Verbal Crisis De-Escalation with Dr. Dawn-Elise Snipes

Unlimited CEUs available for $59 http://allceus.com

Verbal Crisis De-Escalation training CEUs for Licensed Professional Counselors (LPC) and Licensed Mental Health Counselors (LMHC) by AllCEUs and Dr. Dawn-Elise Snipes

Definition of Crisis
People are facing an untenable obstacle to life goals
People's life cycles are significantly disrupted

AND

The person has no response to deal with a situation

6 Basic Fears
The unknown
Loss of control or power
Rejection
Isolation
Failure
Death
Characteristics of Crisis
Presence of opportunity and danger
Change causes crisis and crisis causes change
Increasing anxiety can lead to violent reactions
Complicated
Generally does not have one simple cause
Precipitating events may impact many different areas of life

No Panaceas or Quick Fixes
May provide temporary, immediate relief
Ensure they do not make problem worse
Necessity of Choice
Making a choice requires action
Choosing not to act is a still a choice
Types of Crisis
Developmental
Normal or abnormal events causing dramatic change in physical, cognitive or social development
Situational Crisis
Existential Crisis
Anxieties arising from questions of purpose, responsibility, independence, commitment
Ecosystemic Crisis
Disaster
Models of Crisis Intervention
Equilibrium/Stabilization
Cognitive
Gain control by changing thinking
REBT
Reality Therapy
Psychosocial
Assess internal and external exacerbating and mitigating factors
Choose workable alternatives

Important Points
Danger and Opportunity
Time limited, but may be recurring
Complex
Life experiences of workers enhances their effectiveness
Crisis causes people to make choices

Cultural Competence
There is no one "normal" range of behaviors
Individuals are not necessarily the basic building block of society
Problem definitions can be interdisciplinary, even if worker is not.
Language is not always interpreted in the same way
The value of independence and dependency varies between people and cultures
Not everything can be explained in a linear fashion
We must accommodate the client's needs
Past history certainly impacts current events
Be aware of personal assumptions
Verbal Crisis Deescalation
Define the problem
Listen to identify the person's orientation
Feelings or solutions
Visual, auditory, kinesthetic
Empathize to see the problem as the client does
Ask open-ended questions
Pay attention to verbal and nonverbal messages

VCD cont...
Assess (ABCs)
Affective state
Behavioral Functioning
Cognitive Functioning
Severity of the crisis
SI/HI Intent
Plan (Method, Date/Time)
Means
Future Plans
Putting affairs in order

VCD cont...
Ensure client and personal safety
Physical
Remove the client from the situation (if possible)
Inform client you want to help, but it is hard for you to focus while... Propose solution that does not take away his power.
Maintain an environment free of hazards (scissors, letter openers, heavy objects)
Always maintain a clear path to the door
Do not meet with clients in isolation
Psychological
Remove bystanders (an audience also adds fuel)
Reframe the situation with client not being "bad."
VCD Cont...
Provide Support
Thinking Words
You are...
Stuck
At your wits end
Out of options
Out of control
Feeling words
You feel...
Overwhelmed
Helpless
Hopeless

VCD Support cont...
Seeing
I see that...
You look like...
Hearing
I hear that...
You sound...
Doing
You want...
You regret....
VCD cont...
Acting
Acknowledge the situation and/or the client's feelings
Seek help from the client in understanding what is going on
Tell me what is going on
Ask open ended questions
Own your feelings
Be aware of transference and counter-transference reactions
VCD cont...
Convey understanding
Don't say "I understand"
Provide positive reinforcement for behaviors
Avoid value judgments
Set limits and do not tolerate controlling or aggressive behavior
VCD cont...
Reduce tunnel vision or increase focus
Examine Alternatives
Supports
Coping Mechanisms
Thinking Patterns
Promote Mobilization
Make plans
Implement Order
Obtain commitment with assertion statements
I need you to...
Further Reading
Please read the following book
Client Safety and Crisis Intervention

Summary
Change causes crisis
Crisis is a state of extreme anxiety
It is important to "hear" the client
Help the client
Re-establish equilibrium
Identify environmental and social supports
Develop a plan
Take action
Summary cont...
When in crisis, clients may act out against themselves or others
Ensure your office and common areas are free from potential weapons
Develop a safety plan for
Your exit
Removing bystanders/other staff
Aiding clients
Never make promises you cannot keep

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