Crisis intervention, also known as crisis intervention, is a technology to provide effective help and psychological support for individuals in crisis. The main areas include suicide, sexual assault, disaster, loss of loved ones and many other aspects.
Belgin and others put forward three crisis intervention modes, namely
Balanced mode;
Cognitive model;
Psychosocial transformation model
It provides a theoretical model for the methods and strategies of crisis intervention.
On this basis, Jilin Lan and James and others put forward the six-step crisis intervention method, namely
Identify problems;
Ensure safety;
Give support;
Propose and verify flexible corresponding methods;
Make plans;
Get a promise.
In order to study how to apply the six-step method of crisis intervention in practice, this paper will analyze the six-step method of crisis intervention with specific cases.
I. Case introduction
The help-seeker, a 20-year-old freshman female student in a vocational college in Beijing, was introduced by the head teacher to the school psychological counseling center for psychological counseling.
The counselor learned from the class teacher that the mood of the helper was very unstable, and told the dormitory students many times the night before the consultation that they didn't want to live.
The counselor observed that the helper was slightly fat and walked slowly. When he sits down, his eyes always bow forward and he has no eye contact with the counselor. His body movements are few, his facial expression is indifferent, his speech is calm and lifeless.
Upon inquiry by the counselor, I learned that the helper was extremely depressed and desperate the night before and had written a suicide note. At 9 o'clock in the evening, he wandered around the lake on campus for a long time, trying to jump into the lake to end his life, because there was always someone by the lake, and he didn't find a chance. Later, I was discovered by my classmates and returned to the dormitory.
Two or six-step intervention cases and psychological crisis intervention
Crisis intervention is a special psychological counseling process, and the basic skills of psychological counseling such as listening, asking questions and emotional response are completely needed.
The basic idea of psychological crisis intervention is:
Counselors keep listening and paying attention to provide psychological support for help seekers;
Provide relief opportunities and encourage help seekers to express their inner feelings;
Counselors explain the current situation of help-seekers, so that help-seekers can see hope and build self-confidence;
Psychological counselors guide clients to call various resources to effectively cope with the crisis.
Although there is no fixed procedure for psychological crisis intervention, the six-step intervention method can be used as a guiding step for psychological crisis intervention.
1, identify the problem
In the initial stage of general psychological counseling, the counselor needs to keep a curiosity, that is, actively explore what causes the seeker to come to the counseling room at this moment.
In the early stage of psychological crisis intervention, psychological counselors also need to identify and understand the problems they know and their current psychological situation from the perspective of help-seekers.
At the beginning of this case, the counselor used an open question to determine the problem faced by the helper:
Counselor: "What happened yesterday that made you think and plan to commit suicide?"
Helper: "I don't know what's wrong with me. I've been doing this every year since high school. I just feel particularly unhappy every spring, because there have been times like this before, so this time I know that if I can survive this spring, I will get better, but it is really difficult. I have worked very hard. "
I live very tired, very tired. I try to be a kind person and be as good as possible to everyone, but they will never understand me and they will always think that I have ulterior motives.
One night, I washed my roommate's clothes with my help. I think people should help each other like this. This is not my first time to help my roommate wash clothes, but why do people say that I am deliberately trying to please my roommate? I try to be nice to everyone around me. Why did they treat me like that? "
In this conversation, the counselor identified two main problems faced by the help seekers: one is the depression brought by the coming of spring, and the other is the difficulty of interpersonal relationship.
2. Ensure the safety of those seeking help.
Life first is the first principle of psychological crisis intervention.
In the process of crisis intervention, psychological counselors should always pay attention to the safety of visitors and minimize their physical and psychological risks.
Therefore, after determining the main problems faced by the help-seekers, the consultant should evaluate the impulse of self-mutilation, suicide or hurting others, and take measures to ensure the safety of the help-seekers when necessary. The evaluation process of this case is as follows:
Counselor: If you give yourself a score for this suicidal impulse, 0 means no impulse, and 100 means that the impulse is extremely strong and completely out of your control. What was your impulse when you wanted to commit suicide by the lake last night?
Help: 95 points.
Counselor: I had a strong impulse at that time, but even so, I didn't completely give up my desire to live. I want to know what the remaining five points are. I don't want to give up my life.
Helper: I thought of my parents. I can't imagine what they will do when they know about it.
Counselor: At that time, you thought of your parents, and you didn't want to make them sad.
Helper: Yes.
Counselor: I want to know, at this moment, in our consulting room, if you score your suicidal impulse again, what would it be?
Helper: 50 points. I feel calmer now.
In psychological counseling and therapy, it is a very intuitive and effective psychological evaluation skill to let the help-seekers evaluate their emotions or impulses.
In this case, through the evaluation, we know that the psychological state of the help-seeker is basically controllable at this time, and the possibility that the help-seeker chooses to commit suicide again during the consultation period is low.
With this belief, psychological counselors can relax themselves to a certain extent and continue to understand and pay attention to the deeper psychological situation of help seekers.
Step 3 give support
This step mainly emphasizes that the consultant should establish a good relationship between the consultant and the client through communication and exchange, so that the client can feel that the consultant is completely trustworthy and can give him care and help.
In this case, after confirming that the client's suicidal impulse was under control, the psychological counselor continued to care about and listen to the client, and asked the client about his recent main experience and psychological difficulties with open questions, which made the client have a desire to talk.
? Help-seekers are willing to talk, indicating that their situation is improving, and talking is also a process of emotional healing. Help-seekers show strong trust in counselors and tell them a lot of confusion when interacting with roommates.
? The helper has said many times that he wants to be a kind person and try to be good to everyone. The psychological counselor affirmed and recognized this desire of the helper, and also expressed his grievances and helplessness in interpersonal communication.
? The helper also said that he could not be understood by his classmates and friends around him, and he could only find a confidant through reading. His favorite is a Japanese writer, who has many unspeakable feelings that others can't understand, and finds particularly expressive expressions in his works.
? The assistant also talked about his desire to learn Japanese and live in Japan.
Through listening and communication, psychological counselors and help seekers gradually establish and deepen the trust relationship between consultation and interview, making them feel that someone really cares and is willing to understand themselves, which is difficult for them to experience in their daily life.
4. Propose and verify alternative coping styles.
Individuals in psychological crisis are narrow-minded and can't see that there are actually many ways to deal with every problem. Counselors should let clients know that there are many coping styles to choose from, some of which are more suitable than what they know at present.
In this case, the psychological counselor learned that the client had a lot of depression through her facial expressions, speech intonation, body movements and other information, and initially judged that she had the possibility of depression.
Clinically, depression is mainly manifested as significant and persistent emotional depression, accompanied by cognitive impairment and physical symptoms, as well as serious suicide attempts or behaviors. The help-seekers accepted the consultant's advice and tested themselves with Self-Rating Depression Scale (SDS). The results show that they are currently in a state of severe depression.
The counselor then provides depression information to the client:
(1) The current suicidal impulse is a manifestation of severe depression, which can be cured as a psychological problem;
(2) There are many depressed patients in this world. In order to cure them, scientists have found many treatments, including psychotherapy and drug therapy.
(3) There are many excellent psychological counselors in Beijing who can help. If you choose medication, there are many options.
In the process of psychological counseling, it is generally emphasized that counselors should try to avoid "labeling" the psychological problems of visitors. However, in this case, the diagnosis of "depression" is obviously conducive to guiding the help-seekers to focus on solving depression from suicide.
Because before this, the helper had no clear attribution of her pain and despair, and she "didn't know what was wrong with herself", so there was no way to solve this psychological situation. It seems that suicide is the only way out.
When she knew that she had "depression", she was like an enemy who could fight with her, and at the same time she had an imagination after victory, that is, hope.
The counselor learned that the helper had never sought help from a professional psychological hospital before. According to her current severity, the counselor suggested that she go to a psychological hospital for treatment.
Drug therapy is the main method, supplemented by psychological counseling. For help, the psychological counselor asked if there would be any side effects if the medicine was chosen, and what effect would be expected if the medicine was taken. The counselor then provided more information about the efficacy of antidepressants.
Here, we can see that the help-seekers show more hope to get out of the current psychological predicament, and it is certain that the help-seekers have understood that there are other more rational ways to get out of the current psychological predicament besides suicide.
Step 5 find a way
In this link, the counselor should work out the action steps together with the helper to correct the emotional imbalance of the helper.
In this case, the help-seekers need the support and cooperation of their parents for professional diagnosis and treatment.
After consulting with the help seekers, the school contacted the parents through the class teacher. The counselor communicated with the parents about the current situation and the next arrangement of the help-seekers, and the parents actively cooperated with them.
The psychological counselor emphasized to the visitors that the most important thing now is to relieve their depression and return to normal as soon as possible, and made the following arrangements clear:
(1) Take a week off and go to a psychological hospital for treatment;
(2) according to the doctor's diagnosis, medication or psychotherapy;
(3) If the help-seekers can return to school normally after the situation improves, they can also voluntarily come to the psychological counseling center of the school for psychological counseling.
The situation of visitors has obviously exceeded the scope of work of psychological counseling centers in colleges and universities and needs to be referred to psychological hospitals. At the same time, the third item of the above arrangement is also essential, which will make the client feel that referral is a responsible and better arrangement, rather than abandoning her. This is especially necessary for customers with low self-esteem and high sensitivity, and it is also a protection for the consultation-visit relationship that may need to be continued in the future.
6. Don't worry
That is, the helper is required to repeat the plan made and get the guarantee that the helper will act according to the plan clearly. This link is relatively simple. In this case, the helper assured the counselor that he would not commit suicide and followed his parents to the psychological hospital for treatment.
Third, thinking about this case.
The six-step method of psychological crisis intervention is a highly operational method, but in the specific application, the psychological counselor's thinking can not be completely stylized.
Although the author did not set the intervention procedure in advance according to these six steps when intervening in this case, the process of crisis intervention is basically the same as the six-step method.
Just like all psychological intervention techniques, the so-called method points out a starting point and a reminder for us. In the process of psychological intervention full of fluidity and unknowns, we can't apply it rigidly.
Some scholars appropriately compare psychological crisis intervention to the emergency room of a hospital, revealing that timeliness is an important principle of psychological crisis intervention.
There are generally four endings in psychological crisis.
That is, get through it and grow smoothly;
Get through the crisis but leave a wound;
Fall into crisis and form neurosis or psychosis;
End the crisis by suicide
In this case, the main goal of timely psychological crisis intervention is to prevent suicide, and in more cases, crisis intervention is to prevent the help-seekers from forming mental illness due to falling into crisis.
In the daily practice of psychological counseling, we often find that the mental illness of visitors is generally not formed in a short time. In many cases, psychological problems are caused by a serious crisis in the process of growth. Because of the long time, the traumatic experience brought by psychological crisis has spread to their personality state, and it is particularly difficult to completely cure the psychological problems at this time.
If the help-seekers can get timely professional help when the psychological crisis just happens, they will have more opportunities to get through the most difficult time with the help of psychological counselors, and get out of the psychological crisis smoothly and grow up.
This article comes from the Internet.