Techniques for the Therapist
The ‘Common Denominators Assessment’ Technique
Review CD Track 1 for more information regarding this technique
1. The time factor: general consensus among therapists is that a crisis is acute rather than chronic.
2. Marked changes in behavior: the individual or group therapy is obviously less effective than usual. Client activity is mainly related to attempts to discharge inner tensions, there are successive trial and error abortive attempts to solve the problem without apparent success. Constructive behavior decreases, and frustration mounts. It is usually at this time that scapegoating and excuse giving occurs.
3. Subjective aspects: The person experiences feelings of helplessness and ineffectiveness in the face of what appears to be insoluble problems. There is a perception of threat or danger to important life goals the client has and this is accompanied frequently by anxiety, fear, guilt, or defensive reactions.
4. Relativistic Aspects: Although there are common crisis situations, such as the death of a loved one, the loss of a job, or a sudden disabling accident, the individual’s perception of threat and of a crisis is of course unique to her or him. What may constitute a crisis for your client may not constitute a crisis for another individual or group.
5. Organismic tension. The client in crisis will experience generalized physical tension which may be expressed in a variety of symptoms, including those commonly associated with anxiety. These reactions may be immediate or temporary, or they may constitute a long-term adjustment to the crisis situation itself.
Focus Questions for the Initial Crisis Interview
Review CD Track 2 for more information regarding this technique
• What prompted the client to seek help now?
• What happened to cause this crisis?
• How is the client trying to solve the crisis? What is working? What is not working?
• How was the client behaving before the crisis?
• How is the client behaving now?
• Has anything like this happened to the client before? How was it handled?
• What is the client’s history of handling other crises? What was successful? What was not successful?
• What are the client’s psychological strengths?
• What are the client’s environmental strengths?
• What does the client see as the two or three most important problems to be worked on immediately?
• How much immediate success is the client likely to have in these or other problem areas?
• How life threatening is this situation? Immediately? In the near future?
• What things are likely to stand in the way of successful crisis resolution?
• What is the client’s mental status?