Our Six-step model
Front-line crisis intervention staff address the level of distress and impairment of women in crisis by responding in a logical and orderly manner. They are trained in the use of a standardized model for intervening in crisis situations that help the counselor to be aware of the elements of an effective response to crisis, and to intervene in a way that appropriately supports a woman through the crisis which assists her to maintain ownership of the problem and be empowered toward self-determination.
Our six-step model for crisis intervention is a framework that guides our response to crisis. The model focuses on listening, interpreting and responding in a systematic manner to assist a woman or girl return to her pre-crisis psychological state to the extent possible. Emphasis is placed on the importance of listening and assessment throughout each step, with the first three steps focusing specifically on these activities rather than on taking action. At any point, emerging safety considerations that present risk of the woman being hurt or killed should be addressed immediately.
Our model involves the following steps:
1. Defining the problem to understand the issue from the woman's point of view. This requires using core listening skills of empathy, genuineness and acceptance.
2. Ensuring the woman's safety. It is necessary to continually keep the woman's safety at the forefront of all interventions. This means constantly assessing the possibility of physical and psychological danger to the woman as well as to others. Assessing and ensuring safety are a continuous part of the crisis intervention process.
3. Providing support, by communicating care for the woman, and giving emotional as well as instrumental and informational supports. Acting strategies are used in steps 4, 5, and 6. Ideally, these steps are implemented in a collaborative manner, but if the woman is unable to participate, it may be necessary to become more directive in helping her mobilize her coping skills. Listening skills are an important part of these steps, and the counsellor will mainly function in nondirective, collaborative, or directive ways, depending on the assessment of the woman.
4. Examining alternatives, which may be based on three possible perspectives: a) supporting the woman to assess her situational resources, or those people known to her in the present or past who might care about what happens to her; b) helping the woman identify coping mechanisms or actions, behaviors, or environmental resources that she might use to help her get through the present crisis; and c) assisting the [woman] to examine her thinking patterns and if possible, find ways to reframe her situation in order to alter her view of the problem, which can decrease her anxiety level.
5. Making a plan led by the woman, which is very detailed and outlines the persons, groups and other referral resources that can be contacted for immediate support. Provide coping mechanisms and action steps that are concrete and positive for the woman to do in the present. It is important that planning is done in collaboration with the woman as much as possible, to ensure she feels a sense of ownership of the plan. It is important that she does not feel robbed of her power, independence, or self-respect. The most important issues in planning are the woman’s sense of control and autonomy. Planning is about getting through the short-term in order to achieve some sense of equilibrium and stability.
6. Obtaining commitment. Control and autonomy are important to the final step of the process, which involves asking the woman to verbally summarize the plan. In some incidents where lethality is involved, the commitment may be written down and signed by both individuals. The goal is to enable the woman to commit to the plan, and to take definite positive steps toward re-establishing a pre-crisis state of functioning. The commitments made by the woman need to be voluntary and realistic. A plan that has been developed only by staff will be ineffective.
Increasingly promoted in place of methods which involve debriefing during crisis, Psychological support (referred in some places as “first aid”) is a response option which focuses on:
The approach is ordered around three principles: look (to ensure the situation is safe, identify individuals who have emergency needs or might be in crisis); listen (by approaching and seeking to understand a woman or girl’s concerns, if she chooses to share them, and helping her feel calm); and link (women with relevant information, resources, support to address their basic needs). This makes it a particularly relevant method of response in low-resource settings (WHO, War Trauma and World Vision, 2011).