1. Crisis Management Counselling

2. Need to understand crisis and its management?? The IDU faces number of problems in day-to-day life- most solved by himself or with help of family members* Certain situations are intense and unexpected and ◦ Can precipitate crisis ◦ Are out of client’s capacity to deal with ◦ Require professional help

3. What is Crisis A temporary state of ◦ emotional turmoil and disorganization ◦ following a very sudden and significant stressful situation Cannot be resolved by client alone

4. Crisis Situations *What situations precipitate crisis in client’s life? CRISIS PersonalFinancialOccupationalHealth Drugs- related Legal

5. Crisis Situations* SITUATIONSEXAMPLES OF TYPES OF CRISIS Personal Situation Spouse leaving home; divorce notice; being thrown out of the house; violence at home; sudden death in family; death of a friend with whom injections were used/shared Financial Loss of significant amount of money/assets; accumulated debts leading to a crisis Occupational Situation Being thrown out of the job; violence at work-place Health-related Becoming aware of HIV+ status; developing a physical illness LegalFacing legal action Drug-relatedSudden decrease in availability of usual dose of drugs; overdose; injection-related injury/infection

6. Stages of Crisis* Adaptation Client takes control of situation; completely calms down Stabilization With help, client calms down; looks for alternatives Blow-up Aggression; may harm self or others Disorganization Feeling distressed and confused Precipitating Event Unusual, unanticipated event; perceived as threatening

7. Role of counsellor* Be available and supportive Actively listen to client’s story Do NOT blame the client Express empathy Genrate resources Address unrealistic expectations of client from counsellor (if any)

8. counselling Techniques Providing support to client Being empathic Listen Talk in calm and re- assuring way Instill hope

9. Counselling Techniques Facilitating emotional expression* Client is facing many negative emotions Encourage clients to share their feelings

10. Counselling Techniques Ensure safety of client Client vulnerable to cause harm to self/others Assess for thoughts related to Self-harm Harming others

11. counselling Techniques Defining the problem Conceptualize problem from client’s point of view Reflect back to the client

12. Counselling Techniques Defining the problem (cont…) REMEMBER: Ask open-ended questions Don’t ask too many questions together Avoid using “WHY”* Avoid embarrassing questions

13. Counselling Techniques Defining the problem (cont…) Areas to be explored: What is the problem? Who all are contributing to it? When did it happen? What made it happen? How can it be handled?

14. Counselling Techniques Facilitating problem- solving behavior Teach problem-solving strategy

15. Counselling Techniques Facilitating problem-solving behavior* Defining the problem Brainstorm all possible solutions Re-evaluate Evaluate and implement best solution

16. Counselling Techniques Facilitating problem-solving behavior* Defining the problem Brainstorm all possible solutions Re-evaluate Evaluate and implement best solution

17. Counselling Techniques Facilitating problem-solving behavior* Defining the problem Brainstorm all possible solutions Re-evaluate Evaluate and implement best solution

18. Counselling Techniques Facilitating problem-solving behavior* Defining the problem Brainstorm all possible solutions Re-evaluate Evaluate and implement best solution

19. Other services… Keep a directory of referral services (e.g. legal aid, intensive medical care) Talk to family members, employers… if need be Facilitate generation of possible resources

20. Summary IDU is vulnerable to crisis at any point Crisis is a temporary phase and timely intervention is important Primary task of counsellor is to provide psychosocial support Providing actual logistics in any/every crisis may not be possible