Everyone eventually experiences moments of crisis that might vary in content but tend to share certain characteristics. Crisis usually entails threat, loss, and the unexpected. Different theoretical approaches have been offered for helping those working through crisis. Overall, the most effective approaches tend to follow a brief therapy model that stresses the event isolated from other issues and seeks a plan of action to mitigate the crisis.
ABC Model
The ABC model offers a helpful tool to facilitate the counseling process.
- A: Basic Attending Skills
- B: Identifying the Problem and Therapeutic Interaction
- C: Coping
A: Basic Attending Skills
The first step in working with those in crisis is to establish a therapeutic relationship as quickly as possible. What are some basic attending skills?
Demonstrate respect for the client – Focus on the crisis. Legitimize and normalize but do not trivialize. Assure the client that their response to crisis is not right or wrong. We all must find our path to resolution when crisis enters our lives. However, do not demean their response to their crisis experience as irrational. Communicate in a calm verbal and nonverbal manner Use ethical forms of touch if appropriate. Touching communicates comfort to some clients but touching by a stranger could be another source of anxiety for others. Listen first and reflective listen second. Clients in crisis often need to blow off emotional steam before they can approach the crisis with cognitions or work on a solution. Reflective listening or restating the client’s comments for clarification comes when the person is ready to focus on solution planning.
B: Identification and Therapeutic Intervention
The next critical phase of therapy is to identify the problem. The best approach is to wait until the initial tension is removed from the client’s frustration with the crisis. Problem identification is essential for treatment planning. Sample questions could include: What do you believe is the primary problem? What would you like to work on today? How may I assist you?
Problem Identification – Clients may have problems coming to the best answer for these general and broad questions. A more systematic approach could be:
Identify the precipitating events – What happened that led to the crisis? What happened that you are defining as a crisis? Is what happened causing you to think or act differently that you thought or behaved before? Explore the meaning of events. What do the crisis events mean to you? Do you believe that crisis is unique to your life? What do you think that you should do? Explore effective distress. What emotions are you experiencing now? How are the current emotions different from what you would normally experience? Are you in despair? Are you contemplating suicide? Identify other effects. How has the crisis affected your behavior? How has the crisis affected your relationships? Do you normally enjoy relationships with others? Has the event affected your performance at work? Has your opinion about work changed due to the event? Are you using drugs and alcohol more than before the crisis?
Therapeutic Techniques – Therapeutic techniques that would apply in crisis counseling include listening, assessment, reframing, and planning.
Listening – Effective crisis counseling is more about listening than speaking in the beginning. As the process unfolds the therapeutic communication will become more of a dialogue than a monologue.
Assessment – The questions included in identifying the problem serve as a form of assessment. The counselor will also need to assess the coping skills and supports at the disposal of the client.
Reframing – Reframing is the cognitive technique of assisting the client in developing a new perspective on the event. The new perspective is not delusional but should be a broader view and one that engenders hope for the client.
Planning – The final phase is to assist the client in developing a course of action in response to the crisis. The client must author the plan or the client will not own the plan when implementing the plan encounters obstacles.
C: Coping
The last component of crisis counseling incorporates the coping skills and support mechanisms for the client. The planning phase includes the coping skills we recognized in the assessment. Additional coping skills and support networks will likely be needed. Referrals to community resources like support groups could be helpful. The counselor could recommend helpful books or our media resources. New coping skills could be practiced in therapy.
Conclusion
We all experience a crisis at some point in life. Crisis counseling can be a helpful tool in mitigating the anxiety that comes with these unexpected and unwanted events. The ABC modality offers an effective approach for becoming whole again.
