intense exposure to my client’s stress. Itcould be also caused by the workload being too complex, too much, too urgent oreven too awful.
I fear that I am unable to cope with the burnout thus wearingdown the optimism and motivation in me. Solution for me lacking “Poise” is tounderstand the flaws and better myself. I could engage in Personal Therapy formyself (Miller, 2011). Personal Supervision with the help of a mentor can alsohelp build up my Poise by identifying personal area in my life that may impedethe lack of Poise.
I could try to change my negative thinking into morepositive ones like believing in myself and focusing on my strengths. I mustalways reassure myself to stay stable in crisis for the sake of my client.If I get stuck with words during session,I could use more open-ended questions like “Can you elaborate more on thesituation? Or “Tell me more about the feelings u felt when it happened” becauseby using this type of question or statement, I let my client know that I aminterested in his inner experience and that he sets the direction of thetherapy. Usually he will feel encouraged to continue exploring the thoughts andfeelings related to the current issue or to shift to an issue that feels morerelevant and that prevents unhealthy awkward silence. Other than getting stuckwith words (dianesuffridgephd.com). I am aware that I have the conception ofdiscomfort with silence even though it could be a good therapeutic process, andI should change my way of thinking that actually silence is far from beinguncomfortable and awkward I perceive it as, but is more so a gift, somethingthe client is likely to experience in the company of others, something that isactually productive that provides the client to time to reflect and feelemotions. By thinking that silence is actually a “gift” I am starting to acceptand sit with silence.
Using humour is a challenge for me but thatdoesn’t mean I have to completely avoid using humour. I could still use humour,but one thing I could do is to be extra careful while using it. I could developbetter sub-skills of humour like I could access the client’s ability to accepthumour, what type of humour they are more inclined. Humour is still a risk attimes, if the client reacted negatively it is imperative that I repair themistake and learn the client’s pattern. As for me having a “dry” personality,the solution for me is to seek personal supervision and from the help of mymentor to identify personal areas in my life that may impede the counsellingprocess and improve from there.
Burnout could happen,but there are ways to prevent or at least help with burnout. I should create aboundary between work and home and maintain a personal identity, engage myselfin activities that can promote self-efficacy and empowerment. I could alsoengage myself in psychotherapy. Getting proper and regular supervision isessential as well (Webb, 2007). Getting social support help will benefit me alot.
Periodically, workers like me would also need someone to listen activelyto me in an empathic manner