Equilibrium model of crisis intervention

Crisis Intervention Models

Three basic crisis intervention models discussed by both Leitner (1974) and Belkin (1984) are the equilibrium model, the cognitive model, and the psychosocial transition model. These three generic models provide the groundwork for many different crisis intervention strategies and methodologies. Two new models that target ecological factors that contribute to crisis are the developmental-ecological model (Collins & Collins, 2005) and the contextual-ecological model (Myer & Moore, 2006). Two field-based practice models are psychological first aid (Raphael, 1977; U.S. Department of Veterans Affairs, 2011), which is used in the immediate aftermath of disasters and terrorist attacks, and Roberts’ (2005) ACT model, which is more generic but primarily trauma based.

The Equilibrium Model

The equilibrium model is really an equilibrium/disequilibrium model. People in crisis are in a state of psychological or emotional disequilibrium in which their usual coping mechanisms and problem-solving methods fail to meet their needs. The goal of the equilibrium model is to help people recover a state of precrisis equilibrium (Caplan, 1961). The equilibrium model seems most appropriate for early intervention, when the person is out of control, disoriented, and unable to make appropriate choices. Until the person has regained some coping abilities, the main focus is on stabilizing the individual. Up to the time the person has reacquired some definite measure of stability, little else can or should be done. For example, it does little good to dig into the underlying factors that cause suicidal ideation until the person can be stabilized to the point of agreeing that life is worth living for at least another week. This is probably the purest model of crisis intervention and is most likely to be used at the onset of the crisis (Caplan, 1961; Leitner, 1974; Lindemann, 1944).

The Cognitive Model

The cognitive model of crisis intervention is based on the premise that crises are rooted in faulty thinking about the events or situations that surround the crisis—not in the events themselves or the facts about the events or situations (Ellis, 1962). The goal of this model is to help people become aware of and change their views and beliefs about the crisis events or situations. The basic tenet of the cognitive model is that people can gain control of crises in their lives by changing their thinking, especially by recognizing and disputing the irrational and self-defeating parts of their cognitions, and by retaining and focusing on the rational and self-enhancing elements of their thinking.

The messages that people in crisis send themselves become very negative and twisted, in contrast to the reality of the situation. Dilemmas that are constant and grinding wear people out, pushing their internal state of perception more and more toward negative self-talk until their cognitive sets are so negative that no amount of preaching can convince them that anything positive will ever come from the situation. Their behavior soon follows this negative self-talk and begets a self-fulfilling prophecy that the situation is hopeless. At this juncture, crisis intervention becomes a job of rewiring the individual’s thoughts to more positive feedback loops by practicing and rehearsing new self-statements about the situation until the old, negative, debilitating ones are expunged. The cognitive model seems most appropriate after the client has been stabilized and returned to an approximate state of precrisis equilibrium. Basic components of this approach are found in the rational-emotive work of Ellis (1982), the cognitive-behavioral approach of Meichenbaum (1977), and the cognitive system of Beck (1976).

The Psychosocial Transition Model

The psychosocial transition model assumes that people are products of their genes plus the learning they have absorbed from their particular social environments. Because people are continuously changing, developing, and growing, and their social environments and social influences (Dorn, 1986) are continuously evolving, crises may be related to internal or external (psychological, social, or environmental) difficulties. The goal of crisis intervention is to collaborate with clients in assessing the internal and external difficulties contributing to the crisis and then help them choose workable alternatives to their current behaviors, attitudes, and use of environmental resources. Clients may need to incorporate adequate internal coping mechanisms, social supports, and environmental resources in order to gain autonomous (noncrisis) control over their lives.

The psychosocial model does not perceive crisis as simply an internal state of affairs that resides totally within the individual. It reaches outside the individual and asks what systems need to be changed. Peers, family, occupation, religion, and the community are but a few of the external dimensions that promote or hinder psychological adaptiveness. With certain kinds of crisis problems, few lasting gains will be made unless the social systems that affect the individual are also changed, or the individual comes to terms with and understands the dynamics of those systems and how they affect adaptation to the crisis. Like the cognitive model, the psychosocial transition model seems to be most appropriate after the client has been stabilized. Theorists who have contributed to the psychosocial transition model include Adler (Ansbacher & Ansbacher, 1956), Erikson (1963), and Minuchin (1974).