Crisis Counseling: an Overview

Topics: Posttraumatic stress disorder, Psychological trauma, Clinical psychology Pages: 23 (6710 words) Published: November 19, 2012
Psychology in the Schools, Vol. 46(3), 2009
Published online in Wiley InterScience (


2009 Wiley Periodicals, Inc.
DOI: 10.1002/pits.20370


University of the Pacific
Psychologists working in schools are often the first contacts for children experiencing a potentially traumatizing event or change in status. This article reviews basic concepts in crisis counseling and describes the components of psychological first aid. This form of counseling must be developmentally and culturally appropriate as well as individualized. Effective intervention can prevent post-traumatic stress syndrome and facilitate normal mourning processes associated with any losses experienced. These prevention activities are also discussed. Some children may need resources beyond those that the school can provide, and appropriate referrals can link children and adults to a variety of treatments such as psychotherapy and medication, also briefly outlined. C 2009 Wiley Periodicals, Inc.

Most children and adults are resilient and have ways of coping with stressful events. In fact, according to the National Institute of Mental Health (NIMH; 2001), recovery from crisis exposure is the norm. Children usually need minimal assistance from family members, teachers, clergy, or other caring adults. Others, particularly those with few social supports, enter into a crisis state (Barenbaum, Ruchkin, & Schwab-Stone, 2004; Caffo & Belaise, 2003; Litz, Gray, Bryant, & Adler, 2002; Ozer, Best, Lipsey, & Weiss, 2003).

People in crisis are in what Caplan (1964) terms a state of psychological disequilibrium. This disequilibrium occurs when a hazardous event challenges normal psychological adaptation and coping. Individuals often behave irrationally and withdraw from normal social contacts. They cannot be helped using usual counseling or teaching techniques. Nevertheless, children in crisis are usually also in school. School psychologists and other guidance personnel must be able to support teachers, parents, and the children themselves during periods of crisis. The primary goal in helping an individual who is undergoing a crisis is to intervene in such a way as to restore the individual to a previous level of functioning. For children, this means returning to the status of learner. Although it may be possible to use the situation to enhance personal growth, the immediate goal is not to reorganize completely the individual’s major dimensions of personality, but to restore the individual to creative problem solving and adaptive coping. Of course, by successfully resolving a crisis an individual will most likely acquire new coping skills that will lead to improved functioning in new situations, but that is only a desired, possible outcome, not the sole objective of the process (Caplan, 1964). Because failure to cope is at the heart of a crisis, the promotion of coping is an overall objective of crisis intervention.

School psychologists and other mental health personnel working in schools are in a position to offer psychological first aid (Parker, Everly, Barnett, & Links, 2006). Analogous to medical first aid, the idea is to intervene early when a hazardous event occurs for an individual, and offer compassionate support to facilitate adaptive coping. At the same time, the need for further intervention may be assessed and planned.

According to The National Child Traumatic Stress Network and National Center for Post Traumatic Stress Disorder (PTSD) (2006) there are eight core psychological first aid actions. Of course, the exact actions taken need to be tailored to the particular circumstances of crisis victims.

Correspondence to: Jonathan Sandoval, Department of Educational and School Psychology, Benerd School of Education, 3601 Pacific Avenue, Stockton, CA 95211. E-mail:


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