What Is the Crisis Intervention Model?

A crisis episode related to mental health can be incredibly overwhelming. As with any other mental health situation, a crisis must be addressed quickly and effectively. There are often no warning signs that a crisis will occur, and they can happen even when someone follows their treatment plan carefully.

Many situations can contribute to a crisis in mental health, including stressors at home, school or work, or experiencing something traumatic. Starting a new medication, community violence, or the use of drugs and alcohol are also contributors to mental health crises.

What Is a Crisis Situation?

Most people use the terms mental health crisis and emergency interchangeably, including the National Alliance on Mental Illness (NAMI). Regardless of what you label it with, someone experiencing a mental health crisis or emergency needs support immediately.

Signs of a mental health crisis you might see in yourself or someone else include:

• Problems functioning
• Not being able to take care of hygiene
• Sudden, intense mood changes
• Psychosis, including symptoms of delusions or hallucinations
• Increasingly violent, angry, or agitated
• Paranoia
• Suicidal thoughts or planning
• Self-harm or self-medication
• Isolation or withdrawal

If you have a mental health condition that you live with, these signs might seem like everyday life, but a sudden behavior change typically characterizes a crisis. A crisis can also be when someone’s state of mind makes them unable to deal with daily life.

There are also three elements of a crisis that you might look for as you determine what situation you’re facing. The first element of a crisis is a stressful situation. The second is difficulty coping, and the third is the intervention’s timing.

If we were to distinguish between a crisis and an emergency, an emergency is usually life-threatening, while a crisis doesn’t have to be.

What about the difference between a problem and a crisis? A problem might create stress and require work to solve. However, it’s not a crisis if an individual or a family can resolve the problem without outside intervention. It can feel like a crisis when you’re in the thick of the problem, but once you calm down and think clearly, you realize it’s not. In simple terms, a crisis refers to a situation in which a person is under so much distress that they are at risk of harming themselves or others, and they are unable to care for themselves or function in daily life.

Situations That Could Lead to a Crisis

While everyone’s situation is unique, certain factors are more likely to lead to a mental health crisis. These factors include:

• Family: These can involve a wide variety of situations, like a very ill family member, abuse, or being deserted by a family member.
• Economic: Sudden financial strain or the loss of employment can lead to a crisis. Other triggers for a crisis related to finances include not having food, an eviction, high medical costs, or having your utilities cut off for nonpayment.
• Community: Community situations that can trigger a crisis include a lack of resources, neighborhood violence, or a lack of housing.
• Life events: Sometimes even things that most people view as happy events, like marriage or the birth of a child can lead to a crisis. There are also negative life events, like the death of a loved one or a divorce.
• Natural: A natural disaster like a hurricane or flood can lead to a crisis.

What Is the Crisis Intervention Model?

Developed by Albert Roberts, the seven-stage crisis intervention model is frequently used for the crisis intervention process because it is trauma-informed. This is important as clinicians need to reduce the chances of retraumatizing someone during stabilization.

The Roberts Seven Stage Crisis Intervention Model is widely applicable. Counselors, clinical social workers, psychologists, and clergy can all use it when facing a situation where someone is potentially in a crisis. There are also certified crisis intervention specialists who work in settings such as drug rehab centers and hospitals.

The basics of crisis intervention include mitigating the event’s impact, supporting normal recovery processes, and restoring adaptive function. Crisis intervention is an immediate, short-term response to mental, physical, emotional or behavioral distress.

The goal of crisis intervention is to help someone get back to their normal level of functioning and reduce the likelihood of long-term distress and trauma. The goal is not to provide psychotherapy or long-term treatment. It’s a short-term intervention that helps someone until they’re stabilized and connected with longer-term support and resources.

7 Steps of the Crisis Intervention Model

Roberts says there are seven identified stages a client will usually pass on the road to stabilization, resolution, and mastery. The the stages of the Roberts’ crisis intervention model include:

1. Assess

The first step when dealing with a potential crisis is assessing the situation. You should determine if there’s any risk of lethality or imminent danger.

A crisis worker has to quickly do what’s called a biopsychosocial assessment. This is a time to assess:

• Environmental support and stressors of the client
• The current use of drugs and alcohol
• Internal and external coping methods
• If there are suicidal thoughts and feelings
• The strength of the client’s intent to inflict deadly harm
• How lethal their suicide plan is
• The person’s suicide history

The clinician doesn’t interrogate the client as part of the assessment. Instead, they use an interviewing style that lets information come out as a narrative.

2. Make Psychological Contact and Establish Rapport

To establish rapport, a sense of genuine concern, care, respect, and acceptance of a client must exist. This is when the behaviors and traits of the crisis worker are important and help create a sense of trust with the client.

3. Identity Major Problems

A crisis intervention focuses on the client’s current problems, often leading to the crisis. A clinician can learn about the event that led to the crisis and prioritize the problems that need to be addressed.

The clinician is working to figure out how the situation escalated to become a crisis and will also get an idea of the client’s coping style.

4. Deal with Emotions and Feelings

During this time, a crisis worker will let the client express their feelings and explain their story about the current crisis. The crisis worker includes challenging responses into the dialogue with the client. This involves reframing the person’s situation and giving them information that can help them overcome some of their unhelpful beliefs.

5. Offer and Explore Alternatives

When someone is in a crisis, they are unable to see the so-called big picture. At this point, though, the person should be regaining some level of emotional balance. This is the time to give the client options and collaborate to figure out what will work for them.

6. Implement a Plan of Action

The strategies worked on in the previous step will become part of a treatment plan. This could be a time to negotiate safety and then set up plans. This could mean temporarily moving into a shelter, going to a 12-step program, participating in a rehab program or joining a support group.

7. Follow-Up

After the initial intervention, it’s important to follow up with the client to ensure the crisis is resolved, if not already fully resolved. The clinician can take this opportunity to evaluate the client’s status following the crisis.

Is the person functioning better? Do they have a better understanding of why the crisis happened? Are they happy with the ongoing treatment or action plan?

Crisis Intervention and Substance Abuse

When someone is experiencing a crisis or a triggering situation, they may turn to self-medication to deal with the stress of it. Some people develop substance use disorders because of a mental, emotional and physical response to a crisis.

When a person has a substance use disorder, their use of drugs or alcohol can lead them to a situation where they’re at serious risk of harming themselves or someone else. At this point, intervention becomes necessary.

Many people with a substance use disorder also have a co-occurring mental health disorder, which makes coping in a crisis even more difficult.

If someone is currently sober, they’re also at risk of relapsing if they face a crisis situation and haven’t yet developed the coping mechanisms they need to get through it.

Early intervention is essential if someone is using drugs to deal with a crisis. Crisis intervention can be a means to help someone learn healthy coping strategies to replace alcohol or drugs before their self-medication becomes an addiction.

What Is a Crisis Intervention Team?

Many hospitals, rehab facilities, emergency services providers, and local governments have crisis intervention teams. Crisis intervention teams include mental health professionals and peer counselors certified and trained in crisis intervention.

A crisis intervention team can listen to an assessment of the current situation. These professionals will then create a plan to address immediate behavioral health needs. When possible, a crisis intervention team will also provide follow-up care.

Crisis Intervention Hotlines

There are various crisis intervention hotlines available. Some of these are operated by national organizations, and they’ll often direct callers to a local center or resource.

• The NAMI Hotline is available Monday through Friday from 10 a.m. to 10 p.m. ET. This number is reachable at 1-800-950-NAMI (6264). The NAMI Crisis Text Line is available at 741-741 and is available 24/7 for crisis support by text.
• The National Suicide Prevent Lifeline is another option. The Lifeline offers free, 24/7 support for people in distress or crisis. As of July 16, 2022, there is a new three-digit number—988. This number will route callers to the National Suicide Prevention Lifeline.
• The SAMHSA National Helpline is free and always available. The number is 1-800-662-HELP (4357).
• The Southwest Washington Crisis Line is available 24/7 by calling 800-626-8137.

Seek Help with the Recovery Village Ridgefield

You aren’t alone if you struggle with substance use and mental health disorders. Help is available, and we’re here to answer your questions about treatment. Contact The Recovery Village Ridgefield team to learn what the next step might look like for you or your loved one.