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  • Crisis Intervention

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    18 Ansichten4 Seiten

    Crisis Intervention

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    SLCNtc

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    Editorial Five Principles of Crisis Intervention: Reducing the Risk of Premature Crisis Intervention George 8. Everly, Jr, Ph.D. ABSTRACT: isis intervention, as it has evolved over the last five decades, has clearly demonstrated fas effectiveness as a tool to reduce human distress, Nevertheless, as with any effort to alter human behavior, there are risks associated with risi intervention. One such riskis tha of premature intervention. Premature intervention may not only waste valuable intervention resources, but may serve to interfere with the natural recovery mechanisms of some victims, By clearly defining the nature of the crisis ‘phenomenon itself, premature intervention may be averted (International Journal of Emergency Mental Health, 2000, (1), I]. KEY WoRD: ‘The need for urgent psychological support inthe wake of crisis events is evidenced by the high prevalence of traumatic events and the subsequent development of posttraumatic stress disorder (PTSD). For example, it has been estimated that 90% of Americans will be exposed toa traumatic stressor as defined by the Ametican Psychiatric Association (Breslau tal, 1998), Furthermore, recent summaries have concluded that about 9% of those exposed to a traumatic stressor will develop PTSD (U.S. Dept. HHS, 2000). Thus, the need for urgent erisis intervention seems in evidence. Similarly the effectiveness of crisis intervention programs has also been demonstrated (see APA, 1989; Everly, Flannery, & Mitchel 1999; and Everly and Mitchell, 1999 for reviews; see also Everly, Boyle, & Lating, 1999; Everly, Flannery, & Byler, 2000; Flannery, 1999). Despite the best of intentions, combined with both the existence of an empirically demonstrated need and empirically demonstrated tactical effectiveness, criticism has arisen surrounding what some perceive as premature and perhaps even overzealous psychological intervention inthe wake ofacrisis event. Such is evidenced by articles entitled: “Shamans of Sorrow at Columbine High,” and. “The Grief Racket,” appearing in reputable newspapers such asthe Washington Post, as well as a paper entitled “A Surfeit of Disaster” which appeared George S. Everly, Ic, P.D., Loyola College and The Johns Hopkins Univesity, Address correspondence to: Dr. Every, 702 Severnside Ave.,Severna Patk, MD 21146, ‘isis intervention; crisis; critical incident; disaster; posttraumatic stress in the Economist, Responsibility dictates thatthe need for urgent psychological support be recognized, while acknowledging thatthe exposure toa traumatic stressor isa necessary, butnot sufficient, condition forthe development of disabling posttraumatic sequelae. As soted above, only the minority of individuals will develop PTSD. One might infer the existence of natural healing and recovery ‘mechanisms, It may be further inferred that these natural restorative mechanisms may actually be interfered with by premature or overly aggressive intervention, The purpose of this eurrent paper isto offer some general guidelines for the timing of psychological crisis intervention. Let us begin with a review of the nature of a crisis, A ctisis isan acute response to a critical incident wherein: {Psychological homeostasisis disrupted. 2)One's usual coping mechanisms have failed. And, 3) There is evidence of human distress and/or dysfunction. ‘The crisis response is often confused with thecritical incident (crisis event). A critical incidents the stressor ‘event which initiates the crisis response. More specifically, the critical incident may be thought of as ‘the stressor event which sets the stage for the emergence ofthe crisis response in those so adversely affected. Lastly, a review of the term crisis interdention may prove of value. Crisis intervention may be defined as the provision cof acute psychological support, the goals of which are: 1) Stabilization of the symptoms/signs (evidence) of distress. Here the crisis interventionist asks the question, “What can I donow that willkep the victim's

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