1. HN 220 Chapter 2 Maria Brown, MS

2. Key Figures – 1940’s Eric Lindemann His work came out of the Coconut Grove fire in Boston Recognized the value of people outside of psychiatry in community mental health What did he study in the people he worked with? Gerald Caplan With Lindemann, Caplan established a community mental health program called Wellesley Project which focused on bereavement or birth of a premature child Preventative psychiatry Theory from the Wellesley Project is foundation of modern crisis intervention theory

3. Legislation – 1950’s & 1960’s Short-Doyle Act Why was this act significant? Community Mental Health Centers Act This act was intended to provide for chronically mentally ill persons, but mental health staff were seeing more persons with less dysfunction. In turn, there were not enough resources for the chronically ill. The Lanterman Petris Short Act was passed to help provide for both short-term mental services as well as case management for chronically ill.

4. History – 1960’s & 1970’s Suicide prevention programs What tools did these programs use that are still valued today? Education, research, and journals Research and scholarly journals published information on crisis-related topics University’s offered more programs focused on psychology, counseling, and crisis intervention

5. History – 1980’s & 1990’s Brief Therapy Model Effective for clients Low cost intervention 10 sessions or less (often around 6) HMO’s Would approve brief therapy (4-6 sessions) Offered crisis intervention services Cost effective Crisis Intervention by paraprofessionals Why were paraprofessionals used to begin with? Why is there some controversy over their use today?

6. Contributions-Other modalities Psychoanalytic Theory Who is famous for psychoanalytic theory? Theory asserts that people have a limited amount of psychic energy, so people with mental health conditions have less capacity to deal with new crises as they have no psychic energy left to cope with the crisis. Existential Theory This theory asserts that anxiety and stress help to promote personal growth. Acceptance of personal accountability is necessary to recognize that problems may be the result of choices.

7. Contributions-Other modalities Humanistic Approach Carl Rogers founded person-centered counseling. Person-centered/Humanistic approaches stress the value of a cooperative and trusting therapeutic relationship. Client drives the direction of their lives as well as the therapeutic plan Cognitive-Behavioral Theory This theory focuses on identifying the problem and behaviors associated with it. Then alternative behaviors are identified, a plan developed, a commitment to follow through, and worker follow-up.

8. Contributions-Other modalities Family Systems Theory Interventions are focused on solutions to help families adapt to change. Helps families to identify and change unhealthy structures including enmeshment, diffusion, disengagement, and rigidity. Brief Therapy Therapy explores patterns of behaviors that lead to unsuccessful results. Clients develop new behaviors that lead to positive results. Critical Incident Debriefing We’ll discuss this more in Unit 8.

9. ABC Model of Crisis Intervention What is the A stage? Which stage is the most important? What needs to happen in the B stage? What is the final stage of this model?

10. ABC Model of Crisis Intervention A – Developing a relationship and building rapport is essential in this stage. A genuine and trusting relationship is necessary for the client to be able to move to the next stages. B – Identifying the problem, assessing the client’s functioning, and offering new ways to perceive the situation make up this stage. C – Client and counselor explore new coping techniques that client can commit to. Counselor follows up. This form of intervention can last minutes or several sessions.

11. Conclusion Crisis intervention developed over several decades. Many other modalities have made contributions to crisis intervention. Crisis intervention is eclectic, effective and efficient. Any questions or concerns? Have a great week!