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Assessment Intervention Connection

Rick A. Myer, Ph.D., NCC

Associate Professor, Director of the Center for Crisis Intervention and Prevention

Duquesne University

phone: (412) 396-4036

e- mail: myerra@duq.edu

Crisis intervention is dependent on crisis workers' effectual transition from assessment to intervention. Undue dependence on traditional assessment skills and counseling techniques will prove inadequate for crisis workers faced with clients needing immediate assistance. Assessment techniques and intervention strategies specifically developed for crisis intervention are necessary to provide the help needed by people in crisis. A seamless transition between assessment and intervention is also needed if help is to be given in a timely fashion.

A critical element in this formula is an assessment process that delivers information directly needed in the intervention. This process must identify clients' reactions as well as evaluate the severity of those reactions. Reactions to crisis include affective (i.e., anger, sadness, anxiety), behavioral (i.e., immobile, avoidance, approach), and cognitive (i.e., transgression, threat, loss). The severity of the reactions can be classified into six basic categories of impairment: (1) no; (2) minimal; (3) low; (4) moderate; (5) marked; and (6) severe. Utilization of this information enables crisis workers to shift easily into the intervention process. However, caution must be exercised because the reactions of people in crisis fluctuate. Assessment, therefore, must be ongoing, continually informing the intervention process.

Three general levels of intervention are used in crisis work: (1) indirect - "What can you do to make things better?"; (2) collaborative - "How can we work together to resolve the crisis?"; and (3) direct - "I want you to do [this]." The indirect level of intervention is helpful for people whose crisis reactions fall into the no, minimal, and low impairment categories. As reactions move toward the upper end of the low through the moderate impairment categories, the collaborative level of intervention is the most beneficial. People whose reactions fall into the upper two categories of impairment, marked and severe, will likely be helped primarily by using the direct level of intervention.

Specific intervention strategies can be used at any of the three levels. These are:

	AFFECTIVE Awareness: Helps clients become cognizant of feelings.	COGNITIVE Ordering: Promotes systematizing of perceptions.	BEHAVIORAL Guiding: Assisting clients to obtain resources.
	Catharsis: Enables clients to express feelings.	Clarifying: Facilitates expansion of perceptions.	Protecting: Keeping clients safe from harm to self or others.
	Supportive: Provides clients with understanding of feelings.	Delimiting: Encourages focusing of perceptions.	Mobilizing: Organizing resources for clients.

Use of these strategies is determined by the reaction that is the most severe. If the affective reaction is the most severe, affective strategies are used, and so on. Continuous assessment allows crisis workers to judge which intervention strategy is needed at any given time while working with clients.