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CRISIS FOCUS


Thus far, we have located the
conflict within the interaction between the individual and his total
situation.  We have determined that it
has a high now potential and a low self-resolution factor, justifying our
intervention.  We have asked, “What
happened,” and are developing an understanding of the precipitating event.  Our picture of the crisis is taking on form
and content.  We are ready to consider
the assessment set.  From this point on,
crisis intervention is unlike more traditional forms of counseling and therapy.  Traditionally, we want to know as much as
possible about the person; his total situation; his “now,” “then,” and “when”;
and as many other related factors, situations, conditions, circumstances, and
events that possibly concern the individual and his situation now.  Our “picture” needs to be as complete and as
detailed as possible.  To achieve this
level of understanding requires long-term interaction between therapist and
“patient” as well as a high level of skill and training on the part of the
“therapist.”


In crisis intervention, our focus
is considerably more narrow, centering sharply and clearly on the crisis
itself.  This point can hardly be
overemphasized, and as a test of crisis focus, we should always consider these
questions.


  1. Specifically,
    what is likely to get worse?
  2. How
    bad might it get?
  3. If
    things get worse, what is the potential effect and on whom?
  4. Why
    do we think the individual or someone else in the crisis will not be able
    to deal with it?


If we can adequately and clearly
answer these four questions, we may conclude that we have clear crisis
focus.  Crucial to effective
intervention, then, is maintaining that clear focus throughout the crisis
intervention process.  Establishing and
maintaining this crisis focus enables us to avoid going off on tangents or
becoming involved with unrelated problems and concerns.  Generally, our effectiveness in crisis
situations is thereby increased.


Bryan, age seventeen, comes to you with a
problem.  He is one of your son’s friends
and has worked for you in your store from time to time.  Other than that, you don’t know him very well
and have never really talked with him. 
As he talks, he is noticeably uneasy and repeatedly asks for assurance
that you are trustworthy and that you will not tell anyone what he has to
say.  You reassure him that you will not
tell anyone unless is seems that someone is going to really get hurt or
something terrible might happen.  “Do you
promise not to tell?  [You say: Why don’t
you start into it kind of slow, and if you begin to get into anything that I
would have to do something about, I’ll let you know so you can decide whether
or not you want to tell me more.]  Well,
okay.  I’m really worried and don’t know
what to do about it.”  Bryan then goes on to tell you a rather
involved story.  His fifteen-year-old
sister got pregnant and “had to get married.” 
She, her sixteen-year-old husband, and their three-month-old baby lived
with Bryan and his mother.  Bryan says that the
husband has quit school, does not have a job, and spends most of his time
hanging out at the gas station.  Bryan saw him “throw the
baby” on the floor one night when it would not stop crying.  His sister has been drinking two or three
bottles of wine every day, and Bryan
thinks she is probably an alcoholic.  She
and her husband get into a lot of fights, and Bryan thinks that the bruises on her arms are
where her husband hit her.  His mother
usually takes care of the baby, but she and Bryan’s sister got into a big fight last
night.  It started when his mother
started nagging his sister about not straightening up the house and ended with
the sister saying that she was going to take the baby and leave today.  Bryan
tried to get his mother to stop her but was told to mind his own business.  The sister took the baby, and Bryan does not know where
they are.  He is worried about the baby
and is afraid that something really bad might happen.


Bryan’s situation is loaded with conflict,
and maintaining crisis focus may be difficult. 
What is the crisis?  Who is in
crisis?  From Bryan’s point of view, it is clear that the
baby is the person in crisis.  He sees
the now potential in terms of the baby’s getting hurt.  The low self-resolution factor is related to
the baby’s inability to resolve the problem. 
In this complex situation, it would be tempting to focus on Bryan’s relationship with
his mother, his sister’s relationship with her husband and her apparent
alcoholism, her husband’s poor adjustment and apparent abuse of his child, his
mother’s poor relationship with his sister, or the fact that his sister has
taken off without any apparent means of support.  Establishing and maintaining clear crisis
focus on the baby’s situation will enable you to help Bryan think about his options for dealing
with his problem.  Perhaps you might want
to get him to think about where his sister might have taken the baby.  He might talk with his sister’s husband to
see if the husband had any ideas. 
Perhaps he could receive help at the local child welfare office.  In any event, failure to establish and
maintain focus on the baby’s crisis could lead to missing the point of the
problem entirely.  In this and other
crisis situation, establishing and maintaining clear focus is essential to
effective crisis reduction.




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