Crisis Counselling

CRISIS COUNSELLING - HOME STUDY COURSE

Learn more about the strategies and methods of supporting people after a crisis.

ACS Student Comment: I have done several counselling courses in the past and the coaching course fitted in well with the learning experiences I had encountered previously. The reading material was detailed and interesting and the feedback was detailed and constructive. Sarah, Life Coaching

Crisis problems are problems that require assistance within 24 hours. They are emergency problems that have been evaluated by a suitably qualified professional, who has decided that their evaluation cannot wait for 24 hours. This includes – potentially dangerous, threatening, violent, self-harming, destructive or suicidal behaviour, but the professional feels that the person can wait for an appointment within a 24 hour time frame. Domestic abuse or abuse where there is no immediate risk of violence may also be defined as being able to wait 24 hours.

Develop your ability to effectively counsel and assist clients in times of crisis. This course provides those already in the counselling or helping industries with knowledge and skills to give specialised counselling, and will contribute to comprehensive counselling training for those wishing to work in this field.

Lesson Structure

There are 9 lessons in this course:

1. Understanding methods of crisis intervention
   • What constitutes a crisis and methods of crisis intervention?
2. Ethical, professional and legal issues
   • Current ethical, professional and legal implications of crisis intervention.
3. Dangers of crises and effective intervention
   • Dangers posed by crisis to the individual, the counsellor, and those around them. Determining effective modes of intervention.
4. Developmental Crises
   • Recognising and comprehending crises from a developmental perspective.
5. Post-traumatic stress disorder
   • Symptoms, treatment options and possible outcomes of post-traumatic stress disorder.
6. Violence and sexual assault
   • Effects of violence and sexual assault on the individual, and possible modes of intervention.
7. Crisis and drug addiction
   • Determining the relationship between crises and drug dependence.
8. Family crises
   • Major issues raises in family crises and appropriate methods of intervention.
9. Crises and cultural issues
   • Cultural influences on crisis situations.

Each lesson culminates in an assignment which is submitted to the school, marked by the school's tutors and returned to you with any relevant suggestions, comments, and if necessary, extra reading.

What You Will Do

• Role play a critical incident debriefing session
• Familiarise yourself with the Australian Counselling Association Code of Conduct
• Interview a counsellor from a community mental health service in your area
• View films, read or listen to stories (where possible) about personal or family crises
• Discuss post-traumatic stress disorder with a community mental health worker
• Explore physical, emotional, cognitive and social responses to sexual assault or violence
• Examine the relationship between trauma and drugs
• Interview or observe people from other cultures to identify cultural and sub-cultural responses to crises
• Explore how sub-cultural groups may require different counselling approaches
• Consider various methods of crisis intervention.

An example of notes from the course -

Critical Incident Stress Debriefing

In the wake of critical incidents, communities and individuals may be ill-equipped to cope with the aftermath of a catastrophic situation. So survivors may struggle to regain control of their lives, when friends or family may be injured, dying or dead or missing. Others may be traumatised by events and need support and personal care for months and years to come. The true extent of a traumatic situation may never be fully known. Psychological reactions are common and fairly predictable and CISD can be a useful tool following a traumatic event.

Critical Incident Stress debriefing (CISD) is highly significant to the fields of traumatic stress and emergency responses throughout the world. It has been used by emergency response personnel, disaster counsellors, American Red Cross workers, mental health workers, and so on.

CISD was originally developed to mitigate stress responses among people who were the first to respond to emergency situations. CISD can help disaster victims.

CISD is a label applied to a range of protocols used in a variety of settings with different groups and often carried out by people trained in CISD. A CISD is a group process, usually led by a facilitator. It is usually conducted soon after a traumatic event when individuals are considered to be under stress due to exposure to trauma.

Most CISD approaches use a seven part model. In this process, individuals are encouraged to describe their experience followed by a didactic presentation on common reactions to stress and stress management. This early intervention is thought to encourage people to verbalise, offer peer and group support for therapeutic factors to add recovery.

CISD is increasingly used in settings outside the normal emergency response sites, such as emergency rooms, police stations and is now used in a wide range of settings eg. Schools.

1. Introduction – The team leader introduces the CISD process, encourages participation by the group, and sets the ground rules by which the debriefing will operate. These guidelines usually involve confidentiality, attending the full duration of the group, non-forced participation and non-critical atmosphere. Assessment – the impact of the critical incident on survivors or personnel is assessed. The debriefer or facilitator assesses the individual’s involvement in the crisis situation, their age, level of development, exposure to the critical incident. The age of the individual and their developmental level may affect how they respond to an event and how they understand an event.

2. Fact Phase – During this phase, the group are asked to describe their incident from their own perspective. Immediate issues are identified, surrounding security and safety, particularly with children. Feeling safe and secure are important. When suddenly these feelings are lost, without warning, individual’s lives can be shattered by tragedy and loss.

3. Thought Phase – The group are asked to discuss their first thoughts during the critical incident. Defusing is used to allow for the ventilation of thoughts, experiences and emotions associated with the event and validation of possible reactions. This ventilation and validation are important as individuals need to express their feelings, exposure to the event, sensory experiences, thoughts and feelings. They give the individual the opportunity to express their emotions.

Defusing is another component of CISD that allows for the ventilation of emotions and thoughts associated with the crisis event. Debriefing and defusing should be provided within the first 24 to 72 hours after the initial impact on the event. The longer the time after the event until CISD occurs, the less effective CISD becomes. People who experience CISD 24 – 72 hours after the initial incident experience less short-term and long-term crisis reactions or psychological trauma. People who do not receive CISD are at greater risk of developing clinical symptoms described above.

4. Reaction Phase – This phase is where the participants move from the cognitive level of intellectual processing to the emotional processing level. Events and reactions to come after the event are predicted. The debriefer will assist survivors and support personnel to predict future events. This involves discussing their emotions, reactions and possible problems they may experience due to the traumatic exposure. By predicting, preparing and planning for the psychological and physical reactions that might occur after the critical incident, the debriefer can help the survivor prepare and plan for the short and long term future. This can help avert long term negative reactions to the event.

5. Symptom Phase – This phase moves back from the emotional processing level to the cognitive level again. The participants are asked to consider their emotional, cognitive and behavioural signs of distress – within 24 hours of the incident, a few days after the incident and those that are still being experienced. A systematic review of the incident is conducted, considering the impact – emotionally, cognitively and physically – on the survivors. The debriefer should conduct a thorough systematic review of the emotional, psychological and physical impact of the critical incident on the individual. The debriefer should listen, evaluate the thoughts, mood, choice of words and perceptions of the individual and look for clues as to how they are coping with the event or might experience future problems.

6. Education Phase – Information is exchanged on the nature of the stress response and the psychological and physiological reactions to critical incidents. This helps them to normalise the stress experience and the coping response. Closure of the incident – encouraging people to start rebuilding after the event – emotionally and physically, such as encouraging the review of positive events. A sense of closure is needed. Support services and resources information should be given to survivors and assistance to plan for future action to anchor the person in times of high stress.

7. Re-entry phase – This is where the sessions are wrapped up, referrals made for individual follow ups and how they can get help from others in the group and other resources. Debriefing assists the “re-entry” process back into the workplace or community. Debriefing can be done in small groups, one to one or large groups, depending on the situation. It is a systematic review of events leading up to, during and after the crisis occurs.

Our bookshop offers a range of counseling and psychology courses which you may find useful. You can see our range of books at:  http://www.acsbookshop.com/category/68-psychology-and-counselling-books-and-textbooks.aspx