ABC Model: Steps to Crisis Intervention

1. Achieving Rapport
   • Trust
   • Fondness
   • Foundation
   • Comfortable
   • Calamity

Listening Skills: Why should we listen?

• Client feels heard/ understood/ not judged
• They hear themselves
• They get it off their chest
• You get to understand really well
• Relationship building + trust = RAPPORT

Why don’t we listen?

• We want to help (we think we’re the problem solvers)
• Discomfort (things we hear might not be conventional)
• Habit (go off topic)

ADVICE

• They may ask for…
• They may expect…

 

 

Why say no to giving advice?

• Heard it already
• Tried it already
• Discourage disclosure
• Discourages listening
• Disqualify you
• Implies judgement

Purpose of Listening Skills

• Shows interest
• Encourages sharing
• Gain understanding= Empathy (true, deep understanding)

 

Basic Listening Skills (Invitation Skills)

Attending Skills: present and interested

Following Skills: stay out of the way

Reflecting Skills: heart of therapy

 

• Attending Skills: Be Aware and Manage
  • Eye contact: too much or not enough
  • Body position: determines if you care or not
  • Silence: can be uncomfortable or powerful tactic
  • Voice tone: can escalate or de-escalate the crisis
  • Facial expression: can say a lot without saying anything
  • Gestures: shows a reaction
  • Distance: want to be close enough to see reactions and movement, but far enough to be comfortable
  • Touch: (don’t do it) can be okay but can lead to something very bad; allow client to initiate appropriate physical touch
• Following Skills: stay out of the way
  • Door opener: “tell me more about that”
    • Find something compelling, dig deeper
  • Minimal encourager: “Mmm”
    • Short simple reactions à “Oh”, “I see”, etc.
  • Questions: WITH CAUTION! Why caution?
    • Distraction from listening
    • Interrogation
    • Sidetracked
    • Implied judgement
    • Pressure
    • Sets expectations of a Q & A
    • “Why?”
    • Leading questions: “Do you think that was the right choice?”, “How has that been impacting you?”
  • Reflecting Skills: Most important and awkward

Why reflection instead of questions?

• Proves understanding and empathy
• Chance for accuracy check
• Provides mirror for introspection
• Direction with minimal interference
• Simple action on clients open door
• Slows things down, allows emphasis and elaboration
• No question
• Minimal interruption

Types of reflection

Pure: repetition of a key word or phrase

Paraphrase: condensed, non-judgmental version of facts and thoughts

Feeling: focused reflection of the often unspoken or nuclear emotional content.

“Sounds like what you’re describing is…”

Meaning: focused interpretation of themes

Summarizing: broad wrap up of a bulk of client content

 

1. Therapeutic Interaction
   • Validating: letting them know their situation is normal, feelings are normal
   • Psychoeducation: giving reasons why they may feel the way they do
   • Empowerment: letting clients know that oftentimes they don’t give themselves enough credit, letting them know they have control
   • Reframe: turning your negative emotions into something else that can be more positive, different perspective
2. Coping
   • What are their current coping mechanisms?
   • Use the presented issue to find the end result
   • Suggest but don’t advise
   • “Why don’t we try to come up with some ways to better help you?” à you’re not telling thing what to do, both of you are coming up with ideas together
   • Listen to their invitation to help them through their talks
   • Suggest progressive actions
   • “I’ve heard… works well for some people, are you open to trying this method?”
   • Give them the opportunity to have power over their decision
   • “You seem safe for now, maybe you can go home, get a shower, some food, and relax.” ß future planningà getting them to get ready for their future, investing in it