Separation crises and crises after the death of a close person are more common reasons for crisis counseling. The strength of the crisis experience is related to the characteristics that Filipp identified in her concept “Critical Life Events” presented above.(Filip 1997). These characteristics include the required level of re-adaptation or re-adaptation, as well as the unpredictability of the event and its severity. Other stressful factors can be a symbiotic relationship with relatives, a lack of social support, the course of the event and, in the case of separations, the associated impairment of self-esteem(Dross 2001, p. 70). Learn about our cpi nurse online training at our cpi nurse online training page.
In terms of a successful relationship, it is important when experiencing grief that the sympathy of the counselor is experienced as authentic by the clientele. Allowing the client’s feelings – including ambivalent ones and feelings of guilt – are Ciompi(1993) are central to every crisis intervention. The grief can be associated with physical complaints that require attention and, under certain circumstances, medication. The loneliness and exclusion of those affected must be counteracted. Mourning rituals can also help.
The end of a love relationship in the form of a separation or divorce is often perceived by those who have left as a drastic life event and can severely impair their psychological, physical and social well-being. Ua they suffer(Dross 2001):
- despondency and hopelessness
- as well as anger and anger
- physical complaints
- loss of self-esteem.
The experience of loss can refer to the loss of home, a familiar relationship with a feeling of security and intimacy, the loss of joint future planning, impairments in living together with children who may be present, but also financial losses and the loss of the common social network.
The separation process is often characterized by disbelief, burgeoning hope, despair in realizing the end and finally – if it succeeds – a reorientation of life(Kahlenberg 1993).
The following tasks must be completed in this process:
- Allowing pain, sadness, anger and other distressing feelings
- seeking practical and emotional support
- Helping in the gradual realization of the finality of the breakup and the failure of the relationship
- building your own social network
- dealing with being alone and feelings of loneliness and meaninglessness
- the reflection on one’s own resources and strengths.
Rather subsequent help is incumbent(Kastele 1999):
- reorientation and the formation of a new life
- the drafting of a separation story with the abandonment of idealizations, demonization, one-sided accusations of guilt and assumption of blame
- the reconciliation and creation of a new basis, especially in the case of children together.
A good, stable relationship should support the process of crisis intervention, characterized by positive expectations on the part of the crisis workers that the crisis can be overcome, supported by knowledge of different separation processes, and above all characterized by network and resource work.
5.3.2 The suicidal crisis
According to data from the Berlin Crisis Service, the use of crisis counseling for acute suicidality is less common than expected(Zimmermann and Bergold 2003, p. 29). However, the possibility of potential misconduct or omission is very distressing for the counselor. Therefore, knowledge of the suicidal crisis is indispensable. This includes:
- explanatory models
- Knowledge of indirect signs of suicide, warning signs and risk factors
- Knowledge of the presuicidal syndrome
- the phase model of the process (consideration, ambivalence, decision)
- diagnostic knowledge about the assessment of the risk of suicide
- history of suicide
- Knowledge of the importance of protective factors(e.g. Hülshoff 2017).
This knowledge gives the helper security for professional support with the aim of preventing acute danger.
Kunz et al.(2004) have compiled some approaches to dealing with a suicidal crisis(2009, p. 43 ff.). The rapid start of the intervention and a clarification of the urgency are self-evident due to the acute danger. In the flowchart by Sonneck(2000) attaches great importance to establishing relationships, as this has an antisuicidal effect and counteracts the increasing narrowing (presuicidal syndrome). An announcement of suicide should be taken seriously and it should always be addressed openly.
This makes it possible to assess the risk and determine the reasons without the person concerned feeling questioned. Knowing the context enables the helper to develop empathy to develop. Relieving those affected is a very important step that can be made possible by addressing emotions. At the same time, building vicarious hope while simultaneously accepting despair is a central moment of the intervention. Addressing failed attempts at coping, but also the search for solutions and resources as well as the activation of networks, ties in with the understanding that suicidality can also be understood as a problem-solving strategy. This also includes supporting the smallest constructive intellectual approaches and carefully questioning inappropriate assessments. An emergency plan can be helpful, but also inpatient accommodation if the client is still acutely suicidal,
Since the procedure for suicidality in children and adolescents differs from that in adults, Meurer (1993) provided some pointers: It makes no sense to discuss the legitimacy of suicidal thoughts. Instead, you should rather listen calmly, patiently and attentively and give yourself space for your own thoughts, since concrete solutions are usually rejected as impracticable. Positive experiences should be found and reinforced, and reliable and limited offers should be made instead of unlimited ones. In addition, no promises of silence should be made, but rather the family should be involved if possible.