Crisis intervention

Crisis intervention is generally a short-term external influence when a situation becomes acutely threatening for an individual or a social system. The aim of the intervention is to stop and manage a critical development towards a possible disaster .

Psychological technical term

In psychological or psychotherapeutic as well as church-pastoral counseling work, crisis intervention - in contrast to long-term therapy - initially generally means outpatient or clinical care and counseling for people who are acutely psychologically at risk. Triggers are usually sudden, massive changes in living conditions, for example due to terminal care or death of a close relative, experience of violence, a natural event, an accident or a serious illness. Those affected should be enabled by professional help to cope with the life crisis. From a psychotherapeutic point of view, crisis intervention is supportive psychotherapy . In many cities, there are support offers from specialized crisis intervention services and telephone counseling .

In a more specific meaning, the care of people with acute psychological stress reactions after accidents, unsuccessful resuscitation , self-harm, suicide attempts or disaster relief is meant. Here appropriately trained helpers from crisis intervention teams, the police, the fire brigade, the churches ( emergency pastoral care ) or the rescue services ( crisis intervention in the rescue service ) are deployed. The Mental Health Facilitator of the National Board for Certified Counselors is an internationally widespread certificate for lay rescuers and first aiders (e.g. in the event of natural disasters) .

In the medical context, the term is particularly used to describe the professional response to a psychiatric crisis .

In the context of social work , crisis intervention means social work intervention in the face of crisis phenomena such as unemployment , poverty, violence, over-indebtedness and the like. The socio-educational crisis intervention is both preventive - through socio-cultural youth work , life planning discussions, information events e.g. B. on drugs or debts in schools, introduction to self-help groups etc. - as well as on the support of those affected in individual crisis situations - e.g. through debt counseling , taking children and adolescents into care, returning from home education or from child and adolescent psychiatry into the family Environment, through women's shelters , perpetrator and victim counseling, psycho-oncology , educational assistance, etc.

Psychotherapeutic crisis intervention

Psychotherapeutic crisis intervention is understood to be short-term, intensive psychotherapy that begins quickly in a crisis and is provided by a crisis intervention advisor , in which the current conflict or the immediate trigger, such as a traumatic experience, is discussed in a targeted manner. At the same time, the aim is to overcome the problem and provide acute relief. In the case of a serious marital conflict, for example, this can include a clarifying discussion and immediate intervention. The aim is to alleviate the current state of suffering and to keep the psychosocial or medical consequences of the crisis as low as possible. Typically, the person concerned is in a situation that exceeds their normal coping capacities. It is therefore important to take him seriously in his individual experience and to give concrete support in the development and implementation of immediate goals.

The crisis intervention essentially focuses on the here and now. An empathic (sensitive), appreciative attitude is of great importance. In addition to the concrete alleviation of the most urgent difficulties, for example through problem-solving strategies or the transfer of information, relief by activating existing resources (the “individual strengths and strengths”) is an essential component. This can be the mediation of support from relatives or the reflection on one's own strengths. Crisis interventions are often very effective as immediate relief.

A psychotherapeutic crisis intervention focuses the treatment on the acute emotional and cognitive state of the patient, as well as on the trigger of the crisis and the available resources. By definition, it is a time-limited intervention with a specific therapeutic approach aimed at the immediate stabilization of the patient and should begin immediately at the beginning of the crisis or as quickly as possible (Berger & Riecher-Rössler 2004). The patient should be emotionally relieved and his ability to act and make decisions should be restored.

In practice, this comes up against many problems, such as waiting times that are too long for resident psychotherapists as well as current regulations within the framework of the psychotherapy guideline, according to which psychotherapeutic treatment may only be given in the event of a mental illness and after promising costs. This requires probatory sessions for diagnostic and differential diagnostic clarification, which are difficult to reconcile with immediate crisis intervention. In addition, there is the explicit exclusion of life, upbringing and marriage counseling and of measures that serve exclusively professional adaptation. Therefore, the psychotherapeutic crisis intervention concentrates primarily on inpatient and semi-inpatient facilities, including institute outpatient clinics of the regional psychiatric acute hospitals. Due to the current structure and legally regulated organization of outpatient psychotherapy, possibilities of psychotherapeutic crisis intervention in psychotherapeutic practices are almost impossible.

On the procedural side, numerous methods of behavior therapy , as well as approaches of psychodynamic supportive therapy in the context of depth psychologically founded psychotherapy, offer effective interventions for a psychotherapeutic crisis intervention.

Technical term for security policy

In foreign and security policy, crisis intervention means a quick military-strategic reaction. In the German Bundeswehr, intervention forces (formerly: crisis reaction forces) are used for military units which, thanks to their equipment and crew, are able to react at short notice to regional or international threats to peace ; For this purpose, the NATO Response Force is to be deployed at NATO level .

In the EU (in response to the unconvincing engagement of the European nation- states in overcoming the Yugoslav wars ) but also within NATO (in response to a new threat scenario and new global peacekeeping tasks after the Warsaw Pact threat no longer exists ), since the end of the 20th Century increasingly sought ways to set up flexible, supranational military units. In 2004 it was decided to set up such flexible, small combat groups within the framework of the European security and defense policy , which should be available at short notice within 10 to 15 days. The first of these EU battlegroups were operational in 2005.

Individual evidence

↑ Berger P & Riecher-Rössler A (2004) Definition of crisis and crisis assessment. In: Riecher-Rössler A, Berger P, Yilmaz AT, Stieglitz RD (ed.) Psychiatric-psychotherapeutic crisis intervention. Göttingen: Hogrefe, 19–30
↑ BPtK study: Waiting times in outpatient psychotherapeutic care Archived copy ( Memento from July 5, 2014 in the Internet Archive )
↑ Guideline of the Federal Joint Committee on the Implementation of Psychotherapy Status: January 3, 2015 (PDF; 139 kB), accessed on May 4, 2015.

[1] Berger P & Riecher-Rössler A (2004) Definition of crisis and crisis assessment. In: Riecher-Rössler A, Berger P, Yilmaz AT, Stieglitz RD (ed.) Psychiatric-psychotherapeutic crisis intervention. Göttingen: Hogrefe, 19–30

[2] BPtK study: Waiting times in outpatient psychotherapeutic care Archived copy ( Memento from July 5, 2014 in the Internet Archive )

[3] Guideline of the Federal Joint Committee on the Implementation of Psychotherapy Status: January 3, 2015 (PDF; 139 kB), accessed on May 4, 2015.