People in Crisis Clinical and Diversity Perspectives

Student Self-care and Reflection

  1. Human Services Resiliency Model
  2. Guideline: Resilience-Vulnerability Assessment in the Crisis Experience
  3. Resilience and Vulnerability Guide in the Crisis Experience
  4. Self-reflection Guideline
  5. Vicarious Traumatization in Crisis Work

Study Guide:

Over their years of classroom teaching and conducting Continuing Education crisis workshops, as well as related research, the authors have seen that boundary issues, burnout, and principles of self-care are significant themes-expressed either subtly or explicitly. This issue was prominent in the beginning phases of developing suicide prevention and crisis hotlines, in which some applicants for volunteer training on these hotlines had very recently survived a suicide attempt, were grateful for the help they received, and eagerly wanted to help others in similar straits-often, it appeared, before they were psychologically "ready" for the helping role. Policies for screening applicants and offering guidance and counseling referral sources emerged from this experience.

As every mental health professional knows, self-reflection and its role in our effectiveness in practice with vulnerable people has been a mainstay of graduate programs across the range of psychiatric and counseling disciplines. In this context, we offer several tools intended especially for undergraduate students, some of whom (in addition to their career goals) may enroll in a Crisis Intervention course at least partly as an avenue for dealing with their own issues-a factor exacerbated by the major life transition phase of being a pre-career college student.

In addition to these tools, readers are referred to Violence and Abuse Issues by Lee Ann Hoff (2010, Routledge), Chapter 12. Implementation Issues: Personal/Professional Victimization, sections on The "Wounded Healer" and "Vicarious Traumatization and Boundary Issues."

Human Services Resiliency Model

Adapted by Bonnie Joyce Hallisey, LICSW, Curry College.

Werner, E.E, & Smith,R.S. (2001) Journeys from Childhood to Midlife: Risk, Resilience and Recovery. Ithaca,NY: Cornell University Press.

Schorr, L. (1988) Within Our Reach: Breaking the Cycle of Disadvantage. NY: Anchor Books, Doubleday.

  1. OPTIMISTIC INDIVIDUAL
    • Autonomy
    • Initiative
    • Internal Locus of Control
    • Self Efficacy
    • "Easy" Temperament
    • Self Distinct from Trauma
    • Active Genotype-Environment
  2. CHARISMATIC ADULT "saving grace"
    • Intrafamilial
    • Extrafamilial: mentoring role
    • Able to Ask for Help when needed
    • Recruit Adult Caregivers
    • Basic Trust
  3. AFFIRMING TALENT
    • Uniqueness
    • Reinforce & Reward Competencies
    • Positive Self Esteem
    • Intelligence/Scholastic Aptitude
    • Opportunity at Life Transitions
  4. NO SUBSTANCE ABUSE
    • Absence of Destructive Coping
    • Presence of Higher Level Defenses

Resiliency-Vulnerability Model

Adapted by Bonnie Joyce Hallisey, LICSW, Curry College.

Corwin, M. (2001) Brief Treatment in Clinical Social Work Practice. Brooks/Cole, Cengage Learning

Resilience-Vulnerability Assessment in the Crisis Experience

Guideline: Resilience-Vulnerability Assessment in the Crisis Experience

It is important to asses the person's "usual functioning" before an impending crisis state. See column 1 in the resilience-vulnerability guide. It is helpful to consider a continuum from "thriving" to "in trouble." See + and- in the first row which correspond with whether a resolution is likely to be positive or negative. Consider three major dimensions of person's existence: Individual or how they are within themselves, Friends/ Family or how they are in relationships and Society or how they are in larger community and world.

Column 2 regards the life stage that the person is in. For instance if a teenager is struggling with his or her homosexuality, it is particularly crucial issue at this developmental period when adolescents are trying to establish their own identity. Many societies assume heterosexuality so that those who differ from the norm must define themselves against the prevailing culture. Since we are social creatures who internalize societal standards, homophobia is often internalized even within the individual with a same sex orientation. They may be conflicted within themselves prior to affirming their own identity, may be vulnerable if "coming out" to family and friends and may feel not affirmed and discriminated against by larger society. The "safe school" programs and "gay-straight alliances" began as a support for the alarming suicide rate among homosexual teens. It is vital to consider this when planning aids to positive resolution.

Only by assessing one's usual functioning can we appreciate one's relative stability before a crisis. We can hypothesize that if one is thriving before a crisis they may be better able to withstand life's blows. Conversely, if one is "in trouble" already, then further hazardous events may imbalance them more severely.

Being mindful of vulnerabilities and building in protective factors may make the difference between collapse under pressure or recovery with even enhanced growth.

Resilience and Vulnerability Guide in the Crisis Experience

Adapted from class discussion guide by Bonnie Joyce Hallisey, LICSW. Curry College

1 2 3 4 5 6 7 8
Usual Functioning Life Stage Vulnerable State Hazardous Event Precipitant Basic Attachments (more at risk) Contributing Factors Meaning of Crisis to Person

Thriving

  • Individual OK with self, sense of well being, privacy
  • Family Friends OK w/others, supportive network, intimacy
  • Society OK with world, sense of identity & belonging to the community

In Trouble

Specific developmental time in person's life with particular tasks and themes that are significant and pose a challenge: both danger and opportunity

Previous losses

Illness

Poor coping strategies

Social factors

Deeply disturbing event or situation

An often minor trigger that sets things off

"The straw that broke the camel's back"

Acute, final, stressful happening in a series of difficulties that pushes someone from acute vulnerability into crisis

Physical necessities

Self identity

Close loving relationship

Group belonging

Role performed w/dignity and respect

Money

Timing

Duration

Sequencing

Cohort specificity

Contextual purity

Probability of occurrence

Subjective interpretation

Significance to life

Meaning and values to set goals and understand self and world

A person's resilience and vulnerability during crisis intersects with several fluid and interacting factors, including one's usual problem solving means. While there is opportunity for growth and development through crisis, the potential danger of crisis increases in the absence social support and other aids to a positive resolution.

Self-reflection Guideline

Social Sciences Interdisciplinary 218
State University of New York at Buffalo
Dennis Kane

The Self Reflection should be presented in your writing style, the way you feel most comfortable—and most confident in—communicating effectively. The purpose is for your personal realization of who you are, how far you have come in life and where you believe you will be going.

Everyone's experience is different and the following questions may help outline a self reflection but don't necessarily have to be part of it. There may be many other questions that you feel are more appropriate to you.

Who are you today?

What do you believe to be your vocation?

Where do you expect to be in the next few years?

What would you like your future to be?

Vicarious Traumatization in Crisis Work

See Violence and Abuse Issues by Hoff (2010, Routledge), Chapter 12: Implementation Issues: Personal/Professional Victimization.