Practice Intervention

Literature-supported Description of the Crisis Intervention Model According to Richard James (2008), a crisis is defined as “a perception of an event or situation as an intolerable difficulty that exceeds the resources or coping mechanism of the person” (p. 3). The crisis intervention model is best used when a person’s immediate crisis is affecting his or her ability to function.

James established a crisis intervention model that consists of six steps: 1) defining the client’s problem, 2) ensuring the clients safety, 3) providing support to the client, 4) examining lternatives to help client cope with stress, 5) making plans, and 6) obtaining commitment. It is important for social workers to allow the clients to state what his or her problem is and explain his or her meaning of such problem. This first step allows the client to talk about the problem, which can be therapeutic, and the social worker has the opportunity to gather information and display empathy to establish rapport.Determining if a client is at risk of harming others or himself or herself is the second step in the crisis intervention model. In the third step, the social worker ants to ensure the client that he or she is there to support him or her, and to let the client know that he or she will not be Judged.

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In crisis situations, many times clients will not open up for fear of being Judged, which hinders the process of working the full model. Examining alternatives is the fourth step in the model, and the client should try to explore his or her own choices of ways to help him or her reduce the level of depression first.The social worker can assist the client with coming up with some ideas, but studies have shown that clients are more apt to omplete tasks when they establishes their own goals. Once the social worker and client have established a list of choices, the fifth step of the model, which is making plans, is initiated. Developing realistic goals and time frames are important when making plans. The focus should be on the client’s immediate need so resources can be identified and coping mechanisms to relieve immediate stress can be established.The last phase in the six-step crisis intervention model is obtaining commitment from the client. Completing the tasks on the action plan can be ewarding for the client and allows him or her to learn new, positive coping mechanisms for the future.

Rational for Crisis Intervention Model I selected the crisis intervention approach because the client I am working with stated she has been feeling sad, overwhelmed, and has been having spurts of crying over the past two weeks. During my initial evaluation, she informed me about changes she has noticed in her normal daily activities over the past week.Her normal daily routine includes eating three meals a day, sleeping approximately 8 ours a night, attending school five days a week, and spending time with her family and friends. In the last week, she has been eating one meal a day, has not been attending school, has not been sleeping, and has confined herself to her room.

My client also reported not having the energy to get out of bed and stated she does not have the desire to talk with friends and family. When she has felt like this in the past, she would isolate herself, listen to music, and write poetry.My client has tried strategies are not working. Using the crisis intervention approach will help me work ith the client to assist her with finding other coping methods that will help to reduce her stress and sadness. Using this approach will benefit the client because she will be able to discover new methods to cope with her current crisis and any others shall they arise again in the future. This approach will also give her the opportunity to talk about the things that have been bothering her and may help her discover other stressors in her life that may be affecting her as well.The crisis intervention approach is normally used when one is seeing a client during for period f four to six weeks. I believe four to six weeks is a reasonable time to establish positive coping skills, follow the plan of action established, follow-up with the client, and do an evaluation to ensure the process is working.

Although I do not think I will need to see the client for the full six weeks, The timeframe will allow me to evaluate the clients progress and making any necessary changes to her plan of action.Progress Note (Subjective) Client said she has been feeling sad and overwhelmed for the past two weeks. She got into an argument with he roommate yesterday, has been sad about er boyfriend moving to Alabama, and has been having problems concentrating in school. Client is full-time undergraduate student studying political science. She mentioned she has not been eating, sleeping, or going to school in the past week. The client lives with her mother, father, and her sister. The client reports her family has a close relationship and she has been talk not to discuss personal problems with others outside of the home.She said “counseling is not a cultural norm for me, but I was willing to give it a try.

The client appeared to be alert and willing to work with me to help solve her crisis. She stated “l am willing to do whatever it takes to make myself feel better and be able to focus on my schooling”. (Objective) Client is a 20 year old African American female. She was dressed appropriate for the weather. Client wore black pants, a red sweater, and black boots. She was able to process the information I gave her and responded with appropriate answers without hesitation.

When talking about her boyfriend moving so far away, client started to cry. (Assessment) Client is feeling sad about her boyfriend moving out of state and about the argument she had with her roommate. She no longer communicates with her boyfriend often, since he has moved. He is always busy when she call him and when he comes to town he never comes to visit her. She has been friends with her roommate for four years and that is the person who she normally talks to when she is feeling depressed. They are not on speaking terms, so the client feels like she is all alone.Client’s loss of appetite, decreased sleep, feeling alone, and crying, are signs of depression. Client was able to come up with a list of coping strategies.

(Plan) Client will write her roommate and boyfriend a letter telling hem how she feels, exercise in the morning for 30 minutes before going to school, take warm baths at night to help her relax and sleep, rate her level of depression on a scale from 1-10 daily for a week, and return for a follow-up appointment with me next week to evaluate her progress.Measurement Instrument Retrieved from www. withfriendship.

com Literature-supported Description for Instrument The Beck Depression Inventory instrument uses a self-report scale that consists of 21 questions. The client rates each question on a scale from zero to three. The cores on the scale rate the intensity of the feelings a client is having. For example, a question may ask the client if his or her sleeping pattern has changed.Zero would reflect the clients sleeping pattern has not changed at all, while a rating of three would indicate the clients sleeping pattern has severely changed. According to Stulz and Crits-Christoph (2010), anxiety and depression symptoms overlap making it difficult to diagnose clients (p. 927).

Stulz and Crits-Christoph conducted a study in effort to differentiate the two and create separate measurement tools. Some participants in the study were given the Beck Anxiety Inventory (BAI) and others were administered the Beck Depression Inventory-II (BDI-II).Based on the outcome of the study, neither one of the measurement instruments could assist clinicians in determining whether a client was experiencing anxiety or depression.

However, the study did validate using the appropriate Beck inventory instrument after proper diagnosis would be beneficial for tracking treatment affects. With that in mind, I would use the Beck Depression Inventory instrument to measure the effectiveness of he coping methods established by the client to see if her level of depression is decreasing.Rational for Instrument Chosen I selected the Beck Depression Inventory instrument to use with this client. Beck offers both an anxiety and depression inventory measuring tool. Administering both of the tests to the client during the initial session would allow me to determine if the problem is anxiety or depression. Based upon the scores, I would be able to detect it is depression and continue to use this tool the evaluate her progress prior to each session.



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