As much as we like to think of ourselves as unbreakable, we break, and when we do it’s usually hard and fast. If this feeling of being in crisis comes we may not feel comfortable to reach out for support. It’s embedded in our DNA that we are firefighters and we are supposed to fix problems.
Our exposures to high stress calls and events have given us the ability to overcome our feelings and work through them. Over time we store up our issues until they may overflow into other parts of our life. Sure, we may use dark humor or sarcastic remarks to move past our own feelings and continue to do our jobs but what happens when the floor falls out from under us, and we or a friend needs help.
If we finally do decide to accept help we will need somebody we can trust. We will need to know what the help will look like. So if you or somebody you know is in crisis and you decide to ACCESS RESOURCES to get help. What can you expect to happen next?
‘What will a crisis intervention look like?’
Each program is different, but all professional licensed counselors adhere to regulations when it comes to crisis intervention. Crisis Intervention should not be confused with traditional Therapy or Counseling. Crisis Intervention is used in acute situations to assist those who are in urgent need of help.
- Their behavior constitutes a danger of inflicting serious physical harm upon oneself, including attempted suicide or the serious threat thereof, or if the threat is expected that it will be carried out.
- There is potential that the continued behavior can reasonably be expected to result in serious physical harm to others.
Behavior in which a person is likely to come to serious physical harm or serious illness because he/she is unable to provide for his basic physical needs.
- They are showing signs that they are suffering severe and abnormal mental, and emotional issues and that these issues are significantly impairing judgment, reason, behavior or capacity to recognize part of reality.
These four guidelines are reasons for a Crisis Intervention. It is after intervention and when the person is back to more stable that they would benefit from therapy or Counseling in hopes of creating a new healthy baseline.
A Crisis Specialist will ask a series of questions to identify relevant safety issues, and to assess if the person meets the criteria above. Some of these questions may seem intrusive when asked, but regulations dictate that the level of safety is assessed. Here are some sample questions to expect:
Safety Assessment Questions
- Have you had any thoughts or actions, now or in the past, to do anything to hurt yourself?
- Are you concerned about your ability to maintain your own safety?
- Is anyone else concerned about your ability to maintain your safety?
- What, exactly, are any thoughts you have had or are having to hurt yourself?
- Do you have a plan on what you would actually do to hurt yourself?
- Have you ever acted on these thoughts? What did you do?
- Regarding any past actions to hurt yourself, was your intention to hurt yourself, die, let someone know how bad things are?
- What were you trying to get away from or are you trying to get away from, by doing something to hurt yourself?
- How are you hoping hurting yourself/killing yourself will solve your problems?
- Do you have the means to hurt yourself? Do you have access to weapons or drugs?
- Has anyone in your family ever hurt themselves/committed suicide?
- What level of support do you have in your life?
- Are you willing to make a no-harm contract with me?
- Define the Problem. Explore and define the problem from the patient’s point of view. Use active listening, including open-ended questions. Attend to both verbal and nonverbal communications.
- Ensure Personal Safety. Assess lethality, criticality, immobility and seriousness of threat to patient’s physical, emotional and psychological safety. Assess internal impact as well as environmental situation.
- Provide Support. Communicate (by words, voice, and body language) a caring, positive, non-possessive, nonjudgmental, acceptant, personal involvement with the one in crisis and the family.
- Examine Alternatives. Assist in brainstorming choices available now. Search for immediate supports. These supports might include hospitalization or rehabilitation facility
- Plan. Develop a plan with your patient which: provides something concrete and positive for the patient to do now with definite action steps which the patient can own and comprehend.
- Ask the patient to verbally summarize the plan and commitment.
- Demonstrate your part of the commitment if you collaborate.
- Follow up on the patient’s performance or in obtaining assistance.
Click Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) to receive a FREE digital copy of suicide assessment guidelines put out by the Substance Abuse and Mental Health Services Administration (SAMHSA).
For Help or more information on Crisis Intervention please visit FireStrong.org.