Crisis Counseling, Intervention and Prevention in the Schools

Jonathan Sandoval, Jonathan Sandoval

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781136506901
• Edition: 3
• Topic: Éducation
• Subtopic: Éducation et orientation

Since the first edition was published in 1988, the role of crisis intervention and prevention has become central to mental health professionals working in the schools. Disasters such as hurricane Katrina, terrorist attacks both in this country and around the world, and various school shootings have greatly increased school crisis research and policy development. This book is designed for an introductory graduate course taken by students in school psychology, school counseling, and school social work. Section I provides a crisis response overview, section II deals with crises for children and adolescents and section III covers crises that manifest in adolescence. Discussions of the 16 most prevalent types of crises are covered in sections II and III and include their characteristics, causes, interventions, and preventive programs. All chapters will be updated, six heavily revised or totally rewritten by new authors, and two new chapters (chapters 8 & 19) have been added.

1 Conceptualizations and Principles of Crisis Counseling, Intervention, and Prevention

Jonathan Sandoval

DOI: 10.4324/9780203145852-1

Perhaps the feature of a traumatic event that is most dramatic to witness is the effect on the individual. Children in crisis suddenly function with greatly diminished capacity when meeting everyday demands. Students whom others have seen behaving only competently and efficiently suddenly become disorganized, depressed, hyperactive, confused, or hysterical (Pynoos, 1994). Customary problem-solving activities and resources seem to evaporate. Individuals who are in what Caplan (1964) refers to as a state of psychological disequilibrium often behave irrationally and withdraw from normal contact. They cannot be helped using usual counseling or teaching techniques. Nevertheless, children in crisis are usually also in school. Their crisis reaction to stress makes learning almost impossible and many are unable to comply with classroom rules and expectations for behavior. School psychologists, counselors, and other guidance personnel must be able to support teachers, parents, and the children themselves during periods of crisis. In addition, school personnel must be forward-thinking and anticipate that crises will often occur in children's lives. They must be prepared to act and find ways to help children master the challenges of crises when they occur.

A History of Crisis Intervention Theory

The earliest work on crisis intervention is usually attributed to Erich Lindemann (1944) and his studies of the aftermath of the Coconut Grove nightclub fire. This disaster, which occurred in Boston in the late 1930s, took a large toll of human life. For the first time, a social scientist conducted systematic observations of the reactions of victims and their families to a natural disaster, although others, including Anna Freud, noted the traumatic impacts of war on combatants (Fletcher, 2003). The Coconut Grove study, plus Lindemann's experiences after opening a community mental health agency in Wellesley, Massachusetts, formed the basis for his ideas about crisis and crisis intervention that linked observations of social transitions and reactions to traumatic events.

Erik Erikson (1962) contributed the next major milestone in crisis intervention theory with the 1950 publication of Childhood and Society. Erikson's theory revolves around the notion of specific crises characterizing each developmental stage of an individual's life. His contribution was the notion of crisis as a normal developmental phenomenon, and that intervention that led to a balanced resolution at the time of a crisis would prevent later problems in emotional development and maturation.

The third early pioneer was Gerald Caplan, whose formulations about the primary prevention of emotional disorders and mental health consultation led to the notion of an entirely new field of preventive psychiatry (Caplan, 1961, 1964). Caplan's data came from early work with Peace Corps volunteers, with parents reacting to premature birth and with families coping with the affliction of tuberculosis. His (and others' associated with the Harvard School of Public Health) adoption of ideas from public health and the application of them to mental health settings had an enormous influence that led to the blossoming of crisis intervention centers throughout the country.

Caplan's work came at a time when there was a great push on the part of the federal government for community mental health agencies and at a time of great social unrest in our country. The 1960s brought unprecedented illegal use of psychoactive drugs on the part of adolescents and young adults. These forces, particularly drug abuse, led to the creation in the community and on college campuses of crisis counseling agencies, often nontraditional in nature, which could deal with the problems of alienated youth, especially drug overdose (Beers & Foreman, 1976). During this time, telephone crisis lines also came into widespread use, spurred on by a growing interest in suicide prevention services (Golan, 1978).

The late 1970s and early 1980s saw the burgeoning of a great deal of interest in brief psychotherapy (e.g., Bellak & Small, 1978; Davanloo, 1978). This trend emerged as a result of cuts in mental health funding and of new techniques and procedures for dealing rapidly with mental health problems. Mental health workers began to appreciate that as much could be accomplished in six to eight sessions as had earlier taken years.

Another trend from this period was an interest in stress and its impact on physical and mental health. Theorists such as Hans Selye (1974) and Adolph Meyer (cited in Moos & Schaefer, 1986) have noted how a variety of environmental events may have broader effects than previously believed. Physical events may have emotional sequelae and vice versa. Normal life events such as graduation from school, birth of a child, or marriage, not to mention unpleasant events such as job failure, a death in the family, or divorce, may foreshadow the development of symptoms and disease. Moreover, stressful events are additive or perhaps multiplicative in their action, in that the more events with which the individual must cope, the more likely an illness response will develop (Moos & Schaefer, 1986).

During the 1980s and 1990s focus has shifted to more extreme forms of crisis intervention. In succeeding revisions of the American Psychiatric Association's Diagnostic and Statistical Manual, the concept of posttraumatic stress disorder (PTSD) came to be refined and identified in children and youth (Fletcher, 2003). The definitions of PTSD have focused more attention on this phenomenon and more study of therapeutic techniques to ameliorate the effects. Also this period saw a number of school-based acts of terrorism and violence that were widely publicized and discussed in the popular media. Perhaps the most dramatic example was the murderous attack on Columbine High School in Littleton, Colorado. These events led to legislation outlawing the possession of certain types of weapons, increased attention to the causes and prevention of violence in youth, and an awareness of the impact of bullying.

Two events defined the first decade of the 21st century: the 9/11 destruction of the World Trade Center and Pentagon, and the aftermath of Hurricane Katrina. Because of the extreme nature of the events and the widespread media coverage, more effort has gone into preparing psychologists and others to respond to disaster, and more attention has been given to the effects on children of witnessing traumatic events (Eisenberg & Silver, 2011). National professional organizations such as the National Association of School Psychologists and the American Psychological Association have sponsored the training and certification of crisis workers.

Although crisis theory has had a relatively brief history, sufficient research findings and clinical observations exist for school psychologists and other school mental health workers to apply the ideas and techniques to the school setting, and crisis response teams exist in many school districts (Brock et al., 2009; Brock, Sandoval, & Lewis, 2001).

Definitions and Distinctions

The term crisis is used generically to stand for both the event and the reaction. It is useful to make a distinction, however. Donald C. Klein and Erich Lindemann (1961) offer the following definition:

An emotionally hazardous situation (or emotional hazard) refers to any sudden alteration in the field of social forces within which the individual exists, such that the individual's expectations of himself and his relationships with others undergo change. Major categories of hazards include: (1) a loss or threatened loss of significant relationship; (2) the introduction of one or more new individuals into social orbit; (3) transitions in social status and role relationships as a consequence of such factors as (a) maturation (e.g., entry into adolescence), (b) achievement of a new social role (e.g., marriage), or (c) horizontal or vertical social mobility (e.g., job promotion). (p. 284)

Klein and Lindemann use the term hazard to capture the notion that many individuals are able to pass through such alterations with little difficulty or with a minimum amount of stress. They are resilient in the face of the hazard. Others, however, find themselves immobilized or damaged by the hazard. Natural disasters and acts of terrorism would be included in their definition of hazard, but other events, such as witnessing domestic violence or being victimized by a bully, can also impact children.

Klein and Lindemann (1961) reserve the term crisis “for the acute and often prolonged disturbance that may occur in an individual or social orbit as a result of an emotional hazard” (p. 284). Emotional hazards faced by school children include: losses in significant relationships associated with the death of a parent, parental divorce and remarriage, death of a sibling or the loss of a parent to illness, maturational challenges such as the beginning of puberty, and transitions such as those accompanying movement into new schools or new educational programs. Nonpromotion is a hazard, but so is promotion to a new grade, with its separation from a known, possibly favored teacher and the adjustment to change and an unknown, new teacher. Disasters typically bring about these same disruptions since they often result in loss of life or of status, such as becoming homeless. Many children will navigate these hazards with little or no ill effect. Others will develop crisis reactions and come to the attention of school psychologists and other school personnel.

Caplan (1964) offers a general view of an emotional crisis as a “psychological disequilibrium in a person who confronts a hazardous circumstance that for him constitutes an important problem which he can, for the time being, neither escape nor solve with his customary problem solving resources” (p. 53). Caplan views a crisis as being a period when the individual is temporarily out of balance. This state of disequilibrium provides an opportunity for psychological growth as well as a danger of psychological deterioration. Although there are great risks that may occur to the future mental well-being of an individual who passes through a crisis, there is also an opportunity for an individual to change. It is an old but traditional cliché to point out that the Chinese character for crisis includes ideographs related to the concept of danger as well as the concept of opportunity. An aspirational goal in helping an individual who is undergoing a crisis is to intervene in such a way as to use the situation to enhance personal growth, or at least to restore the individual to a previous level of functioning. The goal is not to reorganize completely the individual's major dimensions of personality, but to restore the individual with creative problem solving. Of course by successfully resolving a crisis an individual will most likely acquire new coping skills that will lead to improved functioning in new situations, but that is only a desired, possible outcome, not the...