CRISIS INTERVENTION KIERAN GRAHAM MUNDY

Tokiwa International Victimology Institute

TRAINING OF TRAINERS ON VICTIMOLOGY AND VICTIM ASSISTANCE

Lembaga Perlindungan Saksi Dan Korban 18 - 28 Maret 2013

Introduction

A wide range of human emotions and behaviors can accompany crisis, particularly when the crisis relates to victimization

•Overview

•What is Crisis Intervention?

•Phases of Crisis Intervention

•Intervention for specific populations

OVERVIEW

Overview 1

• People react differently to stress and crisis situations based on their own skills or behaviors, abilities to cope, maturation levels, and personalities

• For some, a crisis situation may be coupled with changes in behavior such as sleeplessness or over-eating

• For others, a crisis may include denial, disbelief, and the inability to cope

• Still others may experience physiological changes such as an increase in their heart rate, sweating, or fainting

Overview 2

• The importance of crisis intervention for victims of crime is paramount

• The goal of crisis intervention is to help victims confront the reality of what happened

• Begin to deal with the crisis

• Go beyond the pain and emotional trauma toward new strength and opportunities for growth and change

VICTIMS OF TRAUMA

Victims of Trauma

• Motor Vehicle Accidents• Distressing memories and nightmares about the accident, insomnia, irritability, elevated startle response, and

concentration problems. Avoidance of situations consistent with the event in which the victim is injured

• Crime • Victims of crime are more likely to suffer from depression rather than PTSD, with up to 13% of rape victims

attempting suicide

• Sexual assault • For adults with PTSD following sexual assault, the trauma may range from a discrete adult trauma of rape to

repeated sexual abuse during childhood, or a combination of both. Typical presenting problems differ according to the type and number of sexual assaults experienced

Victims of Trauma

• Natural disasters• Exposure to trauma in disasters varies considerably according to the type of disaster and the proximity of the

individual to the causal agent

• The various roles that people can play in disasters means there will be a significant difference in the impact on the primary victims, compared with the impact on secondary victims, (i.e., emergency service personnel who are required to become engaged in the search and rescue

• Terrorism• Terrorist acts are generally high magnitude traumatic events, of very rare occurrence, capable of generating

widespread fear and hypervigilance

Victims of Trauma

• Significant differences between these trauma populations

• Experience common to many is exposure to sustained and/or repeated traumatic experiences (Type II trauma).

• Sustained and/or repeated traumatic events are of human design, intended to leave the victim fearing, and feeling helpless to prevent, recurrence

• Examples of type II trauma include childhood sexual or physical abuse, domestic violence, incarceration as a prisoner of war, torture and, arguably, prolonged combat

Victims of Trauma

•Because of the sustained nature of some traumatic experiences, people presenting for treatment may still be facing ongoing threat and be at risk of further exposure to trauma

•Emergency and defense personnel, victims of domestic violence and victims of sexual assault perpetrated in the context of their current employment or intimate and family relationships, are some of the groups whose treatment may be affected by having to return to unsafe environments

•In the context of such ongoing risk, the focus of interventions should be on ensuring safety, stabilization and symptom management, rather than commencing the trauma-focused components of treatment

CRISIS INTERVENTION

Crisis Intervention

• The challenge of Crisis Intervention is:

• To provide effective crisis support and assistance as soon as possible following victimization

• To make available resources and services to meet the needs of victims by providing direct assistance or referrals to other agencies

Crisis Intervention

Crisis intervention for victims may vary depending on the needs of the victim and the type of victimization. However, there are some critical elements to crisis intervention services that are necessary for all victims, including:

•Psychological First Aid is initial assistance involving practical survivor needs assessment and emotional support, information and ongoing monitoring, tailored to individual needs

•Recovery Intervention

FIRST RESPONSE

First Response

Immediate crisis intervention or "psychological first aid" involves

•Establishing a rapport with the victim

•Gathering information for short-term assessment and service delivery

•Averting a potential state of crisis

First Response

•Most people recover on their own or with the help of family and friend

•If someone is very distressed or their reactions are interfering with work and relationships, they should be referred to a counselor

First Response

Many victims may be resistant to immediate crisis intervention due to fear or anxiety. Resistance is one form of the victim's response to a crisis situation.

•The immediacy of the response is critical to ensure the safety of the victim and his or her family

•Time may be extremely important because of impending danger to the victim or the family

•Victims should not wait hours or days to see a crisis intervention counselor to assist in their time of need.

Survivor Needs Assessment

•The purpose is to determine how the crisis affects the victim's life so that a plan for recovery can be developed, allowing the victim to begin moving towards the future

First Response

• Victims should be supported in using strategies and resources that meet their needs, and that are readily available

• If victims seek professional support immediately following a traumatic event, it is likely that a health practitioner will take a practical approach that meets the person’s immediate needs and helps them cope with their distress

First Response

For example, a victim of a severe car accident might need:

• Encouragement to ask help from, and spend time with, family and friends

• Information about the right pain relief

• Information about possible emotional reactions to traumatic events

• Gentle encouragement and support to get back into a car

First Response

It is important to monitor people at risk of developing mental health problems following a traumatic event. For example, people may be at risk if they have experienced:

• Physical or sexual assault

• Repeated traumatic experiences

• Mental health problems after past traumatic events

Screening for high risk individuals should be considered when planning services following major disasters or incidents

RECOVERY FROM TRAUMA

RECOVERY FROM TRAUMA

• Immediately following a traumatic event, people may experience strong reactions - For most, these reactions will gradually decrease over time.

• fear, sadness, guilt and anger

• question their beliefs about their safety

• how much control they have over their life

• how predictable the world really is (A just world?)

RECOVERY FROM TRAUMA

• The way people adapt to stressful life events and the support they receive from others

• are important for recovery. Help following a traumatic event does not have to come

• from a health professional • the answers are often found within ourselves and with the

• help of trusted friends and family. It is important that people involved in traumatic

• events use the resources and support systems most readily available to them. For

• example, if someone tends to use exercise to deal with stress, it might also help them

• to manage tension following a traumatic event. Spending time with people that have

• been supportive in the past might be another way of coping with what is happening.

RECOVERY FROM TRAUMA

• Self-help tips for someone who has gone through a traumatic experience:

•

• Do’s

• • Spend time with people who care

• • Give yourself time

• • Find out about impact of trauma • and what to expect

• • Try to keep a routine going – • work, study

• • Return to normal activities

• • Talk about how you feel or what • happened when ready

• • What can you do right now….?

• • Do things that help you relax

• • Do things that you enjoy

Recovery

• Don’ts

• • Use alcohol or drugs to cope

• • Keep yourself busy and work too • much

• • Engage in stressful family or work • Situations

• • Withdraw from family and friends

• • Stop yourself from doing things • that you enjoy

• • Avoid talking about what • happened at all cost • • Take risks

• • Do things that you enjoy

Recovery Intervention 1

• To help victims re-stabilize their lives and become healthy again

• To help the victim prevent further victimization from the criminal justice system or other agencies the victim may come into contact with in the aftermath of victimization

• This is the initial period of recovery for the victim, and may require considerable time, effort and resources before the victim resolves long-term issues associated with the victimization

Recovery Intervention 2

Victim service providers should also focus on

•Reducing risk factors for victims

•Maximizing the social support systems of victims, maximizing and improving their coping skills, helping victims attain greater self-esteem and self worth

•Working with other agencies to reduce added trauma imposed on victims who go through the complex and often frustrating criminal justice system

CRISIS INTERVENTION

• An important element of the healing process for victims

• Should not be assigned to one specific agency or organization

• Should be an important element of each agency or organization that deals with victims of crime• This includes victim advocacy organizations, private agencies or organizations (such as hospitals or

schools), social service agencies, law enforcement, and corrections

• Many law enforcement agencies have developed crisis intervention teams staffed by professional social workers to respond to crisis situations they face as a result of emergency calls

• To be effective, crisis intervention must be provided in an orderly, structured, humanistic manner and must focus on the individuality of the victim and his or her needs