In need of a 250 word response/discussion to each of the following forum posts. Agreement/disagreement/and/or continuing the discussion.
Original forum discussion/topic post is as follows:
respond to the following:
- Consider the 6-step approach of the single-session crisis intervention model. For each of the steps identify and discuss challenges and obstacles that may be encountered in a multicultural or ethnic context.
- How might an individual’s sex, gender, religion, ethnicity, affect his or her response to crisis and intervention approaches?
- Discuss examples of prolonged terror situations and your approach to intervention considering the factors mentioned in item #2.
Forum post response #1
- Taking into consideration a person’s gender, religion, and ethnicity when assisting with crisis interventions can make or break the outcome. Every culture has a particular set of rules or standard of conduct which they expect their people to abide by. In some cultures, it is inappropriate for a woman to speak to a man that is not a relative. The use of a male provider could greatly hinder the recovery process if cultural understanding or intelligence is not utilized. In some religious cultures it is not acceptable for a person of that faith to see guidance from someone who is not a spiritual leader. This could bring a huge barrier if you are trying to conduct therapy with someone from one of these religions. They may be extremely apprehensive or flat out non-compliant with any attempts at counseling. Gender might bring about a trust issue when it comes to interventions. If the person has been greatly harmed in the past by someone of the opposite gender, they might be less willing to participate in therapy. Fear of harm from the opposite gender does not always have to be this issue, for example, if someone feels that those who are the opposite gender are beneath them or a lower class then them, they will be more resistant to intervention approaches to someone of that gender.
- Some examples of prolonged terror situations would be those who have been in a war zone. Whether they live in the area under conflict or they have participated in extended military deployments to those areas. Victims of childhood sexual abuse that extended into adolescents or happened for a long period of time would also be an example. I think when dealing with individuals that have been exposed to prolonged terror the first thing a person can do is to show empathy and caring. Depending on the country, one might take into consideration and do background research on typical behavioral cues, gestures, and general acceptance to help. Some cultures might see us as invaders that have helped prolong or caused the conflict, therefore they might not want to work with us. Understanding a culture and how they operate would be nothing more than beneficial to someone wanting to work in these types of environment or with victims of prolonged exposure. Cultural sensitivity and sensitivity to what the victim has gone through, even if you cannot imagine the atrocities they endured, is a good starting point.
- From my personal experience, one thing I suggest never telling someone is that you understand how they feel. I sought therapy a few years back for PTSD, anxiety, and depression, military related, and the one thing that turned me off from wanting to seek further treatment with the therapist was when she told me she understood how I felt. This woman had never been in the military, never deployed, never had mortars come in, never had to go months on end wondering if/when the day would come, never dealt with what I had dealt with but decided to tell me she understood how I felt. Needless to say, I quit therapy with her and did not return until a few years later to someone else.
Forum post response #2
The primary purpose of a single-session crisis intervention is to help an individual restore a sense of control and mastery after being impacted by a crisis event (Collins, 2005). This type of counseling is provided in several different types of settings such as hospital emergency rooms, other medical settings, schools, churches, offices, walk-in centers, and telephone hotlines. A person that would benefit from a single-session crisis intervention would be someone in a period of overwhelming emotional upset or a breakdown in coping and problem-solving, or a violation of an individual’s belief’s and images about themselves and the world (Collins, 2005). It is important to ensure the safety, promote greater stability for this person, and providing emotional support. There are three primary goals of a single-session intervention which are that the client is safe and lethality is reduced, client is psychologically stable and has attained short-term mastery of self and situation, and client is connected with formal and informal supports and resources (Collins, 2005).
Step one consists of supportively and empathetically join with the client. This is where you will establish a connection with your client. It can be a challenge if you are a different race and your race targeted another race in the crisis situation. The client is not going to connect with you. I think that would be the biggest challenge because they may not trust you so you would be of no help to them. If you can’t be empathetic towards the person and the situation than that could cause an obstacle. Step two consists of intervening to create safety, stabilize, de-escalate, and handle immediate needs. The challenge here comes from step one. You will not be able to help them with their needs if they are not able to connect with you. If you are the race that they are scared of then that could escalate the issues they are having. Step three consists of the ABCDE. This is when you listen to get a better understanding of what is going on. The client may not be able to communicate what they are saying because they speak a different language so this makes them uncomfortable especially if you have to get an interpreter to translate. If you don’t speak their language then it can be difficult to make the proper assessment. Step four consists of examining alternatives and develop options. This is where you identify possible solutions to meet their current needs. If you are not family with their ethnic or cultural background you may not know all the rules that they go by and it can cause them to be offended. Step five consists of assisting the client to mobilize personal and social resources and connect with community resources. Depending on the situation, the culture they live in may not allow for them to come back to the community so this can be a challenge. Step six is to anticipate the future and arrange a follow-up. A challenge with this is that they may not want others to know who helped them or why they helped them so they may not want to come back for a follow up. I think that if they can’t connect with you in step one then all of the other steps are going to be unsuccessful.
An individual’s sex, gender, religion, ethnicity, may affect his or her response to crisis and intervention approaches because of what they believe and who they can connect with. For instance, A male isn’t going to be as comfortable talking with a female counselor as they would a male counselor. Same thing would go for a female. If a person feels that they can relate to that person then they will make the connection and have a more positive response to the approaches. The society we live in today relates to each other according to these categories. It is important to make sure you are competent in all of these areas so you can be more effective in helping others.
Some examples of prolonged terror situations would a woman who was raped on her way home. She is going to have fear of coming home for a while until she heals from what had happened. I think of soldier’s who have experienced war and come home. They develop PTSD and have prolonged terror about what happened over there. Another example would be if a person witnessed a trauma it would cause them prolonged terror. The country had prolonged terror when 9/11 happened and waiting to see if their family members survived or not. It is important to remember that therapy is to adapt to meet the needs of the client. In the end, every individual is different in how they handle crisis situations no matter their sex, gender, religion, or ethnicity.
Collins, B. G., & Collins, T. M. (2005). Crisis and trauma: Developmental-ecological intervention. Boston: Lahaska Press.
Forum post response #3
Step 1 of the single-session crisis intervention model is to supportively and empathically join with the client, verbally and nonverbally. Within a multicultural or ethnic context, this may be difficult to do, particularly if the person in crisis speaks another language and there is not someone around who can help to interpret (as with the other steps in the model). This will make it very important to demonstrate genuinely empathic nonverbal expressions (i.e. tone of voice, body language and proximity). Even if verbal communication is possible, it will be important to consider that within multicultural or ethnic contexts, the person in crisis may have a very different interpretation of what is causing his/her distress. For example, the authors of the article point out that a person exhibiting panic symptoms from native Navajo background could be experiencing 'cognitions involving visions of black dogs and werewolves' (p. 507).
Step 2 of the model is to assess and intervene immediately to: a. create safety in environment, b. stabilize and de-escalate, and c. handle immediate needs. Within a multicultural or ethnic context, it may be challenging to assess whether a person is at risk for causing harm or to determine triggering factors if the assessor is unfamiliar with cultural norms/beliefs/practices. For example, the authors of the article explain that 'Native individuals may conceptualize illness as an imbalance among the mind, body, and spirit or as stemming from spiritual causes,' therefore it will be important to consider a more nontraditional approach to assessment, (p. 514) rather than a cause-and-effect system for analyzing contributing factors of distress.
Step 3 of the model is to explore and assess dimensions of crisis event and crisis reaction (ABCDE), encouraging ventilation. Within a multicultural or ethnic context, it may be challenging to encourage a person nontraditional worldviews to talk with a stranger about what they are experiencing and what interventions would be helpful for him/her in the moment. The article includes more helpful information to take into consideration, that 'American Indians have long had their own mental health services in the form of spirit healers, medicine people, friends, and kin,' (p. 513). Clinicians attempting to assist a person from differing cultural or ethnic backgrounds would do well to learn about multiculturally appropriate ways to help assess and intervene during crises.
Step 4 of the model is to examine alternatives and develop options. This step of the model would seem to be more conducive for assisting a person in crisis within a multicultural or ethnic environment for helping the person regain empowerment over the situation. As clinicians, it will be important to be mindful to allow our clients to identify what solutions will be helpful for them, particularly for those from differing cultural and ethnic backgrounds and worldviews than our own. Moreover, we need to keep in mind that there are sub-cultures amongst different populations and groups of people (to include, but not limited to, gender identification, religious beliefs, etc.) that we might not be aware of by just looking at a persons' outward appearance or even behavior. The authors in the article suggest that 'American Indians tend to view mental health services as more of a crisis management intervention than do majority-culture members. Because fewer than half of urban American Indians return after the initial contact (S. Sue, 1977), it is even more important to focus on the client’s immediate needs' (p. 514). It can be overwhelming enough for one to find him/her self in the state of crisis and important for crisis responders to keep focused on helping the person in crisis to restore equilibrium and empowerment.
Step 5 of the model is to assist the client to mobilize personal and social resources and connect with community resources, as needed. In the article, the authors recommend to involve the support of family members, friends, kin, etc., as American Indians seem to have more of an external locust of control and would seem to do well to receive assistance being able to identify which supports to include during this step of crisis responding.
Step 6 of the model is to anticipate the future and arrange follow-up. This step may present challenges when working within a multicultural or ethnic context. In relation to the article, it is indicated that Native Americans seem to view participating in counseling as crisis intervention and have significantly high drop-out rates after just one session. Recommending next steps for treatment to continue (or begin) may be resisted by this population. More immediate recommendations such as hospitalization or further evaluation may also be resisted (and might be viewed as culturally inappropriate methods for healing).
An individual's sex, gender, religion, ethnicity, etc. might affect his/her response and/or receptiveness to receiving support during crisis. Such factors may cause the person to have prejudgments of what will be helpful for them or not, according to their beliefs and experiences. The person may not be open or willing to receive help from a responder with whom they cannot trust on some level, or they may be too fearful of consequences during the process/protocol of being assisted. It will be important for responders to approach a person(s) in crisis with transparent respect and genuine concern, without intent to impose assistance/plan/protocol.
An example of a prolonged terror situation was the abduction of Elizabeth Smart. She was held captive and raped repeatedly by her male captor. Because of the sexualized trauma, it would seem that intervention should not involve being assisted by a male of similar ethnicity to try avoiding unhelpful triggering. Another example of prolonged terror was the captivity of Dr. Paul Needham and over 60 other Americans during the Iranian hostage crisis. The horrifying conditions led some captives to attempt/commit suicide. It would seem that crisis intervention for service member survivors would include trusted American responders and that the survivors might do well to have some recovery time before having to go through any interviewing process for recalling their traumatic experiences.