***See Bottom of Page for Crisis Contact 24/7 Phone/Text Lines ***
Table of Contents
Overview
Crisis Models
Behavioral Intervention Strategies
Phases of CISD
References & Tools
Contact Phone #s and Text Lines
“ You can’t rewrite your past, but you can grab a clean sheet of paper and write your future." - Anonymous
Crisis intervention is emergency first aid for mental health. It refers to the methods used to offer immediate, short-term help to individuals who experience an event that produces emotional, mental, physical, and behavioral distress or problems. A crisis can refer to any situation in which the individual perceives a sudden loss of his or her ability to use effective problem-solving and coping skills. A number of events or circumstances can be considered a crisis: life-threatening situations, such as natural disasters (such as an earthquake or tornado), sexual assault or other criminal victimization; medical illness; mental illness; thoughts of suicide or homicide; and loss or drastic changes in relationships (death of a loved one or divorce, for example) (http://www.minddisorders.com/Br-Del/Crisis-intervention.html). Crisis intervention involves three components: 1) the crisis, the perception of an unmanageable situation; 2) the individual or group in crisis; and 3) the helper, or mental health worker who provides aid. Crisis intervention requires that the person experiencing crisis receive timely and skillful support to help cope with his/her situation before future physical or emotional deterioration occurs (https://www.counseling.org/resources/library/eric%20digests/95-034.pdf).
Warning Signs of Suicide
IS PATH WARM MODEL
Crisis Models
Crisis Formation Formula
1) Precipitating event 2) Perception of the event (* Most important) 3) Subjective Distress 4) Lowered Functioning When Coping Fails
Increase of Functioning Formula
1) Change in perception of the precipitating event and acquiring new coping skills
2) Decrease in subjective distress
3) Increase in Functioning (* Most important*- get back to normal level of functioning)
Models of Crisis Intervention
Robert's Seven-Stage Model
In conceptualizing the process of crisis intervention, Roberts has identified seven critical stages through which clients typically pass on the road to crisis stabilization, resolution, and mastery.
PDF - Robert's Seven-Stage Model
Crisis Incident Stress Management
The CISM model is a comprehensive, multicomponent program to maintain or restore the individual(s) involved to their usual state of health by alleviating the severe effects of traumatic stress.
The interventions are conducted throughout three stages of the model:
-pre-crisis
-acute crisis
-post-crisis
WEBSITE - Overview of CISM
Psychological First Aid
Psychological First Aid (PFA) is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping.
WEBSITE - Collection of Tools - Psychological First Aid Resources
Caplan's Model
Caplan describes the four stages of a crisis reaction as follows:
1. An initial rise in tension occurs in response to an event.
2. Increased tension disrupts daily living.
3. Unresolved tension results in depression.
4. Failure to resolve the crisis may result in a psychological breakdown.
PDF - Crisis Interventions
Behavioral Intervention Strategies
Common Goals of Crisis Intervention Regardless of Model
1) Relieving the client's symptoms (listen to them)
2) Restoring the client to his/her previous level of functioning
3) Identifying the factors that led to the crisis state (what was going on right before the crisis)
4) Identifying and applying remedial measures
PDF - Crisis Intervention
Phases of CISD
There are seven phases to a formal CISD.
1. Introductory remarks: team sets the tone and rules for the discussion, encourages participant cooperation.
2. Fact phase: participants describe what happened during the incident.
3. Thought phase: participants state the first or main thoughts while going through the incident.
4. Reaction phase: participants discuss the elements of the situation that were worst.
5. Symptom phase: participants describe the symptoms of distress experienced during or after the incident.
6. Teaching phase: team provides information and suggestions that can be used to reduce the impact of stress.
7. Re-entry phase: team answers participants' questions and makes summary comments.
(reference- http://www.info-trauma.org/flash/media-f/mitchellCriticalIncidentStressDebriefi
Tools/References
WEBSITE/CONTACT #s - Pennsylvania Crisis Hotline List by County
WEBSITE/CONTACT #s - Crisis Hotline List by Category
WEBSITE/CONTACT #s - Crisis Hotline List
VIDEO- Robert's 7 Stage Crisis Intervention: Role Play
VIDEO - Robert 7 Stage Crisis Intervention
SLIDES/PRESENTATION - Crisis Intervention Models
WEBSITE - Suicide Prevention in Primary Care
https://www.integration.samhsa.gov/about-us/esolutions-newsletter/suicide-prevention-in-primary-care
JOURNAL - Crisis Intervention for People With Severe Mental Illnesses
PDF - A Practical Guide to Crisis Management
PDF- Crisis Management Form
WEBSITE - Toolkit for PCPs
TOOL/SCALE- SAFE-T for PCP offices
PDF/PPT - Effective Crisis Planning with Families
TOOL - Adult Assessment and Referral Tools
TOOL -Risk Assessment Tool For Behavioral Crisis
TOOL - Shortened Version Of The Ptsd Checklist
TOOL - Risk Assessment Tool
TOOL - CHILD/ADOLESCENT FULL ASSESSMENT
CONTACT PHONE/TEXT LINES
-NATIONAL SUICIDE PREVENTION LIFELINE: P# 1-800-273-8255 The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones.
Text SIGNS to 741741 for 24/7, anonymous, free Crisis Counseling & Resources
Depression & Suicide The Trevor Project Call 866-488-7386 (24/7) Live Chat with the Trevor Project (Fridays 4:00 PM to 5:00 PM EST)
Dating Abuse & Domestic Violence loveisrespect Call 1-866-331-9474 (24/7) Chat Online with loveisrespect (7 days/week, 5:00 PM to 3:00 AM EST) or text loveis to 22522
National Domestic Violence Hotline Call 1-800-799-7233 (24/7) Email the National Domestic Violence Hotline (24/7)
RAINN: Rape, Abuse and Incest National Network Call 1-800-656-4673 (24/7) Live Chat with RAINN (24/7)
Child Abuse Childhelp National Child Abuse Hotline Call 1-800-422-4453 (24/7) National Safe Place Text SAFE and your current location to the number 69866 (24/7)
Runaways, Homeless, and At-Risk Youth National Runaway Safeline Call 1-800-786-2929 (24/7) Live Chat 7 days/week, 4:30 to 11:30 PM CST Home Free Family reunification program provides free bus tickets to eligible runaway and homeless youth.
CRISIS #s BY COUNTY
Adams, Franklin, Perry, Upper-Dauphin Crisis P# 1-800-932-4616
Carlisle Crisis P# 717-249-6226
Lancaster County Crisis: P# 717-394-2631
Lebanon P# 717-274-3363
Harrisburg Crisis p# 717-652-4400
Adams: 717-632-4900 Adams Hanover Crisis Information Referral Hotline
Allegheny: 888-796-8226 Resolve Crisis Network
Armstrong: 724-465-2605 Armstrong-Indiana Crisis Hotline
Beaver: 800-400-6180 Beaver County Crisis Help Line
Bedford: 866-611-6467 Bedford-Somerset MH/MR
Berks: 610-236-0530 Service Access and Management (SAM)
Blair: 814-889-2141 Altoona Regional Center for Behavioral Health Services
Bradford: 888-829-1341 Help Line
Bucks: 800-499-7455 Bucks County Crisis Line
Butler: 800-292-3866 Center for Community Resources
Cambria: 877-268-9463 Behavioral Health/Intellectual Disability/Early Intervention
Cameron: 800-652-0562 Cameron and Elk Behavioral/Developmental Program
Carbon: 800-338-6467 Carbon-Monroe-Pike Mental Health and Developmental Services
Centre: 800-643-5432 Centre County Can Help
Chester: 610-280-3270 Chester County Crisis
Clarion: 814-226-7223 Clarion County Crisis Intervention Services
Clearfield: 800-341-5040 Clearfield/Jefferson Crisis
Clinton: 570-326-7895 Crisis Helpline Mental Health Services
Columbia: 800-222-9016 Columbia, Montour, Snyder, and Union Crisis
Crawford: 814-724-2732 Crawford County Mobile Crisis Services
Cumberland: 866-350-4357 Cumberland-Perry County Crisis Intervention
Dauphin: 717-232-7511 Dauphin County Mental Health/Intellectual Disabilities Program
Delaware: 610-447-7600 Crozer Chester Medical Center
Elk: 800-652-0562 Cameron and Elk Behavioral/Developmental Program
Erie: 800-300-9558 Safe Harbor Behavioral Health
Fayette: 724-437-1003 Fayette County Crisis Hotline
Franklin: 717-264-2555 Keystone Health Crisis Intervention Program
Fulton: 717-264-2555 Keystone Health Crisis Intervention Program
Greene: 800-417-9460 Mental Health Program, Department of Human Services
Huntingdon: 800-929-9583 Tri-County Crisis-Mifflin, Juniata, Huntingdon
Indiana: 724-465-2605 Armstrong-Indiana Crisis Hotline
Jefferson: 800-341-5040 Clearfield/Jefferson Crisis
Juniata: 800-929-9583 Tri-County Crisis-Mifflin, Juniata, Huntingdon
Lackawanna: 570-348-6100 Scranton Counseling Center
Lancaster: 717-394-2631 Lancaster County Crisis Intervention
Lawrence: 724-652-9000 Lawrence County Crisis Intervention
Lebanon County Crisis Intervention
Lehigh: 610-782-3127 Lehigh County Crisis Intervention
Luzerne: 888-829-1341 Help Line
Lycoming: 570-748-2262 Crisis Helpline Mental Health Services
McKean: 800-459-6568 The Guidance Center
Mercer: 724-662-2227 Crisis Intervention Hotline
Mifflin: 800-929-9583 Tri-County Crisis-Mifflin, Juniata, Huntingdon
Monroe: 800-338-6467 Carbon-Monroe-Pike Mental Health and Developmental Services
Montgomery: 610-279-6100 Montgomery County Emergency Services
Montour: 800-222-9016 Columbia, Montour, Snyder, and Union Crisis
Northampton: 610-252-9060 Northampton County Behavioral Health
Northumberland: 800-222-9016 TAPLINE
Perry: 866-350-4357 Cumberland-Perry County Crisis Intervention
Philadelphia: 215-686-4420 Suicide and Crisis Intervention Line
Pike: 800-338-6467 Carbon-Monroe-Pike Mental Health and Developmental Services
Potter: 800-652-0562 Potter County Human Services
Schuylkill: 570-628-4731 Mental Health and Developmental Services Office
Snyder: 800-222-9016 Columbia, Montour, Snyder, and Union Crisis
Somerset: 866-611-6467 Bedford-Somerset MH/MR
Sullivan: 888-829-1341 Help Line
Susquehanna: 570-348-6100 Scranton Counseling Center
Tioga: 888-829-1341 Help Line
Union: 800-222-9016 Columbia, Montour, Snyder, and Union Crisis
Venango: 814-432-9111 Mental Health Services
Warren: 814-726-8413 (8:30AM-5PM) 800-406-1255 (all other hours)
Washington: 877-255-3567 Washington County Crisis Line
Wayne: 570-282-1732 NHS Human Services of Northeast PA
Westmoreland: 724-552-0305 Westmoreland Community Action
Wyoming: 888-829-1341 Help Line
York: 717-851-5320 York Hospital Crisis Intervention Services
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