TOC Next Previous

INTERVENTION


Our actual intervention is,
surprisingly enough, the least complicated part of the intervention process,
but it requires the most skill.  Once we
develop our intervention hypothesis, our actual intervention only involves
following through with that hypothesis.


Some further comments related to
intervention hypotheses may be helpful. 
Fundamentally, our intervention hypothesis in any given crisis can focus
in only a few areas.  As we discussed, we
can focus on the individual and attempt to get him to calm down, slow down, and
plan ahead.  As varied as crisis
situations are, this focus on the individual is by far the most common need in
crisis intervention.  Later we will
discuss crisis communication as a way of responding to this kind of individual
need.  In addition to individual focus,
our intervention hypothesis could relate to environmental modification or an
attempt to change something or someone in the individual’s total
situation.  In some crises, we may want
to focus our intervention hypothesis on the interaction between the individual
and his total situation.  At other times,
we may want to direct our intervention hypothesis specifically toward reducing
the now potential of the crisis.  If a
man tells you that he is going to kill himself, one of your first questions
should relate to “how” he proposes to accomplish that.  If he tells you that he is going to shoot
himself with a gun that is lying on the table between the two of you, the now
potential will be substantially reduced if you take the gun or at least make it
inoperative.  If a mother tells you she
is afraid that she is going to injure one of her children severely, it would be
wise to get someone else to watch the children for a while.  What can you do or what can you get the
individual to do, either to lower the now potential or to increase the
self-resolution factor?  Your answer to
that question in any specific situation is your intervention hypothesis.


Throughout our discussion of crisis
intervention, we have considered numerous examples of crisis situations and of
people in crisis.  Generally,
intervention has been in terms of talking, thinking, responding to feeling, and
helping the individual evaluate alternative plans of action.  Intervention has been primarily a verbal,
feeling process.  There are, however,
many crisis situations in which we should try to either get the individual to
do something specific or do it ourselves. 
The example about the man who is going to shoot himself can serve to
stimulate our thinking.  If someone tells
us that he is thinking about killing himself, we should always try to find out
how he proposes to do that.  If we are
talking with someone on the hot line and he tells us that he is going to
overdose with a bottle of tranquilizers he has in his bathroom, we will talk
with him to try to get him to externalize and focus his anger.  At some point in our conversation, we will
hopefully get him to agree not to kill himself. 
If it is at all possible, we should get him to flush the tranquilizers
down the toilet.  If possible, we want
him to lay the telephone receiver down, go flush the medication, and come back
to the telephone to tell us that he has done it.  Someone who is considering suicide in a
serious way usually has a good idea about how he will do it.  If the person no longer has the bottle of
tranquilizers, he will at least have to think up a new way of killing himself
if he again becomes acutely depressed after talking with us on the telephone.


If a young mother tells us that her
child has accidentally swallowed some household cleaning fluid, we tell her to
rush the child to a hospital emergency room. 
It is also important that we tell her to take the bottle or container
with her.  If an elderly person calls us
and tells us that she is afraid that someone is trying to break into her house,
the likelihood is that she has become lonely and somewhat upset.  If she really thought someone were breaking
in, she would probably have called the police instead of the hot line.  Nevertheless, if we think that someone may indeed
be trying to break in after we have talked with her for a few minutes, it would
be a good idea to have her hang up, call the police, and then call us
back.  If a teenager calls us to inquire,
for a friend, about the signs and symptoms of venereal disease, we want to give
him full and complete information.  In
addition, we will want to make sure that he knows that venereal disease is
potentially progressive; it can get much worse over a period of time.  We want to be sure he understands that “his
friend” should go immediately to the VD clinic or to his family doctor for an
examination.  If a young woman calls us
for abortion information, we should be sure that she knows she should first be
certain she is pregnant.  It is
surprising how many young women and teenage girls decide they are pregnant and
make plans for an abortion without having a pregnancy test.  One of our good friends may come to us quite
upset, telling us about something he has heard about his wife.  He has decided to file for a divorce on the
strength of the rumor.  We should
encourage him to confront his wife directly with the information before doing
anything drastic.


If we talk with an individual who
seems to have overdosed himself with drugs and convince him to go to a hospital
emergency room, we should be sure to call the emergency room and explain the
situation before the individual gets there. 
If we refer someone to a welfare department, a mental health clinic, a
physician, or other service, we should always call someone there and discuss
the situation so that the agency has the benefit of our understanding and
thinking.  If a young child came into our
office and told us that he was lost and asked us to call his parents for him,
we would do it without hesitation.  It is
surprising, though, to hear of situations where children and teenagers have
come to counselors, drop-in centers, emergency services, and so on, indicating
that they are in some kind of desperate situation and asking if someone would
call their parents and talk with them about the problem, only to be told, “We
do not do that sort of thing.  You will
have to contact your parents yourself.” 
How do we, as crisis intervention workers, decide when it is okay for us
to do something very specific?  If it is
something consistent with good ethical practice, we will do whatever needs to
be done to help the individual through this crisis.  The goal of crisis intervention is crisis
reduction.  The value framework
underlying crisis intervention directs us to do whatever is reasonable and
necessary to help the individual in crisis.




TOC Next Previous