Volume 35/Number 2IApril 2OI3IPages 95-107

THEORY

The Introduction of a Task Model for

Crisis Intervention
Rick A. Myer
J. Scott Lewis
Richard K. James

This article reviews published models for crisis intervention to identify common tctsks. Two cat-
egories of tasks were identified, continuous and focused. Continuous tasks (assessment, safety,
and support) are those that are addressed throughout the entire intervention process. Mental
health counselors (MHCs) must attend to these at all times when assisting clients in crisis.
Focused tasks (contact, re-establishing control, defining the problem, and follow-up) are time-
encapsulated: once a task is accomplished, MHCs can move on to another. However, given the
chaotic nature of crises, MHCs may have to return to these at points during the intervention.

Crisis intervention as a counseling specialty has been growing for the past
25 years. Disasters like Hurricane Katrina, the terrorist attacks of 9/11, and vio-
lence on college campuses have accelerated its emergence. To date, models for
crisis intervention focus on steps in helping people overcome a crisis (e.g.,
Aguilera, 1998; Hoff, 2009; James, 2008; Roberts, 2005). Though these mod-
els are useful, each implies a linear progression as professionals attempt to help
clients regain control of their lives. However, clinicians who work with clients
in crisis understand that the helping process can be anything but linear
(Vernberg et al, 2008). A few authors (e.g., James, 2008; Kanel, 2011) have
stated that some situations may require clinicians to deviate from the steps in
their models, for instance, when clients are out of control, possibly psychotic,
and not able to manage anything about their behavior. In working with clients
in crisis, the situation can change from moment to moment as they cycle
through degrees of stability and instability. A client who may seem calm and
in control after talking to a mental health professional for several minutes can
suddenly become extremely distraught again. When this happens, the coun-
selor cannot just say, "We're past the step where I help you regain control so we

Rick A. Myer is affiliated mth the University of Texas EJ Paso. j . Scott Lewis with Duquesne University,
and Richard K. jomes with the University of Memphis. Correspondence about this article should be
directed to Dr. Rick A. Myer, College of Education, University ofTexas El Paso, 500 W University Ave.,
El Paso. Texas. 79968. Email: ramyer@utep.edu.

Journal of Mental Health Counseling 95

 cannot go back to calm you down again." Mental health counselors (MHCs)
must have the capacity to be with clients where they are in that moment.
Crisis intervention involves addressing the immediate concerns of chents
in order to help them to reclaim a sense of equilibrium (Myer & James, 2005).
It can be used both with people experiencing a psychological emergency that
makes them defenseless and incapable of caring for themselves or others
(Callahan, 1994, 1998) and with people who are so overwhelmed that their
ability to cope is significantly compromised (Myer & James, 2005). Currently
the emphasis in crisis intervention is shifting toward provision of psychological
first aid to assist people after a traumatic experience (e.g., Rodriguez & Kohn,
2008; Ruzek et al., 2007). However, research in crisis intervention has not kept
pace with its use (Plummer, Cain, Fisher, & Bankston, 2008; Wessely et al.,
2008). Ruzek et al. (2007) proposed a basic format for psychological first aid
but did not provide support for their model from research or the literature. One
reason for the lack of research may simply be that the models do not lend
themselves to systematic inquir}'.
The Council for the Accreditation of Counseling and Related
Educational Programs (CACREP, 2009) has revised its accreditation standards
to include training in crisis intervention and trauma therapy. Obviously, there
is a growing need to examine current practices in order to draft practice guide-
lines. This article begins by outlining common step models for crisis interven-
tion and then proposes a new theoretical model focused on tasks rather than
steps. We believe this model lends itself to systematic examination as a basis for
evidence-based practices and also to better training in crisis intervention. The
goals and activities for each task are discussed. Throughout, examples demon-
strate how the model can be applied.

REVIEW OF STEP MODELS

Purposive sampling was used to select nine books for background review.
This procedure allowed us to seek out standard models for crisis intervention
while also permitting variation in the selection criteria (Heppner, Wampold, &
Kivlighan, 2008) in order to acquire a more in-depth understanding (Patton,
2002). Criteria used to select these books were (a) number of editions (e.g..
Aguilera, 1998; Hoff, 2009; James, 2008); (b) different disciplines, including
psychology, counseling, social work, and medicine (e.g.. Aguilera, 1998;
Kleespies & Richmond, 2009; Roberts, 2005); (c) recent publication date (e.g..
Greenstone & Levitn, 2011; Kanel, 2011); or (d) presentation of a unique per-
spective (e.g., Collins & Collins, 2005; Echerling, Presbur>', & McKee, 2005;
Slaikeu, 1990).
A heuristic approach was used to examine the models. In this approach
the gist of the issue being examined is described and then there is a creative

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 Task Model for Crisis Intervention

synthesis based on our understanding of these models (Patton, 2002). The

heuristic model of inquiry recognizes that the researchers have personal expe-
rience with the phenomenon being studied (Patton, 2002). Undoubtedly, our
combined experience of 50 years of clinical practice as mental health profes-
sionals influenced our interpretation of the data. After reviewing the models,
discussion was used to confirm decisions and ultimately to draw up the task
model presented here.
Table 1 lists step models commonly used in crisis intervention. The first
column lists steps used in well-known models found in textbooks. Although we
attempted to retain the original step descriptors of the developers, some are not
an exact match listing the verbatim original descriptors would result in a
table with well over 20 rows. Descriptors that were modified and incorporated
into another step because of obvious similarity are marked by an asterisk. The
order of the steps also differs from one model to the next. For example.
Greenstone & Levitn (2011) listed assessment as the third step while Roberts
(2005) placed it first. The emphasis placed on each step also varies. For exam-
ple, James (2008) emphasized assessment far more emphatically than Kanel
(2011). The reasons for variations on the name, order, and emphasis of the
steps cannot be conclusively determined.
The middle column lists developers who use the steps in the first column.
Not all models use each step: The number varies from as many as seven
(Roberts, 2005) to as few as three (Kanel, 2011). One reason for the variance
may be that models with fewer steps seem simpler to use; incorporation of sev-
eral functions into each step makes these models seem more streamlined and
straightforward. Another reason for different numbers of steps may be the way
developers assign different tasks to steps. These differences are likely due to the
way developers envision the crisis intervention process enfolding. This situa-
tion is to be expected; each developer has different perspectives, training, and
experience in crisis intervention.
The final column identifies the tasks associated with each step. Some
tasks appear in several rows, notably those related to assessing and supporting
people throughout the crisis intervention process and ensuring the safety of
clients and others. Several tasks are encapsulated in only one or two steps, such
as communicating with clients and helping them work out ways to resolve the
crisis. Although the developers may have different ways to express how they
envision these encapsulated tasks, parallels can be seen in the goals of each as
described by the developers. For example, the Kanel (2011) step that addresses
the task of gaining cognitive control corresponds with the Hoff (2009) task of
making plans. The goal for both is to help clients to regain control in order to
resolve the crisis.
Two developers have unique steps in their models. Greenstone and
Levitn (2011) have as a specific step "control," which refers to controlling the

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 Table I. Crisis Intervention Models

Steps Models Tasks

Assessment Aguilera; Collins & Collins;
Greenstone & Levitn; Hoff;
james; Roberts*
Assess clients' level of functioning. Some models encourage
continuous dynamic assessment virfiile others promote
assessment as an encapsulated process. Goals vary with the
model but generally involve understanding the situation and
the meaning clients gve the situation.

Make contact Collins & Collins*; Echerling, Establishment of a connection with clients. Goal is to instill a
and establish Presbu7. & McKee*; Kanel*; sense of respect and acceptance of the client.
rapport Kleespies & Richmond; Roberts
Control Greenstone & Levitn Manage and organize the situation and clients. Goal is to
make a connection and demonstrate an understanding of the
immediate situation.
Provide support James; Kleespies & Richmond*; Ensure clients experience empathy. Goal is to demonstrate a
Slaikeu nonjudgmental positive involvement with clients.
Ensure safety Collins & Collins; James; Kleespies Assess and ensure client safety vflth respect to suicidal and
& Richmond*; Slaikeu* homicidal ideations and in terms of capacity to function psy-
chologically and behavioralty. Might also include ensuring
safety of crisis workers safety in the immediate situation.
Goal is to maintain personal safety.
Examine the p i l e r a * ; Collins & Collins*; Explore client perceptions of the crisis. Assess client under-
problem Echerling, Presbu^, & McKee*; standing of the crisis. Identify specifics of the problem. Goal
Kanel; James; Kleespies & is to help clients to sort through botfi the immediacy of the
Richmond; Roberts situation and the meaning of the crisis.
Encourage Collins & Collins; EcheHing, Assess client affective functioning. Permit expression of
and explore Presbu7, & McKee *; Greenstone these feelings. Goal is to help clients to re-establish control
emotions & Levitn*; Roberts of affective reaaions.
Assess past Roberts Assess past client coping skills as part of helping clients plan
coping strategies 0 resolve the crisis. Goal is to use this as part of resolving
the crisis.
Restore cognitive Kanel *; Roberts; Slaikeu* Assess client cognitive functioning and ability to take con-
functions/action tructive steps to resolve the crisis. Goal is to re-establish
control w t h respect to perception of the problem and abil-
ty to take positive steps to resolve crisis.
Make plans Aguilera*; EcheHing, Presbu^, & ^elp the client to draft plans to facilitate resolution of the
McKee; Hoff; James risis. This process may entail brainstorming possible solu-
tions, finding additional assistance, securing resources, pro-
viding support, assessing the viability of the plan, and helping
lients be realistic about resoMng the crisis. Goal is a sensi-
)le and practica) plan to resolve the crisis.
Obtain commit- Hoff; James; Obtain assurance clients will follow through witfi plans. Goal
ment s to reestablish autonomy and ownership of the resolution
f the crisis.
Referral Collins & Collins; Greenstone & ^eIp clients to make contact witfi appropriate resources,
Levitn; Slaikeu*; V ^ n r i b & Bloch joal is to assist clients in locating and obtaining assistance
rom sources outside diemselves.
Follow-up Collins & Collins; Greenstone & tay available and check back vwth clients. Goal is to ensure
.eviton; Hoff; Roberts lients have carried out the recommended plan.

*Step listed with different tide in these modek

Sources: Aguilera. 1998; Collins & Collins, 2005; Echeriing. Presbu^, & McKee, 200S; Greenstone & Levitn. 2011;
Hoff, 2009; James. 2008; Kanel, 2011 ; Kleespies & Richmond. 2009; Roberts, 2005; Slaikeu, 1990

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 Task Model for Crisis Intervention

situation rather than helping clients resolve the crisis. In his model Roberts
(2005) has a step for "assessing past coping skills," because, he stated, he
believes this step is important for helping clients to activate problem-solving
skills. Although other developers do not specify these steps, they are incorpo-
rated in other steps in their models.

TASK MODEL FOR CRISIS INTERVENTION

Our selective review of the literature identified two categories of practical
tasks associated with crisis intervention (see Figure 1). The first group appears
to be continuous and used throughout the entire crisis intervention process
these tasks must be constantly attended to if the intervention is to be effective.
The second group of tasks is more focused. These tasks are incorporated at var-
ious points during the intervention. We describe these as focused because,
once they are completed, MHCs move on to another task. However, because
crises are chaotic and the dispositions of persons in crisis unstable, these tasks
must on occasion be revisited, with the clinician cycling back to a task to
address issues related to it before moving on. We discuss these situations below.

Gontinuous Tasks
The continuous category consists of three separate but related tasks:
assessment, safety, and support. The tasks are listed in no particular order and
performed throughout the intervention. Although the tasks are continuous, the
emphasis developers place on each of them varies. The tasks of assessment and
support seem to form the foundation for the intervention. Together, they allow
MHCs to adjust the intervention to meet client needs as they surface moment-

Figure I. Task Model

SAFETY - SUPPORT
CONTACT
RE-ESTABLISH
CONTROL

DEFINE THE
PROBLEM

FOLLOW-UP

ASSESSMENT

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 to-moment. The need to constantly monitor safety is obvious. MHCs must
throughout be willing to take direct action to assure the physical and mental
well-being of ever)'one caught up in the crisis.
Assessment. Assessment is an independent step in some crisis interven-
tion models (e.g., Kleespies & Richmond, 2009), but other models infuse this
task into other steps (e.g., Hoff, 2009). Some models treat assessment as time-
limited (e.g.. Aguilera, 1998); others believe it is a dynamic process for moni-
toring client functioning throughout the intervention (e.g., James, 2008). For
this task, crisis intervention models also look at different aspects of client func-
tioning. For example, Kanel (2011) emphasized client cognitive functioning
whereas James (2008) advocated for assessing client affective, behavioral, and
cognitive reactions to a crisis. Collins and Collins (2005) took assessment a step
further, believing this task should take into account a client's developmental
stage and also ecological components of the client's world. Roberts (2005)
believed part of this task was to assess the clients past coping skills. Creenstone
and Levitn (2011) advocated that clinicians continuously assess the surround-
ings as well as the client for potential positive or negative changes. They took
this view because crises can be volatile situations, and awareness of surround-
ings helps to assure the physical safety of ever)'one involved. Assessment is per-
haps best viewed as a continuous task that monitors client functioning.
The goal of assessment in every model is to guide the intervention process
(see, e.g., James, 2008). Intervention with clients in crisis must be fluid in order
to respond to the changing needs of the situation. For example, consider a
client who is distraught and considering suicide. In common with many of the
crisis intervention models, MHCs would assess the situation and begin review-
ing options to help stabilize the client. As the client is stabilizing, however,
unforeseen triggers could re-aggravate the clientperhaps a sudden change in
mood due to the stress of the crisis that causes the client to depersonalize or
become confused. Or a family member may unintentionally exacerbate the
client's behavior by attempting to intervene. Because of such potential triggers,
it is essential that assessment be a continuous process. Continuous assessment
also helps to identify if a previously completed task needs to be repeated.
Safety. Every step model recognizes the importance of the task of safety
to crisis intervention. Each model stresses the need for ensuring safety contin-
uously. Although some crisis models define "safety" as a specific step (e.g.,
James, 2008), they all incorporate safety at least into a broader intervention. A
few models (e.g., Creenstone & Levitn, 2011; James, 2008) have pointed out
that safety must be ensured for clinicians as well as clients. Slaikeu (1990)
incorporated safety into a general category, "psychological first aid." The safety
aspect of psychological first aid addresses reducing lethality.
Some models extend the idea of safety beyond issues pertaining only to
suicide and homicide (e.g., James, 2008) to deal with safety as protecting

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clients from themselves. Among the many forms of protection are not allowing
clients to be alone because they are not capable of regulating their behavior
and may unintentionally cause harm to themselves or others. MHCs may stay
with these clienfs until they can consistently control their actions. Safety also
involves seeking involuntary commitment for clients who, due to mental ill-
ness, engage in behaviors that could lead to physical harm, such as one caught
in the middle of a busy intersectionalthough not actively suicidal, the poten-
tial for physical harm to self or others is very high because of this crisis. Clients
can also be psychologically vulnerable in crises such as the tragic death of a
family member or receiving a medical diagnosis with a poor prognosis; in such
cases MHCs need to take steps to ensure safety. Thus, based on the models
reviewed, safety is a continuous task that ensures the physical and psychologi-
cal safety of clients and MHCs.
Each model recognizes that how much emphasis to place on safety varies
depending on the assessment of risks and danger (e.g.. Aguilera, 1998; Hoff,
2009). As MHCs assess the situation and the client, they are simultaneously
assuring that everyone involved in the crisis is safe, though the practical appli-
cation must be adapted to the situation. In addition, throughout the interven-
tion, MHCs must watch for potential triggers that could change the client's
behaviors and endanger anyone involved. Among the triggers might be inter-
ference from bystanders, if the intervention is taking place in public, as might
occur when MHCs conduct crisis intervention in homes or accompany law
enforcement officers called to intervene with a mentally ill person.
Support. The third continuous task is support. Every crisis intervention
model incorporates this as a task but not all models define support as an inde-
pendent sfep. James (2008) listed support as the third step in his model and
stated that it involves having clients see the clinician as a caring person, and
that the more severe the reaction, the more support is needed. In his model,
James described support as a continuum from nondirect to direct strategies.
Nondirect intervention resembles the support MHCs give in individual coun-
seling; direct intervention involves taking control of clients and usually means
that their psychological or physical safety is threatened. Creenstone and Levitn
(2011) argued that support also involves stopping emotional bleeding and mov-
ing to bring some order to a chaotic situation. Slaikeu (1990) assigned support
as the first subgoal of his psychological first aid. He stated that by helping peo-
ple shoulder part of the load, support becomes one of the more humane
aspects of crisis intervention. Although Aguilera (1998) did not specifically
define it, support is also necessary for her interventions to be successful.
Based on our review of the models, support as a task is crucial in crisis
intervention. Clients are often under duress because of a lack of support in
their social structure. MHCs support the client during the crisis and identify
resources that can continue the support once the crisis is over. Consider a sit-

101
uation where a client is distraught and contemplating suicide because a close
relative has just died. Grieving people often find themselves lost and unable to
manage their thoughts and feelings to the point that they feel that they cannot
go on living. MHCs can provide the empathie, nonjudgmental support the
client needs in that moment. They can empathize with the pain of the loss,
provide positive feedback and at times ust be present for the client. MHCs can
then continue the support by setting up resources for the client to address grief
issues on a more long-term basis through, for example, an outpatient mental
health counseling clinic or a grief support group.
The continuous tasks allow the crisis clinician to constantly evaluate the
crisis and adapt the intervention as the situation warrants. This flexibility helps
to facilitate the appropriate intervention and ensure that the client's needs are
being met.

Focused Tasks
Our research identified four focused tasks: contact, re-establishing con-
trol, problem-solving, and follow-up. These tasks may be completed more or
less in order. Some crisis situations do not lend themselves to addressing these
sequentially, however, or they may be worked on simultaneously. For example,
because contact with clients who are hysterical may be impossible, interven-
tion might work first on the task of re-establishing control. Once that is done,
MHCs can then work on making contact with the client. The instability of the
person in crisis may also require revisiting these tasks periodically throughout
the intervention process, as may happen when clients become distracted or
new information surfaces.
Contact. All the developers of crisis intervention models have made
establishing contact a task, but the emphasis they give it varies. Some models
(e.g., Creenstone & Levitn, 2011; James, 2008) do not make initiating com-
munication a separate step but infuse the task into other steps, and not always
the first one. On the other hand, Kanel (2011) viewed making contact as a
foundation of crisis intervention and considered the task synonymous with
building rapport, apparently as in personal counseling. Echerling, Presbury,
and Mckee (2005) echoed this sentiment, stating that making contact is a fun-
damental connection that demonstrates a genuine commitment throueh the
counselor's willingness to stand by the client. Kleespies and Richmond (2009)
described establishing contact as forming a working alliance; they believed this
task can be challenging because of such client characteristics as demographic
variables, client condition, and clinician reactions. Each issue affects the abil-
ity to successfully accomplish this task.
Some models view the task of establishing communication with the client
as making contact (e.g., Echerling et al., 2005), others as establishing rapport
(e.g., Kanel, 2011). Collins and Collins (2005) described supportively and

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 Task Model for Crisis /ntervent/on

empathically joining with clients in crisis. James (2008) echoed this belief, dis-
cussing the task as communicating a sense of earing to clients. Regardless,
every model in some way incorporates contact as a task that must be accom-
plished at some point during the intervention.
Although usually considered an initial task, we believe that in some situ-
ations establishing communication may be delayed, for example, when the
client's life is at risk. James (2008) implied this by making establishing safety
the second step and postponing establishing contact until the third step. The
Roberts (2005) model implies much the same by first assessing lethality and
making establishing rapport step two. Like these authors, we believe that client
safety must be attended to first.
Re-establish control. This task involves helping clients to regulate their
reactions to the crisis. Several models discuss this task of restoring a client's
sense of equilibrium (e.g., Echerling et al., 2005) and empowering clients to
see that the crisis can be resolved. Other models concentrate on putting
together a plan to address the problems associated with the crisis (e.g..
Aguilera, 1998; Hoff, 2009; James, 2008; Roberts, 2005). The plans should be
short-term and have a realistic possibility of being accomplished (James, 2008).
Obtaining client commitment to carry out the plan is part of re-establishing
control (James, 2008). Echerling et al. (2005) added that re-establishing con-
trol also involves helping clients make meaning from the crisis situation
because that helps clients recognize the enormity of what has happened and
work out a way to organize the crisis into their world view.
Model developers tend to see this task in two ways. The first is to help
clients re-establish control in the immediacy of the intervention. For example,
Creenstone and Levitn (2011) discussed managing the immediate situation
by helping clients to reorder the chaos the erisis has caused in their world.
James (2008) discussed using direct interventions with someone who has a
severe reaction to a crisis by, e.g., MHCs taking over for clients by making deci-
sions that can help resolve the crisis. Some models also advocate use of de-esca-
lation techniques to facilitate a client's ability to re-establish control (e.g.,
James, 2008). Some models also consider setting of verbal limits (e.g.,
Kleespies & Richmond, 2009) to be a de-escalation. The second way of re-
establishing control involves empowering the client to resolve the crisis.
Several crisis intervention models advocate using basic problem-solving strate-
gies to complete this task. James (2008) considered obtaining commitment
from clients to carry out an agreed plan to be critical here. Client commitment
may range Tom an oral acknowledgement to a signed agreement.
Define the crisis or problem. Every model discusses the task of defining
the problem by helping clients to identify the crisis that must be addressed
(Aguilera, 1998). An essential aspect of this task is to understand the crisis from
the client perspecfive (James, 2008). James stated that unless this task is aecom-

103
 pushed, the clinician's strategies and interventions may be of no use. An impor-
tant part of this process is to identify what caused the person to seek assistance
(Roberts, 2005). James (2008) made this task the first step in his model. Some-
models break the task into several components, such as examining alternatives
(e.g., James, 2008; Roberts, 2005); identifying precipitating events (Kanel,
2011); exploring cognitions (e.g., Kanel, 2011; Roberts, 2005); exploring emo-
tions (e.g., Collins & Collins, 2005; Echerling et al., 2005; Greenstone &
Levitn, 2011); and identifying impairment to functioning (Kanel, 2011).
We believe that once the problem is defined, MHCs can move on to dif-
ferent tasks, but if assessment reveals new information, such as a threat to
safety, they may need to revisit this task. A good example is the client who has
just lost a loved one. Initially the MHC might define the problem as someone
needing support with grief. If during the intervention the client mentions feel-
ing that life is nothing without the deceased, the MHC would need to redefine
the problem in terms of safety. Or if during the intervention process the client
reveals using alcohol to dull the pain of the loss, the MHC will need to rede-
fine the problem in terms of abuse of alcohol.
Follow-up. A few step models (Collins & Collins, 2005; Creenstone &
Levitn, 2011; Hoff, 2009; Robert, 2005) make follow-up a task. We have done
so even though it may be difficult to accomplish. For example, following up
with clients who contact a telephone-based crisis intervention service is compli-
cated. Tlie confidentiality on which these services are based would be compro-
mised if the day after receiving a crisis call the MHC called the phone number
back asking to talk with a client. However in some settings follow-up is not so
difficult, as when a university student sought crisis intervention fi-om the coun-
seling center (Myer, James, & Mouton, 2011); in that case follow-up may be
considered a necessary and standard part of providing services.
Roberts (2005) suggested that the task of follow-up can be accomplished
formally or informally. He stated that agreement should be reached with
clients to gauge their success up to one month after the intervention. This con-
tact can be either in person or by phone. A second function of this task is to fol-
low up with MHCs. This part of the task involves examining the intervention
process to evaluate its effectiveness. Both the usefulness of the strategies used
and the competence of the MHC can be assessed; the goal is to improve upon
crisis intervention services.
Follow-up also occurs during the intervention. MHCs should periodically
check with clients in crisis to ensure that they are aware of what is happening.
Follow-up of this kind is needed because client awareness of immediate circum-
stances is offen compromised. Clients may seem to be paying attention, yet the
focus on the crisis impairs their ability to respond to questions and follow sim-
ple instructions. Follow-up allows MHCs to monitor client attentiveness to the
current situation and ability to take action on plans to resolve the crisis.
 Task Model for Crisis Intervetition

Generally speaking movement through the four focused tasks follows a

typical order; contact, re-establishing control, defining the problem, and fol-
low-up. However, because crises are chaotic, situations do arise that require
these tasks to be performed in a different order. Situations may also arise that
eall for MHCs to recycle through these tasks several times.

IMPLICATIONS
Our review of step models for crisis intervention has identified seven tasks
embedded in them. Three of these are continuous throughout the intervention
and four seem to be limited to specific times. The implications of this review
and the resultant task model have the potential to improve erisis intervention
in two areas: training and research.

Training
Crisis intervention has consistently focused on pragmatie issues. Our lit-
erature review has raised questions about the practicality of using step models
to train MHCs in erisis intervention. Step models imply a linear process, yet
many model developers (e.g., James, 2008; Kanel, 2011) have stated that fol-
lowing the models in order is not prudent when aetually working with clients
in crisis. Adjusting training around the tasks identified in this article may help
MHCs beeome more effective by helping them to monitor their progress
through the tasks. Training should also emphasize that beeause crises are
chaotic situations, MHCs must be flexible when working with clients in crisis.
Locking into a step-by-step model may be neither effieient nor effective.
The task model ean also improve the supervision of MHCs and students
practicing crisis intervenfion. If video or audio recordings are used, supervisors
can analyze these using the task model. Analyzing sessions in this way seems
realistic given the practical importance of erisis intervention. Both tasks
accomplished and tasks that are missed or not done well can be pointed out,
and supervisors can help MHCs and students identify points in the interven-
tion that suggest they should revisit speeific tasks. This process will help to
improve the effectiveness of crisis intervenfion.

Research
Researeh on erisis intervention is difficult because crises are not only
chaotic, they are unexpected. Yet systematic researeh is needed to continue to
enhance the field and identify evidenced-based interventions. We believe the
model described in this paper is a positive step for facilitafing researeh in crisis
intervention. The model is based on observable MHC behaviors. Observations
of MHCs actually doing crisis intervenfion could be used to test the effieacy of
the model. At least three options could be used to collect data; (a) Videos could

105
 be made of role-play crisis intervention situations, and observers could be
trained to identify whether the proposed tasks were accomplished, (b)
Practicum settings in counseling laboratories might also be used to have
trained observers view and rate practicum students when tliey practice crisis
intervention with clients, (c) Audiotapes of sessions with internship students
could be rated to determine if the intervention used in the tape matches or
does not match the tasks outlined in this paper. However, clearly special care
should be taken in research when clients are in crisis.
Another possible method for collecting data would be to interview MHCs
either individually or in focus groups, drafting questions that allow them to
explore the things they do when helping clients in crisis. These potentially rich
data could provide an in-depth examination of crisis intervention. For exam-
ple, in these interviews MHCs might be asked to identify situations in which
they must do the same thing or address the same task on several occasions with
clients. Data from such research could help improve training and supervision
of MHCs involved in crisis intervention.
Crisis intervention is increasingly recognized as a specialty area in the
field of mental health counseling. The emphasis in the fiele has always been,
rightly, on providing help rather than conducting systematic research.
However, we feel the time is right for the crisis intervention field to take the
next step. To make this move, thorough understanding through systematic
research is critical. The model proposed here has identified basic components
of the crisis intervention process that can be observed and tested. Testing the
model could be a positive step toward evidence-based treatment models for
crisis intervention.

REFERENCES
Aguilera, D. C. (1998). Crisis intervention: Theory and methodology (8th ed.). Saint Louis, MO:
Mosby.
Callahan, J. (1994). Defining crisis and emergency. Crisis, 15, 164-171.
Callahan, J. (1998). Crisis theory and crisis intervention in emergencies. In P.M. Kleespies (Ed.),
Emergencies in mental health practices: Evaluation and management (pp. 22-40). New York,
NY: Cuilford Press.
Collins, B. C , & Collins, T. M. (2005). Crisis and trauma: Developmental and ecological interven-
tion. Florence, KY: Wadsworth.
Council for Accrediting Counseling and Related Education Programs. (2009). 2009 standards.
Alexandria, VA: Author. Retrieved from http://www.cacrep.org/doc/2009%20Standards%20with
%20cover.pdf
Echerling, L. S., Presbury, J. H., & McKee, J. E. (2005). Crisis intervention: Promoting resilience
and resolution in troubled times. Upper Saddle River, NJ: Pearson.
Creenstone, J. L., & Levitn, S. C. (2011). Elements of crisis intervention: Crises and how to
respond to them (3rd ed.). Belmont, CA: Brooks/Cole.
Heppner, P. P., Wampold, B. E., & Kivlighan, D. M. (2008). Research design in counseling (3rd
ed.). Belmont, CA: Thomson Higher Education.

106
 Task Model for Crisis Intervention

Hoff, L. A. (2009) People in crisis: Clinical and diversity perspectives (6th ed.). New York, NY;
Routledge.
James, R. K. (2008). Crisis intervention strategies (7th ed.). Belmont, CA: Brooks/Cole.
Kanel, K. (2011). A guide to crisis intervention (4th ed). Belmont, CA: Brooks/Cole.
Kleespies, P. M., & Riehmond, ). S. (2009). Evaluating elinieal emergencies: The elinical inter-
view. In P. M Kleespies (Ed.), Behavioral emergencies: An evidence-based resource for evaluating
and managing risk of suicide, violence, and victimization (pp. 33-56). New York, NY: Cuilford
Press.
Myer, R. A., & James, R. K. (2005). CD ROM and workbook for crisis intervention. Paeifie Grove,
CA: Brooks/Cole.
Myer, R. A., James, R. K., & Mouton, P. (201 \).This is not a ftre drill: Crisis intervention and pre-
vention on college campuses. Hoboken, NJ: Wiley.
Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA:
Sage Puhlieations.
Plummer, C. A., Cain, D. S., Fisher, R. M., & Bankston, T. Q. (2008). Practice challenges in
using psychological first aid in a group format with children: A pilot study. Brief Treatment and
Crisis Intervention, 8, 313-326.
Roherts, A. R. (Ed.) (2005). Crisis intervention handbook: Assessment, treatment, and research (3rd
ed.). New York, NY: Oxford University Press.
Rodriguez, J. J., & Kohn, R. (2008). Use of mental health services among disaster survivors.
Current Opinion in Psychiatry, 4, 370.
Ruzek, J. I., Brymer, M. J., Jacohs, A. K., Layne, C. M., Vernherg, E. M., & Watson. P. J. (2007).
Psychologieal first aid. journal of Mental Health Counseling, 29, 17-49.
Slaikeu, K. A. (1990). Crisis intervention: A handbook for theory and practice (2nd ed.). Needham
Heights, MA: Allyn and Bacon.
Vernherg, E. M., Steinherg, A. M., Jacohs, A. K., Brymer, M. J., Watson, P. J. Osofsky, J. D., ...
Ruzek, J. I. (2008). Innovation in disaster mental health: Psychological first aid. Professional
Psychology: Research and Practice, 39, 381-388.
Wessely, S., Bryant, R. A., Creenberg, N., Earnshaw, M., Sharpley, J., & Hughes, J. H.(2008). Does
psychoeducation help prevent post traumatic psychological distress? Does psychoeducation
help prevent post traumatie psyehological stress disorder? In reply. Psychiatry, 71, 303-307.

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