People going through a divorce, the breakup of a significant relationship, a custody battle, or some other tremendous change in their lives often experience coping problems. Sometimes, it’s temporary or insignificant. Somtimes, it’s not.
Authorities in Baltimore prepared a “POLICE RESPONSE TO THE MENTALLY ILL,” which includes crisis intervention strategies. This curriculum, prepared by National Alliance for the Mentally Ill, Maryland Chapter- Metropolitan Baltimore, Baltimore County Health Department, Bureau of Mental Health, and the Baltimore County Police Department, includes the following advice (excerpt):
INTERVENTION STRATEGIES:
Your goal is to:
1. Build relationship.
2. Help the person identify the crisis.
3. Assess person’s usual mechanisms for coping with stress.
4. Refer the person to counseling services, e.g. mobile crisis team.
Closure
Problem solve
Identify problem- break down
Gather info. -ask concrete questions
Establish relationship
1. ESTABLISH A RELATIONSHIP: Your main goal is to establish trust. The client needs to feel that you accept, respect and understand his feelings. The client also needs to develop confidence that you can be helpful. Your role is to be a helper/listener.
Reflect feelings paraphrase
Minimal verbal response summarize
Clarify confront
Focus inform
Silence reframe
A. SUPPORTIVE LISTENING- let the person have the opportunity to express feelings freely. Receive info in a calm, nonjudgmental manner. Don’t tell the client he shouldn’t feel a certain way.
B. VALIDATE THE FEELINGS- Tell person it’s all right to have those feelings. This helps to de-escalate.
C. IDENTIFY THE CLIENTS STRENGTHS- Point out strengths that you observe in client- what are their values, what is important to them?
2. GATHER INFO AND MAKE AN ASSESSMENT: You begin to ask pertinent factual questions. Focus on the current situation (e.g. don’t ask what it was like when client was 13). What’s going on today? What happened? How do you take care of yourself?
3. IDENTIFY PROBLEM: Together with the client, you agree upon what is the most urgent problem. Prioritize.
4. PROBLEM SOLVE: Explore alternatives, identify options, anticipate obstacles, develop alternative plans, give resource information, support client’s ability to carry out the plan. This step is intended to help the person gain control of the situation and develop some confidence in managing the problem. It is
very tempting to give advice- but DON’T. If you find yourself saying I think you should, If I were you… The clinician needs to reframe the comments to say- Have you considered, what do you think about…
5. CLOSURE: As the process ends, review with the client the actions they will take and the contingency plans.
MANAGING VIOLENT BEHAVIOR: Some psychiatric emergency clients may be potentially violent. The astute officer or counselor will be knowledgeable about signs or impending violence and will be acquainted with the techniques for limiting the potential for danger.