Wherever you work in community services you will encounter crisis situations, so you will need to know how to recognise when someone is experiencing a crisis and how to respond appropriately within your work role, within the policies and procedures of your organisation and within relevant legal and ethical requirements. This includes recognising common indicators or signs of crisis and being able to identify a range of different crisis situations.
By the end of this topic, you will understand:
- how to identify imminent crisis situations, recognise direct and indirect indicators of crisis in other people and how to recognise the presence of safety issues
- how to identify and consider types of crisis situations, including:
- potential suicide
- threats to harm others
- self-harm
- received threats
- abuse, including child abuse
- domestic and family violence.
A crisis is a situation in which something or someone is affected by one or more very serious problems.
Before we discuss how to recognise and respond to crisis situations in community services work, we must first clarify what we mean by ‘crisis.’
Most definitions of crisis include these elements:
- The person reaches a turning point
- Being a time of:
- Great difficulty or danger
- Important change
- Important decisions
Within the context of community services work, the term crisis is generally used to mean a state in which the person is unable to function in their usual way or by using their accustomed resources, often due to a significantly stressful event. Crisis events cause emotional, psychological and physical distress and affect the person’s behaviour and ability to function.
A crisis is triggered by an event or situation that the person finds overwhelming and seeks help to deal with. Crisis interventions usually consist of short-term immediate help.
The American psychiatrist Gerard Caplan defines a crisis as ‘occurring when a person faces an obstacle to important life goals that is, for a time, insurmountable by customary means of problem solving.
A crisis is seen as presenting both threats and opportunities for personal growth.
Triggering Events
Events that trigger a crisis can arise from:
- Situations such as natural disasters, health and wellbeing, violence, financial hardship and other high-risk situations
- Relationships such as the breakdown of relationships and abusive relationships
- Life changes and developmental issues such as issues relating to developmental stages, e.g., adolescence, mid-life, ageing and changes in social roles and status
Crisis Intervention
Crisis intervention aims to address the immediate crisis and to reduce distress so that the person can identify and use resources to resolve issues and problems.
Crisis intervention also encourages a focus on crisis as an opportunity for change and emphasises the importance of exploring and expressing feelings as part of supporting meaningful change.
THINK
A crisis does not have to arise from a major event such as a natural disaster. A crisis can stem from changes that occur across the life span, such as the transition from childhood to adolescence, adolescence to adulthood and the aging process. A crisis may arise from mundane events such as not being invited to the school ball, failing to pass an exam, not getting the job you applied for, not having the means to pay the rent or the electricity bill or the loss of a friendship that was important to you. Think about times in your life when you experienced a crisis or times when you felt overwhelmed by an event or situation and sought help to deal with it.
Think about:
- What was the event or situation? How did it happen?
- How did you feel?
- What was at risk or what did you lose in this event or situation?
- What resources did you lack? What were you not able to do? How was your ‘normal’ functioning affected?
- Where did you seek help?
- What was the outcome? How was the crisis resolved?
- What were the longer-term impacts?
In your work you will need to be able to identify signs that a person is experiencing a crisis, or that a crisis is imminent, so that you can provide appropriate support.
Direct and Indirect Indicators
Direct indicators that someone is experiencing a crisis are observable signs that something has happened to cause the person significant distress.
Common indicators or signs that a person is experiencing a crisis include:
- There has been a triggering event, such as a disaster situation, a serious health condition, a breakdown in relationships or a significant life change
- The person experiences distorted perceptions of the event
- The person loses their ability to solve problems and respond appropriately to the event
- The person’s emotions overwhelm them and stop them from functioning effectively
Sometimes signs that a person is experiencing a crisis are less obvious. These indirect indicators may include a range of behaviours and verbal statements that are not directly about the crisis and its impact on the person, but that still show that the person is experiencing significant distress.
Changes in social engagement, mood, physical health, abilities and skills, and use of drugs or alcohol can be indirect signs that a person is experiencing a crisis.
EXAMPLE
John and Mary have recently lost their house and all of their possessions in a bushfire. They have moved into Mary’s parents’ house with their three children. The Red Cross has provided them with clothing, food and some other basic requirements. They are living with Mary’s parents while they look for accommodation.
John is experiencing panic attacks. He cannot ‘think straight’ and is unable to fill in the paperwork for insurance claims and other assistance. He feels as if his life is over and that he has failed his wife and children. He believes that his wife will divorce him and that he will never see his children again.
Every morning he returns to the ruins of his home and searches futilely through the rubble for lost possessions. He has stopped eating and cannot sleep at night. He avoids social activities and seeing friends and has become withdrawn and moody.
At night he sits alone drinking and he has become short tempered with Mary and his children and finds living in the crowded house with Mary’s family unbearable.
Communication
During a crisis, the way people communicate changes. People process information differently and often revert to ‘fight or flight’ reasoning. Their responses may be exaggerated, and their perceptions become distorted.
- Important or complex information may be missed and messages may be misinterpreted
- People tend to fall back on existing beliefs and find it hard to absorb new information
- People tend to believe the first message and fill in the blanks with speculation when there is not enough information
- Emotions include fear, anxiety, dread and feelings of despair and powerlessness
- Denial is common and people find it hard to believe the threat or danger
- Panic may result from the flight or fight response to extreme stress
LEARN MORE
- Psychological crisis types and causes, Cherry, Very Well Mind, 2020
- Common psychological responses to traumatic events, Cherry, Very Well Mind, 2021
- Crisis intervention: an overview, Catholic Charities, undated
There are several different types of crisis situations that you may encounter in your work. The situations outlined below may arise as responses to a triggering event or situation or may be triggering events that result in a person experiencing crisis.
Potential Suicide
In responding to attempted suicide your priority must be to keep the person safe. There are many guidelines available from suicide prevention and support organisations.
Your organisation will have policies and procedures that you should follow.
Always work within the boundaries of your job role and use the following guidelines:
Ask
If you think someone might be suicidal, ask them directly ‘Are you thinking about suicide?’ Do not be afraid to do this; it shows you care and will actually decrease their risk because it shows that someone is willing to talk about it. Make sure you ask directly and unambiguously.
Listen and Stay
If they say yes, they are suicidal, listen to them and allow them to express how they are feeling. Do not leave them alone. Stay with them or get someone else reliable to stay with them.
Get Help
Get them appropriate help. Call a crisis line like Lifeline 13 11 14 or 000 if their life is in danger. If you can get in straight away, visit a GP or psychologist. Offer to make the appointment and accompany them if it is their wish. Even if the danger is not immediate they may need longer-term support for the issues that led to them feeling this way.
RESOURCE
Other useful sources of information for crisis intervention:
- How To Help When Someone Is Suicidal, SANE
- How To Help In A Crisis, SANE
- Emergency With People At Risk, Suicide Call Back Service
- How To Make a Safety Plan, Reach Out
- Suicide, Beyond Blue
Responding to a Person Contemplating Suicide
This learning activity provides an opportunity for you to apply strategies for responding to a person who is contemplating suicide.
Use the Beyond Blue website cited above to review guidelines for responding to suicide.
Read the scenario below and answer the questions at the end.
Case Study
Catalina is in her early twenties. She is studying to be a laboratory assistant. She lives alone in a small apartment and has recently broken up with her boyfriend.
Catalina has started drinking heavily. She often refuses invitations from her friends and has become quiet and withdrawn. She has not visited her family for several weeks and has stopped telephoning her mother. She is missing classes at TAFE and her results have dropped. She has made comments to fellow learners about feeling directionless, dispirited and hopeless, and has joked about ‘ending it all.’
Catalina is a keen dancer and attends a ballet exercise and practice class twice a week. Although she was devastated by the breakup with her boyfriend, she has continued to attend these classes and to drop into the studio to practise. Her grandmother Lisa was a famous ballerina and Catalina is very close to her. She still visits Lisa every Sunday at the nursing home where she now lives.
You live next door to Catalina and you are casual friends. You have noticed the changes in her and you are concerned.
Complete the following questions
Threats of Harm to Others
You may encounter situations where there is a threat of harm to others such as family members, children, neighbours, other residents or other workers, for example, within the context of domestic and family violence, child protection, family law disputes, mental health issues, drug and alcohol intoxication or conflicts between residents in residential services.
Your first concern will be to keep everyone involved as safe as possible. This means identifying who is at risk, what the risks are and how serious the risks are. Use your observation skills and ask questions.
If the threat is imminent, remove yourself and any others from the threat, if possible. When you have done this, call for help.
Follow your organisation’s policies and procedures for responding to threats (and use your common sense!).
Case Study
Jane works in a women’s refuge.
She is alone on duty tonight. Jason, the partner of one of the residents has discovered the address of the refuge and believes that his wife and children are living there.
Jason arrives at the refuge and is demanding to see his wife and children, banging on the front door, shouting abuse and threatening to ‘shoot everyone.’ Jane sees that he has a rifle with him.
Jane uses the intercom to tell Jason that his wife and children are not there and asks him to leave. He refuses and continues to make threats, becoming more and more agitated. He then tries to break into the refuge and starts shooting at the security door and windows.
Jane moves the residents nearest to the front of the house into the kitchen area, which is at the back of the building. She then calls the police, explains the situation and tells them that it is urgent. She then continues to talk to Jason over the intercom, using her listening skills to try and calm him.
When the police arrive, they disarm Jason and arrest him.
LEARN MORE
Managing aggressive and disruptive behaviours, Australian Government Department of Health, undated.
Client violence towards workers in child family and community welfare sector, Broadley & Paterson, AIFS, 2020
Do’s and don’ts of managing a client who is angry or aggressive, Cracks in the Ice, 2021
Employ strategies to prevent escalation of aggression and potential violence, Youth AOD Toolbox, The Centre for Youth AOD Practice Development,
Aggressive behaviours, Dementia Australia, 2020
WATCH
Watch the following YouTube video by Dartmouth Trauma Interventions Research Center called Calming & De-escalation Strategies:
Duration 4:21
Checkout the following YouTube video titled How to de-escalate someone by Dr. Christian Conte:
Duration 7.55
Self-Harm
Guidelines for responding to self-harm are similar to those for responding to potential suicide:
- If necessary, provide first aid and call for help
- Use active listening to talk to the person and offer support
- Remain calm and non-judgmental
- Encourage the person to seek professional help from someone they trust
Case Study
James is a physical education teacher in a high school. After a football match, James notices that Sam, one of his students, has fresh cuts on the insides of his arms.
He takes Sam aside, sits down next to him and asks him how he got the cuts on his arms.
Sam bursts into tears and tells James that he often cuts himself when he feels ‘down.’ James talks quietly to Sam, asking him about times when he feels down and what makes him feel like this. He reassures Sam that he will help him and explains that people sometimes harm themselves as a way of trying to cope with painful feelings and situations and that there are less harmful ways of dealing with these.
James offers to refer Sam to a service for young people that he knows and talks to Sam about what the service does. He also offers to go with Sam to see a counsellor at the service.
Self-harm is any behaviour that involves the deliberate causing of pain or injury to oneself. Self-harm can include behaviours such as cutting, burning, biting or scratching the skin, pulling out hair, hitting oneself, or repeatedly putting oneself in dangerous situations. It can also involve abuse of drugs or alcohol, including overdosing on prescription medications
Responding to People at Risk of Self-Harm
This activity will help you to develop your awareness of services and supports for people at risk of self-harm and give you an opportunity to apply strategies for identifying and responding to risk of self-harm.
This is an individual learning activity.
Use online sources to collect information about services such as:
- Headspace: What You Need to Know About Self Harm
- Reach Out: How to Help a Friend who Self Harms.
Read the scenario below and answer the questions at the end.
Case Study
Maxine is seventeen. She lives with her mother, stepfather and two younger sisters. She is in her final year of high school and is studying hard for exams.
Maxine has always been slightly overweight. She wears glasses, is not very good at sports and her skin has recently erupted in a bad case of acne. She is embarrassed and unhappy about her appearance and is often teased by her classmates.
Her younger sisters are both slim and athletic. Her stepfather frequently praises them and often tells them how pretty they are. Maxine’s mother is also slim and attractive and takes pride in her appearance. She sometimes comments that she has ‘just about given up on Maxine’ and tells her that she is the ‘ugly duckling’ of the family.
Recently Maxine has become more withdrawn. She has begun starving herself and making herself vomit after meals in an attempt to lose weight and has also started cutting the insides of her arms and upper thighs, especially when she is feeling depressed.
Received Threats
Threatening, aggressive and violent behaviour often stems from fear, anger and defensiveness. In some sectors of community services such as domestic and family violence, child protection, mental health services, alcohol and other drugs services and other areas where feelings of fear and powerlessness can run high, people may become threatening towards staff members, organisations and family members.
There is no simple blueprint for responding to threats, but as with any situation where there is a risk of serious harm, keeping everyone as safe as possible is a priority. This means that you must follow your organisation’s policies and procedures (and use your common sense).
EXAMPLE
Susan is a coordinator for a service that provides supervision for parental contact visits to children who are in care. These visits usually occur on a weekend at a community centre and are supervised by a support worker.
One Saturday morning, Susan receives a phone call from Alice, the mother of one of the children. An access visit with the child’s father has been arranged for that afternoon. Alice tells Susan that her ex-husband sent her a text message last night saying that he planned to take the child away and if she told the police, he would kill himself and the children.
Susan is not sure whether Alice is telling her the truth, but she cancels the access visit and notifies the police so that the allegation can be investigated.
RESOURCE
There are many different situations where a worker or an organisation might receive a threat. The article below provides some guidelines for responding to threats:
- Model guidelines for managing and responding to threats aggressive behaviour and violence, NSW Ombudsman, 2017
- How to respond to angry behaviour, ABIOS.
Abuse
Working with people experiencing abuse, including children, women, people with disabilities, and older people, can present you with frequent crisis situations.
As with any crisis situation your first concern will be to protect the safety and wellbeing of those affected.
What is Abuse?
Abuse is any action or behaviour that causes intentional harm. This includes verbal, emotional, psychological, financial, economic and physical harm.
In situations where abuse happens, there is usually an imbalance of power, so that one person has more power and control than the person being abused. It is common for the person experiencing abuse to be dependent on the abuser. For example, in child abuse, adults have more power than children, an older person may have less power than their carer, a person with a disability may have less power than their carer and in domestic and family violence, the person being abused may be dependent and less powerful than their abuser.
Principles for Responding to Abuse
Legal Requirements
Depending on the context, there may be legal requirements for responding to abuse. For example, child protection legislation sets out how to respond to child abuse, disability services legislation provides service standards that must be met for services to continue to receive funding, aged care legislation also provides service standards and avenues for responding to and reporting abuse within residential aged care services.
In the context of assessing your clients’ needs, duty of care means that you must:
- Work within your job role and within the scope of your competency – If you undertake tasks for which you are not qualified or do not have the requisite skills and knowledge, you risk harming your clients. If you carry out tasks that are not included in your job role, your organisation may not protect you from legal action for any harm resulting from your actions.
- Follow your organisation’s policies and procedures – Following your organisation’s policies and procedures for assessing clients’ needs will protect you and your clients.
- Use your common sense, be vigilant, and seek advice if you are unsure – You are not expected to predict risks to your clients that arise from unusual and extraordinary situations, but you are expected to use your common sense, be vigilant in identifying potential risks, and seek advice from your supervisor if you are not sure about what to do.
In some cases, abuse may involve criminal offences such as assaults, theft or financial fraud. For ethical decision making, read through the following resources.
Reading
Review the following examples of codes of ethics relevant to community services work:
- Australian Community Workers Association Code of Ethics and Practice Guidelines
- Youth Affairs Council of Western Australia Code of Ethics
- Aged Care Quality Standards from My Aged Care
Review the following examples of codes of conduct relevant to community services work:
- Mental Health Council of Australia Code of Conduct
- National Disability Insurance Scheme Code of Conduct (Workers)
- Australian College of Care Workers Code of Conduct for Care Workers
- ‘New Code of Conduct Covering Aged Care Workers: What You Need to Know’ from Australian Ageing Agenda
Review the following examples of codes of practice relevant to community services work:
- Domestic Violence Victoria Code of Practice: Principles and Standards for Specialist Family Violence Services for Victim-Survivors
- Professional Standards and Codes of Practice’ from The Lookout
Service Approaches to Supporting People Experiencing Abuse
Services that support people experiencing abuse use approaches such as rights-based, person-centred and strengths-based.
These approaches have a common focus on empowerment, advocacy and meeting individual needs.
| Approach | Principles/ Practice |
| Rights-based Approach |
Participation Accountability Non-Discrimination and Equality Empowerment Legality |
| Person-centred Approach |
|
| Strengths- based Approach |
|
LEARN MORE
- What is abuse? Healthy Place, 2021
- What is abuse? Kids Helpline, 2021
- Elder abuse, Australian Human Rights Commission, undated
- Protecting the rights of older Australians, Attorney General’s Department, 2021
Domestic and Family Violence
Domestic violence refers to violent behaviour between current or former intimate partners – typically where one partner tries to exert power and control over the other, usually through fear. It can include physical, sexual, emotional, social, verbal, spiritual and economic abuse.
Family violence is a broader term that refers to violence between family members, which can include violence between current or former intimate partners, as well as acts of violence between a parent and a child, between siblings, and more. Family violence is the preferred term for violence between Aboriginal and Torres Strait Islander people, as it covers the extended family and kinship relationships in which violence may occur.
READ
- Domestic and family violence, Lifeline, undated.
- Guide to responding to disclosures of domestic and family violence, Community Services ACT, ACT Government
- Safety planning in crisis situations with and for Aboriginal women experiencing domestic and family violence, Anrows, 2017
- Identifying and responding to family violence, The Royal Women’s Hospital, 2017 https://scnv.io/v05L
Mandatory Reporting
In many cases, your role will require you to follow mandatory reporting guidelines.
- Mandatory Reporting, 1800RESPECT
- Mandatory Reporting of Child Abuse and Neglect, Australian Government
This learning activity will help you to extend your knowledge and understanding of how to respond to crises within the context of domestic and family violence.
Use online and other sources to collect information.
Read the scenario and answer the questions at the end.
Case Study
Danica is in her sixties. She lives with Waldis, her husband of forty years. They have four adult children and five grandchildren.
Waldis has always managed the family finances. He gives Danica a housekeeping allowance, but she does not have access to their bank account and they do not have a joint bank account. Waldis works as a store manager.
Danica has never worked outside the home. She has a small circle of close friends and is an active member of the local parish, but Waldis has never encouraged her to participate in hobbies or activities outside of the home. He has a quick temper and she has learned to avoid confronting him. He does not allow her to have a mobile phone and he demands to know what she does and who she sees when she leaves the house.
Now that Waldis is nearing retirement, Danica is anxious and fearful about how she will cope with his moods and demands when he no longer goes to work each day. She has been experiencing panic attacks and bouts of insomnia. She wants to consult their GP, but Waldis tells her that there is nothing wrong with her and that she is imagining things.
In responding to a person experiencing a crisis, safety is always a primary consideration. You will need to be able to recognise and respond to direct and indirect indications that a person’s safety may be at risk and follow your organisation’s policies and procedures for addressing safety issues.
Who is at risk and the specific risks involved will vary according to the particular crisis situation, but in most situations, physical safety will be an immediate priority. Longer term risks of psychological and emotional harm may also be present.
EXAMPLE
The template below provides an example of a safety plan used in the context of domestic and family violence. The key points can be adapted to other contexts.
Practice Tool 4 Personal Safety Plan, British Colombia 2010
The process of identifying and addressing immediate safety issues and concerns includes the following steps:
- Listen empathetically to collect information about the situation.
- Affirm the person’s links to safety and living.
- Support the person to identify possible solutions and strategies to deal with the crisis.
- Use a balance of collaborative and directive approaches according to the person’s capacity to make informed decisions.
- Work with the person to identify and agree on actions to minimise risks.
- Call for emergency assistance if required.
- Check that your actions are legal, ethical, meet duty of care requirements and are consistent with your organisation’s policies and procedures.
These steps may not always be completed in this order, depending on the specific situation. For example, it may be necessary to call for emergency assistance earlier in the process.
The following passage about SMART goals identifies the key points for effective safety planning. Goals should be:
LEARN MORE
- My Safety Plan, The Lookout, no date
- Beyond now – suicide safety planning, Beyond Blue, 2021
- Help someone create a suicide safety plan, Suicide Call Back Service, 2021
- Safety planning: Child Safety Practice Manual, Queensland Government, 2021
- Suicide and self-harm: a guide to staying safe, Kids Help Line, 2021
- Safety support planning where suicidality is an identified risk, Youth AOD Toolbox, no date.
- Safety planning, My Mental Health, no date.
In community services, it is essential to be prepared for crisis situations and know how to identify them and respond appropriately.
This involves recognizing common indicators of crisis, understanding safety concerns, and adhering to organizational policies and legal and ethical requirements. The topic aimed to help readers understand how to identify imminent crisis situations, recognize direct and indirect signs of crisis in individuals, and identify safety issues. It also covered various types of crisis situations, including potential suicide, threats to harm others, self-harm, received threats, abuse (including child abuse), and domestic and family violence.
