INTERVENTION TECHNIQUE
⇉↵↫ě—‰ntervention techniques
There are various approaches to supporting individuals in crisis, for example, using non-counseling methods such as psychological first aid, more technical models involving strategies for listening, assessing and acting in crisis intervention, or activities related to responding to trauma. The guidance in this section describes interventions that require specific skills, development training and supervision. Information alone is not sufficient for shelter staff to be able to apply these techniques, and individuals should not conduct crisis intervention without proper training and supervision.
Effective crisis intervention must follow ethical principles which ensure that survivors are not placed in further harm, their decisions and opinions are respected throughout the process and the intervention upholds a rights-based approach. This involves good communication skills, demonstrating empathy, among other support provided by shelter workers.
Strategies for listening in person
Listening involves focusing, observing, understanding and responding with empathy, genuineness, respect, acceptance, non-judgment and sensitivity. A number of specific strategies can be used to promote effective listening during crisis intervention. These include:
Using open-ended questions - “what” or “how” questions. They are used to encourage sharing of information from a woman or girl about her feelings, thoughts and behaviours, and are particularly useful when exploring problems during a crisis. Open-ended questions encourage the woman to provide a greater depth of information including what situations or events mean to her.
Using close-ended questions that seek specific details and are designed to encourage a woman or girl to share information about behaviours (such as the abuser's specific actions or behavioural coping strategies used by the woman), as well as “yes” or “no” responses. Closed-ended questions usually begin with action words such as "do", "does", "can", "have", "had", "will", "are", "is" and "was". These questions can be used to gather specific information or to understand the woman's willingness to commit to a particular action (e.g. to complete a safety plan).
Restating and clarifying what the woman has said can help the shelter staff conducting the crisis intervention to clarify whether she has an accurate understanding of what the woman intended to say, feel, think and do. Restating can also be used to focus the discussion on a particular topic, event or issue.
Owning feelings and using statements that start with “I” in crisis intervention can help to provide direction by being clear about what will occur (e.g. ‘I am going to explain the steps we will take today’), what is being asked of the woman (e.g. ‘I would like to ask whether you agree to the steps I have described’). Staff can be trained in various skills for practicing “I”-statements in order to support clear and effective communication with women in crisis. For example, these statements can also help to acknowledge confusion or convey understanding of what is being discussed (e.g. “I am not sure I understand what happened when you left the house” or “I hear how nervous you felt on the day you left home”).
Facilitative listening is a strategy which helps to build trust and strengthen relationships with the woman. It involves focusing entirely on the woman's experience by:
Noticing the woman's verbal and nonverbal communication. For example, "I noticed that when you talked about the time you spent with your daughter, your eyes lit up and there was excitement in your voice.”
Noticing when she is ready to make emotional or physical contact.
Using non-verbal cues to show that you are listening (e.g. by nodding the head, making eye contact, facing the woman).
Assessing in crisis intervention
Assessment is an intentional practice that occurs throughout the crisis intervention process, and involves seeking information from a woman or girl (although practices for engaging child survivors are distinct from those working with adults), actively listening and interpreting what she shares in order to understand her emotional state, level of emotional mobility or immobility, options for action, coping mechanisms, support systems and other resources.
Assessment allows staff to draw conclusions about the woman’s situation and her responses to it, in order to plan and offer ways to assist her.
It is also used to determine the level of risk and any specific threat of self-harm or being killed by their abuser(s).
During crisis intervention, shelter workers should seek to understand the woman’s:
Emotional state. Emotional distress is often an initial sign that a woman is experiencing a crisis, which may appear as though she is emotionally "out of control" or severely withdrawn. Shelter staff can be trained to help a woman to regain control and emotional mobility by assisting her to express her specific feelings using language that accurately reflects the emotion.
Behavioural functioning. Observing a woman's behaviour can help to understand her ability to cope with the situation she is experiencing. For example, noticing whether she is pacing the floor, having difficulty breathing, or sitting calmly, and whether she appears withdrawn or unresponsive. Shelter workers can be trained to assist women to take positive actions that she can able to complete in that moment. For example, asking her to breathe slowly.
Cognitive state. Determining a woman's thinking patterns is essential in assessing her current ability to cope with the situation she is experiencing. When listening to what a woman is saying, staff can be trained to consider whether her verbal communication is coherent and logical, and whether her words make sense.
Acting in crisis intervention
Taking action in crisis intervention involves intentionally responding to the assessment of the woman's situation and needs in one of three ways: nondirective, collaborative, or directive.
Nondirective counseling is preferable when a woman is able to plan and implement actions on her own that she chooses to take. In this case, the shelter worker's role is to assist the woman in mobilizing her existing capacity to solve her own problem. Comments that support a woman's self-determination and action can be helpful in this situation, such as “What do you want to have happen? Is there anyone that could support you with this plan?”
Collaborative counseling involves working together with a woman to evaluate the problem, identify options for addressing it, and taking actions toward a particular option. Collaborative counseling approaches are helpful when a woman is able to participate in planning and taking action, but is not able to complete the entire process on her own. For example: “You are saying that you have decided to leave your partner, but you are unsure of the legal options available. Let’s explore together where you could go for legal advice.”
Directive counseling is necessary when a woman is assessed as being immobilized by her experience to the extent that she is unable to cope with the crisis. Shelter staff can be trained to use directive counseling to take temporary control and responsibility for the situation. For example: “What I want you to do right now is breathe with me. That's good. Breathe in for a count of 6 and out for a count of 6.” In these situations, shelter workers may move back and forth between directive counseling and collaborative counseling as the woman shows signs of decreased anxiety and increased ability to participate in the process.
It is particularly important for staff to have sufficient training in in this area in order to ensure that directive counseling is used only when necessary, and women are empowered as much as possible within the counseling relationship (James, 2008 as cited in Alberta Council of Women's Shelters, 2009).
There are various approaches to supporting individuals in crisis, for example, using non-counseling methods such as psychological first aid, more technical models involving strategies for listening, assessing and acting in crisis intervention, or activities related to responding to trauma. The guidance in this section describes interventions that require specific skills, development training and supervision. Information alone is not sufficient for shelter staff to be able to apply these techniques, and individuals should not conduct crisis intervention without proper training and supervision.
Effective crisis intervention must follow ethical principles which ensure that survivors are not placed in further harm, their decisions and opinions are respected throughout the process and the intervention upholds a rights-based approach. This involves good communication skills, demonstrating empathy, among other support provided by shelter workers.
Strategies for listening in person
Listening involves focusing, observing, understanding and responding with empathy, genuineness, respect, acceptance, non-judgment and sensitivity. A number of specific strategies can be used to promote effective listening during crisis intervention. These include:
Using open-ended questions - “what” or “how” questions. They are used to encourage sharing of information from a woman or girl about her feelings, thoughts and behaviours, and are particularly useful when exploring problems during a crisis. Open-ended questions encourage the woman to provide a greater depth of information including what situations or events mean to her.
Using close-ended questions that seek specific details and are designed to encourage a woman or girl to share information about behaviours (such as the abuser's specific actions or behavioural coping strategies used by the woman), as well as “yes” or “no” responses. Closed-ended questions usually begin with action words such as "do", "does", "can", "have", "had", "will", "are", "is" and "was". These questions can be used to gather specific information or to understand the woman's willingness to commit to a particular action (e.g. to complete a safety plan).
Restating and clarifying what the woman has said can help the shelter staff conducting the crisis intervention to clarify whether she has an accurate understanding of what the woman intended to say, feel, think and do. Restating can also be used to focus the discussion on a particular topic, event or issue.
Owning feelings and using statements that start with “I” in crisis intervention can help to provide direction by being clear about what will occur (e.g. ‘I am going to explain the steps we will take today’), what is being asked of the woman (e.g. ‘I would like to ask whether you agree to the steps I have described’). Staff can be trained in various skills for practicing “I”-statements in order to support clear and effective communication with women in crisis. For example, these statements can also help to acknowledge confusion or convey understanding of what is being discussed (e.g. “I am not sure I understand what happened when you left the house” or “I hear how nervous you felt on the day you left home”).
Facilitative listening is a strategy which helps to build trust and strengthen relationships with the woman. It involves focusing entirely on the woman's experience by:
Noticing the woman's verbal and nonverbal communication. For example, "I noticed that when you talked about the time you spent with your daughter, your eyes lit up and there was excitement in your voice.”
Noticing when she is ready to make emotional or physical contact.
Using non-verbal cues to show that you are listening (e.g. by nodding the head, making eye contact, facing the woman).
Assessing in crisis intervention
Assessment is an intentional practice that occurs throughout the crisis intervention process, and involves seeking information from a woman or girl (although practices for engaging child survivors are distinct from those working with adults), actively listening and interpreting what she shares in order to understand her emotional state, level of emotional mobility or immobility, options for action, coping mechanisms, support systems and other resources.
Assessment allows staff to draw conclusions about the woman’s situation and her responses to it, in order to plan and offer ways to assist her.
It is also used to determine the level of risk and any specific threat of self-harm or being killed by their abuser(s).
During crisis intervention, shelter workers should seek to understand the woman’s:
Emotional state. Emotional distress is often an initial sign that a woman is experiencing a crisis, which may appear as though she is emotionally "out of control" or severely withdrawn. Shelter staff can be trained to help a woman to regain control and emotional mobility by assisting her to express her specific feelings using language that accurately reflects the emotion.
Behavioural functioning. Observing a woman's behaviour can help to understand her ability to cope with the situation she is experiencing. For example, noticing whether she is pacing the floor, having difficulty breathing, or sitting calmly, and whether she appears withdrawn or unresponsive. Shelter workers can be trained to assist women to take positive actions that she can able to complete in that moment. For example, asking her to breathe slowly.
Cognitive state. Determining a woman's thinking patterns is essential in assessing her current ability to cope with the situation she is experiencing. When listening to what a woman is saying, staff can be trained to consider whether her verbal communication is coherent and logical, and whether her words make sense.
Acting in crisis intervention
Taking action in crisis intervention involves intentionally responding to the assessment of the woman's situation and needs in one of three ways: nondirective, collaborative, or directive.
Nondirective counseling is preferable when a woman is able to plan and implement actions on her own that she chooses to take. In this case, the shelter worker's role is to assist the woman in mobilizing her existing capacity to solve her own problem. Comments that support a woman's self-determination and action can be helpful in this situation, such as “What do you want to have happen? Is there anyone that could support you with this plan?”
Collaborative counseling involves working together with a woman to evaluate the problem, identify options for addressing it, and taking actions toward a particular option. Collaborative counseling approaches are helpful when a woman is able to participate in planning and taking action, but is not able to complete the entire process on her own. For example: “You are saying that you have decided to leave your partner, but you are unsure of the legal options available. Let’s explore together where you could go for legal advice.”
Directive counseling is necessary when a woman is assessed as being immobilized by her experience to the extent that she is unable to cope with the crisis. Shelter staff can be trained to use directive counseling to take temporary control and responsibility for the situation. For example: “What I want you to do right now is breathe with me. That's good. Breathe in for a count of 6 and out for a count of 6.” In these situations, shelter workers may move back and forth between directive counseling and collaborative counseling as the woman shows signs of decreased anxiety and increased ability to participate in the process.
It is particularly important for staff to have sufficient training in in this area in order to ensure that directive counseling is used only when necessary, and women are empowered as much as possible within the counseling relationship (James, 2008 as cited in Alberta Council of Women's Shelters, 2009).
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