Everyday understanding of crisis
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Bruce Wampold(2001), an American psychotherapy researcher, emphasizes in his “contextual model” that the client expects, among other things, that the therapist provides a plausible explanation for his or her suffering and an associated action plan has. Entering into a trusting relationship, which according to Wampold is essential for the success of an intervention, is made easier by the fact that these explanations are comprehensible for the clientele. This applies all the more in the very short encounters in crisis intervention, in which there is not much time to negotiate interpretations.
As Bergold et al.(2004) were able to show that, according to a survey of crisis workers, there are differences between an everyday understanding and a professional understanding of the crisis, but the differences are not too great. Both crisis workers and laypersons see crises as a process in which external, stressful and overwhelming and internal conditions such as certain vulnerabilities, a lack of self-esteem come together and can trigger a crisis.
While the specialists tend to focus on the internal factors, the laypersons increasingly emphasize material emergencies and catastrophes as the causes of crises. The professionals also tend to address a lack of resources, while the laypersons address social conditions as a crisis trigger. Professional advisors name another factor in the causes of crises, which is the endangerment of physical integrity (e.g. due to an accident).
Crisis intervention as a care model
Crisis intervention facilities agree that their most important task is prevention: the prevention of chronic crises and mental disorders, the timely intervention aimed at promoting positive development, as well as the early detection of a mental disorder. Identifying and reducing hazards is particularly important. The crisis intervention offered is not always sufficient, and it is the job of crisis counseling to motivate people to seek further help. Frequently, however, the counselors have to cover social deficits in mostly telephone contacts, especially in the case of lonely callers. Relief from a conflict-ridden or overwhelming everyday life are further tasks, as well as the relief of relatives. Another goal is to avoid placement in a psychiatric hospital. Should this still be displayed,
General models of action
There are a number of action models (Ciompi 1993; Schnyder 1993; Egidi and box books 1996; Sonneck 2000; Dross 2001; Hühlshoff 2017, etc.), which provide orientation for the helper. Caplan’s action model, which is summarized here, is fundamental(Caplan and Grunebaum 1977). In addition, the practice-oriented action model of Ciompi(1993), also intended for psychiatric emergencies.
Caplan’s model of action
The following intervention proposals by Caplan are historically significant for all other ideas for crisis intervention(Caplan and Grunebaum 1977):
- Close monitoring
This means short intervals during the four to six weeks of a crisis. Caplan took this period for granted, but it no longer agrees with current knowledge.
- Family orientation
The cohesion of the family should continue and their support should be guaranteed. Some authors have included this network orientation in their action model.
- Avoidance of dependency
This is to be achieved by focusing on current problems.
- Promote coping
This approach increases the possibility of facing the crisis and regaining hope.
- Getting support from outside
Help should not only come from the respective institution, but from people in everyday life.
- Goals: The goal is a step-by-step and effective approach to the crisis.