CRISIS COUNSELING

THE SCHOOL COUNSELOR’S ROLE

 CRISIS

• A SITUATION THAT OCCURS SUDDENLY, UNEXPECTEDLY, WITHOUT

WARNING, AND SURPASSES A PERSON’S ABILITY TO COPE (JAMES
& GILLILAND, 2005).
 CRISIS INTERVENTION

• AN EMERGENCY FIRST AID FOR MENTAL HEALTH & DOMESTIC VIOLENCE. IT

REQUIRES THAT THE PERSON EXPERIENCING THE CRISIS RECEIVE TIMELY AND
SKILLFUL SUPPORT TO HELP COPE WITH HIS/HER SITUATION BEFORE PHYSICAL
OR EMOTIONAL DETERIORATION OCCURS.
 HISTORY OF CRISIS COUNSELING

• ERICH LINDEMANN
• A GERMAN PSYCHIATRIST AUTHORED THE FIRST PAPERS IN THE FIELD OF CRISIS
INTERVENTION, RELATING TO BEREAVEMENT IN THE AFTERMATH OF
THE COCOANUT GROVE NIGHTCLUB FIRE WHICH KILLED NEARLY 500 PEOPLE.
• HIS PAPER, SYMPTOMATOLOGY AND MANAGEMENT OF ACUTE GRIEF NOTED THAT CRISES
TENDED TO SHARE A SIMILAR FEATURES AND PROGRESSION AND MOST DID NOT REQUIRE
FORMAL INTERVENTION. (1944)
 HISTORY OF CRISIS COUNSELING

• GERALD CAPLAN
• HE EXTENDED THE FIELD OF CRISIS INTERVENTION TO LOOK AT ALL KINDS OF TRAUMATIC
EVENTS.
• HE IDENTIFY AFFECTIVE, BEHAVIORAL AND COGNITIVE IMPACTS.

TWO HISTORICAL EVENTS IN THE 1970S HALLMARK THE BIRTH AND EVOLUTION OF CRISIS
INTERVENTION AS A CLINICAL SPECIALTY.
(1) THE VIETNAM WAR AND THE PERPLEXING PSYCHOLOGICAL TRAUMA THAT VETERANS
CARRIED OUT OF IT.
(2) THE WOMEN’S MOVEMENT THAT EXPOSED DOMESTIC VIOLENCE IN ITS MANY FORMS.
 COMMON SITUATIONS

• STRESS AND PERSONAL ISSUES

• DEATH OF A SPOUSE OR FAMILY MEMBER
• MARITAL SEPARATION OR DIVORCE
• THE LOSS OF A JOB
• EXTREME WEATHER OR NATURAL DISASTERS
TYPES OF CRISES
 DEVELOPMENTAL CRISIS

• IT IS THE RESULT OF A NORMAL LIFE EVENT (LIKE A PREGNANCY OR GRADUATION) THAT

CAUSES STRESS AND STRAIN ON AN INDIVIDUAL. (JAMES, 2008, P. 13)
• ONE USEFUL WAY OF CONCEPTUALIZING A DEVELOPMENTAL CRISIS IS TO CONSIDER THE
CONCEPT OF GRIEF AND LOSS. BECAUSE ALL CHANGES IN A PERSON’S LIFE RESULT IN LOSS
AND LOSS REQUIRES GRIEF WORK TO PROCESS, AN INDIVIDUAL WILL NEED TO TAKE THE TIME
TO PROCESS THEIR LIFE CHANGES.
 SITUATIONAL CRISIS

• A SITUATIONAL CRISIS IS THE MOST COMMON KIND OF EVENT WHEN WE CONSIDER CRISIS
INTERVENTION. THIS IS AN EVENT THAT IS SO OVERWHELMING AND SUDDEN (SCHOTTKE,
2001, P.236) THAT IT OVERWHELMS NORMAL COPING. EXAMPLES OF SITUATIONAL CRISES
INCLUDE SEXUAL ASSAULT, A MOTOR VEHICLE ACCIDENT OR SUDDEN LOSS OR GRIEF.

• THIS IS THE MOST COMMON FORM OF CRISIS THAT EMERGENCY RESPONDERS AND OTHER
CRISIS INTERVENTION WORKERS (HOTLINE WORKERS, SOCIAL WORKERS) ARE LIKELY TO
ENCOUNTER.
 EXISTENTIAL CRISIS

• EXISTENTIAL CRISES ARE BASED ON LARGER CONCEPTS OF A PERSON’S PURPOSE AND ATTAINMENT
OF ACTUALIZATION, A DEEP SENSE OF PERSONAL FULFILLMENT (OLSON, 2013)
• OFTEN EXISTENTIAL CRISES ARE RELATED TO SITUATIONS OF REGRET OR BELIEF THAT LIFE HAS
PASSED THEM BY (PRICE, 2011) OR REALIZATION THAT ONE WILL NOT REACH GOALS THEY HAD SET
FOR THEMSELVES AT A CERTAIN AGE (JAMES, 2008, P. 13)

• EXISTENTIAL CRISES ARE PARTICULARLY COMMON AT LIFE TRANSITION POINTS LIKE 30, 40, AND 50
WHEN PEOPLE “TAKE STOCK” OF THEIR LIFE. A SIGNIFICANT EXISTENTIAL CRISIS CAN PREDISPOSE
SUICIDE AND MAY BE LINKED TO THE MARKEDLY HIGH SUICIDE RATE AMONG MEN AND WOMEN
BETWEEN 45 AND 54. (MACDONALD, 2015)
 SYSTEMIC CRISIS

• IT RIPPLE OUT INTO LARGE SEGMENTS OF THE POPULATION AND THE ENVIRONMENT ITSELF.
• NATURAL DISASTERS SUCH AS HURRICANE, TSUNAMI, TORNADO, ETC.
• THEY RESULT IN DEATH AND INJURY, AS WELL AS THE LOSS OF BASIC HUMAN NECESSITIES
SUCH AS FOOD AND SHELTER. INFRASTRUCTURE SERVICES ARE DESTROYED, AND THE MEANS
OF EMPLOYMENT ARE LOST BECAUSE THE BUSINESSES WHERE PEOPLE WORKED ARE NO
LONGER IN EXISTENCE.
 CRISIS STAGES AND RESOLUTION

New State of Normalcy

Attempts at

Crisis Incident
Equilibrium Problem Solving

Crisis Resolution
 COMMON STUDENT STRESS REPONSES

PHYSICAL
• AGITATION
• HYPER-ALERTNESS
• ERRATIC HEARTBEAT
• BREATHING PROBLEMS
• GASTROINTESTINAL DISTRESS
• SLEEP PROBLEMS – EXCESSIVE SLEEPINESS OR INABILITY TO SLEEP
• TENSION ACHES & PAINS
• HEADACHES
 COMMON STUDENT STRESS REPONSES

COGNITIVE
• NEGATIVE OUTLOOK
• ANXIETY IN PROBLEM SOLVING
• DISORGANIZED WITH INABILITY TO CONCENTRATE
• SLUGGISH OR HYPERACTIVE THOUGHT PROCESS
• INABILITY TO SEE A DIFFERENT PERSPECTIVE
• EGOCENTRISM
 COMMON STUDENT STRESS REPONSES

EMOTIONAL
• GENERALIZED DISTRESS
• ANGER OR HOSTILITY
• DEPRESSION
• ANXIETY, FEAR , OR PANIC
• POWERLESSNESS
• UNDIRECTED OR DIRECTED GUILT
• SHAME OR SELF-DISGUST
 COMMON STUDENT STRESS REPONSES

SOCIAL/BEHAVIORAL
• SUBSTANCE ABUSE
• EATING DISORDER
• CONSTRICTION OF ACTIVITIES (DOING NOTHING)
• INABILITY TO PERFORM ROUTINE FUNCTIONS
• RESTRICTED SOCIAL CONTACTS
• DETERIORATION OF SPIRITUAL FAITH
• RIGID ADHERENCE TO OR REJECTION OF PERCEIVED CULTURAL VALUES
CRISIS INTERVENTION MODEL
 TRADITIONAL COUNSELING VS CRISIS COUNSELING

TRADITIONAL
• TO INCREASE PERSONAL AND
INTERPERSONAL FUNCTIONING.
CRISIS
• TO DECREASE ANXIETY AND INCREASE
COPING WITH THE INTENTION OF
RETURNING A PERSON TO A STATE OF
NORMALCY.
 LAPC MODEL OF CRISIS INTERVENTION
(CAVAIOLA & COLFORD, 2011)

LISTEN
ASSESS
PLAN
COMMIT
 LISTEN
• LISTEN, UNDERSTAND, AND VALIDATE (LUV) BY ECHTERLING, ET. AL. (2005).
• LISTEN FOR THE STUDENTS NEEDS WHILE REMEMBERING THAT WHAT HE OR SHE IDENTIFIES AS
A NEED MAY NOT BE NECESSARILY BE WHAT YOU BELIEVE TO BE ESSENTIAL TO THE STUDENTS'
RECOVERY.
• KNOWLEDGE OF THE BELIEFS, VALUES, AND EXPERIENCES OF CULTURALLY DIVERSE
INDIVIDUALS FACILITATES CRISIS RESOLUTION.
 ASSESS
• LET THEM TELL THEIR STORY, EVEN IF THEY DO REPEATEDLY, WITHOUT INTERRUPTION , WITH
THE LIKELIHOOD THAT THE STUDENT MAY NEED ASSISTANCE IN FINDING THE RIGHT WORDS
TO ACCURATELY REFLECT HIS OR HER FEELINGS.

• THROUGH REFLECTION OF FEELINGS AND VALIDATION, THE INDIVIDUAL MAY BEGIN TO

RECOGNIZE THAT HIS OR HER FEELINGS DO NOT MEAN THAT HE OR SHE IS “CRAZY” BUT
RATHER SHE IS HAVING A NORMAL REACTION TO AN ABNORMAL SITUATION.
 PERCEPTION OF THE EVENT

• COGNITION IS THE MEANING A PERSON PUTS ON A STRESSFUL EVENT AND HOW THE THREAT
IS PERCEIVED AS A DISRUPTION TO GOALS, VALUES, OR COPING STYLES (AQUILERA, 1998).

• SIGNIFICANT EVENT MAYBE DENIED AND AVOIDED, WHICH HINDER A REALISTIC VIEW OF THE
EVENT.

• DETERMINING WHAT THE EVENT MEANS TO THE PERSON AND HOW GOALS ARE INFLUENCED
AID IN ASSESSING THE PERSON’S PERCEPTION OF THE INCIDENT.
 SITUATIONAL SUPPORT

• THEY ARE THE INDIVIDUALS WHO CAN BE COUNTED ON TO NURTURE AND PROVIDE SUPPORT
WHEN SELF-ESTEEM IS THREATENED AS A RESULT OF DISTRESSING EVENT (AQUILERA, 1998).

• QUESTIONS:
• WHO ARE THE PEOPLE IN YOUR LIFE TO WHOM YOU CAN GO WHEN YOU NEED HELP?
 COPING MECHANISM

• COPING SKILLS RANGE FROM EITHER CONSCIOUSLY OR UNCONSCIOUSLY EXPRESSED

COGNITIVE, AFFECTIVE, SPIRITUAL, OR BEHAVIORAL RESPONSES.

• WHEN A PERSON BELIEVES HE/SHE HAS THE SKILLS TO OVERCOME A SITUATION, HIS OR HER
WORLD APPEARS MORE MEANINGFUL AND UNDERSTANDABLE, AND THE COPING SKILLS ARE
UTILIZED LEAD TO A SENSE OF CONFIDENCE, STRENGTH, AND SELF-EFFICACY (ABERNATHY,
2008).
 COPING MECHANISM

• CRISIS EVENTS USUALLY OCCUR 12-14 DAYS PRIOR TO THE PERSON SEEKING COUNSELING
(AQUILERA, 1998).
• ASK THE PERSON THE REASON HE OR SHE DECIDED TO SEEK HELP FROM YOU AT THE
PARTICULAR TIME.
• PEOPLE IN CRISIS OFTEN HAVE AN IMPAIRED TIME ORIENTATION WITH DIFFICULTY THINKING
ABOUT AND TELLING THEIR STORY IN A LOGICAL MANNER.
• LISTEN FOR HOW THE INDIVIDUAL TALKS ABOUT THE TRAUMATIC EVENT.
 PLAN
• HELP THE STUDENT CREATE LONG TERM AND SHORT TERM GOALS WHILE SUPPORTING THE
STUDENT IN FINDING WORDS TO DESCRIBE HIS OR HER TERROR, PAIN, OR SADNESS.
• HELP THE STUDENT GAIN A SENSE OF CONTROL AND EMPOWERMENT WHILE EXPLAINING
THAT WHAT USED TO BE CONSIDERED “NORMAL” NO LONGER EXIST, BUT NEW “NORMAL”
WILL EMERGE.
• GIVE HOMEWORK'S OR ASSIGNMENTS SUCH AS JOURNALING OR EXERCISING IN ADDITION
TO ART, MUSIC, DANCE OR OTHER CREATIVE TECHNIQUES AID STUDENTS RETURN TO
NORMALCY.
 COMMIT
• TO EMPOWER THE STUDENT WHILE COLLABORATING AND COMMITTING TO A PLAN OF
ACTION.

• SEVERAL MEETINGS MAYBE NEEDED TO MODIFY THE PLAN, AND A FOLLOW-UP MEETING AT
SOME POINT IN THE FUTURE PROVIDES AN OPPORTUNITY TO ASSESS STUDENT PROGRESS.
TRAUMA AND STRESSOR-RELATED
DISORDER
POST-TRAUMATIC DISORDER & ACUTE
STRESS DISORDER
POST-TRAUMATIC DISORDER
It is marked by frequent re-experiencing of
a traumatic event through images, memories,
nightmares, flashbacks, illusions, or other
ways.

People with PTSD may also feel detached

from others, have fewer emotional responses
than before the event, and expect further
harm or negative consequences.
POST-TRAUMATIC DISORDER
A diagnosis of PTSD requires the presence of 3 types of symptoms:
1. Repeated experiencing of the Traumatic event.
2. Persistent avoidance of stimuli associated with Trauma and
emotional numbing.
3. Hypervigilance and chronic arousal.
POST-TRAUMATIC DISORDER
A person may believe others will not want to socialize with her because
of the trauma. The person may also experience substantial physical
arousal and have problems sleeping, concentrating, or completing
everyday tasks.

Symptoms of posttraumatic stress disorder must last at least 1 month

for a diagnosis to be made.

If symptoms last 1 to 3 months, then posttraumatic stress disorder is

described as acute; more than 3 months is chronic; and if delayed more
than 6 months is described as delayed onset.
ACUTE STRESS DISORDER
It refers to anxiety and dissociative
symptoms (feelings of detachment from
reality or disconnectedness from others)
following a trauma that last between 2
days and 4 weeks.
ACUTE STRESS DISORDER
Traumatic events that are experienced directly include, but are not
limited to:
exposure to war as a combatant or civilian, threatened or actual violent
personal assault (e.g., sexual violence, physical attack, active combat,
mugging, childhood physical and/or sexual violence, being kidnapped,
being taken hostage, terrorist attack, torture), natural or human made
disasters (e.g., earthquake, hurricane, airplane crash), and severe
accident (e.g., severe motor vehicle, industrial accident).
ADJUSTMENT DISORDER
ADJUSTMENT DISORDER
Consists of emotional and behavioral symptoms (depressive, anxiety,
and or antisocial behaviors) that arise within 3 months of the experience
of a stressor.

The stressor that lead to adjustment disorder can be of any severity,

while those that lead PTSD and acute stress disorder are by definition
extreme.
ADJUSTMENT DISORDER
Common Stressors:
• termination of a romantic relationship
• marked business difficulties and marital problems
• associated with seasonal business crises, unfulfilling sexual
relationships
• a persistent painful illness with increasing disability, living
in a crime-ridden neighborhood
• losing a loved one
THEORIES ON ETIOLOGY OF TRAUMA AND
STRESSOR-RELATED DISORDER
ENVIRONMENTAL AND SOCIAL FACTORS
People’s reaction to trauma includes its severity and duration and the
individual’s proximity.
Ex. Surviving veterans after the war
Rape survivors
Victims of natural disasters

Social Support
People who have emotional support of others after trauma recover
more quickly.
PSYCHOLOGICAL FACTORS
People already experiencing increased symptoms of anxiety or
depression before trauma occurs are more likely to develop PTSD.
Ex. Children who were anxious prior to natural disaster
War veterans who have psychological distress or poor
interpersonal relationships.
People who have self-destructive or avoidant coping
strategies such as drinking and self-isolation.
BIOLOGICAL FACTORS
The amygdala appears to respond more actively to emotional stimuli.
While the medial prefrontal cortex, which modulates the reactivity of
amygdala is less active in people with trauma.

Shrinkage in the hippocampus, due to overexposure to

neurotransmitters and hormones released in the stress response.
BIOLOGICAL FACTORS
Lower cortisol level, down regulates sympathetic nervous system
following stress. As a result people may more easily develop a
conditioned fear of stimuli associated with the trauma and
subsequently develop PTSD.

Genetics
Vulnerability to trauma is inherited.
TREATMENT TO TRAUMA AND STRESSOR-
RELATED DISORDER
COGNITIVE BEHAVIORAL TREATMENT
Systematic Desensitization

Stress-management Interventions
Teach client skills for overcoming problems in their lives that
increase their stress and may result to PTSD such as marital problems
or social isolation.
BIOLOGICAL TREATMENT
Selective Serotonin Reuptake Inhibitors (SSRI)

Benzodiazepines

These helps to treat symptoms of trauma particularly sleep

problems, nightmares, and irritability.
CRITICAL INCIDENT MANAGEMENT
• “THE PROFESSIONAL SCHOOL COUNSELOR SERVES AS A LEADER IN
SAFE SCHOOL INITIATIVES AND A VITAL RESOURCE IN THE
CREATION, DEVELOPMENT, AND IMPLEMENTATION OF RESPONSE
PLANS BEFORE, DURING, AND AFTER A CRISIS. A CRISIS OR A ACT
OF VIOLENCE THRUSTS PROFESSIONAL COUNSELORS INTO
POSITIONS OF RESPONSIBILITY TO ENSURE THE SAFETY AND WELL
BEING OF ALL STUDENTS AND STAFF (ASCA, 2013, PARAG, 1)
 TRAINING
• TRAINING ON:
• ISSUES OF GRIEF
• DEVELOPMENTAL ISSUES
• SUICIDE PREVENTION
• TRAUMA
• ORGANIZATIONAL MATTERS
 POSTVENTION
• DEFUSING/DEBRIEFING
ARE GROUP INTERVENTIONS DESIGNED FOR THE PREVENTION OF POST-TRAUMATIC
STRESS DISORDER (PTSD). DEBRIEFINGS USUALLY OCCURS WITHIN 2 TO 7 DAYS AFTER THE
CRISIS, WHEREAS DEFUSING, OCCURS THE SAME DAY OR WITHIN 24 HOURS OF THE INCIDENT.

GOALS OF DEFUSING IS TO PROVIDE COPING STRATEGIES TO EXPEDITE A RETURN TO A STATE

OF EQUILIBRIUM AND TO POSSIBLY ELIMINATE THE NEED FOR A DEBRIEFING.
 THE MITCHELL MODEL OF DEFUSING/DEBRIEFING

COGNITIVE

INTRODUCTION RE_ENTRY

FACT TEACHING

THOUGHT SYMPTOMS
REACTION

EMOTIONAL
 INTRODUCTION

• THIS STEP INCLUDES INFORMING GROUP MEMBERS ABOUT THE

GROUP MEMBERS, THE MODEL PROCESS, GOALS, FORMAT, RULES, A
DISCUSSION OF CONFIDENTIALITY AND EXPECTED OUTCOMES.
 FACT PHASE

• IN THIS PHASE THE FACTS, ROLES OF MEMBERS, THE THOUGHTS AT THE SAME
TIME OF THE EVENT, AND EACH INDIVIDUAL’S INTERPRETATION OF THE EVENT
ARE SHARED. THE DETAILS ARE RELAYED AND RUMORS ARE DISMISSED.
• LEADS:
• WHERE WERE YOU AT THAT TIME?
• WHAT CAN YOU STILL REMEMBER ABOUT THE EVENT?
• WHAT DID YOU SEE, SMELL, HEAR, ETC.?
 THOUGHT/FEELING PHASE

• DURING THIS PHASE EACH MEMBER REVEALS HIS OR HER WORST

VIVID THOUGHTS AT THE TIME OF THE INCIDENT. FROM HERE, THERE
IS A TRANSITION TO AN EMOTIONAL LEVEL.
• LEADS:
• WHAT WERE YOU THINKING AT THAT TIME?
• WHAT DID YOU FEEL AT THAT TIME?
 REACTION PHASE

• AT THIS TIME, MEMBERS IDENTIFY THEIR EMOTIONS AND AFFECTIVE

RESPONSES IN ADDITION TO THEIR PERCEPTIONS OF THE WORST
PART OF THE EXPERIENCE.
 SYMPTOM PHASE

• AT THIS PHASE, THERE IS A SHIFT BACK TO A COGNITIVE LEVEL.

MEMBERS IDENTIFY SYMPTOMS AND REACTIONS THEY ARE
EXPERIENCING SUCH AS STOMACHACHES, FLASHBACKS, OR
NIGHTMARES.
LEADS:
WHAT DID YOU NOTICE IN YOUR BODY AFTER THE INCIDENT?
DID YOU NOTICE ANY CHANGES IN YOUR ROUTINE OR BEHAVIOR?
HOW ARE YOU DIFFERENT PRIOR TO THE INCIDENT?
ANY CHANGES IN YOU FUNCTIONING?
 TEACHING PHASE

• IN THIS PHASE, MEMBERS ARE TAUGHT ABOUT THOUGHTS, FEELINGS, AND

PHYSIOLOGICAL REACTIONS THAT ARE NORMAL DURING A CRISIS EVENT. IN
ADDITION, COPING SKILLS ARE DISCUSSED TO TEACH MEMBERS APPROPRIATE
SKILLS TO UTILIZE TO FACILITATE A RETURN TO NORMALCY.
• LEADS:
• HOW DID YOU OVERCOME THE CRISIS YOUR EXPERIENCED?
• WHAT DID YOU DO?
 RE-ENTRY PHASE

• THIS FINAL PHASE OF THE MODEL IS INTENDED TO GIVE MEMBERS

NECESSARY SKILLS TO ACTIVATE WHEN STRESSED AS WELL AS
RESOURCES FOR ASSISTANCE.
 EVALUATION

• FINAL COMPONENT OF A CRITICAL INCIDENT PLAN, AND IS ALSO ONE THAT IS

OFTEN OVERLOOKED.
• THIS PHASE PROVIDES THE PLANNING TEAM WITH AN OPPORTUNITY TO
REVISIT THE PLAN.