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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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