Crisis is an experience of an event or situation with an intolerable difficulty that exceeds the coping resources and mechanisms of the person. Such situations include: being a victim of violence or abuse, being a witness of violence, suicide or homicide, experiencing threat for one’s own life, health or integrity, experiencing personal loss. Crisis is usually a short-term process, but it can have long-term consequences. Receiving support or professional help in a situation of crisis reduces the risk of developing a psychological trauma for the person. Trauma is a state where the person has exhausted their coping mechanisms, self-esteem, social support and perception of control over the situations and their life in general.
Crisis consultations/interventions is an emergency psychological help which is intended to help the individual in a crisis situation stabilize their potential and reduce the risk of development of trauma. Crisis consultations is a type of short-term, goal-oriented help with a limited number of sessions for the client. It is a temporary emergency care for a person who, because of experiencing an unbearable stress in their life, feels incapable of functioning at their usual level. Crisis consultations aim at interrupting the maladaptive behavior and returning the person to their level of functioning before the crisis.
The first task of the crisis consultant is to make a risk assessment (an assessment of the danger and safety for the individual in crisis). In risk of repeated violence, the client is accommodated in the Crisis center. If the client is a mother with children, the same or other consultant additionally assesses the state of the children and the risk for them. The consultant refers to the social environment and support of the client (relatives, friends, colleagues) and tries to understand what the usual response to crisis events is for this particular person.
Often, victims of violence blame themselves for what happened. They feel disoriented and insecure, become hyper-sensitive or confused, have poor concentration, cannot take decisions. The physical reactions to crisis include:
increased heart rate, tremors, dizziness, weakness, chills, headache, vomiting, shock, loss of consciousness, sweating and fatigue. Some emotional reactions of a person in crisis are expressed as apathy, depression, irritability, anxiety, panic, helplessness, hopelessness, anger, fear, guilt and denial. Other typical responses to the crisis are difficulty in eating and / or sleeping, conflicts with others, withdrawal from social situations and lack of interest in social activities.
Stages of crisis counseling include:
– Risk assessment – the consultant assesses if there is a danger for the clients immediately after their arrival;
– Assessment of the resources and coping mechanisms of this client, including what in his life has led to the crisis. During this stage it is important that the client restores his/her sense of control and power to discuss their story in their own words; as he / she describes the situation, the intervention of the consultant is to identify ways to address what could be corrected in future with long-term consultative work, can offer care plan and discuss it with the client, refer the client to other services or subsequent psychological work
– Ventilating feelings – the consultant enables clients to express their feelings and emotions, he listens actively, validates, does not judge, accepts; the client becomes able to make sense of the crisis event
– exploration of alternatives to cope – the consultant and the client work together, this is the most difficult part of the crisis counseling for the victims of violence; it is an experience unlike any other in their life and they hardly similar situations in which they have managed to cope and gain control; However, this step is a crucial part of the crisis intervention.
– An individual plan for the client – it aims not only to identify the type of care, but also to empower the client; the plan is specific, agreed with the client, and most importantly, it makes sense for the client, it restores his sense of control over situation;
– Follow-up – negotiating further sessions or long-term psychological work