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A caller in crisis may be experiencing some impairment of this usual level of functioning. It is important to assess the degree of that impairment of functioning and if the caller is in immediate danger (emergency risk). This assessment will determine how directive and involved we need to be with this caller. We do not want to further disable a caller by taking over for him; thus increasing his dependency on others. Nor do we want a dysfunctional caller to continue a downward, out of control spiral into a more serious crisis. In effect, we as counselors are trying to assess how much control we need to take with a caller in order to help him. We make this assessment by gathering relevant information. The following questions are useful in making this determination.
- Is the person able to carry on normal responsibilities: are they paying bills, attending work, school, caring for kids?
- Are they eating/sleeping normally?
- Is the caller catastrophizing? “No one cares”; “It’s hopeless”.
- Are there other behavioral indicators of distress: i.e. inappropriate laughter, hearing voices, can’t stop crying, inability to concentrate, make decisions, distorted perceptions of people, places, or things?
Generally, the more “yes” answers the assessment reveals, the more dysfunctional the caller, and the more directive the intervention should be.
Consider the following continuum when making your decision about intervention strategy.
