A Comprehensive Guide to Crisis Intervention

If an individual experiences a crisis, responding appropriately can make a life-saving difference. 

A crisis is generally triggered by an overwhelming event such as a divorce, violence, the death of a loved one, or the discovery of a serious illness. In these instances, crisis intervention is a short-term management technique used to address an immediate health emergency to avoid permanent damage to the individual.

Once feelings have been de-escalated and stabilized, crisis intervention may also involve implementing a safe, appropriate next steps plan for future treatment. 

Mental health professionals, psychologists, and those who have studied a Masters in Mental Health Counseling online will likely be familiar with the crisis intervention model ‘Gilliland’s six-step crisis intervention strategy’. By moving through these six steps, professionals can help guide an individual in crisis away from dangerous actions and towards safety. 

In this comprehensive guide to crisis intervention, we will look at this model and how it can assist those in crisis.

Gilliland’s six-step crisis intervention strategy

When a person experiences a stressful or traumatic event, they can go into a crisis as they cannot process what has happened. Even if the traumatic event occurred a long time ago, a person may still enter a crisis if triggered in the present moment.

Crisis intervention is not limited to those who experience a traumatic event. It can also help address people with various mental health issues such as mood disorders, psychotic disorders or substance abuse may also experience a sudden, acute increase in their symptoms. Someone who is experiencing suicidal thoughts can experience a crisis if they feel they may act on these thoughts and will also benefit from crisis intervention. 

Whatever the circumstances, a person in crisis needs assistance to regain control and stabilize. Gilliland’s six-step model provides a systematic process of listening and responding to empower a person to return to their pre-crisis state of mind. 

1. Define the problem

The first step of the six-step model requires the crisis worker to define the problem. By determining and fully understanding what the problem is, the crisis worker can establish a connection between themselves and the client and begin the process of discussing the issue. The crisis worker should implement; 

• Active listening: the crisis worker must give their full attention to the client, demonstrate acceptance, and remove bias. 
• Empathy: the crisis worker must practice empathy and make a conscious effort to understand the client’s point of view while showing that they understand and empathize with their current situation. 
• Genuineness: the crisis worker must speak genuinely, but carefully, to avoid seeming untrustworthy and thus breaking down the building relationship between themselves and the client. 

2. Ensure the individual’s safety

During this step, the crisis worker must conduct checks to ensure the individual’s safety. This includes suicide risk and homicide risk assessments, determined by evaluating factors such as agitation and the client’s potential for causing harm. 

Another important aspect of this step is controlling the individual’s access to potentially dangerous items. The crisis worker must ensure the client is in a safe environment before moving forward with the next step.

3. Provide support

Providing support to the client is the next important step. Showing care and acceptance, discussing the problem, and then offering support to meet their basic needs will set the client up to understand the options available to them to deal with the situation. Types of support can include;

• Emotional support: via statements that illustrate empathy, trust and care.
• Instrumental support: by providing services like aid, shelter and food. 
• Informational support: offering advice and suggestions on coping strategies or information on available support resources. 

4. Explore alternatives

Exploring alternatives is the first ‘action’ step in the method. Here the crisis worker should focus on finding navigating possibilities and devising new solutions in collaboration with the person in crisis.

If the client’s coping skills are not in a good state, the crisis worker may need to provide more direction at first and spend time helping the client reframe their thoughts in more positive ways. 

5. Make plans

With trust established in a safe environment and options explored, it is now time for the crisis worker to build a crisis management plan. The plan must be clear and realistic, with simple steps outlined to empower the client and make them feel as though they can accomplish the tasks and take ownership of the recovery process. 

This step must be done in collaboration with the client. A sense of control over the situation can do wonders, and it is important for the client to feel they have contributed to their healthcare plan. 

6. Obtain commitment 

The very last step in the process is to obtain a commitment from the client. This may be as simple as a verbal agreement that the plan is understood, to a more complex arrangement where the plan is documented and signed off by both parties. In either case, it is the crisis worker’s responsibility to ensure the client fully understands the plan, and that they have the tools they need to follow through on it.

The crisis worker should also make plans to follow up with the client to ensure a sense of accountability for both parties and to check in on the client’s well-being. 

Why use Gilliland’s six-step strategy

An unmanaged crisis can lead to significant stress and can have long-term negative impacts on an individual’s life. Crisis intervention has proven efficacy in preventing some of these long-term effects.

The six-step model is effective as it emphasizes two distinct components that are relevant when helping someone with a problem – listening (the first three steps) and taking action (the last three steps). Its systematic approach helps ensure crisis workers have a clear process to follow while ensuring the client is receiving the help they need.