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As we evaluate the effectiveness of
our intervention, we should ask ourselves, “Are the critical symptoms going
away?  Are things getting better?”  If our answer is Yes, then we need only
follow our hypothesis; our understanding of what is happening, what happened,
and what might happen; and our understanding of the individual and his total
situation.  If our intervention is not
working, then either our definition of the crisis or our intervention
hypothesis is wrong.  We need to develop
either a better definition of the crisis or consider alternative intervention
hypotheses.  The result of this
rethinking should be the development of a new or modified intervention
hypothesis.  That new hypothesis is then
reevaluated in terms of its effectiveness.

Mr. H contacts us with what seems
to be a fairly concrete problem.  He and
his wife live on Social Security, and their check is a few days late.  He is very worried about how they are going
to pay their bills and is concerned because they will not have any money to buy
food.  You ask him if he has called the
Social Security office to ask about his check. 
Your initial hypothesis is that Mr. H needs some specific
suggestions.  He says that he has called
the Social Security office and in the next breath asks if you will take him to
keep an appointment at his doctor’s the next afternoon.  You tell him that you will not be able to
take him; you suggest that he call someone in his church.  Maybe they will give him a ride.  Your hypothesis suggests that you should try
to help him think of a way to get to his doctor’s office to keep the
appointment.  Instead of responding to
your suggestion, he tells you that his wife is sick and may have to go to the
hospital.  At that point, you reevaluate
your initial hypothesis, which said that Mr. H wanted information and
suggestions, and try a new hypothesis that Mr. H wants to talk with someone
about his wife.  As you continue talking
with Mr. H, developing and testing out various intervention hypotheses, you finally
come to the conclusion that Mr. H is lonely and simply wants someone to talk
with.  You say to him, “You seem rather
lonely and sound as if it is good to have someone to talk with.”  He responds to this in a positive way,
confirming your new intervention hypothesis.

Cathy, age fourteen, comes into
your office and seems to be very interested in you, your family, the kinds of
things you do, your education, and so on. 
Your initial hypothesis is that Cathy is interested in becoming a crisis
intervention worker and wants to know more about it.  As you begin to talk about crisis
intervention, you notice that Cathy is focusing most of her questioning around
teenagers.  You begin to suspect that
Cathy is having some kind of problem herself and is interested in talking about
“what is normal.”  You follow this new
intervention hypothesis for a while, and Cathy relaxes a little and becomes
very chatty.  She tells you about a
friend who has been shoplifting.  She
goes on to ask what you might do if the friend were to come to talk with
you.  You develop a new intervention
hypothesis while wondering if Cathy is talking about a friend or if she is
really talking about herself.  As the
discussion goes on, you learn that Cathy really does have a friend who has been
shoplifting and who wants to talk with you. 
The friend has talked Cathy into bringing up the subject with you to see
what kind of reaction the friend would get were she to come to talk with
you.  Your intervention hypothesis
finally focuses on Cathy’s real concern: Would you be willing to talk with her
friend without turning her in to the authorities?  You assure Cathy that you are very willing to
talk with her friend and that you will not turn her in.  Cathy leaves and comes back in about fifteen
minutes with her friend.

As we can see from these two cases,
it is important for us to develop an initial intervention hypothesis.  We need to have some idea of what may
help.  As mentioned earlier, help is only
to avoid premature adoption of our initial hypothesis.  In these two cases we become helpful only
after evaluating our intervention hypothesis and developing a new one as the
discussion progresses.

People who come to us always want
something.  The point needs
emphasis.  People who contact crisis
intervention services always have some reason, goal, purpose, or need.  Even if they are cranks and are contacting us
“just for kicks,” they do have some purpose. 
They think they will get some kind of thrill from calling us or coming
to our drop-in center.  It is worth a
moment’s thought to consider an individual who would contact a crisis service
“just for kicks.”   Most of the time, he
is fairly lonely, has some kind of social or emotional problem, or has been put
up to it by friends.  In any event,
talking to us does make him feel better. 
If we keep this in mind, it may be a little easier to deal with the next
“crank” situation we come in contact with. 
In the vast majority of situations, however, people who contact crisis
services have a good and serious reason for doing so.  We must start at the very outset of our
contact with them by trying to understand their reasons for contacting us.  We develop an initial understanding of why
they contacted us and some initial ideas about how we might help.  As our contact with them continues, our
understanding of their reasons for contacting us and our ideas about what we
can do will usually shift and may sometimes change quite drastically.  Our picture of the crisis and our
intervention hypothesis must remain quite flexible and open to change and
modification.  We must be alert to the
individual’s thoughts, messages, and feelings. 
This alertness will enable us to develop and evaluate an intervention
strategy responsive to the individual’s special needs.

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