CRISIS COUNSELING

At different points in life most people experience some kind of crisis. A crisis is defined as a situation or event in which a person feels overwhelmed or has difficulty coping. A crisis might be caused by an event such as the death of a family member, the loss of a job, or the ending of a relationship. During such times people experience a wide range of feelings, and each person's response to a crisis is different. It is normal to feel frightened, anxious, or depressed at such a time.

Crisis counseling involves providing support and guidance to an individual or a group of people such as a family or community during a crisis. The purpose of crisis counseling is to decrease emotional pain, provide emotional support, make sure that the person in crisis is safe, and help develop a plan for coping with the situation. Sometimes it also involves connecting a person to other community or health services that can provide long-term support.

Crisis counseling can be linked to health education if it is used to increase knowledge of how to avoid or cope with a crisis in the future. It can also be used to change people's attitudes and beliefs about people in crisis, and to provide people with information about help available in their community. Public health professionals, for example, might educate a community on how to cope with a natural disaster such as a hurricane or an earthquake.

Crisis counseling is also related to health promotion. People can be taught useful skills that will help them to anticipate and cope with a crisis. Skills, information, and support services gained through crisis counseling can also help a person or a group of people to improve their health and quality of life. Crisis counseling can also be tied to health promotion through the development of health-related public policy and supportive environments. For example, public health professionals might create a policy to build crisis counseling centers or to develop a peer counseling program in high schools or colleges.

A valuable tool for public health, crisis counseling has several advantages over other types of counseling or health services. It is relatively low-cost and simple to provide, and it is flexible and easy to learn. A wide variety of health professionals, including doctors, nurses, psychologists, and social workers, can be taught to help people through the application of crisis counseling techniques. Crisis counseling services can also be provided in a wide variety of places or settings, including hospitals, community clinics, military bases, and police stations, as well as through telephone-based services. New technologies have also created the possibility of Internet-based crisis counseling.

Such services provide an important link between a community and the health care system. By using these resources people can sometimes get the help they need without using more expensive health care services, and they can often take advantage of twenty-four-hour crisis services. People with chronic health problems such as schizophrenia or depression can also get help from twenty-four-hour services when their physician or psychiatrist is not available. Many communities have developed peer counseling programs for specific groups such as adolescents and senior centers.

Public health professionals who offer crisis counseling have been faced with a growing variety of issues and clients. Many communities are home to an increasing number of people from a wide variety of cultural and ethnic backgrounds. There are also more older people in society than ever before. These trends have increased the number of incidents of elder abuse, hate crimes, and cultural clashes. These types of events, along with issues such as AIDS (acquired immunodeficiency syndrome), have increased the workload of crisis counselors. The field has also grown with the development of "first response" programs. Police officers, firemen, paramedics, and others are being trained to deliver on-the-spot crisis counseling. People working in public places such as stores and airline terminals are also learning how to do crisis counseling in order to deal with unhappy or violent customers. These types of programs only add to the importance of crisis counseling for individuals, families, and communities.

C. James Frankish

Robbin Jeffereys

(see also: Communication for Health; Counseling; Health Promotion and Education; Hotlines, Helplines, Telephone Counseling )

Bibliography

Everly, G. S.; Flannery, R. B.; and Mitchell, J. T. (2000). "Critical Incident Stress Management (CISM): A Review of the Literature." Aggression & Violent Behavior 5 (1):23–40.

Janosik, E. (1994). Crisis Counselling. Sudbury, MA: Jones and Bartlett Publishers Incorporated.

Quartaro, E. (1997). "Medical Crisis Counseling." Families in Society 78 (1):107–108.

Sandoval, J., ed. (1988). Crisis Counseling Intervention and Prevention in the Schools. Mahwah, NJ: Lawrence Erlbaum Associates Incorporated.