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Crisis-inducing events are common in human life and every day, thousands of people are faced with crisis inducing events. Responses to crisis may take acute forms such as extreme anxiety, confusion, and anger. This is because crises are typically characterized by the persons involved lacking the ability to deal with the problem since the familiar coping strategies do not work (Roberts, 2002).
Crisis may be precipitated by bad news being delivered to the family. In the particular case in point, the crisis was caused by news of a baby being diagnosed with Cystic Fibrosis. Longo and Bond (1984) suggest that families with chronically ill children are likely to face acute grief reactions as well as sorrow.
The family in question failed to seek crisis intervention which led to a lot of damage. This paper will seek to address the emotional turmoil associated with the crisis and how the crisis would have been handled differently if a crisis worker was involved. The paper will reference the 7 stage Crisis Intervention Model in addressing the crisis.
A crisis can be defined as “an acute disruption of psychological homeostasis in which one’s usual coping mechanisms fail and there exists evidence of distress and functional impairment” (Roberts, 2005, p.778). Parad (1971) asserts that a crisis is not the event itself but rather, “the individual’s perception of and response to the situation”.
This explains why the same event (baby being diagnosed with Cystic Fibrosis) elicits very different reactions in the three members of the family. A systematic and structural approach is preferred in handling crisis. Conceptual models assist the clinician to “visualize the implications of each proposed crisis intervention guidepost and technique in the model’s process and sequence of events”(Roberts & Ottens, 2005, p.330).
A model presents a blueprint which the crisis worker can utilize as a guide in their crisis intervention. A good model will allow the crisis worker to assist the client without risk of exacerbating the crisis.
One of the most commonly used models is Robert’s seven stage crisis intervention model (R-SSCIM). While there exist many models of crisis intervention, R-SSCIM sets itself apart in that it builds upon the thinking of the founders of crisis theory and applicable across a broad spectrum of crisis situations.
Roberts and Ottens (2005) declare that this model is well suited for clients who experience crisis as a result of interpersonal conflicts or a crisis-inducing event.
This model identifies the seven critical stages through which an individual must go through before the crisis is resolved. By following the steps in the model in a sequential manner, the crisis worker is able to guide the clients into resolution of the crisis.
The crisis in question came about when a baby in the family was diagnosed with Cystic Fibrosis. The daily living of the family was disrupted because the individuals involved (mother, father and grandmother) could not resolve the crisis through their innate problem-solving methods. A conceptual framework is mandatory is the crisis worker is to deliver services to the client in an effective manner.
Stage I in the R-SSCIM model is planning and conducting a crisis assessment on the clients. From this stage, the risk factors for each member of the family could have been assessed including the lethality levels.
The focus should be on the crisis situation at hand but even so, it should focus beyond the facts of the event and include the clients’ emotions. In assessing lethality, the crisis worker would have discovered the suicidal thoughts by the grandmother and gauged the lethality of the suicide plan.
Stage II in R-SSCIM is establishing of rapport and relationship with the client. There are ranges of psycho-logical health and dysfunction for families with chronically ill children and the crisis worker must establish a relationship with the family so as to identify the particular issues that the family suffers from.
Establishing rapport is very much intertwined with Stage I since good rapport is necessary for the client to feel that they have been heard and understood. This stage is based on the understanding that the clients are more likely to open up to a person they trust. The crisis worker will therefore be better positioned to assist the family if he/she is not viewed as a trusted friend and not a stranger
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Stage III is the identification of major problems and from this stage, the main issues in the crisis would have been highlighted. It would have been discovered that the grandmother was at high risk due to her earlier unresolved crisis as well as crisis precipitants particular to her.
On top of the news of the diagnosis of the baby with Cystic Fibrosis, the grandmother had a number of additional stressors. To begin with, she experienced guilt since she is the one who had talked her daughter out of having an abortion and convinced her to have the baby.
The grandmother was also traumatized about losing a granddaughter since she had lost her baby years ago. For the mother and father of the baby, additional stressors included the limited financial resources that the couple had and the lack of social support to help them through the crisis.
Stage IV involves dealing with feelings and emotions and here the client is allowed to express their feelings on the situation. Roberts and Ottens (2005) suggest that allowing the client to vent brings about healing and the client is able to tell their story.
In this stage, active listening skills are necessary on the part of the crisis worker. In addition to this, the crisis worker can challenge the client hence assist to loosen maladaptive beliefs held by the client.
At this stage, the crisis worker would have explored with the boyfriend if the best way to resolve the issue was to leave his girlfriend and child. The grandmother would have been assisted to see that her suicide attempts were a maladaptive solution to the crisis.
Stage V involves generation and exploration of alternatives. Roberts and Ottens (2005) deem this as the most difficult stage since the client in crisis lacks the ability to reason rationally or look at the big picture. The clinician can assist the client by putting feasible options on the table for the client.
An important factor in this stage is that the alternatives proposed should be generated collaboratively with the client. If the family had sought crisis intervention support, productive alternatives could have been generated for each member of the family. The clinician is required to work with the client in agreeing on short-term goals and tasks which will assist in crisis management.
Stage VI is implementation of an action plan which includes concrete and achievable plans. This step is critical to restoring the lost psychological balance by the client. Robert (2005) proposes that if it is possible, the client(s) should work through the meaning of the event since this will enable them to effectively cope with similar situations should they arise in future.
Step VII which is also the last step involves follow up. The crisis worker comes up with a follow-up plan which articulates how he/she will contract the client after the initial intervention to make sure that the crisis is being resolved productively. Follow up will ensure that satisfactory progress is being made and any current stressors are being handled well.
The individual’s perception of the event which has taken place has a direct effect on the level of stress and trauma experienced. The crisis worker is able to explore the meaning and importance of the crisis situation from the perceptive of each client and from this come up with effective responses to help them cope.
The grandmother was traumatized about losing a granddaughter since she had also lost a daughter years ago. This trauma may be as a result of the unresolved crisis that the grandmother faced when she lost a baby since as Roberts (2005) suggests most traumas begin as crises which go unresolved.
Crisis intervention could have enabled the grandmother to seek other alternatives to dealing with the crisis rather than resort to suicide.
Research indicates that fathers of mentally retarded and chronically ill children experience greater emotional disturbance compared to mothers (Longo & Bond, 1984). In addition to this, research indicates that the presence of a chronically ill child has a deleterious effect on the relationship between mother and father.
Love (1973) revealed that separation or divorce in married couples with chronically ill or disabled children was as high as three times the normal population.
This would explain why the baby’s parents split up over the diagnosis. If the family had sought crisis intervention support, the clinician would have taken into consideration the fact that fathers may be more at risk than mothers.
From this, support would have been offered to the father to enable him to cope with the high levels of depression and impaired self-esteem that come from having a chronically ill child.
By use of crisis intervention services, the family could have been equipped with coping skills and provided with the support necessary to restore normal pre-crisis functioning.
The crisis worker would have enabled the family to explore feelings and meanings in such a manner that they understand the issue and the alternatives that are open to them. By so doing, the family would have discovered useful ways to deal with the crisis as opposed to the destructive ways that the family adopted due to lack of support.
This paper set out to address the emotional turmoil that the family underwent because of the baby being diagnosed with Cystic Fibrosis. The dysfunction manner in which the family reacted to the crisis event can be attributed to a lack of crisis intervention support.
From the discussions advanced in this paper, it is evident that the family would have coped better with the crisis if they had sought crisis intervention support.
This paper has revealed that the crisis worker is trained to identify suicidal and homicidal ideation in the client and this would have helped prevent the attempted suicide by the grandmother. By using a crisis worker, the family would not only have managed to deal with the crisis at hand but also gained the skills to deal with potential future crisis.
Longo, D.C. & Bond, L. (1984). Families of the Handicapped Child: Research and Practice. Family Relations, 33 (1), 57-65.
Love, H. D. (1973). The mentally retarded child and his family. Spring-field, IL: Thomas.
Parad, H. (1971). Crisis intervention. In Morris R. (ed) Encyclopedia of Social Work (16th ed, pp. 196-202). New York: National Association of Social Workers.
Roberts, A.R. (2002). Assessment, crisis intervention, and trauma treatment: the integrative ACT intervention model. Brief Treatment and Crisis Intervention, 3(2), 1-21.
Roberts, A.R. (2005). Bridging the past and present to the future of crisis intervention and crisis management. In A.R. Roberts (Ed.), Crisis intervention handbook: Assessment, treatment and research (3rd ed., pp. 3-34). New York: Oxford University Press.
Roberts, A.R. & Ottens, A. J. (2005). The Seven-Stage Crisis intervention model: A road map to goal attainment, problem solving, and crisis resolution. Brief Treatment and Crisis Intervention, 5 (1), 329-339.