UNIVERSIDAD ANÁHUAC MÉXICO NORTE

Psychology

7th semester

Subject: Crisis Intervention

MID TERM ESSAY – SKILLS USED IN CRISIS

INTERVENTION

Teacher:
Hector Armienta

Student:
P. Janeth Guerrero Medrano

Huixquilucan, Edo. De México

September, 30th, 2019.

 CLINICAL SKILLS WHEN INTERVENING DURING A CRISIS

In this essay, some of the most important clinical skills will be described, and each one of them
will be provided with an example on how they can be used at an intervention session. These
skills allow the client to feel comfortable with the counselor and to perceive a relaxed, non-
judgmental space for talking and exploring his or her issues. It involves observing the client’s
verbal and non-verbal language, and to adjust one’s own behavior to them so that the client
feels understood and listened. I became aware of these skills by analyzing the literature about
crisis intervention programs, and by revising the contents of previous counseling courses. It is
important to keep in mind all of the presented skills, as they’re useful in crisis intervention.
When a person is in crisis, they need to feel specially listened and comforted, if the counselor
doesn’t show the required skills, then it may cause some distress to the person, hence, it is of
great importance to be consciously and entirely aware of them while providing with a crisis
intervention program.

1. Rapport: state of understanding and comfort, is where trust and openness follows. It is
referred to the capability to relate to others in a manner that generates a level of belief and
understanding. When building rapport, the goal is that the client feels contented, peaceful, and
open to suggestions. It is one of the most common aspects of the unconscious human
communication. When rapport is built, an environment of safety and belongingness is created.
Establishing rapport increases the likelihood that the patient will comply with the intervention
plan.
Example: The counselor builds rapport with the person by learning their name, asking what to
call them, paying attention to the person’s movements and pace, matching their words, using
similar vocabulary, and mirroring their body language, so let’s say Anna is the patient and she
crosses her legs, then the counselor will subtly imitate this movement, also the counselor
noticed how Anna says a lot the word “friendly”, so he will try and say it too so that they’re in
the same tune. The counselor also learnt Anna’s name and asked her what she wanted to be
called, so that Anna felt respected and cared about.

2. Attending Behavior: demonstrates that you respect a person and are interested in what
they have to say. The effect of attending is an encouragement for the person to keep talking
about themselves, and to continue expressing his ideas and feelings freely. It shows that the
counselor is interested in what’s being said. If no attending behavior is shown, it may
discourage the person to keep talking, and can be interpreted as lack of interest and/or apathy.
Example: While Anna is talking about her traumatic event, the counselor leans forward to
show interest, and to keep physical proximity, he keeps a constant yet subtle eye contact that
doesn’t seem threatening, he uses a soothing voice to respond, keeps a relaxed posture and
an interested face.

3- Questioning: Questions during the session can help open up new areas for discussion.
Questions can be open ended or close ended. The first type of questions help explore more
information about what the client just said, may be used to gain information, explore thoughts
and feelings, and they require a more extended answer than “yes” or “no”. Close ended
questions are used to extract precise data and may be unhelpful in terms of the replies given.
Example: Anna is telling the story of how she didn’t act up when the precipitating event was
happening, so the counselor would ask an open-ended question: “¿What do you think stopped
you from acting or doing something at the moment?” instead of a close ended question “So…
¿did you stay motionless during the event?”.

4- Paraphrasing: It occurs when the counselor repeats what the client just said, using his or
her own words, without changing the meaning of what the client said. A paraphrase reflects
the essence of what has been said. It helps the client feel both heard and understood, it shows
that the counselor is listening and paying attention. While paraphrasing, the counselor can use
either the same words or just the meaning or idea of the statement.
Example: Anna was talking about how the stressful relationship with her boyfriend may had
influenced her reaction to the crisis, so she said “If I could, I would’ve never met him”, so the
counselor responds “Oh so would you rather that he had never been part of your life?”. The
sense of the phrase is still there, but the counselor paraphrased it in other words.

5- Clarification: When using clarification, the counselor has the client clarify vague or
ambiguous thoughts, feelings or behaviors by asking the client to restate what he or she just
said, or by stating to the client what the counselor has understood and verifying the information.
Its function is to make sure that the counselor has understood correctly, and to gain clarity
about vague material. It is important to make sure that the counselor has understood correctly
so that there’s no room for misinterpretations or wrong assumptions.
Example: Anna was telling the counselor about her decision to give back the engagement
ring to her boyfriend, and that her dad had called her at the phone before that, so she said “I’d
been thinking about giving him back the ring, and then my dad called so I told him I was going
out, minutes after I hung up, he suddenly arrived at my home” and the counselor replied “Sorry,
I’m having trouble keeping the his’ and him’s straight. Who arrived at your house before you
hung up?”
6- Reflection: It helps to accurately describe the client’s affective state from either verbal or
nonverbal cues. By listening and responding to the feelings of the client rather than the content
of their statement you are communicating that you can accurately sense the world as they are
perceiving it. This facilitates the client's movement toward greater self-awareness and self-
understanding. It is also the ability to make contextual considerations with the purpose of
understanding the client and identify his or her feelings and problems. Sometimes it can
resemble a paraphrase, but with an emotional interpretation included.
Example: Edward was talking about how everyone thought he was doing amazing after he
got hit by a car and lost some movement on his right hand, so he said: “Everyone thinks I’m
doing great, but I actually feel really sad and frightened all the time, as if I was a hoax to
everyone” so the counselor replied “Could it be that you feel at some point embarrassed that
you haven’t lived up to other people’s expectations of you?”.

7- Summarization: The counselor combines two or more of the client’s thoughts, feelings or
behaviors into a general theme. It is usually used as a skill during choice points of a counseling
interview in which the counselor wants to draw connections between two or more topics.
Otherwise, when the client appears to be jumping from one topic to another without any
particular focus or direction, a summarization can help the client to decide which topic is most
important. Summarization is also used as a way to close a session. It integrates elements of
what the person has been discussing and sums up the main ideas, shows that the counselor
has paid attention, organizes the information, and clarifies doubts.
Example: After listening to Edward talk about how the crisis event affected his marriage, his
relationship with his daughter, his performance at work, and his overall health, the counselor
then proceeds to close the session by saying the following: “So far you’ve indicated that the
event caused you trouble with your marriage and your daughter, you feel like you perform less
efficiently at work, and you’ve been experiencing chest pain mainly”. Then Edward said “Yes,
that’s right”.

8- Silence: The utilization of silence allows the client to speak more about the issues without
interruption, it enables the client space to process their thoughts and feelings. Sometimes the
counselor may create a moment of silence that has to be filled, so the client feels the need to
speak more or to think deeper about what they just said. It should not be used when there’s
no adequate rapport established because it can create some discomfort. Sometimes, by
keeping silence after the client stopped talking will enable them to continue doing so and
explaining their ideas further.
Example: Clara was talking about how her retirement made her feel miserable and useless.
After she suddenly stopped talking, the counselor kept quiet in order to allow her to explore
her ideas more deeply. Clara then, proceeded to explain her feelings further after having
analyzed them thanks to the brief moment of silence.

Conclusion and thoughts

These skills make the client feel important and understood, they open the door to a good
communication, and make it easier for the client to express themselves and to explore
thoughts, feelings, emotions, and behaviors. These skills are perhaps the key to success in an
intervention or counseling program, because if the client is not feeling comfortable or
understood, then the intervention becomes of no use. These skills are a bit hard to keep in
mind at all times, and maybe not because of lack of interest from the counselor, but because
sometimes he or she may forget to physically and verbally show interest or empathy towards
the client. Some skills are useful for making sure that the information was correctly understood,
such as clarifying, and summarizing, and this is quite important because they avoid
misunderstandings, and an accurate integration of the emotional contents and thoughts of the
client. So, in order to create a safe environment, these skills must be put in practice at all times,
the counselor must be aware of their body language, and voice tone the entire time so that the
interpretations and/or confrontations don’t seem aggressive and the person in crisis feels
comfortable enough to speak freely. As the counselor gains experience, these skills will be
easier to apply, and will eventually come up in a natural way. While writing this essay I noticed
that some of the skills might seem quite similar, but, the purpose of them is what makes them
stand out or different from the others, for example, paraphrasing might look like clarifying, but
their purposes are entirely different, so the counselor must be able to tell them apart and use
them in the right way for the right purposes.

References:

California State University, Northridge, (2017), School Psychology Program: Candidate

Handbook. California: Department of Educational Psychology and Counseling

Geldard, D., & Geldard, K. (2001). Basic personal counselling: A training manual for
counsellors. Frenchs Forest, NSW: Pearson Education Australia.