STEPS FOR GETTING STARTED

STEP 5 – Modalities & Best Practices

Crisis Intervention Models 

We invite you to investigate various crisis intervention modalities to identify and become trained in the model that best fits your philosophy, personality and professional style. You should also take into consideration the organizations with which you plan to affiliate. Most demand the use of specific protocols so they know their volunteers are properly trained, supervised appropriately, and can work well with other team responders when deployed.

Numerous crisis response programs, services, approaches, and methods have been developed to prevent, mitigate, and recover from the natural human stress reactions in the aftermath of tragic events. All crisis intervention modalities have the same goals: to stabilize, reduce symptoms, and return to adaptive functioning or to facilitate access to continued care. Although there are some psychotherapy treatment methods that can be used appropriately for crisis intervention and most crisis intervention techniques can be effectively used in treatment, the methods presented here are in the context of crisis intervention, not treatment.

Please review the Crisis Intervention Models presented here:

1. ABCD Crisis Intervention
2. Critical Incident Stress Management (CISM)
3. NOVA Crisis Intervention
4. Psychological First Aid (PFA)

Crisis Response Best Practices 

Disaster Mental Health and Crisis Response are terms frequently used interchangeably. However, Disaster Mental Health is actually a subset of Crisis Response and has dynamics and characteristics unique to large scale community-wide natural and man-made disasters. The mental health intervention needs in the intensive aftermath of a disaster are complex and wide-ranging and must take into consideration the phase of recovery, the disaster setting, cultural differences, and special needs populations. Often mental health services are provided during the disaster event so responders are at greater risk of direct and secondary traumatization. See Phases of Disaster Chart and Description.

The development of Disaster Mental Health Core Competencies enables California to identify training strategies and California Disaster Healthcare Volunteer registration strategies. The Core Competencies were added to the Disaster Framework because there was consensus that they are comprehensive, widely supported, and set crucial guidelines for the training of disaster mental health service providers in ‘best practices’ and evidence-based interventions.

1. Understand and describe key terms and concepts related to disaster mental/psychosocial/behavioral health preparedness and response.
2. Communicate effectively.
3. Assess the need for and type of intervention (if any).
4. Formulate and implement an action plan.
5. Demonstrate knowledge of responder peer-care and self-care techniques.

See State of California Mental/Behavioral Health Disaster Framework, Appendix D. for the full description of the competencies.

Strategic Crisis Response planning is necessary for developing a comprehensive crisis intervention plan before deployment and providing services. Knowing what sequence of crisis intervention processes to use for which individuals or groups, at what times, and under what circumstances is crucial to all effective early intervention programs. An effective strategic plan identifies and assesses target populations and determines the types of interventions, when to apply the interventions, and the resources available. Strategic planning and tactical decision-making help determine one set of crisis intervention processes over another so the right choices of interventions for the populations under specific circumstances are selected.

The crisis intervention strategic planning formula consists of six components:

1. THREAT is the event that may result in adverse reactions.
2. THEME are special conditions, which may modify the impact and response.
3. TARGET are who should receive services.
4. TYPE are what interventions, if any, should be used.
5. TIMING is when the interventions should be implemented, with what target groups.
6. TEAM are the intervention resources available to be mobilized, for what target groups, when.

This information is taken from the International Critical Incident Stress Foundation Strategic Response to Crisis course that teaches crisis interventionists to make the right choices of interventions for the populations they are assisting under specific circumstances. See ICISF Strategic Response to Crisis.  

Post Action Staff Support is a group intervention to help crisis response teams returning from a crisis or disaster deployment to process their experience and help them adjust back to civilian life. It consists of three phases: Review, Response, and Remind. Review utilizes questions designed to have members think about and discuss the deployment and their participation in it. Response validates their reactions to the experience and provides guidance.  Remind helps the team members practice self-care. See Bringing Your Crisis Team Home After A Disaster.

Psychological Simple Triage and Rapid Treatment (PsySTART) is not a crisis intervention per se, but is a vital process for rapid mental health triage and incident management during large-scale disasters and terrorism events. It is believed to be the first evidence-based, disaster mental health triage system in the U.S. that can help responders identify and assess the mental health impact of a disaster at the individual, disaster service site, and community-wide population levels. PsySTART includes four components: 1) an evidence-based rapid triage system designed for field use by all levels of responders (including those without mental health expertise); 2) an information technology platform to manage the collection and analysis of triage needs, cloud based/smart phone application, 4) Population based ICS, Incident Action Plan (IAP). Individual triage data is collected across key disaster systems of care, including hospitals, clinics, schools, shelters, and other community disaster relief settings. The data are used to help responders determine immediate and future strategies and level of mental health interventions needed. PsySTART measures disaster mental health impacts such as: severe/extreme stressors, level of exposure to the disaster, traumatic loss, ongoing stressors, peri-traumatic panic, and prior history of PTSD. The developer of PsySTART is Merritt Schreiber, PhD. See: PsySTART Disaster Mental Health Triage and Incident Management System.