11.2 Crisis intervention and trauma-informed care

Crisis intervention and trauma-informed care are crucial skills for social workers. These approaches help individuals in acute distress and those dealing with trauma's lasting effects. Understanding these techniques enables social workers to provide immediate support and foster long-term healing.

Social workers must recognize trauma's widespread impact and integrate this knowledge into their practice. By employing crisis intervention strategies and trauma-informed approaches, they can create safe spaces, build trust, and empower clients to regain control and resilience.

Crisis Intervention Strategies

Immediate Response Techniques

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• Crisis intervention involves providing immediate, short-term assistance to individuals experiencing acute emotional distress or psychological crisis
• Psychological first aid offers practical support and coping strategies to reduce initial distress and promote adaptive functioning
• Safety planning creates personalized strategies to mitigate risks and enhance security during crisis situations
• De-escalation techniques utilize verbal and non-verbal communication to reduce tension and prevent aggressive behavior
  • Includes active listening, maintaining a calm demeanor, and offering choices
  • Aims to restore a sense of control and safety for the individual in crisis

Crisis Assessment and Stabilization

• Rapid assessment evaluates immediate risks, mental status, and support systems available to the individual
• Triage determines the level of care needed based on the severity of the crisis
• Crisis stabilization focuses on restoring equilibrium and preventing further deterioration
  • May involve brief counseling, medication management, or referral to appropriate resources
• Follow-up care ensures continued support and monitors progress after the initial crisis intervention

Trauma-Related Conditions

Acute Stress and PTSD

• Acute stress response manifests immediately after a traumatic event and can last up to one month
  • Symptoms include anxiety, hypervigilance, and difficulty concentrating
• Post-traumatic stress disorder (PTSD) develops when symptoms persist beyond one month after trauma exposure
  • Characterized by intrusive memories, avoidance behaviors, and altered mood and cognition
  • Affects approximately 7-8% of the U.S. population at some point in their lives
• Triggers consist of stimuli that remind an individual of past trauma and elicit stress responses
  • Can be sensory (sounds, smells), situational, or emotional
• Retraumatization occurs when a person experiences renewed trauma symptoms due to exposure to reminders of past traumatic events
  • Can happen during therapy or in everyday situations that resemble the original trauma

Trauma Responses and Coping Mechanisms

• Dissociation serves as a defense mechanism where individuals mentally detach from their surroundings or experiences
• Hyperarousal involves a constant state of alertness and heightened physiological responses
• Avoidance behaviors develop as individuals attempt to escape trauma-related thoughts, feelings, or situations
• Maladaptive coping strategies may include substance abuse, self-harm, or risky behaviors
  • Often used to manage overwhelming emotions or numb psychological pain

Trauma-Informed Approaches

Principles of Trauma-Informed Care

• Trauma-informed care recognizes the widespread impact of trauma and integrates knowledge about trauma into policies, procedures, and practices
• Safety ensures physical and emotional security for both clients and staff
• Trustworthiness and transparency build and maintain trust through clear communication and consistent boundaries
• Peer support utilizes shared experiences to promote healing and recovery
• Collaboration and mutuality emphasize partnerships between providers and clients, recognizing that healing happens in relationships
• Empowerment, voice, and choice prioritize client autonomy and self-determination in the healing process
• Cultural, historical, and gender issues address the unique needs and experiences of diverse populations

Building Resilience and Preventing Secondary Trauma

• Resilience encompasses the ability to adapt positively in the face of adversity or significant stress
  • Can be cultivated through developing coping skills, building support networks, and fostering a positive outlook
• Protective factors that enhance resilience include social support, problem-solving skills, and a sense of purpose
• Vicarious trauma results from repeated exposure to others' traumatic experiences, often affecting helping professionals
  • Symptoms mirror those of direct trauma exposure and can impact personal and professional functioning
• Self-care strategies help prevent and mitigate the effects of vicarious trauma
  • Includes maintaining work-life balance, seeking supervision, and engaging in stress-reduction activities
• Organizational support plays a crucial role in preventing vicarious trauma among staff
  • Involves creating a supportive work environment, providing adequate resources, and promoting self-care practices