The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis Resolution

Albert R. Roberts, phD

Allen J. Ottens,

PhD

This article explicates a systematic and structured conceptual model for crisis assessment and intervention that facilitates planning for effective brief treatment in outpatient psychiatric clinics, community mental health centers, counseling centers, or crisis intervention settings. Application of Roberts' seven-stage crisis intervention model can facilitate the clinician's effective intervening by emphasizing rapid assessment of the client's problem and resources, collaborating on goal selection and attainment, finding alternative coping methods, developing a working alliance, and building upon the client's strengths. Limitations on treatment time by insurance companies and managed care organizations have made evidence-based crisis intervention a critical necessity for millions of persons presenting to mental health clinics and hospital-based programs in the midst of acute crisis episodes. Having a crisis intervention protocol facilitates treatment planning and intervention. The authors clarify the distinct differences between disaster management and crisis intervention and when each is critically needed. Also, noted is the importance of built-in evaluations, outcome measures, and performance indicators for all crisis intervention services and programs. We are recommending that the Roberts' crisis intervention tool be used for time-limited response to persons in acute crisis. [Brief Treatment and Crisis Intervention 5:329-339 (2005)] KEYWORDS: crisis intervention, lethality assessment, establish rapport, coping, performance indicators, precipitating event, disaster management.

We live in an era in which

crisis-inducing

resolve on their own, and they often turn for help to crisis units of community mental health centers, psychiatric clinics, and hospital screening units, outpatient emergency violence rooms, college (Roberts,

events and acute crisis episodes are prevalent. Each year, millions of people are confronted with crisis-inducing events that they cannot

counseling centers, family counseling agencies,
From Rutgers, The State University of New Jersey (Roberts) and Northern Illinois University (Ottens). Contact author: Albert R. Roberts, Professor, Criminal Justice, Faculty of Arts and Sciences, Rutgers, The State University of New Jersey, Lucy Stone Hall, B wing, 261 Piscataway, NJ 08854. E-mail: prof.albertroberts@comcast.net. doi:1 0.1 093/brief-treatment/mhi030 Advance Access publication October 12, 2005 University

domestic

programs

2005). Imagine the following scenarios:

• You are a community psychologist
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330 Brief Treatment and Crisis Intervention / 5:4 November 2005 . took place last week at the corporate The employee assistance counselor. and the director of disaster planning want you to provide crisis intervention training corporate security officers. counseling center. Now she tells you she is seriously considering taking an overdose of nonaspirin pain capsules in their presence to "teach them a lesson. services to police. the director of training.. over the weekend a patient assaulted the psychiatric resident you are supervising. the' director of strategic planning. Thus.ROBERTS AND OTIENS Police Department to deliver crisis intervention responders. the counseling learning about each component or stage of a model. What do you do now? What types of training should be provided to all psychiatric patient-staff residents and mental conflict from reaching health clinicians in order to prevent a crisis point? • You are the counseling psychologist at a state university assigned to see walk-in emergency clients. and a. broken ro- who present in a crisis state as a consequence of an interpersonal mance or divorce). and problem solving.g. emergency and survivors of Hurricane you she just came from her residence hall room and found her boyfriend in bed with her "best friend" roommate. It is midnight and one of the survivors (who was brutally raped 1 week prior to Hurricane Katrina) wakes up screaming and throwing things at the young man in the cot next to hers. a crisis-inducing isting mental health problem event (e." How can crisis intervention effective problem-solving her predicament? This article delineates and discusses a systematic and structured intervention conceptual model for crisis persons calling or clinic. and crisis resolution. the clinician can visualize the implications of each proposed crisis intervention guidepost and technique in adjustments before the the model's process and sequence of events and make any necessary program a series of guideposts thus facilitating is fully operational. walking into an outpatient or crisis intervention a prototype crisis clinician/counselor psychiatric screening center. shooting . the clinician will better understand how each component should facilitate relates to one another goal attainment. volatile domestic violence-related headquarters. The focus of this article is on the clinical application tervention of Roberts' seven-stage crisis inmodel (R-SSCIM) to those clients conflict (e.. • You are a crisis consultant to a large Fortune 500 corporation. but instead you are called on the loudspeaker services. By remember alternative methods and techniques. A systematic crisis intervention of the actual roads. psychiatric useful with help her to approach to find adaptive coping skills and a more Katrina who just arrived at the Houston Astrodome disaster shelter. The resident wants to be transferred to another unit of the hospital because he had a nightmare and cold sweats last night. You were walking out the door to drive home and get a few hours sleep. dating violence and sexual assault). program. analogous to establishing a road map as a model and directions one will be taking on a trip.g. • You are the new psychiatrist in an inpatient psychiatric unit with 50 patients diagnosed with co-occurring disorders. A model is of the real-life clinical process the would like to implemodel is ment. The model is that makes it easier to process. highways. An 18-year-old freshman appears one afternoon and tells to all employee assistance counselors and all to defuse the acute crisis episode and provide crisis intervention . or a preexthat flares-up.

psychiatrists. took However. health counselors. It is then (2) the individual's to resolve the by previously used coping mech- anisms. psychologists. p. to and crisis hotline workers-be knowledgeable of crisis intervention. and build upon the client's strengths. the event will overwhelm their ability to cope. and one is needed for a host of reasons. The main cause of a crisis is an intensely stressful. then emergency rescue services. At the start it is critically important to establish rapport while assessing lethality and determining the precipitating important to problem and involves and then events/situations. Clinicians need to be aware. it is imperative that crisis workers blueprint have in mind a framework them in responding. agement. Crisis also refers to "an upset in the steady state. such as Hurricane as this there article place went by natural which press. crisis intervention coping skills failed helping the client to replace them with adaptive mental health mental short. Critical decisions need to be made on behalf ofthe 'client. crisis intervention We will discuss the An acute disruption of psychological homeostasis in which one's usual coping mecha. compromises impairment. in the principles and practices Several million individseems to be the emergof choice for most is a functional community difference disaster uals encounter crisis-inducing events annually. but two other conditions necessary: (1) the individual's cause of and of the event upset and/or inability as the disruption. 2005. a time of crisis seems to be an opportunity the crisis clinician's effectively client's as long as he or she is problem and resources. such as the ones given as follows. ability to Thus. willing to rapidly suggest goals and alternative coping methods. a vulnerable or unbalanced state. the individual's The subjective that and stability to a. focused in the here and now. When confronted by a person in crisis. stressful life experience differences between disaster management and later in this article. Crisis clinicians must respond quickly to the' challenges posed by clients presenting in a-crisis state. method between crisis intervention A large-scale and disaster man- such as a major hurricane first requires disaster management. social workers. psychiatric nurses. rather than the psychological needs and responses of those who experienced the di- Crisis Intervention: a Model The Need for saster. a precipitating factor. A "crisis" has been defined as . clinical psychologists." It often has five components: a hazardous or traumatic event. develop a wotking alliance.nisms fail and there exists evidence of distress and functional reaction . and crisis intervention ing therapeutic individuals. 778) Given such a definition. traumatic.The Seven-Stage Crisis Intervention Model Crisis states can be precipitated disasters. For some. it is those people for whom R-SSCIM is invaluable. that some clients in crisis are making one last ' heroic effort to seek help and hence may be highly motivated to maximize intervene assess the to try something different. or hazardous are also perception considerable disruption event. The first two phases address the event itself. identifying coping skills. well versed and Katrina. clinicians need to address that person's distress. It is imperative clinicians-counseling that all (Roberts. Brief Treatment and Crisis Intervention /5:4 November 2005 331 . ability to cope or function. or In to guide mutually agree on short-term goals and tasks. an active crisis state based on the person's perception. and the resolution of the crisis. a crisis intervention model is needed. identify the primary presenting By its nature.

2005) has identified seven critical stages through clients typically pass on the road to crisis stabilization.and (1944): 1991. Specifically. the and Golan a model should suggest steps for how the crisis worker can intentionally client resources. clinical experience. Lindemann's pioneering (1991. A comprehensive allows the novice as well as the experienced clinician to be mindful of maintaining the fine line that allows for a response that is active and directive ownership enough away but does not take problem from the client. 2005). However. 2. and instability by operating in & emotionally hazardous crisis precipitating event. 1968. Finally. 2002. (1978). the model. Collins & Collins.ROBERTS AND OTIENS impairment. identify the major problems. responding often with but crisis model is less likely to exacerbate the crisis with well-intentioned haphazard within intervention the framework of a systematic when trained to work emergency problem-solving methods. increased disruption of daily living because the individual is stuck and cannot resolve the crisis quickly.g. Based on a solid 1970). It represents a practical stepwise that has applicability across a broad: now evolved into a specialty mental health field' . 1964) was the first clinician to describe and document the four stages of a crisis reaction: initial rise of tension from the 3. establish the collaborative work. including crisis precipitants. A number of crisis intervention practice & models have been promulgated over the years & Grau. there is one crisis intervention expands seminal thinking Caplan Lindemann example ofa founders R-SSCIM blueprint of crisis (Roberts. and meet the client where move strategically to he or she is at. and mastery (Figure 1). Caplan (1961. assess level of risk. make psychological contact and rapidly relationship. We have come a far cry from its inception in the 1950s and 1960s. a psychiatry professor at Massachusetts General Hospital and the expanded Harvard School of Public (1944) Health. Gerald Caplan. The roots of crisis intervention Roberts' Seven-Stage Crisis Intervention Model In conceptualizing tervention. dividual tension rapidly fails to resolve increases the as the inand the crisis through a logical and orderly limited process (Greenstone Leviton. Greenstone Leviton. 1950s. 2005. person goes into a depression or mental collapse or may partially resolve the crisis by using new coping methods. mobilize stabilize the crisis and improve functioning. It has that stands on its own. Erich Lindemann at Massachusetts General Hospital conceptualized crisis theory based on his work with many acute and grief stricken survivors and relatives of the 493 dead victims of Boston' s worst nightclub fire at the Coconut Grove. Roberts model theory. Jones. What follows is an explication of that model. in the sequential. and 1960s.1995. that builds upon of the (1964). 1998. 2002). resolution. plan and conduct a thorough biopsychosocial and lethality/imminent danger assessment. (e. Crisis intervention is no longer regarded as a passing fad or as an emerging discipline. Dr. and sometimes overlapping process of crisis intervention: 1. The crisis worker. for crisis. method.. in 1943 and 1944 community psychiatrist. 2000. Roberts the process of crisis inwhich Caplan in the mid-1940s. These stages. responding theoretical foundation and a praxis that is born out of over 50 years of empirical and experiential grounding. crisis intervention has become come Gerald a multidimensional from the pioneering psychiatrists-Erich and flexible intervention work of two community Lindemann and spectrum of crisis situations. are essential. listed below. 332 Brief Treatment and Crisis Intervention / 5:4 November 2005 .

this assessment should cover the client's needs and medications. At a minand stressors. Brief Treatment and Crisis Intervention / 5:4 November 2005 333 . Generate and explore alternatives (untapped resources and coping skills) . 1--- 6. 2000). Crisis resolution 4. andformulate . encourage emotions. (Eaton & Brtl. . current and external medical coping imum. 6.The Seven-Stage 4. Develop.. Roberts. restore functioning implementation 7.. plan follow-up through of an action plan.. "an actiou plan 5. 5. and an exploration of feelings and Crisis Intervention Model Stage I: Psychosocial Assessment The crisis worker and Lethality a swift but must conduct thorough biopsychosocial environmental supports assessment. Explore feelings and emotions (including active listening and validation) 3.. generate and explore alternatives new coping strategies. Reprinted by permission of the author.. Plan and conduct crisis and biopsychosocial assessment (including lethality measures) FIGURE 1 Roberts' Seven Stage Crisis Intervention Model Source: Copyright © Albert R. and internal methods and resources use of drugs What follows is an explication of that model. 1991. Identify dimensions of presenting problem(s) (including the "last straw" or crisis precipitants) 2.. Establish rapport and rapidly establish collaborative relationship 1. and booster sessions. and alcohol.

is that an indication you are thinking of hurting yourself?").. heard and understood. the sensitive clinician or counselor uses an artful interviewing unfolds. for example. such as drugs or a firearm?). • taking into consideration certain risk factors (e. experiencing a significant loss such as divorce or layoff?). flexibility. Stage III: Identify the Major Problems or Crisis Precipitants Crisis current intervention problems.g. the crisis worker is interested in elucidating just what in the client's life has led her or him to require help at the present time. "When you say you can't take it anymore. style that allows this information to emerge as the client's story A good assessment is likely to have 2002).. or fundamental character strengths of the crisis worker come to fore in order to instill trust and confidence in the client. focuses which on the client's are often the ones that precipitated the crisis. Myer. Ottens. cognitive. the crisis worker should inquire about the client's "potential" harm. the clinician gains of the client's that will likely crisis is to For coping require modification be resolved if the present and future crises prevented. conditions such as genuineclient and acceptance (Roberts.g. a hotline caller who suffers from a fatal disease or painful condition may have strong intent).g. 334 Brief Treatment and Crisis Intervention / 5:4 November 2005 . first and foremost. 2005). volves ascertaining whether the client has actually initiated a suicide attempt. Thus. feels as though he or she has been Thus.. Roberts. or sexual abuse. As Ewing (1978) pointed out. in this process. the crisis for self- Stage II: Rapidly Establish Rapport Rapport ness. With regard to imminent danger. • gauging the lethality of suicide plan (e. 2001. is facilitated by the presence of the of counselor-offered respect. behaviors. is the client SOcially isolated or depressed. model (Myer.identified. does the person in crisis have a plan? how feasible is the plan? does the person in crisis have a method in mind to carry out the plan? how lethal is the method? does the person have access to a means of self-harm. Assessment and the client. Rather than grilling the client for assessment information. nonjudgmental positive mental creativity. If no suicide attempt is in progress. This is also the stage in which the traits.g. attitude. • inquiring about suicide history. and resiliency.ROBERTS AND OTIENS One useful (and rapid) method for assessing the emotional. it is quite underEstablish standable that in the Roberts model. Williams. a violent stalker. & Schmidt. good a host of such strengths have some of the most prominent eye contact. Stage 1inand Stage II-Rapidly Rapport are very much intertwined. and behavioral is the triage aspects of a crisis reaction assessment occurred if the clinician has a solid understanding of the client's situation. reinforcing small gains. include attitude. the question asked from a variety of angles is "Why now?" Roberts (2005) suggested not only inquiring about the precipitating event (the proverbial problems in (Egan.. how the on first. In the course of understanding an evolving "modal conceptualization style"-one event escalated into a crisis. Although bee~ . 1992. such as ingesting a poison or overdose of medication. This assessment requires • asking about suicidal thoughts and feelings (e. if the caller on the hotline is now a target of domestic violence. 2002). • estimating the strength of the client's psychological intent to inflict deadly harm (e. Assessing lethality. a concept for leverage" "last straw") but also prioritizing terms of which referred to work to as "looking worker must establish.

the crisis worker relies on the familiar "active Very the listening" cautiously. giving eventually responses reframing. Now. work can skills the like paraphrasing. For example. an action plan can involve several elements: • removing the means-involving parents and tend to doggedly cling to familiar ways of coping even when they are backfiring." beliefs Challenging responses. therapy techniques. interpretations. if Stage IV has been achieved. the client's safety. Stage V: Generate and Explore Alternatives This stage can often be the most difficult to accomplish in crisis intervention. and playing if when values or customs of the traditional culture are ignored or violated in the United States. Clients in to crisis. the counselor at Stage IV allows the woman to express The counselorv acetaminophen her feelings of hurt moment. 2002). To do this. Ottens and Pinson (2005) in their with care can some emotional a no-suicide for ensuring alternatives balance. Stage IV: Deal With Feelings and Emotions There are two aspects to Stage IV. However. help to loosen clients' other found behavioral options.The Seven-Stage Crisis Intervention example. The crisis worker strives to allow the client to express feelings. Berman. (Egan. client can brainstorm the more outlandish. it frequently clients will experience crises that that relatively recent immigrants or bicultural a result of a cultural clash or "mismatch. Solution-focused is a unique experience. suicidal youth. For example. treatment Martin (2005). like contract or brief hospitalization. The United States has no such custom. by definition. to vent and heal. into an empowering intervention. that works in similar happens occur as as tant to keep in mind that these alternatives selected are The clinician certainly can inquire about what the client has found situations. and to explain her or his story about the current crisis situation. It may help to consider how the client has coped with or negotiated other cultural mismatches. and to consider who applied. or discuss housing. "devil's appropriately maladaptive example challenging include client can begin to put options on the table. who described crisis intervention with high-risk. or It is imporcolla borafor finding temporary consider the pros and cons of various programs for treating chemical dependency. worker responses must into reflecting feelings. are better when they are generated tively and when the alternatives "owned" by the client. at a judicious wonder out loud whether taking an overdose of will be the most effective way of getting her point across. study the big picture lack the equanimity can be applied to the current such as "Amplifying Solution Talk" (Dejong & Berg. the client in crisis has probably worked through enough feelings to re-establish or Significant others in the removal of Brief Treatment and Crisis Intervention / 5:4 November 2005 335 . and will jealousy and to tell her story of trust betrayed. For example. in Mexicp the custom is to accompany or be an escort when one's daughter starts dating. advocate. If this crisis precipitant then clinician and alternatives-sometimes the better-that event. Stage VI: Implement an Action Plan Here is where ordinated strategies become integrated plan or coand Jobes. in our earlier of the young woman boyfriend and roommate locked in a cheating embrace. and probing crisis dialogue. clinician Model and work with caregivers in crisis have identified a repetitive coping style-argue recipient-acquiesce to care recipient's demandsblame self when giving in fails-that eventually escalate into a crisis." crisis-counseling Challenging information. For these suicidal youth. 1998) can be integrated into Stage IV. noted the shift that occurs at Stage VI from crisis to resolution.

ROBERTS AND OTTENS all lethal means and safeguarding environment. sleeping. Thus.. • negotiating safety-time-limited agreements during which the client will agree to maintain his or her safety. family. p.g. • satisfaction and progress with ongoing treatment (e. (e. potential booster problems session. financial counseling). recovering from a divorce or death of a child or drug overdose requires making some meaning out of the crisis event: why did it happen? What does it mean? What are alternative constructions that could have been placed on the event? Who was involved? How did actual events conflict with one's expectations? What responses (cognitive or behavioral) to the crisis actually made things worse? Working through the meaning of the event is important for gaining Follow-up can also include the scheduling "booster" ment crisis intervention gains and discussed at the that has been terminated.g.g. Stage VII: Follow-Up Crisis workers should plan for a follow-up contact with the client after the initial in- ter response-CrISIS intervention-usually begins 1-4 weeks after the disaster Phase I is generally known as "Impact" and Phase II is known as the "Heroic or Rescue" 336 Brief Treatment and Crisis Intervention / 5:4 November 2005 . the tervention to ensure that the crisis is on its way to being resolved and to evaluate the postcrisis status of the client. events to look forward to. for those crisis counselors working with victims of violent crimes. neighbors need to be mobilized to keep ongoing contact with the youth in crisis. and that is the cognitive dimension. 411). it is session be date of the counselors working with grieving recommended scheduled a follow-up around the anniversary deceased's death (Worden.. as Roberts (2005) indicated. However. • decreasing anxiety and sleep loss-if acutely anxious. • an assessment of overall functioning including. spiritual employment. seeking temporary residence in a women's shelter) are critical for restoring the client's equilibrium and psychological balance.. it is recommended up session be scheduled l-year anniversary that a followand at the I-month of the victimization. nutrition. • future linkage-scheduling phone calls. medication may be indicated but carefully monitored. legal. • hospitalization-a necessary intervention if risk remains unabated and the patient is unable to contract for his or her own safety (see Jobes et al. 2005. Similarly. mastery over the situation and for being able to cope with similar situations in the future.g. subsequent clinical contacts. Obviously. joining a support group. • any current stressors and how those are being handled: • need for possible referrals 'housing. entering a 12-step treatment program. medical). there is another dimension that is essential to Stage VI. Differentiating Crisis Intervention Disaster Management For those in need. hygiene). social. of a session in about a month after the Treatcan be For those clients.. 2002). • decreasing isolation-friends. • cognitive mastery of the precipitating event (does the client have a better understanding of what happened and why it happened?). and academic. This postcrisis evaluation of the client can include at this stage (e.. the concrete action plans taken • physical condition of the client (e. the third From phase of disasunfolds.

Phases I and II involve and emergency the disaster R-SSCIM is the same for survivors of commu- management squads. Then. of time-limited & Pfeiffer. As a growing number of clinicians move Brief Treatment and Crisis Intervention / 5:4 November 2005 337 . anxiety. One person with inner strengths resiliency may bounce back quickly earthquake. and host homes. often look the same. is to apply best practices based on evidence-based systematic reviews such as theR~SSCIM providing quickly growing in order to assist clinicians by framework episodes for in A acute crisis a stable sequential addressing number must be voluntary. Roberts & Grau. and rest. the Salvation Army. of studies have provided evidence of the effectiveness crisis intervention Davis & Taylor. Neimeyer life experiences. tion. The research literature on quasiexperimental studies of the effectiveness of and crisis intervention ments supports compared to other treatHowever. A crisis is personal and is dependent the individual's crisis-inducing temperament. & Rajab. a challenge to life goals. their families medical care for survivors survivors rescued and transported and their families. transportation. American Red Cross volunteers. can begin-if Crisis intervention Evaluation Research and Outcome Measures The current approach in healthcare and mental health settings. to dry land and safe shelter. Normal and specific reactions local and state police. indecisiveness. suffering whereas a young social worker from major crisis intervention completed. 1-4 weeks after surviving tervention the loss of their home. continued medical care. But we suggest that extra care be taken in applying R-SSCIM so that the mental health professional understands and distinguishes an acute stress reaction from the intense impact of the disaster from which most people rapidly recover. 2000. anger. and housing and are units. frequently inexhaustion. A young emergency room physician might adapt well upon reaching Atlanta or Houston. of or a positive turning point in the and 1994. their personality of the potentially and varying a continuously changing care environment. Joiner. 2005). frustration. Otherwise. sadness. and provided on an as-needed basis. degrees of coping skills (Roberts. temporary clean After water. the goal is to provide them with wellbalanced meals. firefighters and rescue emergency medical technicians. and/or community. the clothing. relief efforts of the nity disaster. deon and inbors. sleep. Rudd. after an whereas the use of time-limited intensive crisis intervention. 6. (Corcoran & Roberts. This takes skill on the surface because both reactions clude shock. A crisis event can provide an opportunity. livered quickly. on locating disaster shelters. and the Federal Emergency Management Agency. 1995). we will probably continue to see positive outcomes wash out compleafter 12 months postcrisis intervention depression may completely go to pieces upon arrival at her cousin's house in Dallas. It is also critically important to help survivors to reconnect and reunite with family members and close friends. TX. 1995). The disaster and emergency management agencies focus on public safety. of evicrisis until longitu- quality of one's life (Roberts & Dziegielewski.The Seven-Stage Crisis Intervention Model phase. applications need to be refined so that booster sessions after I. and on providing food. perception event. despite effects. numbness. tornado or hurricane. 1970. neighPhase III-crisis it is requested. 1997. and fear. and 12 months are implemented. we cannot impact First. promising crisis treatment yet determine dence-based dinal studies intervention the long-term are another person of the same age with a preexisting mental disorder may completely fall apart and go into an acute crisis state. a rapid deterioration functioning. disbelief. impulsiveness.

crisis intervention clinic. schizoaffective disorder. treatment and 338 Brief Treatment and Crisis Intervention / 5:4 November 2005 . References Caplan. Initiation of crisis intervention for persons with mental health problems: the percentage of persons identified during the year with a new crisis episode related to major depression. Crisis crisis intervention intervention handbook: Assessment.L. mental health. psychologists-who are called upon to make rapid assessments arid clinical decisions when faced with a client who is in the midst of a crisis-inducing properly. crisis intervention can facilitate an earlier resolution of acute stress disorders or crisis episodes.. & Collins. Corcoran. and inpatient crisis services. Follow-up after hospitalization: percentage of persons discharged from 24-hr inpatient psychiatric treatment. or bipolar disorder who have had either a single encounter or two outpatient encounters within 30 days outcome measures and measures after the initiation of crisis intervention (Teague et al.). (1961). to every crisisstrengths 2. schizophrenia. An approach to community 3. lead to quality mental health and services. Research on and recommendations for research. (2000). effective crisis intervention Trabin. Principles of preventive psychiatry. future . Treatment duration: mean length of crisis service during the reporting period for persons receiving services in each of three levels of care: 24-hr crisis intervention at outpatient psychiatry hotline. Common should are clearly work. it is imperative reviews and the need that they become familiar with best practices 4. but the components of the model take into consideration counseling what the persons inner in crisis bring with themselves encounter-their and resiliency. Crisis and trauma: Developmental-ecological intervention. (1964). panic disorder. New York: Grune and Stratton. Not only does this model give the crisis worker an overarching plan for how to proceed. for the wide paraproclergy. G. Caplan.We have applied four of these performance indicators to a crisis intervention program: range of crisis workers-counselors. In A. G. or and Outcome Measures in Health and Human Services identified and discussed key concepts and common performance indicators and measures. or traumatic event. and quality behavioral performance eventually improvement. p. T. and Ray (2004) in their chapter in the book Evidence-Based Practice Manual: Research Conclusion The R-SSCIM has applicability fessionals. R. Engagement in treatment for mental health problems: the percentage of persons identified during the year with a new episode of major depression. schizophrenia. Roberts [Ed. or outpatient intervention care who day receive follow-up ambulatory. In order to measure effectiveness resolution. crisis within 30 days of discharge. If done 1. & Roberts. Teague.. R.]. (2005). clinical social workers. B. M. schizoaffective inpatient treatment disorder.ROBERTS AND OTTENS into crisis intervention based on evidence-based for built-in evaluations. 2004. A. 59. G. New York: Basic Books. Collins. social phobia. or bipolar disorder who have had either an inpatient encounter for treatment of that disorder or a subsequent crisis intervention treatment encounter within 14 days after a first session. and quantifiable indicators and crisis as well as facilitate accountability it is critical that explicated in terms. Boston: Lahaska Press.

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