The following is a literature review on the effectiveness of crisis intervention, with a focus on crime victims. Research has shown that there is limited literature on the effectiveness of crime intervention on crime victims. The limited publications available have demonstrated the areas which are crucial to effective crisis intervention with victims of crime. The available research also points to the need for more accountability in the results of crisis intervention; there is very little data available.
There is however, an abundance of information on crisis intervention within disaster situations and school settings; some of which will be discussed in this review of literature. There were approximately 1,400,000 violent crimes committed in 2005 (Green & Diaz, 2007). According to Green and Diaz (2003) a U. S. citizen is more likely to be a victim of a violent crime than be in a car accident. With the increasing number of crimes occurring yearly, crisis intervention has become a necessary element to recovery.
It is impossible to know how a victim will react to a crisis. The victim’s reaction is based on “their own skills or behaviors, abilities to cope, maturation levels, and personalities” (InfoLink, 1997). Changes of behavior, an inability to cope, denial and physiological changes, such as rapid heartbeat, are a few of the possible reactions to a crisis. Crisis intervention is an important element in the recovery of victims of crime. In order to understand crisis intervention, one must understand the definition of a crisis.
According to the National Center for Victims of Crime, the Random House (1987, as cited in NCVC, sect. 1, 2001) definition for crisis is as follows; “a dramatic emotional or circumstantial upheaval in a person’s life” and “a stage in a sequence of events at which the trend of all future events, especially for better or for worse, is determined; a turning point”. Critical elements of crisis intervention are “psychological first aid and survivor needs assessment and empathetic support” (NCVC, sect.
2, 2001). Roberts (2005) defines the goal of crisis intervention as the ability to “resolve the most pressing problem within a one to twelve week period using focused and directed interventions aimed at helping the client develop new adaptive coping methods” (p. 12). Roberts’ (2005) reports that the general consensus among mental health workers is that a person is in crisis when the following characteristics are present: • The person perceives a recent event as meaningful and threatening
• The individual seems unable to use traditional coping methods to modify or lessen the impact of the event. • The individual is experiencing an increased “fear, tension and/or confusion” (p. 13). • The individual exhibits a high level of subjective discomfort. • The individual is quickly proceeding to an active state of crisis. It is essential that crisis intervention is immediate; crisis theory explains why an individual needs crisis intervention in order to deal with the crisis at hand.
When a crisis occurs, it can be one event or a series of events which disturbs an individual’s normal state of mind. When the crisis is not addressed by the individual, either by being redefined, avoided or resolved then the tension level increases; at the peak of tension an individual will no longer be able to function normally which will cause more difficulties (Roberts, 2005). The individual will thus remain in a constant state of turmoil (Roberts, 2005).
Roberts’ (2005) research indicates that the typical crisis state will stabilize within four to six weeks. Other research however, demonstrates that it may take up to a year before the individual will exhibit recovering characteristics. Crisis intervention will stabilize the crisis, restoring the balance of emotions and erratic behaviors exhibited in an individual. Intervention is needed because during the state of crisis an individual experiences severe emotional discomfort; the individual will then take action to reduce this discomfort.
A crisis can be considered resolved when the individual is able to develop new coping methods through personal growth; with the assistance of outside resources (Roberts, 2005). There are three phases of crisis intervention, psychological first aid, the first step, involves “establishing a rapport with the victim” so that the victim will feel safe and be able to provide the information needed for a short-term assessment which is conducted in the second phase (NCVC, sect. 3, 2001).
It is critical to respond immediately to the victim once the crisis has occurred; at that time the medical and physical, as well as emotional and personal needs of the victim needs to be addressed. Referrals would also be made at the time of assessment. The third phase consists of recovery intervention, this phase focuses on helping victims “re-stabilize their lives and become healthy again” (NCVC, sect. 3, 2001). Prevention from further victimization should be addressed, as well as establishing a plan for social support.
A successful intervention will address the victim’s needs and assist with the healing process. The key to effective crisis intervention is “creative listening”; which should be used during all three phases of crisis intervention (Young, 2007). Roberts (2005) discusses the various methods of crisis intervention, the most popular being the crisis hotline; in which an assessment in made and referrals are given over the phone. There are many types of crises that can be addressed using the crisis hotline; including calls concerning suicide ideation, substance abuse issues and crime victimization.
The hotlines provide immediate assistance twenty-four hours a day. Crisis Intervention in Public Schools Canada (2005) makes a valid argument for the need for more effective crisis intervention among grade school students; especially those of diverse backgrounds. According to Canada (2005), a trend began in 2000 to provide mental health services, including crisis intervention, to “children and families ‘where they are’” (p. 1). This trend began with the advice of the U. S. Department of Health and Human Services to mental health agencies.
Problems with mental health services provided in a public school atmosphere arise when funding and resources are stretched too thin (Canada, 2005). Canada’s (2005) research demonstrated the enormous workload that school counselors face; according to the researcher, the statics show that there is a nationwide ratio of “one school-based mental health professional for every four-hundred students” (p. 2). When crises occur, it is very difficult for a mental health professional to address the issue quickly and effectively; due to the workload.
A school crisis can effect any number of people, students and faculty; making it all the more difficult (Canada, 2005). Canada (2005) realized the often under-addressed problem of identifying human diversity and how it affects the effectiveness of crisis intervention. Canada (2005) excellently summarizes the issue of diversity definitions; Although some general differences among and between various groups of people are visible and easily recognized, there are also subtle individual differences which dilute the broad term of diversity to the fact that each individual is unique.
In order to honor this uniqueness, counselors must consider an individual within multiple layers of diversity, ranging from the individual to the broader context of interconnectedness with society (as cited in Canada, p. 6, 2005). There are many elements which must be addressed by a crisis intervention councilor in a school setting; such as how they function individually, within their peer circle, in their environment, and with their family, community and at school (Canada, 2005).
A student’s culture must also be woven into the crisis intervention strategy; as well as within other mental health services. A student’s culture includes his or her beliefs, customs, values, ethnicity, faith etc (2005). Canada (2005) discusses the Cleveland Elementary schoolyard shooting, which occurred on January 17, 1989 in Stockton, California, as a prime example of “how a lack of culturally sensitive services greatly increased chaos and confusion” (p. 12). The school had a population of seventy percent Asian students; with the majority of parents unable to speak English.
The situation quickly turned chaotic, with school personnel unable to tell the parents what had occurred and communicate what children were injured or killed. During the incident, five students were killed, twenty-nine injured; as well as one teacher (Canada, 2005). The mental health workers called to the Stockton incident were English speaking and were of no help to the children or parents (Canada, 2005). To make matters worse, the parents of the Asian children were not willing to send there children back to school due to cultural beliefs in ghosts and evil spirits (2005).
The school recognized the need for culturally appropriate intervention and asked a Buddhist monk to come and perform two exorcisms at the school. Canada (et. al. 2006) continued research in the area of cultural appropriate intervention with fellow researchers. The study of 236 American School Counselor Association (ASCA) counselors, demonstrated that over half the counselors were concerned with addressing cultural issues and needs within crisis intervention (2006). Kemple’s (2005) research supports Canada’s (et.
al. 2006) research; Kemple’s (2005) study of 276 psychologists found that nearly half of counselors felt there needed to be an “increased understanding of cultural issues when providing crisis intervention” (abstract). These results further demonstrate the need for culturally appropriate intervention strategies for optimal effectiveness. While Canada (et. al. , 2006) and Kemple’s (2005) research is based on diversity within crisis intervention in schools, this research is valuable outside of the school setting.
The lessons learned in current diversity and culture studies concerning crisis intervention in schools could appropriately be applied to other areas of crime intervention, including with victims of crime. Determining the Effectiveness of Crisis Intervention Many studies have determined the effectiveness of crisis intervention by studying how the presence of psychiatric illnesses has been reduced by use of such interventions. Such psychiatric illnesses that have been studied are depressive disorders, suicidal ideation and posttraumatic stress disorder (Roberts & Everly, 2006).
Unfortunately, the effectiveness of certain types of crisis intervention, such as phone hotline intervention, in-home or in-person interventions, have not been “systematically and rigorously studied” (Roberts & Everly,p. 16, 2006). Therefore, it is very difficult to say how effective these intervention methods are; research does however, show that the overall success of crisis intervention is positive (2006). Roberts and Everly, (2006) studied thirty-six studies which investigated crisis intervention effectiveness on various individuals; such as crime victims and disaster victims.
For the purpose of their study, the researchers categorized crisis intervention into family preservation (in-home family intervention implemented over a three month period), multi-session crisis intervention, or group crisis intervention (also known as multicomponent critical incident stress management, which is approximately four to twelve sessions); the final strategy was single-session individual or group crisis debriefing (twenty minutes to two hour debriefings). Roberts and Everly, (2006) found that on crime victims, primarily child abuse and neglect victims; positive results were achieved with family preservation crisis intervention.
One of the studies researched in Roberts and Everly (2006) compared one-session critical incident debriefing to multicomponent critical incident stress management with bank robbery victims as the subject (all employees of where the bank robbery occurred). This study however seems somewhat flawed; there were 524 subjects and 299 were given CISM and 225 were given the one session-debriefing. The results showed that CISM was more effective than the one-session recipients; however there were more test subjects receiving CISM and this was not taken into account.
This unreliable data is typical of crisis intervention research according to Mitchell (2003); this will be discussed further on in this review of literature. The study discussed by Roberts and Everly (2003) did however demonstrate that crime victims do respond well to both types of crisis intervention. This is useful knowledge for mental health workers who work with crime victims. Among the studies discussed by Roberts and Everly (2006), several found in-home crisis intervention to be effective in reducing the presence of psychiatric illnesses in the majority of child abuse victims.
Overall, the researchers found that the in-home intervention method was the most successful, especially compared to one session intervention. Green and Diaz (2007) recognized the need for discovering, recognizing and then identifying certain emotions specific to crime victims. The goal of the researchers was to identify short term and long term affects of certain factors on the recovery process. These factors were: “individual characteristics, coping strategies, social support, well-being”, gender, the crime committed against them, coping strategy and social support.
Surprisingly, the researchers found that only a few factors actually predicted the emotional stress of crime victims. These factors of influence were gender, the type of crime, coping strategy and social support. By identifying the common factors associated with the recovery process, one can identify the proper crisis intervention strategy to use with crime victims. As previously mentioned, Mitchell (2003) makes an excellent argument for the need for better understanding and research on the effectiveness of the various strategies of crisis intervention.
Unfortunately, according to Mitchell (2003), there are many studies that lack reliabilities in terms of how effective crisis intervention strategies are. Mitchell (2003) systematically discusses published studies on crisis intervention and various methods of crisis intervention; proving that it has not been adequately represented; many times it has been reviewed negatively because of poor study methods and implementation. It is for this reason that the researcher believes more study is needed on the actual effectiveness of crisis intervention on a specific test subject; such as victims of crime.
Conclusion The various articles and studies discussed in this literature review point to the obvious need for more research in the area of crisis intervention. The actual effectiveness of crisis intervention on crime victims is very under-studied and needs significantly more research done in that area. Based on this information, the researcher proposes that a study be done specifically on the effectiveness of crisis intervention, preferably one session intervention, on victims of crime conducted. References Canada, M. (2005).
School counselors’ concerns regarding effective crisis intervention for students of diverse backgrounds. Retrieved August 17, 2008 from, http://patriot. lib. byu. edu/ETD/image/etd1134. pdf Canada, M. , Heath, M. A. , Money, K. , Annandale, N. , Fischer, L. & Young, E. L. (2006). Crisis intervention for students of diverse backgrounds: School counselors’ concerns. Brief Treatment and Crisis Intervention Advance Access. Retrieved August 17, 2008 from, http://brief-treatment. oxfordjournals. org/cgi/reprint/mhl018v1 Diane L. Green, D. L. & Diaz, N. (2007).
Predictors of emotional stress in crime victims: Implications for treatment. School of Social Work. Retrieved August 17, 2008 from, http://brief-treatment. oxfordjournals. org/cgi/reprint/7/3/194 Infolink. (1997). Crisis intervention. Retrieved August 13, 2008 from http://www. darkness2light. org/KnowAbout/articles_crisis_intervention. asp Kaminsky, M. , McCabe, L. O. , Langlieb, A. M. & Everly, G. S. (2006). An evidence-informed model of human resistance, resilience, and recovery: The Johns Hopkins’ outcome-driven paradigm for disaster mental health services.
Johns Hopkins University School of Medicine. Retrieved August 17, 2008 from, http://brief-treatment. oxfordjournals. org/cgi/reprint/7/1/1 Kemple, A. E. (2005). School psychologists’ perceived concerns regarding crisis intervention with diverse populations. Retrieved August 16, 2008 from http://contentdm. lib. byu. edu/ETD/image/etd1133. pdf Mitchell, J. T. (2003). Crisis intervention & CISM: A research summary. International Critical Incident Stress Foundation. Retrieved August 18, 2008 from http://www. icisf.
org/articles/cism_research_summary. pdf Roberts, A. R. & Everly, G. S. (2006). A meta-analysis of 36 crisis intervention studies. Brief Treatment and Crisis Intervention. 6(1). Retrieved August 10, 2008 from, http://brief-treatment. oxfordjournals. org/cgi/reprint/6/1/10 Roberts, A. R. (Ed. ). (2005). Crisis intervention handbook: Assessment, treatment, and research. Oxford University Press. New York: NY. Retrieved August 16, 2008 from http://books. google. com/books? id=0GZXYWH2ln4C&printsec=copyright#PPP1,M1
The National Center of Victims of Crime. (2007). Crime Intervention. Retrieved August 11, 2008 from, http://www. ncvc. org/ncvc/main. aspx? dbName=DocumentViewer&DocumentID=32346 Crisis manual: http://www. ojp. usdoj. gov/ovc/publications/infores/crt/ Young, M. (2007). The Community Crisis Response Team Training Manual. (2 ed. ). Chap. 6. National Organization for Victim Assistance. Retrieved August 15, 2008 from http://www. ojp. usdoj. gov/ovc/publications/infores/crt/