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Crisis Treatment: Solution Orientated Simple Therapy

The theory of solution-oriented simple therapy is very suited to crisis involvement. Kanel (2007) explores this perspective when she explains the brief remedy methodology in the turmoil setting up stating, "Simple therapy appears to be as effective as long-term remedy" (p. 23). Since crisis situations are time hypersensitive, solution-oriented crisis treatment becomes practical because it focuses on quick assessment and creative change. Greenstone (2002) stresses that, "Crisis Intervention/Management is an attempt to deal quickly with an instantaneous problem" (p. 1). Given the type and needs of turmoil situations the intervener may plan the encounter in a organised manner that assesses need, recognizes inherent dangers, suggests creative change, and facilitates a positive course of action. Positive encouragement of the treatment can even be achieved through referral and/or follow-up.

The Dynamics of Crisis Intervention

A problems intervener seeks to posture himself in a helping relationship with the counselee in order to arrest maladaptive habit. The idea of maladaptive action is suggested by Greenstone (2002) and he reinforces the point that results when the victim can no longer offer with mounting stress and for that reason, their coping mechanisms begin to are unsuccessful. In turmoil situations, the immediacy and timeliness of the involvement is all-important. Greenstone (2002) advises, "The intervener's skill and the timeliness of involvement can determine the likelihood of the victim's later functioning and growth" (p. 1). The thing of a crisis intervener is then to assist in the counselee through the down sides of an emergency and also to assist them in choosing a path that will allow them to once again function in life better. This can be accomplished by helping them to cope with crises and expanding resiliency. Brammer (2003) accurately defines this assisting romantic relationship stating, "Supporting another individual is basically a process of enabling that person to increase in the guidelines that person chooses, to resolve problems, and to face crises" (p. 4).

Issues of Immediacy

Crisis Treatment can be contacted singly or as a team. In any case, the responsibilities and procedures will be the same. The Bible teaches that people are called to "bear one another's burdens and so fulfill the laws of Christ" (Ga. 6:2, KJV). An emergency counselor is obviously buying a way to help. One thing that is steady in approaching a crisis is usually that the immediacy of the treatment affects the outcome. Greenstone (2002) notes this stating, "In approaching an emergency, the immediacy of the intervention is essential; The [intervention] team must attempt to relieve anxiousness, prevent further disorientation, and ensure that the victims do not harm themselves or others" (p. 37).

Seeing the need to address the problems of immediacy in Problems Intervention, the National Child Traumatic Stress Network, and the National Middle for Post-Traumatic Stress Syndrome are suffering from a modular approach to help children, children, adults and family members. Brymer & Company (2006) suggest that this is "to lessen the initial stress induced by traumatic incidents and foster short and long-term adaptive performing and coping" (p. 5). This process, called Psychological First Aid addresses the problem of immediacy. Brymer & Company (2006) continue by stating, "You must have accurate information about what will happen, what services are available and where they can be found. This information needs to be gathered at the earliest opportunity [emphasis mine] given that providing such information is often critical to lowering stress and prompting adaptive coping" (p. 13)

The Need of Problems Intervention

There are extensive scenarios a crisis counselor might come into contact with. Each one has its unique attributes. However there are certain factors that continue to be the same in regards to to the data of need. In counselling victims of assault, there may be evidences of PTSD (Post Traumatic Stress Disorder). For example, if a female has been abused and has consistently been stalked, PTSD may be an issue that the counselor should watch out for and be alerted to. Sandra Brown (2007) highlights that crisis treatment specifically, require that the intervener informs the counselee how to proceed in the face of imminent danger, proclaiming, "The idea of stalking trauma symptoms has been developed to describe types of PTSD symptomatology (Collins and Wilkas, 2001). A counselor must be alert [and aware] to any kind of traumatic emotional research that can guide the intervention and short-term goals" (p. 54).

Method

Solution-Oriented Short Therapy

A distinct advantage of the Solution-Oriented strategy is that it addresses the issue of immediacy, or the need to provide treatment within a particular effective time-frame, and allows the counselor to immediately focus on the solution rather than become reflective on what precipitated the problems. The difference between being problem centered and solution targeted is that one targets the primary cause in order to ease the situation (Cognitive Guidance) while the other focuses squarely on quickly evaluating the situation and assisting in creative change and a confident course of action. Kollar (1997) says, "the way often used today is dependant on some type of Albert Ellis's rational-emotive remedy (RET) or one of the other cognitive-behavioral techniques" (p. 43). In regards to to becoming Solution-Focused, Kollar (1997) claims, "As we have seen, a question such as "what is the root problem?" assumes that the answer is based on present patterns that need to be analyzed, recognized, and departed from. The question that underlies a solution-focused strategy is, "Just how do we create solutions with the counselee" (p. 44). In this respect, the problems intervener follows certain core actions that will help in successful treatment. These core activities can and really should be inspired by underlying assumptions that include conformity to the image of Christ within the Christian guidance paradigm (Rom 8:29).

Time Limitations

Another advantage of solution focused brief therapy is that it's best suited to time-limited counselling which is inherent in problems involvement. Benner (2003) observes four common rules that are usually followed in time-sensitive counselling. He expresses, "All simple, time-limited approaches to counseling talk about four common key points-- the counselor must be dynamic and directive, the guidance relationship must be considered a partnership, the counselling must focus on one central and specific problem and time limitation must be managed" (pgs. 48, 49).

A third awareness is the natural paradigm change that occurs when the interest is positioned on the solution as opposed to the problem. Hawkins (2010) areas, "Folks are looking for answers (solutions) in the counseling process. Brief therapy recognizes that the problems people encounter are not simply in the individual but around the person; Brief therapy is a paradigm shift that focuses the client on the solution, somewhat than on the issue" (p. 2). This fact is of extreme importance to the problems counselor. His job is never to de-brief the sufferer, ask questions in what occurred, etc. , but instead he needs to shift the focus from the problem/crisis and onto the solution to be able to relax the victim and help them to regain control of their coping abilities.

In addition to these considerations, Hawkins (2010) areas that brief remedy "is a way which allows you to start out immediately in to the counselling process [and] speed up the change process" (pg. 1). Therefore, solution focused short therapy is specially suited to problems intervention.

Seeing that this research concerns itself with a brief model approach to crisis intervention, the researcher has attempted to further explore the merits of solution-focused remedy. The solution-focused method of brief remedy has been applied for some time as is clear in Steve de Shazer's (2007) work A LOT MORE THAN Miracles: the condition of the fine art of solution-focused simple therapy, which expresses, "Solution focused quick remedy (SFBT) is a future-focused, goal-directed method of brief remedy developed primarily by Insoo Kim Berg, Steve de Shazer and their fellow workers and clients at the Milwaukee Brief Family Therapy Centre in the first 1980's. Developed inductively rather than deductively, SFBT is a highly disciplined, pragmatic procedure rather than a theoretical one" (p. 1).

Results

Structured Intervention

There are a number of examples which might serve as helpful information to a set up approach to turmoil treatment. These interventions have achieved significant results when put in place. Whichever some may be adapted, the counselor/intervener will include the four common principles as mentioned above. One good example is the set of core activities within the Psychological First Aid methodology which itself is a compilation of up to date solutions designed from empirical research. These core activities include contact and proposal with the counselee, ensuring the basic safety and comfort of the sufferer, stabilization (if they're physically or psychologically traumatized), information gathering (with regard to their needs or current concerns), and any type of practical assistance that can be given. This can be followed by home elevators coping, connecting the counselee with organizations and linkage with collaborative services (adapted from Brymer & Company, p. 19). These first set of core actions stand for one way of developing a structure of solution concentrated intervention.

A second example of structured intervention and the counselor's task (from an over-all viewpoint) includes lots of the same components. "This technique involves Entrance: planning the counselee and beginning the relationship, Clarification: [re]saying the problem or concern and reasons for seeking help, and Formulating: pushing a hope-filled means to fix the challenge" (adapted from Brammer, pg. 55). The next task would include facilitating positive action. "This might include exploration: formulating goals, planning strategies, consolidation: discovering alternatives, working through emotions, planning: growing an action intend to resolve conflicts, reduce painful thoughts, and consolidating and generalizing new behaviors to keep self-directed activities" (Brammer, 2003, Ibid. ).

Assessing Need

When the crisis worker enters the world of the counselee, whether that is the scene of a major accident or the docile environment of a full time income room, it's important to gather all the information as you can while rapport is being developed between your counselor and counselee. At this point, the intervener will start to inspect the circumstances which have presented the problems to be able to quickly identify the causation. The ABC model of intervention has turned out valuable in directing the thoughts of the intervener to examining need. On this "boiling down" process, the worker quickly recognizes the precipitating event, looks for to understand the cognitions of the counselee, gages their psychological state, including efficient abilities and then moves on to the therapeutic connection (adapted from the ABC Style of Involvement, Kanel (2007), p. 78). The first assessments in treatment prove to be the most critical.

Jeffry Guterman (2006) makes the observation that in most circumstances, folks have existing advantages and skills that may be identified and employed in the crisis guidance engagements. He claims, "Solution-focused counselling, like other guidance models, is not value free [it has assumptions]. It manages commensurate with a view of what problems are and what problems are not. Solution-focused counseling keeps that people have existing advantages, resources and problem-solving skills---in impact, the natural resources that are needed to solve the problems that bring them to guidance" (p. 3).

Recognizing Inherent Danger

In a more recent publication, Albert R. Roberts (2005) has mentioned that no two different people are the same with regard to the inherent hazard they face when striving to cope with crisis. Roberts (2005) says, "When two different people experience the same traumatic event, you can cope in a confident way while the other person may experience a crisis state because of insufficient coping skills and too little crisis counseling. Two key factors in identifying whether or not somebody who activities multiple stressors escalates into an emergency state are the individuals belief of the problem or event and the individual's potential to make use of traditional coping skills" (p. 5). This is illustrative of the fact that the way a person perceives a crisis is very important in the diagnosis process and can help guide the counselor in his work to provide aid. This observation also is true with the thinking that two of the most crucial parts of organized intervention are evaluating need, and realizing inherent hazard.

Richard K. Adam (2008) observes, "People can behave in virtually any one of three ways to problems. Under ideal circumstances, many individuals can deal effectively with crisis by themselves and develop strength from the knowledge. They change and grow in a positive manner and come out of the turmoil both stronger and even more compassionate. Others appear to survive the problems but effectively obstruct the hurtful have an impact on from awareness, only to own it haunt them in countless ways throughout the rest with their lives. Yet, others breakdown psychologically at the onset of the turmoil and clearly illustrate they are incapable of going any further with their lives unless given immediate and intensive assistance" (p. 4). For this reason, and others, it's important that the intervener gets into the crisis circumstance with the goal of first assessing the need. In so doing, he/she can understand something of the severity of crisis and examine the subject's capacity, but moreover, understand and understand the inherent threat in the crisis situation.

Suggesting Creative Change

In many instances, such as doing crisis counseling in relationship, an intervener may effectively use solution-oriented brief therapy to suggest creative change that will facilitate recovery and bring help to struggling connections.

With regard to rapid treatment, Michele Weiner-Davis (1992), in her publication Divorce busting: a revolutionary and fast program for keeping yourself together, the writer explains the following:

"By figuring out each person's role in the manner the problem is being handled today, simple therapists obtain the raw data necessary to make prescriptions for change. By so doing, prolonged reviews of personal histories are bypassed. More importantly though, SBT therapists concentrate on the future, assisting lovers envision what their lives will be like without the problems. Unlike psychodynamic or psychoanalytic approaches which point out how problems develop, SBT asks: "What would you like to become?" and "What are the steps needed to make it happen?" Therapy becomes less explanation-oriented and even more solution-oriented, a process which takes significantly less time" (p. 16).

This situation illustrates how that brief therapy can be effective in an emergency situation. It also underscores the concept of rapid intervention in an emergency situation. Evaluating need and envisioning (with the counselee) a prescription for change can considerably affect the outcome of the crisis. This emphasizes that creative change, suggested in a timely fashion, during which solution-oriented crisis treatment is utilized, can succeed in obtaining significant results.

Active Participation

It is important that the counselee joins the counselor in active participation in reaching the solution oriented goals. Kollar (1997) areas, "a remedy focused counselor, in comparison, will guide however, not control the counselling interview by his skilled use of questions" (p. 50). It's important that the counselee requires a dynamic role in checking out creative change. It is also important that the duty for change is shifted to the counselee. Walter & Peller (1992) condition, "The solution-focused model places responsibility on the far side of the relationshipclients will be the experts on what they want to change, as well as in deciding what they would like to work on" (p. 28).

Discussion

Facilitating a confident Span of Action

Positively reinforcing the treatment through Recommendations and/or Follow-up may be needed in the case of acute emotional trauma after a crisis situation. Occasionally, a lengthier (restorative) plan of action will be necessary. It would be a good idea for the crisis intervener to network with other resources and provide information for follow-up treatment to the victim. In many cases, the solution-based quick therapy model of crisis involvement can be adopted up by experts who utilize this modality in a more controlled setting and for a more expanded encounter.

Some questions may stay with regard to follow-up treatment and the referral process. Increasingly more, professional advisors are taking advantage of the brief remedy model rather than more cognitive treatment but not necessarily because it seems to be the most functional form of treatment approximately that this modality figures into their forced restraints placed after them by insurance companies. In regards to to these restraints, Albert Roberts (1995) state governments, "In regard to the practice environment, an increasing number of therapists and counselors are having to utilize similar theoretical orientations and techniques. The principal reason behind this tendency toward conformity is increasing limitations placed by health insurance providers on the number of reimbursable lessons per customer" (p. 6). While this is barely a justifiable reason to choose simple therapy, it can serve to demonstrate the practicality of the technique. Roberts (1995) goes on to state, "therefore, professional counselors are being pressure not and then be constant in their treatment modalities but to do their best to solve their clients problems in the shortest amount of time possible" (p. 6). This seems scarcely a reasonable reason to choose SFBT yet it appears to be more common today. The question remains, does SFBT give a valid alternative with regard to crisis intervention? This research attempts to prove that a Solution-Focused method of Crisis Intervention is a valid and effective way to start and conduct Crisis Intervention.

Quite often, follow-up is not essential in crisis treatment but on occasion, the counselor may be required to develop a plan for referral for those who are experiencing long-term effects from problems situations. In this case, resiliency is one factor as well as the overall coping skills developed by the counselee. Hamaoka & Company (2007), at the Uniformed Services University of the Health Sciences, observes:

"Many serious negative behavioral and emotional responses remit over time, nor require formal treatment. This inclination toward recovery is often acknowledged to resiliency, a dynamic procedure for health recovery and coping in the face of adversity. Optimism, cleverness, humor, creativeness, and dynamic coping are related to resilience and positive benefits after crises. Through active coping, individuals agree to the impact of distressing events and apply attainable, concrete options to boost things.

Although many people experience stress after an emergency, some experience more continual emotional sequel, such as anxiety, insomnia, increased smoking, increased alcoholic beverages use, and bereavement. This group may benefit from supportive mental interventions, including mental first aid and short pharmacological interventions for rest or stress. A still smaller group will establish psychiatric condition, including nervousness disorders (acute stress disorder, ASD; and posttraumatic stress disorder, PTSD), major depressive disorder, and element use disorders. Such individuals require more formal (as well as perhaps more prolonged) interventions, including psychiatric treatment" (p. 2).

Conclusion

The afore-mentioned quote from Hamaoka & Company (2007) is a sobering reminder that positive, hope-filled, solution-oriented crisis intervention often means the difference between renewed coping and continuous damage. As an emergency intervener, it is imperative to choose the very best modality or paradigm in which to conduct good care.

This research highlights the value of solution-focused simple therapy as a model in the approach to crisis intervention. It might be adequately utilized in lots of scenarios and since research has concluded, can serve to be as effectual as more long-term remedy. Because of the type and the needs of crisis situations the intervener can virtually use the guidelines of solution-focused short therapy as a crises involvement. Employing this modality, the intervener can tackle the initial come across in a set up way, assess the needs and discover the inherent dangers both to himself and in particular to the counselee.

The intervener may then suggest creative change to help a positive course of action as a part of the intervention. After the initial face, positive reinforcement of the connection as well as the further development of coping skills may be performed through referral or productive follow-up.

Resources

Benner, David G. (2002). Strategic pastoral counselling: a short-term structured model. Grand Rapids, MI: Baker Academic Publishing.

Brammer, Lawrence M. & MacDonald, Ginger (2003). The aiding romance: process and skills. Boston, MA: A&B Magazines.

Brown, Sandra L. (2007). Counselling victims of assault: a handbook for helping professionals. Alameda, CA: Hunter House Publishers.

Brymer, M. , Jacobs, A. , Layne, C. , Pynoos, R. , Ruzek, J. , Steinbreg, A. , Bernberg, E. , Watson, P. (2006). Psychological Fist Aid: Field Operations Guide. Washington, D. C. : National Child Traumatic Stress Network and Country wide Centre of PTSD.

DeShazer, Steve & Dolan, Yvonne. (2007). More than miracles: the point out of the art work of solution-focused short therapy. Binghamton, NY: Hawthorn Press.

Greenstone, Adam L. & Leviton, Sharon C. Components of crisis treatment: crises and the way to respond to them. Pacific Grove, CA: Brooks/Cole Publishing.

Guterman, Jeffry T. (2006). Mastering the skill of solution-focused guidance. Alexandria, VA: North american Counseling Connection.

Hamaoka, I. D. , Benedek, D. , Grieger, T. , Ursano, R. J. (2007). Problems Treatment: Uniformed Services University of the Health Knowledge. Bethesda, MD: Elsvier Inc.

Hawkins, Ron E. (2010). Quick Remedy: Liberty Baptist Theological Seminary. Lynchburg, VA (Accessed, 12/2/2010).

James, Richard K. (2008). Problems treatment strategies. Belmont, CA: Brooks/Cole Publishing.

Kanel, Kristi. (2007). A guide to crisis intervention. Belmont, CA: Brooks/Cole Posting.

Kollar, Charles A. (1997). Solution concentrated pastoral counselling. Grand Rapids, MI: Zondervan Publishing.

Roberts, Albert R. (2005) Problems intervention handbook: Evaluation, treatment and research. NY, NY: Oxford University or college Press.

Roberts, Albert R. (1995) Turmoil involvement and time-limited cognitive treatment. Thousand Oaks, CA: Sage Publications.

Walter, John L. & Peller, Jane E. (1992). Becoming solution-focused in quick remedy. Levittown, PA: Brunner/Mazel Publishers.

Weiner-Davis, Michele. (1992). Divorce busting: a ground-breaking and swift program for remaining together. NY, NY: Simon and Schuster.

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