Hybrid Model of Crisis Intervention

• Frances Roulet 

Analysis case study: Vignette.

In the process applying the six step model of crisis intervention in this case, the soldier deployed back home without no type of psychological and social support from the military system or his family. Therefore, there was no prior assessment before sending the soldier back home, and no assessment in understanding the problem itself (James & Gilliland, 2013).

The process of deployment when reintegrating a soldier back home becomes a major issue in mental health. According to Doyle & Peterson (2005) soldiers that have been life threatening warzone when they are allowed to return home, and they are happy to return and see their families and friend, present problems difficulties in adjusting back to their community environment. This veteran soldier which arrived to his hometown, and who was never received by his family members because the military department in charge failed to notify his family and wife. Once he arrived to his hometown and faced the feeling of confusion and loneliness by not having family or military support. Even though, researchers such as, Demers (2011) acknowledge the struggles that these soldiers confront and develop symptoms of depression, Post-Traumatic Stress Disorder, [PTSD] symptoms and even suicidal thoughts when they are returning back home.

Demer (2011) indicated that for a number of soldiers, the reintegration process becomes a challenge which might include a crisis of identity and feelings of alienation.

Although, one of the first elements in contacting the person is the client’s name and introducing themselves in a non-threatening manner. The soldier caught by surprise every single person at his children school. Subsequently, the immediate response was to search safety and manage to call the Police Department as well as, the mother of the children to provide enough information in order to first secure the children and, then attempting to make any type of contact with the soldier and making him think he had control over the situation.

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Even if this was a momentary situation of the crisis. Once the safety of the children was ensured, as well as, the rest of the people; there is a need to continue assessing the possibility of physical and psychological danger to the soldier as well as to others. Wherefore, the assessment and ensuring of safety becomes a continuous part of the process of the crisis intervention (James & Gilliland, 2013). While maintaining an open communication with the soldier in the process of crisis, support may be given allowing the soldier to ventilate his emotions, but also can be an instrumental and informational for the first responders (James & Gilliland, 2013).

Hoge, Lesikar, Guevara, Lange, Brundage, Engel, Orman, & Messer (2002) explained that they consider that the risks factors of mental health problems, such as major depression, substance abuse, PSTD among others, may be presented after military conflicts, deployment stressors and exposing soldiers to combat, and, may produce an impairment in social functioning along with the ability to work; therefore, increase the use of health care services. Demer (2011) also indicated that these additional stressors can have a negative effect when military deployment occur when soldiers returns home and are not follow-up properly. For most of these soldiers, additional stressors, become a major difficulties and even distressing experience instead of a welcomed relief.

One of the consequences of this distressing experience is the intense identity crisis, when military discharge occurs (Demer, 2011). In analyzing this case, the soldier could have presented psychological challenges when he was deployed to warzone, and as an immigrant in a different culture (home and host culture), he could have presented an acculturative stress. This generated a negative impact and reaction in the soldier which lead him to an identity crisis and mental health problem (Berry, Kim, Minde & Mok, 1987).

Maslow’s theory of hierarchy of needs explains different levels of needs that humans portrays. In a crisis intervention one of the first things to assure is the physiological needs, such as water, food, among other. The person will only be focusing on his or her survival. Nevertheless, security also becomes one of the most vital element when we are facing a crisis intervention. In this particular case, the soldier maintained his children and wife life’s threatened and also had the school personnel and coworkers of his wife. In fact, he killed several people in the process of his crisis. The soldier neglected taking care of his own security needs, referring to those things that the individual feels safe of harm. For example, belonging to the community as a member, therefore, protection is given just because the person belongs to this community group. Another vital need within this hierarchy, is the social needs as a human beings. This need encompasses companionship, love and affection. Once again, the soldier of this case, upon his arrival to his hometown confronted by the absentee of his wife and children and lack of support from the military system could not managed the transition of his deployment back home. This circumstances, detonated a crisis which lead to a fatal outcome for everyone. According to Phillips, LeardMann, Gumbs & Smith (2010) when a person is exposed to combat, and have constant threats of death or witness to it, serious injury or witness to it become significant risk factors for screening positive for postdeployment PTSD among soldiers as well as, violence exposures prior entering the infantry.

Hoge, Castro, Messer, McGurk, Cotting, & Koffman (2004) explained that soldiers and marines presented new onset PTSD after returning from combat several months later. These investigators explained that in their study a 7.6% was revealed with probable new onset PTSD. In the soldier case, he definitely was presenting new onset symptoms for PTSD because he felt confused, abandoned without support and no communication. There is a probability that he might have been impacted and presented symptoms of PTSD before being deployed to Vietnam, and returned traumatized with his experience in Vietnam.

References

Berry, J. W., Kim, U., Minde, T., & Mok, D. (1987). Comparative studies of acculturative stress. International Migration Review, (21): 491–511.

Demer, A. (2011). When veterans return: The role of community in reintegration. Journal of Loss and Trauma, (16): 160-179.

Doyle, M. E., & Peterson, K. A. (2005). Re-entry and reintegration: Returning home after combat. Psychiatric Quarterly, 76(4): 361-370.

Hoge, C., W., Lesikar, S., E., Guevara, R., Lange, J., Brundage, J., F., Engel, C., C., Orman, D., T. & Messer, S., C. (2002). Mental Disorders among US military personnel in the 1990s: Association with high levels of Health care utilization and early military attrition. American Journal Psychiatry, 159: 1576-1583.

Hoge, C., W., Castro, C., A., Messer, S., C., McGurk, D., Cotting, D. I. & Koffman, R., L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1): 13-22.

James, R. & Gilliland, B. (2013). Crisis Intervention Strategies. (7th Edition). Belmont, CA: Brooks/Cole, Cengage Learning.

Phillips, C. J., LeardMann, C. A., Gumbs, G. R., & Smith, B. (2010). Risk factors for posttraumatic stress disorder among deployed US male marines. BMC Psychiatry, 10(1): 52.