This document describes a crisis intervention team working in an immigration detention unit. It provides context about the difficult living conditions for detainees and outlines the team's approach. The team uses Gestalt therapy principles and a six-step model of crisis intervention. This involves actively listening, ensuring safety, providing support, examining alternatives, making plans, and obtaining commitment from clients. The team works to help clients regain control during their crisis and restore equilibrium through creative adjustment.

1. Impasse In a Detention UnitImpasse In a Detention Unit
Joanna Kato M.Sc. Psychologist, Speech Therapist,Joanna Kato M.Sc. Psychologist, Speech Therapist,
Gestalt PsychotherapistGestalt Psychotherapist
Bianca Ellinger Psychologist, Gestalt Psychotherapist,Bianca Ellinger Psychologist, Gestalt Psychotherapist,
PhysiotherapistPhysiotherapist
Athanasia Karantzia Psychologist, Psychotherapist,Athanasia Karantzia Psychologist, Psychotherapist,
Gestalt GraduateGestalt Graduate

2. Description of the FieldDescription of the Field
• Place and livingPlace and living
conditionsconditions
CellsCells
Limited access toLimited access to
toilets and phonestoilets and phones
No daily procedureNo daily procedure
(routine)(routine)
Limited access toLimited access to
information aboutinformation about
rightsrights

3. Description of the FieldDescription of the Field
• Population ofPopulation of
detaineesdetainees
 MulticulturalMulticultural
 MultilingualMultilingual
 Age from 4 months till 72Age from 4 months till 72
years oldyears old
 Wide range of problemsWide range of problems
 MigratingMigrating
 In crisis before detentionIn crisis before detention

4. Description of the FieldDescription of the Field
• Intervention TeamIntervention Team
 Program coordinatorProgram coordinator
(nurse)(nurse)
 General PractitionerGeneral Practitioner
(doctor)(doctor)
 Psychologist (GestaltPsychologist (Gestalt
therapist)therapist)
 Social worker (sociologistSocial worker (sociologist
–criminologist)–criminologist)
 Volunteers (2 GestaltVolunteers (2 Gestalt
therapists, 1 psychiatrist)therapists, 1 psychiatrist)

5. Crisis DefinitionCrisis Definition
““Is a perception or experience of an event orIs a perception or experience of an event or
situation as an intolerable difficulty thatsituation as an intolerable difficulty that
exceeds the person’s current resources andexceeds the person’s current resources and
coping mechanisms. Unless the personcoping mechanisms. Unless the person
obtains relief, the crisis has the potential toobtains relief, the crisis has the potential to
cause severe affective, behavioural andcause severe affective, behavioural and
cognitive malfunctioning”.cognitive malfunctioning”.
James R. K. Gilliand B. E. “Crisis Intervention Strategies”James R. K. Gilliand B. E. “Crisis Intervention Strategies”

6. Characteristics of CrisisCharacteristics of Crisis
 Self-Destruction or Self-Self-Destruction or Self-
GrowthGrowth
 Complicated SymptomsComplicated Symptoms
 No Temporary SolutionsNo Temporary Solutions
 A Generalized andA Generalized and
PersonalizedPersonalized
PhenomenonPhenomenon

7. Types of CrisisTypes of Crisis
DevelopmentalDevelopmental
SituationalSituational
ExistentialExistential
EnvironmentalEnvironmental

8. Possibilities at the ContactPossibilities at the Contact
BoundaryBoundary
1.1. Equilibrium is easily establishedEquilibrium is easily established
2.2. Tension on both sides of the boundary isTension on both sides of the boundary is
difficult to equilibrate and is achievabledifficult to equilibrate and is achievable
3.3. Situation of danger: Intolerably overworkedSituation of danger: Intolerably overworked
boundary by environmental forcesboundary by environmental forces
4.4. Frustration, starvation, illness: IntolerablyFrustration, starvation, illness: Intolerably
tensed boundary because of internal demandstensed boundary because of internal demands

9. Crisis in Gestalt PsychotherapyCrisis in Gestalt Psychotherapy
TermsTerms
A person experiences crisis when aA person experiences crisis when a
sudden change or situation cause such asudden change or situation cause such a
tension at the contact boundary, that thetension at the contact boundary, that the
familiar self-functions are unable to handlefamiliar self-functions are unable to handle
it in a bearably comfort and safe wayit in a bearably comfort and safe way

10. Crisis in the Contact CycleCrisis in the Contact Cycle
EXITEMENT
AWARENESS
MOBILISATION
OF ENERGY
WITH-
DRAWAL
CONTAT
ACTION
SENSATION

11. Crisis from a GestaltCrisis from a Gestalt
PerspectivePerspective
 Self: Id – Ego – PersonalitySelf: Id – Ego – Personality
 Creative AdjustmentCreative Adjustment
 I-Thou relationshipI-Thou relationship
 ContactContact
 Here and NowHere and Now
 PhenomenologyPhenomenology

12. The Six Step Model Of CrisisThe Six Step Model Of Crisis
InterventionIntervention
 ListeningListening
1.1. Define the problemDefine the problem
2.2. Ensure clients safetyEnsure clients safety
3.3. Provide supportProvide support
 ActingActing
4.4. Examine alternativesExamine alternatives
5.5. Make plansMake plans
6.6. Obtain commitmentObtain commitment
Assessment

13. Step 1Step 1
Define the ProblemDefine the Problem
Active listening – questions from intakeActive listening – questions from intake
formform
Words from clients language as commonWords from clients language as common
ground of contact makingground of contact making
Translation – as tool to show interest andTranslation – as tool to show interest and
a better understandinga better understanding

14. Step 2Step 2
Ensure Client SafetyEnsure Client Safety
• Minimize danger to self and others - assessMinimize danger to self and others - assess
lethalitylethality
Have you been sleeping? Eating? Drinking?Have you been sleeping? Eating? Drinking?
Since you have been here?Since you have been here?
Are you having bad dreams? Bad thoughts?Are you having bad dreams? Bad thoughts?
about hurting yourself or anybody else?about hurting yourself or anybody else?
Is anything strange/scary happening to you?Is anything strange/scary happening to you?
Is there anything you want to tell me which IIs there anything you want to tell me which I
didn’t ask and you think is important?didn’t ask and you think is important?

15. Step 3 Providing SupportStep 3 Providing Support
• Crisis worker: a valid person for supportCrisis worker: a valid person for support
• Giving something to grab onGiving something to grab on
 I am here to help. If you need anything or want to talk weI am here to help. If you need anything or want to talk we
are here every day in the morning except weekends.are here every day in the morning except weekends.
 What is it that you need now? Here and now how can IWhat is it that you need now? Here and now how can I
help you?help you?
 Is there anyone you can talk to here in detention or inIs there anyone you can talk to here in detention or in
Athens?Athens?
 Is there anyone you can call and talk to?Is there anyone you can call and talk to?

16. Specific Support in Detention –Specific Support in Detention –
Team WorkTeam Work
 Informing about detention procedures and rightsInforming about detention procedures and rights
 Facilitating procedures (referring to hospital, to GCRFacilitating procedures (referring to hospital, to GCR
lawyers, communicating with shelters, enabling meetingslawyers, communicating with shelters, enabling meetings
with other programs or institutions)with other programs or institutions)
 Medical primary careMedical primary care
 Symptomatic treatment for drug abusersSymptomatic treatment for drug abusers
 Close cooperation with other organization – asking forClose cooperation with other organization – asking for
help (modeling)help (modeling)
 Tutoring of psychosomatic symptoms and aid in findingTutoring of psychosomatic symptoms and aid in finding
reliefrelief

17. Step 4 Examining AlternativesStep 4 Examining Alternatives
• Looking for choicesLooking for choices
Let’s see what your options are…Let’s see what your options are…

18. Step 5 Making PlansStep 5 Making Plans
Client regains control and autonomyClient regains control and autonomy
and restores equilibriumand restores equilibrium
When you go out of here what are youWhen you go out of here what are you
going to do?going to do?
If you go back to your country what doIf you go back to your country what do
you need to take care of?you need to take care of?

19. Step 6 Obtaining CommitmentStep 6 Obtaining Commitment
Verbally summarize the planVerbally summarize the plan
I want you to…….I want you to…….
And I will see you again on…. So you canAnd I will see you again on…. So you can
tell me how things are goingtell me how things are going

20. Team IssuesTeam Issues
Supervision (team and individual)Supervision (team and individual)
Transference and countertransferenceTransference and countertransference
issuesissues
Ethical issuesEthical issues
ConflictsConflicts

21. Personal ProcessPersonal Process
Reason for working thereReason for working there
Inner Conflict - ImpasseInner Conflict - Impasse
Team workTeam work

22. Creative AdjustmentCreative Adjustment

23. ReferencesReferences
• F. Perls, R. F. Hefferline, P. Goodman,”Gestalt Therapy: Excitement and Growth in theF. Perls, R. F. Hefferline, P. Goodman,”Gestalt Therapy: Excitement and Growth in the
Human Personality”,(260-261)Human Personality”,(260-261)
• James R. K. Gilliand B. E. “Crisis Intervention Strategies”James R. K. Gilliand B. E. “Crisis Intervention Strategies”
• Ann L Bauer and Sarah Toman“ A Gestalt Perspective of Crisis Debriefing: Working in theAnn L Bauer and Sarah Toman“ A Gestalt Perspective of Crisis Debriefing: Working in the
Here and Now When the Here and Now is Unbearable”. Gestalt Review, 7 (1):56-71, 2003Here and Now When the Here and Now is Unbearable”. Gestalt Review, 7 (1):56-71, 2003
• Glenys Parry,Glenys Parry, Ψυχολογικές κρίσεις και η αντιμετώπισή τους, Ελληνικά Γράμματα, 1996Ψυχολογικές κρίσεις και η αντιμετώπισή τους, Ελληνικά Γράμματα, 1996
• Iris Fodor “Reflections on September 11: “When therapist and Client Participate in the SameIris Fodor “Reflections on September 11: “When therapist and Client Participate in the Same
Trauma” British Gestalt Journal,2001,Vol.10,No2,(80-85)Trauma” British Gestalt Journal,2001,Vol.10,No2,(80-85)
• Juan Miguel Petit, Report of the Special Rapporteur on the sale of children, child prostitutionJuan Miguel Petit, Report of the Special Rapporteur on the sale of children, child prostitution
and child pornography, E/CN.4/2006/67Add.3and child pornography, E/CN.4/2006/67Add.3
• Maria Kichner Gestalt Therapy Theory: an Overview, Website: http://www.g-gej.org/4-Maria Kichner Gestalt Therapy Theory: an Overview, Website: http://www.g-gej.org/4-
3/theoryoverview.html3/theoryoverview.html
• Lin Young, davi Lester, PhD “Gestal Therapy Approaches to Crisis Intervention With SuicidalLin Young, davi Lester, PhD “Gestal Therapy Approaches to Crisis Intervention With Suicidal
clients – Brief treatment and Crisis Intervention /1:1 Summer 2001clients – Brief treatment and Crisis Intervention /1:1 Summer 2001
• Gonzague Masquelier “Gestalt Therapy Living Creatively Today” GestaltPress,2006Gonzague Masquelier “Gestalt Therapy Living Creatively Today” GestaltPress,2006
• Tim Warneka, An Ohio Yankee in Queen Katrina's Court, Website:Tim Warneka, An Ohio Yankee in Queen Katrina's Court, Website:
http://ohioyankee.blogspot.com/2006_03_01_archive.htmlhttp://ohioyankee.blogspot.com/2006_03_01_archive.html