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INTERVENTION HYPOTHESIS


As we work with people in crisis,
we develop an idea about what might reduce the critical effects of the
crisis.  Based on our understanding of
what is happening, what happened, and what is likely to happen, we work with
the individual to develop an intervention hypothesis, or plan for modifying the
causes or outcome of the crisis.  Our
crisis focus, then, combines with our focus on our intervention hypothesis.  What will probably help, of course, depends
upon our intervention hypothesis and upon the precipitating event and possible
unseen effects of the specific crisis. 
Each time we intervene in a crisis, we develop an individualized
intervention hypothesis with the person in crisis.  The specifics of that hypothesis are as
individualized as the person and the crisis itself.  Frequently, however, just getting the
individual to settle down, slow down, and plan ahead is sufficient to resolve
the crisis by helping the individual to a point where he can handle and work on
the conflict himself.  In fact, if we do
get him to settle down, slow down, and plan ahead, we have essentially reduced
the now potential.  If he is then in a
position to deal with the conflict himself, the self-resolution factor is
substantially higher.  We defined a
crisis as a conflict with a high now potential and a low self-resolution
factor.  If, following our hypothesis, we
have reduced the now potential and increased the self-resolution factor, we
have effectively resolved the crisis. 
Our intervention hypothesis is, of course, our idea about what will
help.  What we can do to help in any
particular situation depends, in large measure, on our experience and
ingenuity.  Not to be underestimated,
however, is the effectiveness of developing and following our intervention
hypothesis.  This, combined with our
self-confidence, will come through to the individual and give him confidence
also.


Mrs. G is talking with you about
her difficulties.  “I am at the end of my
rope—just can’t cope with it anymore. 
I’ve been back from the alcoholism center over three months now, and
things are just about as bad as they were before I left.  I thought if I got off the juice maybe that
would straighten things out.  Everyone’s
always blamed me and my drinking for all the trouble, but I’ve been off three
months now, and things aren’t any better. 
I’m just at my wit’s end—can’t follow through with anything.  It’s the old alcoholic story—can’t handle it
and want to drown in a bottle.  It just
goes around in circles.  We [referring to
herself and her husband] fight.  I’m worn
out.  It’s the bills.  I’m unnerved. 
The shakes are getting to me.  I’m
too close to my friends to talk about it. 
They just say, ‘Chin up.  Life’s
tough all over.’  Nobody understands how
hard it really is.  [You say: I’m glad
you’re able to talk to me about it.  It
sounds like it’s really getting to you. 
Are you and your husband fighting now?] 
No, he’s a trucker and is out on a trip. 
He won’t be back for a couple of days. 
We were fighting when he left, but he really loves me.  I don’t know why, but things will be okay
when he gets home for a while.  [You ask:
Do you have anyone else to talk to about things?]  My parents try to help.  They’re getting old and can’t stand the
nervousness and strain.  I don’t want to
burden them with my troubles.  I used to
talk to his mother, but she died a while back. 
I sure miss her.  [You say: I bet
you do.  It’s hard when we lose someone
we could really talk with.  What do you
do to keep yourself occupied?]  Time
means nothing anymore.  I just go day to
day and see what happens.  [You ask: Do
you have any hobbies or other things like that to keep you busy?]  My husband used to work on cars, and I kept
his records for him.  I like figures and
enjoyed doing that.  [You ask: Why did he
stop doing that?]  He just goes from one
thing to another.  He’s had nine jobs
since we’ve been married.  My first
husband was a real reliable man.  My
husband now just goes from one thing to another.  We went for counseling three or four years
ago, and it helped for a while, but now it’s just back to the same old
thing.  He got mad and quit the
counseling like he does everything else. 
[You ask: Do you have any children?] 
Three.  The youngest has a heart
murmur.  I found out about it just a few
weeks ago.  Things just go from bad to
worse.  Sometimes I feel like giving up.  I’m just on a yo-yo, up and down.  [You say: It sounds like you have a lot to
deal with.  I’m not sure I would be able
to handle all of it if I were you.]  Oh,
it’s not really that bad.  A lot of
people have it worse.”


As you talk with Mrs. G, your
picture of her crisis takes on some detail and content.  At first, it may not seem that she really has
a crisis.  She is in a continuingly
difficult situation but seems to be able to cope with it.  She is unhappy, feeling rather down and does
not seem very optimistic.  Nevertheless,
she is dealing with her situation.  Where
is the crisis?  We know that she is an
alcoholic and that she has received treatment at the alcoholism center.  She has been off alcohol for three
months.  The now potential is, then, that
she may revert to drinking as a way of coping with her anxiety and
depression.  At this point, she is
feeling somewhat cut off from her world and seems to feel that no one really
understands her or cares.  For Mrs. G, an
intervention hypothesis, and idea about what might help, would involve some
thought about her feelings that she is “on a yo-yo” and does not have anyone
with whom to talk.  Perhaps speaking with
her in an interested and supportive way will help her get through this
temporary crisis.  In fact, at the end of
the discussion, she expresses somewhat more optimistic thoughts and feels that
“it’s not really that bad.”  This is a
sign she is beginning to believe in her ability to cope with her situation.


Most crisis intervention services
have a few clients who use the service from time to time for social and
emotional support.  It is tempting to
become annoyed with them because we feel that they are taking advantage of the
service.  With Mrs. G, however, it is
clear that occasionally being able to use the crisis service may enable her to
cope with her life situation without falling back on alcohol.  Talking with someone who is interested and
who cares is helpful to Mrs. G.  An
intervention hypothesis involving Mrs. G, then, is fairly uncomplicated.  If you talk with her when she is feeling upset
and at her wit’s end, she will be more able to cope with her world.  In every crisis situation, we need to develop
an intervention hypothesis.   At times,
the hypothesis may be fairly involved and call for a lot of innovative action
on our part.  Very frequently, however,
our intervention hypothesis is fairly simple and limited.  Just giving individuals an opportunity to
talk, think things through, and to have their feelings understood and respected
is sufficient to reduce their crisis.




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