The Nature Of Crisis And Level Of Crisis Social Work Essay
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Crisis can arise from stressful or traumatic situations due to one or more issues pertaining to serious medical illness, violence, personal loss of loved one, sudden homelessness, heavy debts, rape, broken relationships to name a few. According to James (2008) crisis is an intolerable difficult situation or obstacle in life, when an individual's coping mechanisms fail, escalating into emotional anguish and immobilization in his/her daily functioning, and thereby requiring immediate crisis intervention or referral.
A crisis worker should familiarize himself with the levels of crisis, which serve as a guide in understanding the client's symptoms. Barjon (2008) The 'BASICS' model of crisis experience are: Behavioral refers to the precursors and consequences of behavior before and after a crisis, reflected in a client's reactions. Affective is the emotional intensity of the client's behavior post crisis. Somatic is the client's physical symptoms. Interpersonal is the way in which the client may either experience withdrawal or tend to be extremely vocal. Cognitive is the way the client thinks. Lastly, the spiritual aspect is the client's reliance on faith to deal with the crisis.
The crisis worker should be able to make quick assessments prior to crisis intervention. Roberts (2005) asserts the importance of the triage assessment model to make simple, rapid and valid assessments on the levels of crisis and lethality, within a short span of time. Triage assessment is a screening tool that enables the worker to collect and record client's information and helps to gauge a person's coping mechanisms, mobility and equilibrium. On the basis of the severity of the situation, suitable measures such as providing referrals or short term hospitalization, prevent the client from inflicting harm to themselves or to others. Assessment of affective, behavioral and cognitive reactions of the client helps the worker decide whether to take a directive, non directive or collaborative approach.
In accordance to the assessments, the crisis worker should also possess relevant crisis intervention skills. James (2008) describes these skills as the six-step model of crisis intervention. The first three skills of the model require good listening skills, which include attending, showing empathy, observing, understanding, caring and respect. The last three steps of the six-step model require good acting skills in terms of giving directions, especially if the client hesitates to respond. The worker has to find ways to help the client to regain his/her equilibrium.
Gregoire & Jungers (2007) elaborates on the six-step model of crisis intervention. First and foremost, the worker should define the problem. It is essential to deduce a quick gist of the situation to avoid any errors in misinterpreting the client. It is imperative to understand the client and pursue their point of view. Time is not a luxury; therefore, the worker has to address the 'here and now' problem, rather than delve into the past.
The second step is to ensure the client's safety. When a person is in crisis, he/she are not aware of the perils around them. Therefore, crisis workers should visualize assess the situation for imminent dangers and stay vigilant for their own safety and that of the client. However, the worker is not liable to jeopardize his/her life in the process, irrespective of the outcome of the situation (Gregoire & Jungers, 2007).
The third step in crisis intervention is to provide support to the client. Similar to client-centered therapy, the crisis worker should demonstrate and communicate congruence, unconditional positive attitude, and empathy, to make the client feel valued and accepted (Gregoire & Jungers, 2007). The client will feel that the worker is genuine with their feelings towards them, when the worker expresses care and concern. It will also help the client to regain some composure and feel some consolation. Additional support can be shown, by introducing a family member or friend at the scene, and assuring the client that help is on the way.
The fourth step is to examine alternatives. In a state of crisis, the client can no longer process thoughts and make decisions as they feel there are no alternatives left. Therefore, the worker should be able to think ingeniously and provide the client with alternatives and suggest coping mechanisms as a mode to recoup and self-actualize (Gregoire & Jungers, 2007).
The fifth step in crisis intervention is to make plans. Crisis workers need to be directive and prompt in devising contingency plans and providing coping strategies. They should encourage the client to self-actualize inorder to regain some confidence and stability, at least temporarily until help arrives. Further support can be given by suggesting referrals and giving directional steps (James, 2008).
The sixth step involves obtaining a commitment. The work should obtain a firm commitment from the client, only after agreeing jointly on a successful plan of action. Commitment can be made symbolically, by way of a handshake, written statement or a verbal promise to ensure that the client may not cause himself/herself any further harm. The termination of the intervention should take place only when the client regains his/her disequilibrium (James, 2008).
In consideration of the above skills, I feel that one cannot compare a crisis worker's job to any other worker as not everyone can handle the demanding and complex nature of the job, especially those who have high strung personalities. It is not enough that a crisis worker possesses theoretical and practical skills. Hoff & Hoff (2012) highlights the fact that the sheer workload and difficulty of cases and the time taken to make a breakthrough with a client can overwhelm the crisis worker. To deal with stress on a day-to-day basis maybe normal, but the situation could spiral beyond the worker's control if the stress piles up and he/she does not vent it out. Frustration is also inevitable due to remote functioning with little to no direction or consultation.
Furthermore, Corey & Corey (2007) state that crisis workers who are not resilient and emotionally strong risk a burnout. Burnout results from extreme pressure and stress which stems from incessant dealing with people in crisis. Workers tend to overlook their own needs and invest their energy in work, without taking the time out from their routine. Lack of recognition for their work can also dampen their spirit and enthusiasm and lead to discouragement. It also results in mental and physical exhaustion, negativity, helplessness, apathy and affects the worker in both professional and personal life. Eventually, feelings of failure and empathic fatigue may occur.
A good crisis worker can overcome the overall stress of the job by constant reflection on their own personal experiences (Corey & Corey, 2007). Positive personal transformations give them the strength and maturity to handle clients effectively. A worker cannot fix a client's problem unless they fix their own. A worker should watch for early signs of fatigue and seek timely help, to avoid burnout. Involvement in diverse activities, meditation, or pursuing hobbies in their personal life can alleviate stress.
A crisis worker should possess personal skills to do effective crisis intervention. According to James (2008), the salient characteristics of an effective worker are life experiences, poise, quick mental reflexes, creativity and flexibility, and energy and resiliency respectively. Other characteristics can also include courage, empathy, firm resolve, optimism, openness and a nonjudgmental attitude.
One of the main characteristics in a worker is life experiences. Workers with lack of life's experiences may face problems as they have little to contribute, and are likely to face frustration. A crisis worker is a whole person with more life experiences, who, after overcoming past problems in a mature and stable way, and upon further training, can handle clients in a better way. A worker, who has not overcome past problems, may tend to transfer the negative ideas or feelings on to the client (James, 2008).
Secondly, a crisis worker should possess poise. There is a high chance that the worker may encounter unexpected or shocking situations at the scene of the crisis, where any display of agitation on the part of the worker, can lead the client to feed on the negativity of the reaction, and display aggression. Hence, the worker sets an example by maintaining poise and control which will encourage the client to calm down (Miller, 2012).
Miller (2012) is of the opinion that creativity and flexibility are other positive traits in a good crisis worker. Thinking out-of-the-box and being able to find out different solutions and coping mechanisms at short notice can be life-saving. The worker should keep a record of referrals at hand such as support groups as a ready contingency plan. By offering multiple options, even if it means as a temporary fix, the client will be able to find new ground to refocus on positivity and gain back lost stability.
However, a crisis worker should also have quick mental reflexes without which, it will be a difficult task to handle ever-changing situations in a crisis situation. Considering, there is no time to ponder and gather a lot of information, the worker should think and operate quickly, being ready for any twist in events (Miller, 2012).
Energy and resiliency are valuable traits in a crisis worker, which cannot be gained by training. The worker has to be physically and psychologically strong to face tough situations, irrespective of the outcome of the intervention. Upon termination of the intervention, crisis workers should adopt resiliency, and give no room for afterthought, lest that affect their morale. Self-care is extremely crucial to sustain efficiency (James, 2008).
In conclusion, all the above dynamics confirm one fact: A crisis workers job of crisis intervention is demanding in all respects and it takes a strong personality and multiple skills to deal with the sensitivities of a crisis situation. Correct and timely intervention can avert further calamities. The author feels that crisis workers are like unsung heroes who do their job courageously and with tenacity, but disappear without recognition on a job well done, only to get ready for the next intervention.
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