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As we work with people in crisis, we develop an idea about what might reduce the critical effects of the crisis.  Based on our understanding of what is happening, what happened, and what is likely to happen, we work with the individual to develop an intervention hypothesis, or plan for modifying the causes or outcome of the crisis.  Our crisis focus, then, combines with our focus on our intervention hypothesis.  What will probably help, of course, depends upon our intervention hypothesis and upon the precipitating event and possible unseen effects of the specific crisis.  Each time we intervene in a crisis, we develop an individualized intervention hypothesis with the person in crisis.  The specifics of that hypothesis are as individualized as the person and the crisis itself.  Frequently, however, just getting the individual to settle down, slow down, and plan ahead is sufficient to resolve the crisis by helping the individual to a point where he can handle and work on the conflict himself.  In fact, if we do get him to settle down, slow down, and plan ahead, we have essentially reduced the now potential.  If he is then in a position to deal with the conflict himself, the self-resolution factor is substantially higher.  We defined a crisis as a conflict with a high now potential and a low self-resolution factor.  If, following our hypothesis, we have reduced the now potential and increased the self-resolution factor, we have effectively resolved the crisis.  Our intervention hypothesis is, of course, our idea about what will help.  What we can do to help in any particular situation depends, in large measure, on our experience and ingenuity.  Not to be underestimated, however, is the effectiveness of developing and following our intervention hypothesis.  This, combined with our self-confidence, will come through to the individual and give him confidence also.

Mrs. G is talking with you about her difficulties.  “I am at the end of my rope—just can’t cope with it anymore.  I’ve been back from the alcoholism center over three months now, and things are just about as bad as they were before I left.  I thought if I got off the juice maybe that would straighten things out.  Everyone’s always blamed me and my drinking for all the trouble, but I’ve been off three months now, and things aren’t any better.  I’m just at my wit’s end—can’t follow through with anything.  It’s the old alcoholic story—can’t handle it and want to drown in a bottle.  It just goes around in circles.  We [referring to herself and her husband] fight.  I’m worn out.  It’s the bills.  I’m unnerved.  The shakes are getting to me.  I’m too close to my friends to talk about it.  They just say, ‘Chin up.  Life’s tough all over.’  Nobody understands how hard it really is.  [You say: I’m glad you’re able to talk to me about it.  It sounds like it’s really getting to you.  Are you and your husband fighting now?]  No, he’s a trucker and is out on a trip.  He won’t be back for a couple of days.  We were fighting when he left, but he really loves me.  I don’t know why, but things will be okay when he gets home for a while.  [You ask: Do you have anyone else to talk to about things?]  My parents try to help.  They’re getting old and can’t stand the nervousness and strain.  I don’t want to burden them with my troubles.  I used to talk to his mother, but she died a while back.  I sure miss her.  [You say: I bet you do.  It’s hard when we lose someone we could really talk with.  What do you do to keep yourself occupied?]  Time means nothing anymore.  I just go day to day and see what happens.  [You ask: Do you have any hobbies or other things like that to keep you busy?]  My husband used to work on cars, and I kept his records for him.  I like figures and enjoyed doing that.  [You ask: Why did he stop doing that?]  He just goes from one thing to another.  He’s had nine jobs since we’ve been married.  My first husband was a real reliable man.  My husband now just goes from one thing to another.  We went for counseling three or four years ago, and it helped for a while, but now it’s just back to the same old thing.  He got mad and quit the counseling like he does everything else.  [You ask: Do you have any children?]  Three.  The youngest has a heart murmur.  I found out about it just a few weeks ago.  Things just go from bad to worse.  Sometimes I feel like giving up.  I’m just on a yo-yo, up and down.  [You say: It sounds like you have a lot to deal with.  I’m not sure I would be able to handle all of it if I were you.]  Oh, it’s not really that bad.  A lot of people have it worse.”

As you talk with Mrs. G, your picture of her crisis takes on some detail and content.  At first, it may not seem that she really has a crisis.  She is in a continuingly difficult situation but seems to be able to cope with it.  She is unhappy, feeling rather down and does not seem very optimistic.  Nevertheless, she is dealing with her situation.  Where is the crisis?  We know that she is an alcoholic and that she has received treatment at the alcoholism center.  She has been off alcohol for three months.  The now potential is, then, that she may revert to drinking as a way of coping with her anxiety and depression.  At this point, she is feeling somewhat cut off from her world and seems to feel that no one really understands her or cares.  For Mrs. G, an intervention hypothesis, and idea about what might help, would involve some thought about her feelings that she is “on a yo-yo” and does not have anyone with whom to talk.  Perhaps speaking with her in an interested and supportive way will help her get through this temporary crisis.  In fact, at the end of the discussion, she expresses somewhat more optimistic thoughts and feels that “it’s not really that bad.”  This is a sign she is beginning to believe in her ability to cope with her situation.

Most crisis intervention services have a few clients who use the service from time to time for social and emotional support.  It is tempting to become annoyed with them because we feel that they are taking advantage of the service.  With Mrs. G, however, it is clear that occasionally being able to use the crisis service may enable her to cope with her life situation without falling back on alcohol.  Talking with someone who is interested and who cares is helpful to Mrs. G.  An intervention hypothesis involving Mrs. G, then, is fairly uncomplicated.  If you talk with her when she is feeling upset and at her wit’s end, she will be more able to cope with her world.  In every crisis situation, we need to develop an intervention hypothesis.   At times, the hypothesis may be fairly involved and call for a lot of innovative action on our part.  Very frequently, however, our intervention hypothesis is fairly simple and limited.  Just giving individuals an opportunity to talk, think things through, and to have their feelings understood and respected is sufficient to reduce their crisis.

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