Discussion Topic
Completion checkbox for M3 Discussion – Biases
It is important to realize that despite all the training in crisis interventions we all have biases. Training can include professional training such as that received by medical personnel such as physicians, nurses, EMT, paramedics, mental health professionals, or paraprofessionals such as crisis intervention counselors, or persons working in residential or schools with residents/students who are challenged, or in prisons where many are diagnosed with mental health/behavioral health needs.
Using the above information, the knowledge you have about yourself and what’s been learned regarding how to identify crisis intervention services, what types of services are provided, who provides the services, and the steps to providing the services, discuss:
Differences and similarities between crisis counseling and longer term counseling. Include the step by step process of assessment including the assessment tools and interventions you would use.
Most effective means for the client to receive services–In person, via phone, or text, Facetime or other means and if there are cultural preferences in communication.
Training that may be needed to provide crisis services vs. longer term therapy.
How your biases might impact the interaction with the persons in crisis.
Use the readings to support what you write. As a way to help the discussion, use examples of situations where crisis intervention may be best vs. long term counseling.
Content Guide: Crisis vs. Long Term Counseling
In the preceding modules, you learned some of the basic steps and strategies for intervening and characteristics that make for a good crisis counselor. In this module, you will learn additional methods for crisis counseling via a telephone hotline, how to overcome the challenges of intervening over the phone instead of face to face and how to create an atmosphere of unconditional positive regard, empathy, and respect without the cues provided by body language. You will also learn the differences between crisis counseling and long term counseling.
Crisis counselors need supports to stay focused, balanced, and healthy. Chief among these is the development of healthy professional boundaries that enable crisis counselors to demonstrate the behaviors that create the conditions for an effective crisis intervention and to keep the person in crisis and the crisis counselor safe. A good crisis counselor must be able to communicate empathy but cannot take on the emotions that a client experiences. An anecdote used by a colleague illustrates the difference between an appropriate demonstration of empathy and an inappropriate demonstration of shared feelings or sympathy. Imagine that you are on a ship and you become very seasick. Who would you find more helpful, someone who joins you vomiting over the side of the boat or someone who presses a cold cloth against your head and helps you to a chair? The first person demonstrates sympathy by sharing your distress. The second person demonstrates empathy by understanding what you are going through and by responding to your need by bringing you towels, keeping your clothing out of the way, giving you water as needed, helping you sit and more.
It takes both an individual and an organizational effort to create an atmosphere in which crisis interveners are encouraged to explore personal responses to the difficult situations encountered in the course of their work. Crisis counselors who cannot establish and maintain healthy boundaries pay a heavy price. They are prone to burnout which takes many forms. Counselors may become angry at clients. They may respond in a rote manner, failing to demonstrate empathy, respect, and genuineness. They may have difficulties with personal relationships because of what they experience on the job. A good supervisor should be able to recognize the indicators of burnout and recommend time off or supportive counseling. A crisis counselor who doesn’t get help for burnout may do more harm than good by failing to respond to the person in crisis.
Imagine being in crisis and getting the courage to pick up the phone to get help only to have a rude or unfeeling person on the other end of the line. Maintenance of professional boundaries will enable a crisis counselor to continue to provide help while maintaining a healthy and happy personal life. These boundaries need to be maintained when providing crisis intervention or longer term therapy and treatment.
The difference in crisis intervention vs. therapy is manifested in the outcomes and in the focus of the intervention. The intended outcome of crisis intervention is to return the client to pre-crisis functioning. The intended outcome of short or long-term psychotherapy is to manage or alleviate symptoms.
