1. Client and Personal Safety4 Hours Dr. Dawn-Elise Snipes Ph.D., LMHC, CRC Executive Director, AllCEUs.com Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

2. People are facing an untenable obstacle to life goals People’s life cycles are significantly disrupted AND The person has no response to deal with a situation Definition of Crisis Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

3. The unknown Loss of control or power Rejection Isolation Failure Death 6 Basic Fears Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

4. Presence of opportunity and danger Change causes crisis and crisis causes change Increasing anxiety can lead to violent reactions Complicated Generally does not have one simple cause Precipitating events may impact many different areas of life Characteristics of Crisis Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

5. No Panaceas or Quick Fixes May provide temporary, immediate relief Ensure they do not make problem worse Necessity of Choice Making a choice requires action Choosing not to act is a still a choice Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

6. Developmental Normal or abnormal events causing dramatic change Situational Crisis Existential Crisis Anxieties arising from questions of purpose, responsibility, independence, commitment Ecosystemic Crisis Disaster Types of Crisis Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

7. Equilibrium/Stabilization Cognitive Gain control by changing thinking REBT Reality Therapy Psychosocial Assess internal and external exacerbating and mitigating factors Choose workable alternatives Models of Crisis Intervention Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

8. Danger and Opportunity Time limited, but may be recurring Complex Life experiences of workers enhances their effectiveness Crisis causes people to make choices Important Points Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

9. There is no one “normal” range of behaviors Individuals are not necessarily the basic building block of society Problem definitions can be interdisciplinary, even if worker is not. Language is not always interpreted in the same way The value of independence and dependency varies between people and cultures Not everything can be explained in a linear fashion We must accommodate the client’s needs Past history certainly impacts current events Be aware of personal assumptions Cultural Competence Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

10. Verbal Crisis Deescalation Define the problem Listen to identify the person’s orientation Feelings or solutions Visual, auditory, kinesthetic Empathize to see the problem as the client does Ask open-ended questions Pay attention to verbal and nonverbal messages Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

11. Assess (ABCs) Affective state Behavioral Functioning Cognitive Functioning Severity of the crisis SI/HI Intent Plan (Method, Date/Time) Means Future Plans Putting affairs in order VCD cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

12. VCD cont… Ensure client and personal safety Physical Remove the client from the situation (if possible) Inform client you want to help, but it is hard for you to focus while… Propose solution that does not take away his power. Maintain an environment free of hazards (scissors, letter openers, heavy objects) Always maintain a clear path to the door Do not meet with clients in isolation Psychological Remove bystanders (an audience also adds fuel) Reframe the situation with client not being “bad.” Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

13. Provide Support Thinking Words You are… Stuck At your wits end Out of options Out of control Feeling words You feel… Overwhelmed Helpless Hopeless VCD Cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

14. Seeing I see that… You look like… Hearing I hear that… You sound… Doing You want… You regret…. VCD Support cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

15. Acting Acknowledge the situation and/or the client’s feelings Seek help from the client in understanding what is going on Tell me what is going on Ask open ended questions Own your feelings Be aware of transference and counter-transference reactions VCD cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

16. Convey understanding Don’t say “I understand” Provide positive reinforcement for behaviors Avoid value judgments Set limits and do not tolerate controlling or aggressive behavior VCD cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

17. Reduce tunnel vision or increase focus Examine Alternatives Supports Coping Mechanisms Thinking Patterns Promote Mobilization Make plans Implement Order Obtain commitment with assertion statements I need you to… VCD cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

18. Please read the following book Client Safety and Crisis Intervention Further Reading Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

19. Change causes crisis Crisis is a state of extreme anxiety It is important to “hear” the client Help the client Re-establish equilibrium Identify environmental and social supports Develop a plan Take action Summary Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year

20. When in crisis, clients may act out against themselves or others Ensure your office and common areas are free from potential weapons Develop a safety plan for Your exit Removing bystanders/other staff Aiding clients Never make promises you cannot keep Summary cont… Copyright AllCEUs.com 2011. Unlimited CEUs $99 per year