Key Elements of Therapy with Clients in Crisis

What is a ‘crisis’? Glenys Parry (1990), a well-respected British therapist and researcher, outlined eight defining features of a crisis. In listing them below, I will show how a therapist can help clients deal effectively with the crisis, encouraging them to identify and use their internal resources whenever possible.

1  A triggering stress event or long-term stress

Help the person to express in words the situation they have been facing. Such expression to an attentive, non-judgmental listener can be healing in itself, as the person may have spent much time trying to avoid thinking about the situation or internally ruminating about it.

2  The individual experiences distress

Helping the person express their distress and understand it will encourage them to stand back and think about the situation constructively.

3  There is loss, danger and humiliation

Asking the person how they have dealt with similar themes before can encourage them to reconnect with the part of themself as an effective personal problem-solver.

4  There is a sense of uncontrollability

Having the person focus on what they can and cannot control can encourage them to identify their internal resources concerning the former and to drop attempts to deal with the latter.

5  The events feel unexpected

Helping the person to see life as a complex mixture of the expected and the unexpected can lead them to draw on their experiences of accepting (but not liking) unanticipated adverse events.

6  There is disruption of routine

It is important to encourage the person to resume their routine in their own time.

7  There is uncertainty about the future

Helping the person tolerate such uncertainty and encouraging them to detail how they have responded well to such uncertainty in the past shows them that they have relevant internal resources they can draw upon in the present.

8  The distress continues over time (from about two to six weeks)

It is important that the person is offered help at their chosen moment and is not asked to join a lengthy waiting list. Services offering single-session therapy can provide a rapid response to a person in crisis (Dryden, 2021).

From the above, it follows that an effective therapeutic response to a client in crisis involves the following:

• Deal with the person as a unique individual.
   
• Provide a rapid response to the person in crisis.
   
• Offer the person an opportunity to talk about the crisis and express their feelings about it.
   
• Respond to their feeling-based narrative with attention and empathy.
   
• Wherever possible, encourage the person to identify internal resources they have used in similar situations. They may have lost sight of these, but you can reacquaint them with this part of themself and help them to see how they can use such resources in the present crisis.
   
• Target interventions where the person is struggling the most. Thus you may best help them to i) deal effectively with their distress; ii) develop healthy attitudes to the unexpected nature of life and the uncertainty of the future, and iii) focus on what they can control rather than on what they can’t control.