My placement is working with homeless people. So these theories might be useful and anyway one of my lecturers today was talking about some theories as if we already knew all about them. Another testament to how much reading we should be doing. The theories underpin the intervention that you might suggest so knowing them is crucial to practice as interventions should be based on evidence. So thank you Malcolm Payne.

Crisis Theory
Payne discusses it alongside task-centred models for a comparison of brief methods of intervention. Crisis theory is dealing with the immediate problem and could be criticised for being too short-sighted. It assumes that we live in a state of equilibrium most of the time and crises upset the coping mechanisms we have. Crisis either leads to developing these coping mechanisms as a result of the crisis experience which ensures a return to equilibrium or crisis leads to a deterioration into chaos as these mechanisms fail.

Crisis theory is informed by psychodynamic ego psychology (Freud?). Crisis points can be situational or maturational and occur in the context of the individuals circumstances. They are turning points in individuals lives and active crisis is a result of a building up process.

Crisis interventions concentrate on the safety of the individual and then begins building on their strengths to establish their coping mechanisms again. This assumes an accurate assessment of their cognitive and behavioural responses to the crisis.

Wider perspective:

• Caplan- Preventative psychiatry. Basis in mental health.
• Chinese philosophy of gravitating towards fulfilment, balance and harmony.
• Roberts- Modern crisis intervention for all professions especially within disaster services.

Modern approaches (Roberts):
The use of steady state instead of equilibrium. This is because people can face new situations/events and remain in a steady state whereas equilibrium implies that people cannot manage. A crisis is a process not a sudden disastrous event as it is commonly mistaken for. How do individuals react to a precipitating hazardous event? Individual has to manage the event and also their own reaction to that event using coping mechanisms. If they fail then the individual moves to a state of active crisis. This affects the individuals behaviour and obviously they experience strong intolerable emotions also.

The crisis may be public or private or both. E.g. a loved one died in a public fire, victim of rape deciding to prosecute.

Crisis intervention:

• Developing new coping mechanisms
• Work through emotions and experience of crisis
• Mobilising resources for support
• Reduce continuing unpleasant effects/emotions
• Integrating events into individuals private life.

Models:

• Equilibrium model: People in crisis need to return to equilibrium so they can deal with issues in their lives. Caplan.
• Cognitive model: Thinking in faulty ways abouts events that surround the crisis and feelings. Roberts.
• Psychosocial transition model: Crises arise as people move through life stages. Erikson.

Everyone is different, it could be that individuals experience crises differently and in complex ways. Approaches have to be dynamic and fuse theories.

Treatment:
Assessment: involving listening and acting. Intervention: achieving contact, lethality measure, establishing rapport, identifying problem, dealing with emotions, explore alternatives, develop action plan, establish followup. From Contact to Coping. But this intervention process must come from the individual and them exploring their emotions etc. So it will not work if imposed. What are there reactions to the crisis? Affective/behavioural, cognitive/emotive, moral or spiritual?

Critique:
Crisis theory deals with immediate problems and does not provide long-term solutions (except in the development of coping mechanisms for future crises). This has pros and cons. It is effective in determining immediate danger for the individual in active crisis and can help them come down a stage and explore the process of crisis. It therefore if helpful because crises do need immediate attention. Yet the lack of emphasis on long-term approaches mean that for those constantly affected by crises because of poverty or social exclusion it may in reality compound the wider social failings. Crisis theory offers a theoretical underpinning for services providing help in disasters and is a model that describes the process that leads to crisis and peoples emotive and behavioural responses.