Crisis intervention is a preventive offer of help that can provide relief in crisis situations, recognize and reduce dangers and support efforts to cope. Crisis institutions are characterized by specific characteristics, but differ in their mandates or priorities. These can include psychosocial crisis intervention, suicide prevention as well as psychiatric emergency support. A crisis can be understood as a process of change that is open, both towards health and towards illness. There are general as well as specific models of action tailored to the type of crisis. Learn about our crisis prevention training certification at our crisis prevention training certification page.
Crisis intervention is a preventive concern. Crisis intervention should therefore prevent worse, provide relief and seek solutions and, in the best case, restore mental health. It is important that the help is short-term.
If crisis intervention is offered as part of a crisis facility, certain principles apply that affect both the action plan and the structural characteristics of a crisis facility. These are:
- low threshold
- a limited time offer
- Networking or cooperation with other institutions
- flexible approach
- promoting coping
- strengthening of resources (Schuermann 2007).
The low threshold is intended to facilitate access to help and is due to the urgency of the matter. A time-limited offer requires a limited problem focus in the processing and is based on the one hand on the understanding that crises are temporary, then turn for the better or worse and on the other hand, in the latter case, other forms of support and intervention are needed. In this case, crisis intervention also includes qualified referral, which can be more targeted if the crisis center is networked with other services or has close cooperative relationships. In order to get out of a crisis, considerable coping efforts are required on the part of those affected. The task of the helpers is to promote coping and to develop resources.(Antonovsky 1997).
In addition to the general principles, there are considerable differences in the approach and in the design of a crisis facility. This is partly due to the fact that there are different roots of crisis intervention such as
- emergency psychiatry in the sense of emergency medicine
- community psychiatry to avoid placements
- the suicide prevention
- psychosocial crisis intervention to avoid mental disorders and enable problem solving.
Crisis institutions differ in the concerns and goals or the respective priorities that they pursue. For example, telephone counseling primarily wants to relieve callers, while an emergency call focuses on the urgency of the crisis. In addition, those seeking help have different ideas and wishes, which they address to the crisis workers.
On the concept of crisis
Crisis is not a mental illness
The concept of “crisis” is not clearly defined in specialist circles. The breadth of the concept was intended by Erich Lindemann, one of the pioneers of crisis intervention. In 1948 he set up a contact point for emergencies in a community health service in order to be able to recognize crises in good time and treat them preventively(Lindemann 1985). Lindemann sees the crisis concept as a kind of lens through which the multitude of confusing events occurring in a community can be ordered and meaningfully interpreted. Crisis is therefore not a mental disorder or illness, but rather a precarious condition that requires quick help. Nevertheless, a mental disorder can be behind a crisis, just as a crisis can promote it.
Crisis researcher Dieter Ulich(1985, p. 181) proposed a definition that describes the characteristics of a crisis: “Crisis is a stressful, temporary process of change in the person whose course and consequences are open and which is characterized by an interruption in the continuity of experience and actions, through a partial disintegration of the organization of action and a destabilization in the emotional area with the central feature of self-doubt. According to Ulich, a crisis is stressful, temporary, tearing away from everyday life, disintegrating, emotionally destabilizing and associated with self-esteem problems. It presents itself as a process of change that is open, both in the direction of health and illness.
Classification of crises
The understanding of the crisis initially includes a focus on the cause of the crisis. As a result of this understanding, many categorizations of crisis events have been developed. Even if these cannot have any stringent theoretical references, they do have considerable practical consequences.
In this context, one speaks of a psychosocial crisis in contrast to a psychiatric crisis or an emergency. The latter both have a risk potential.
There are a number of other classifications, including those by Caplan and Grunebaum(1977), Schnyder and Sauvent(1993), Sonneck(2000) Huehlshoff(2009). The authors speak of various crises such as
- loss crises
- Crises in life changes
- development crises
- acute traumatization
- suicidal crises
- States of burnout among helpers
- narcissistic crises (personality disorder)
- Crisis related to mental disorders
- psychiatric emergencies.
In all categorizations, however, it should be noted that the decisive factor is the subjective meaning that those affected give to the occasion. Specific interventions can only take place when these are known.