Responding to Families in Crisis
 

Head Start families in crisis may be dealing with an array of challenges. Head Start staff who work with families should develop planned responses for stabilizing families and intervening during a crisis. This training guide suggests concrete and practical services such as arranging for child care, providing transportation and having a telephone installed or reconnected to help lessen the stress on families during difficult times. This guide also lists techniques for diffusing a crisis.



The following is an excerpt from Supporting Families in Crisis.



Key Concepts
Background Information
Crisis Intervention Goals
The Crisis Intervention Role of Head Start Staff
Steps of Crisis Intervention
Techniques for Diffusing a Crisis
Next Steps: Ideas to Extend Practice
Tips for Working with Families in Crisis


Key Concepts

  • Crisis intervention is an intensive short-term service. As a carefully planned and focused service, crisis intervention addresses the "here and now" needs of the family through the resources of the family, Head Start, and the broader community. Crisis intervention is guided by six primary goals, which aim to stabilize and strengthen the family.

  • In working with families in crisis, Head Start staff must always be aware of how their own feelings are affecting them and the intervention process. Sometimes staff experience feelings similar to those of families in crisis. They become overwhelmed, angry, confused, frustrated, hopeless, anxious, helpless, etc. When such feelings go unheeded, they take a draining toll on staff and the family partnership. Thus, it is important for Head Start to provide staff with opportunities to explore their reactions to a family crisis, their level of comfort in handling the crisis, and any personal values or feelings that may make professional boundaries difficult to maintain.

  • Skillful crisis interveners involve the entire family in the assessment and problem-solving processes. Families are systems; what affects one member of a family affects other family members. Therefore, whenever possible, the skillful crisis intervener encourages all family members to share their views about the crisis, what they want help with, and how they want the situation to change. It may take many hours of active listening and observing for a crisis intervener to sort out the family interactions, conditions, and/or events that triggered the crisis, and to help the family choose a path for resolving the crisis.

  • Families in crisis often require specialized crisis intervention services. Unresolved crises can cause a serious breakdown in parent, child, and family functioning. For Head Start programs, crises may take up a large amount of staff time and energy. As a result, other Head Start families in need of support and crisis prevention services may go unserved. To ease the dilemma, Head Start's response to a family in crisis should primarily be to assess the situation, provide support where appropriate, and refer the family to a crisis intervention program or to an intensive family support program in the community. Such programs, often publicly funded, are called family preservation services or home-based counseling services.

Background Information

    This module focuses on crisis intervention and the role of Head Start staff in carrying out or supporting that process.

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    Crisis Intervention Goals

    Crisis intervention is guided by six goals, which influence decisions about Head Start's role with a family in crisis and aim to stabilize and strengthen the family. Major goals are to:

    • Identify and understand the crisis triggering event(s);

    • Relieve the acute symptoms of stress being experienced by the family and individual family members;

    • Restore the family and family members to their best pre-crisis levels of functioning or better;

    • Identify the steps the family, Head Start staff, and community resource providers can take to remedy the crisis;

    • Establish a connection between the family's current situation and past experiences; and

    • Support the family's use of new ways of coping with stressful situations.

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    The Crisis Intervention Role of Head Start Staff

    The role of Head Start staff is generally one of recognizing and assessing the crisis situation, listening and providing reassurance, and helping the family to use specialized resources in the broader community. Sometimes, however, the Head Start staff member may be the crisis intervention team leader.

    The crisis intervention, role of staff varies from family to family depending upon many factors. Important considerations include:

    • The Nature of the Crisis. Some crisis situations may require specialized crisis intervention from a doctor, a mental health counselor, a lawyer, or a substance abuse treatment specialist.

    • Family and Staff Safety. If a family crisis poses serious risk to the safety of family members, staff, or the community, lead responsibility for crisis intervention is usually shifted to law enforcement agencies, child protective services, or domestic violence programs.

    • The Strength of the Current Staff-Family Partnership. Families in crisis are likely to be most open to the intervention of staff whom they already know and trust. If a strong staff-family partnership exists, it is best for the partnership to continue with staff supporting the crisis intervener.

    • Staff Availability. A family in crisis may require a significant number of staff hours each week. The staffing resources of the Head Start community may not allow for the frequent and intense contacts the lead role requires.

    • The Availability of Specialized Crisis Intervention Programs. Many communities today have government-funded programs designed to stabilize and support families during crises. Such programs are usually accessed through social services, child welfare, mental and physical health services, and court services.

    • Local Program Policy. In line with community partnerships, local programs may have interagency agreements or protocols that spell out crisis intervention roles and responsibilities. Thus, local policy may determine the type and extent of Head Start's role with a family in crisis.

    When it is inadvisable or inappropriate for Head Start to take the lead role in crisis intervention, there are still ways staff can support a family in crisis. Examples include:

    • Referring the family to specialized community services;

    • Being the family's advocate;

    • Offering practical and emotional support to the family and assistance to the lead program as services are provided; and

    • Supporting the lead program's intervention with the family.

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    Steps of Crisis Intervention

    Crisis intervention is a short-term, carefully planned, and focused service that addresses the "here and now" needs of the family through the resources of the family, Head Start, and the broader community. Whether Head Start staff assume the lead crisis intervention role or act as a support system to the family and the community resources involved, they should observe eight basic steps:

    • Step 1: Assess the crisis situation. In this first step, the crisis intervener involves the family in an exploration of such questions as:

      -- What happened? Is anyone in danger? Who is involved?

      -- What triggered the crisis? When did the triggering event occur?

      -- What are the immediate effects of the crisis on the family?

      -- What are the family's immediate needs, as expressed by the family?

      -- Where do we go from here?

    • Step 2: Rapidly form a family partnership. Families in crisis are likely to be most open to an intervener whom they already know and trust. If a family does not already have a trusting relationship with staff, staff should quickly lay the groundwork for a family partnership by evoking sincerity, nonjudgmental attitude, and sensitivity to the family's feelings and situation. Belief in the family's ability to overcome the crisis also encourages the family to partner with staff.

    • Step 3: Examine contributing elements. After rapport is established with the family, the crisis intervener's focus turns to the stress-producing situation(s), coping strategies, unmet family responsibilities, or lack of supports that contributed to the crisis.

      Every family member needs to be given the chance to express his or her opinions about what happened and why; different opinions help the intervener gain a complete picture of all the contributing factors. Discussion is encouraged with comments, such as:

      -- I can see you are really upset. Can you tell me what happened? Can you remember when you began feeling this way?

      -- Can you tell me what started all this? Have you been under a lot of stress?

    • Step 4: Assess family strengths and coping strategies. To help the family develop effective strategies for dealing with the crisis, the intervener focuses on family strengths, including ways the family has coped and problem-solved well in the past. During this step, the crisis intervener:

      -- Encourages a strengths perspective in the family by identifying and reinforcing family strengths and resources;

      -- Explores the family's current strategies and alternatives for coping with the crisis; and

      -- Clarifies family priorities (What do you want to have happen? What do you want to change? What do you want to do?).

    • Step 5: Decide on the role of Head Start staff. The crisis intervention role of staff may vary from family to family. Head Start's response to a family in crisis should primarily be to refer the family to a program providing the needed services, a crisis intervention program, or family support program in the community. Questions to ask when deciding on the role of Head Start staff include:

      -- What is the nature of the crisis? Does it require specialized services?

      -- Is any family member in danger due to the crisis?

      -- What is the strength of the current staff-family partnership?

      -- Can Head Start staff devote the appropriate time and resources to defuse the crisis?

      -- Are specialized community intervention programs available in the community?

      -- Does local program policy clarify the crisis intervention services offered by Head Start staff?

    • Step 6: Take action. Once the Head Start staff member has decided on his/her appropriate role, he/she must take action and either: 1) assume the lead in crisis intervention and develop and implement an action plan; or 2) find appropriate resources and make referrals.

      -- Develop and implement an action plan. Rather than attempting to address all the issues affecting a family in crisis, the crisis intervener helps the family to examine its needs and establish priorities. This intervener then helps the family develop an action plan in response to the family's chosen priority(ies). The action plan needs to be brief, simple, and have short time limits set for its completion in order to ensure success. Armed with a concrete action plan, the family begins to feel more in control of the crisis situation.

      When developing an action plan, the staff-family team identifies specific tasks and sets time limits for completing the tasks. As tasks are completed, the intervener reinforces any success, no matter how small, with comments such as "That really worked well, didn't it?", "I am pleased you were able to do that!", "What you did was very important!", "I think you're on the right road now." Further, the intervener always makes sure the family knows what will happen next, saying for example, "Tuesday is a good day for me to see you again. How is it for you?" or "By next week, I will arrange for you to meet with your son's teacher."

      -- Find appropriate resources and make referrals. Many families in crisis require help from community resources. Head Start staff should pave the way for the family's use of community supports. This often means making sure resources are available and accessible prior to referral; working through any distress the family may have about getting outside help; explaining program eligibility criteria; giving the family the name of a person to contact, rather than just the name of an agency; accompanying the family to initial appointments; and being a family advocate.

    • Step 7: Prepare for the termination of crisis intervention services. Crisis intervention services are both intensive and short-term. The crisis intervener lets the family know the time limits at the beginning. A short timeframe serves an important purpose: families realize they must move ahead quickly to complete their action plan. Preparation for service termination continues in subsequent weeks with reminders about when crisis intervention contacts will end. Gradual declines in the frequency and length of contacts with families as they stabilize also help to ease the service termination process.

    • Step 8: Follow up. Final crisis intervention contacts with families include plans for follow-up. Follow-up ensures that the kind, quality, and timeliness of the services received through referrals met the family's expectations and circumstances. Follow-up involves checking in with families to make sure that continuing resources and supports are in place to maintain family stability. Further, during follow-up contacts, the crisis intervener assesses and reinforces family progress in coping more effectively.

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    Techniques for Defusing a Crisis

    Active listening, providing information, modeling a sense of humor and fun, showing enthusiasm, instilling hope, and questioning are some techniques useful for defusing a family crisis and helping a family to stabilize.

    • Active Listening. Active listening is perhaps the most important technique for defusing a crisis. For many families in crisis, active listening may be all that is needed to restore family functioning. Active listening with families may involve:

      -- Encouraging the expression of feelings;

      -- Acknowledging the real loss or tragedy experienced by a family;

      -- Reflecting feelings expressed by the family;

      -- Normalizing the family's reactions;

      -- Conveying acceptance of the family, but not of destructive behaviors;

      -- Reframing family statements or behaviors to emphasize the positives;

      -- Focusing on the "here and now";

      -- Confronting inconsistencies in family statements or behaviors in tactful ways;

      -- Clarifying a family's priorities among many issues; and

      -- Summarizing and bringing closure to emotional topics.

    • Providing Information. It is important for family members to know what to expect throughout the crisis intervention process. Sharing information about the intervention period, when and how often the crisis intervener will visit the family, and what the intervener plans to do to support the family can relieve much of a family's anxiety about what lies ahead. Information about issues related to the crisis can also be helpful.

    • Modeling a Sense of Humor and Fun. Some families need to be able to relax and take themselves and their situations less seriously. Showing a sense of humor about one's own mistakes lets families know that no one is perfect and that laughter is sometimes the best medicine. Many families in crisis can benefit by setting aside time for fun or social activities.

    • Showing Enthusiasm. The crisis intervener's enthusiasm promotes feelings of enthusiasm in the family. Family members begin to gain confidence in their own abilities to resolve the crisis when they see the worker as someone who believes they can do so, too.

    • Instilling Realistic Hope. The crisis intervener's own ability to instill hope in families is a critical variable in defusing crises and motivating families to try new coping strategies. When family members sense that positive approaches and outcomes to the crisis are possible, they begin to feel confident in their ability to bring about change. And, when interveners keep their promises, families begin to trust and believe in change.

      Instilling realistic hope requires helping the family to see its strengths. Encouraging the family to try new approaches imparts hope. Choice of words is critical when discussing action plans; words such as "when" and "will" send much more hopeful messages to families than "if" or "maybe."

    • Questioning. In periods of crisis, it is important for families to be able to organize their thoughts. Asking questions is one way to help families start thinking clearly again. For example, "What have you already tried?", "What do you want to try next?" and "Who can you usually count on?" are questions that can lead families toward a better understanding of their alternatives.

    With appropriate support and services, the tension and struggles created by a family crisis can be channeled quickly into constructive courses of action. The family in crisis learns to use new resources, apply new problem-solving skills, and cope more effectively with stress. The result is often a very strengthening experience that can carry the family through complex challenges in the future.

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    Next Steps: Ideas to Extend Practice

    Follow-up training strategies to reinforce the concepts and skills developed in Module 3 are presented below. After completing Module 3, review the strategies with staff and help them choose at least one to work on individually or as part of a small group.

    • Bringing Community Resources to Families in Crisis

      Have staff conduct a survey of community resources available to families in crisis, such as specialized crisis intervention programs, mutual support groups, and programs offering food, clothing, shelter, health care, legal advice, emergency funds, and language translation services. Help staff develop and distribute a crisis resource directory, based upon the outcome of the survey. Besides the names and telephone numbers of the resources, have staff include brief summaries of the resources and their hours of operation, names of contact persons, and details on how families and Head Start staff can gain access to the resources.

    • Establishing a Crisis Intervention Team

      To help the Head Start community develop planned responses to family crises, have staff establish a multi-disciplinary consultation team. In addition to including Head Start staff representing diverse disciplines, staff may want to ask crisis intervention specialists from community agencies to become part of the team. The team could serve a number of purposes, including:

      -- Conducting an in-depth study of a family's crisis situation;

      -- Providing assistance with decisions about Head Start's role with a family in crisis;

      -- Identifying program or community resources directed on crisis intervention;

      -- Preparing a plan to involve Head Start families in efforts to support a family in crisis;

      -- Developing partnerships with specialized community resources for families in crisis; and

      -- Making presentations on crisis intervention for the Head Start community.

    • Applying Crisis Intervention Response Skills

      After identifying a family in crisis, have staff meet with a coach or supervisor to plan and carry out the crisis intervention process. As envisioned, the coaching/supervisory sessions would parallel the steps of crisis intervention, helping staff to prepare for and assess their experiences in:

      -- Assessing the crisis situation;

      -- Forming a partnership with the family;

      -- Examining the elements contributing to the crisis;

      -- Assessing the family's strengths and coping strategies;

      -- Deciding on the role of Head Start staff;

      -- Developing and implementing an action plan;

      -- Finding and referring the family to community supports;

      -- Terminating crisis intervention services; and,

      -- Following up with community resources and reviewing the family's progress.

      Role plays simulating actual staff-family visits, reviews of professional publications on crisis intervention, discussions on what staff might have done differently, and consultations with specialists on specific areas of concern to the family or staff are some possible activities for enriching the experience.

    • Developing Supports for Head Start Staff

      Have staff meet periodically with a trainer, coach, or supervisor to explore interpersonal issues such as:

      -- The level of staff comfort in responding to different types of family crisis;

      -- Personal experiences, feelings, or values that may affect the ability of staff to partner with some families; and

      -- Staff knowledge about when and how to set limits for themselves as they support families in crisis.

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    Steps of Crisis Intervention

    Overview

    Crisis intervention involves the following eight basic steps. The role of staff in a crisis will vary from family to family.

    Crisis diagram

    Step 1:

    Assess the crisis situation. This step involves the family in looking at the elements contributing to the crisis state in order to assess:

    • What happened? How dangerous is the situation? Who is involved?

    • What triggered the crisis? When did the triggering event occur?

    • What are the immediate effects of the crisis on the family?

    • What was the family's situation prior to the crisis?

    • Where do we go from here?

    While exploring the topics with the family, consider the type and magnitude of the crisis and family safety issues (e.g., whether the crisis places the well-being of the child(ren) at risk). Also encourage the family to express feelings of anxiety, guilt, fear, grief, anger, confusion, etc., related to the crisis. Expressing painful feelings helps the family to move on to problem solving.

    Step 2:

    Rapidly form a partnership with the family. In this step of crisis intervention, a sincere, nonjudgmental attitude, and sensitivity to the family's feelings and situation, lay the groundwork for a family partnership to form quickly, as does belief in the family's ability to overcome the crisis.

    A constructive partnership also evolves from a sense of accomplishment. It is important for the family to feel that something useful has been accomplished during the crisis intervener's first visit and that more will be accomplished in the next. Showing enthusiasm and instilling hope in the family should promote such feelings. Family members begin to gain confidence in their own abilities to resolve the crisis when they see the intervener as someone who believes they have the strengths to do so.

    Step 3:

    Examine contributing factors. After rapport is established with the family, shift the focus to the stress-producing situation(s), coping strategies, unmet family responsibilities, or lack of supports that contributed to the crisis. Every family member needs to be given the chance to express his or her opinions about what happened and why; different opinions help the worker to gain a complete picture of all the contributing factors. Encourage discussion with comments, such as:

    • I can see you are really upset. Can you tell me what happened? Can you remember when you began feeling this way?

    • Can you tell me what started all this? Have you been under a lot of stress lately?

    Step 4:

    Assess the family's strengths and coping strategies. To help the family develop effective coping strategies for dealing with the crisis, focus on family strengths and the strategies for dealing with stress that have worked for the family in the past. During this step:

    • Identify the family's strengths and resources;

    • Explore the family's current coping mechanisms and alternatives for coping with the crisis; and

    • Clarify family goals and priorities.

    Exploring what family members have tried to improve the situation, areas in which they want help, and ways in which they want to make changes contributes to a better understanding of the family's potential for recovery. Questions to ask may include:

    • What worries you most now?

    • What have you already tried?

    • What do you think might have happened if you tried ________?

    • What else might you try?

    • Do you think _______ would be helpful?

    Step 5:

    Decide on the role of Head Start staff. The role of staff may vary from family to family. Head Start's response to a family in crisis should primarily be to refer the family to a program providing the needed services, a crisis intervention program, or a family support program in the community. Questions to ask when deciding on the role of Head Start staff include:

    • What is the nature of the crisis? Does it require specialized services?

    • Is any family member in danger due to the crisis?

    • What is the strength of the current staff-family partnership?

    • Can Head Start devote the appropriate time and resources to defuse the crisis?

    • Are specialized community intervention programs available in the community?

    • Does local program policy clarify the crisis intervention services offered by Head Start staff?

    Step 6:

    Take action. Once the appropriate role has been determined, take action. Either assume the lead in crisis intervention and develop and implement an action plan, or find appropriate resources and make referrals.

    Develop and implement an action plan. Rather than attempting to address all the issues affecting a family in crisis, target intervention on the crisis situation. Help the family identify priorities and develop an action plan that is brief, simple, and has a short time frame to ensure success. Armed with a concrete action plan, the family begins to feel more in control of the crisis situation.

    When developing an action plan, the staff-family team should identify specific tasks and set time limits for completing them. As tasks are completed, reinforce any success, no matter how small, with comments such as: "That really worked well, didn't it?", "I am pleased you were able to do that!", "What you did was very important!", "I think you're on the right road now." Further, always make sure the family knows what will happen next saying, for example, "Tuesday is a good day for me to see you again. How is it for you?" or "By next week, I will arrange for you to meet with your son's teacher."

    Find appropriate resources and make referrals. Many families in crisis require help from community resources. Pave the way for the family's use of community supports by making sure resources are available and accessible prior to referral; working through any distress the family may have about outside help; explaining program eligibility criteria; giving the family the name of a person to contact, rather than just the name of an agency; accompanying the family to initial appointments; and being a family advocate.

    Step 7:

    Prepare for the termination of crisis intervention services. Crisis intervention services are both intensive and short-term. Let the family know the time limits at the beginning. A short timeframe serves an important purpose: families realize they must move ahead quickly to complete their action plan. Preparation for service termination continues in subsequent weeks with reminders about when crisis intervention contacts will end. Gradual declines in the frequency and length of contacts with families as they stabilize also help to ease the service termination

    Step 8:

    Follow up. Crisis intervention contacts with families must include plans for follow-up. Follow-up ensures that the kind, quality, and timeliness of the services received met the family's expectations and circumstances. Follow-up involves checking in with families to make sure that continuing resources and supports are in place to maintain family stability. Brief telephone calls or visits to see how the family is doing boost and reinforce the family's progress.

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    Tips for Working with Families in Crisis1

    Overview

    Listening actively, providing factual information, modeling a sense of humor, showing enthusiasm, instilling hope, and questioning are some techniques useful for defusing a family crisis and helping a family to stabilize.

    Listening Actively

    Active listening is perhaps the most important crisis intervention skill. With many families in crisis, active listening may be all that is needed to restore family functioning. To actively listen to crisis-ridden families, you might:

    • Reflect feelings expressed by the family, e.g., "I hear your fears about losing control."

    • Normalize the family's reactions, e.g., "In this type of situation, anyone would feel anxious and unable to think clearly."

    • Acknowledge the real loss or tragedy experienced by the family, e.g., "You have experienced a terrible loss. I am here to support you and your family."

    • Encourage the expression of feelings, e.g., "Tell me more about how you're feeling right now."

    • Convey acceptance of the family, but not of destructive behaviors, e.g., "You know yelling at the children has to stop. I believe you want to stop and I can help you do that."

    • Focus on the "here and now," e.g., "We only have six weeks to work together, so we have to make every minute count. Let's take another look at what we planned to do this week."

    • Clarify a family's priorities among numerous issues, e.g., "Even though I know you're concerned about many things, we have to focus on one at a time. What do you want to work on first?"

    • Reframe family statements or behaviors to emphasize the positives, e.g., "You're saying there's no hope, but look at what you've been able to do in just one week."

    • Confront inconsistencies in family statements or behaviors in kind ways, e.g., "You say you want to spend more time with your children. Let's see if we can carve out some evenings for you and your children to have fun together."

    • Summarize and bring closure to emotional topics, e.g., "I know it's been hard for you to talk about what happened, but you seem to have a much better handle now on what's bothering you the most."

    Providing Factual Information

    It is important for family members to know what to expect throughout the crisis intervention process. Sharing information about the intervention timeframe, when and how often the crisis intervener will visit the family, and what the intervener plans to do to support the family, can relieve a lot of anxiety in the family about what lies ahead. Education about issues related to the crisis can also be helpful.

    Modeling a Sense of Humor and Fun

    Some families need to be able to relax and take themselves and their situation less seriously. Showing a sense of humor about one's own mistakes lets families know that no one is perfect and that laughter is sometimes the best medicine. Many families in crisis can benefit by setting aside time for fun or social activities.

    Showing Enthusiasm

    Staff's own enthusiasm promotes feelings of enthusiasm in the family. Family members begin to gain confidence in their own abilities to resolve the crisis when they see the worker as someone who believes they can do so, too.

    Instilling Realistic Hope

    A crisis intervener's ability to instill hope in families is critical in defusing crises and motivating families to try new coping strategies. When family members sense that positive approaches and outcomes to the crisis are possible, they begin to feel confident in their ability to bring about change. And, when interveners keep their promises, families begin to trust and believe in change.

    Instilling hope requires helping the family to see its strengths and successes, rather than looking for someone to blame. Encouraging the family to try new approaches also imparts hope. Choice of words is critical when discussing action plans; words such as "when" and "will" send much more hopeful messages to families than "if" or "maybe."

    Questioning

    In periods of crisis, it is important for families to be able to organize their thoughts. Asking questions is one way to help families start thinking clearly again. For example, "What have you already tried?", "What do you want to try next?", and "Who can you usually count on?" are questions that can lead families toward a better understanding of their alternatives.

    1Adapted from C. Gentry, Crisis Intervention in Child Abuse and Neglect (Washington, D.C.: U.S. Dept. of Health and Human Services, 1994).

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"Responding to Families in Crisis." Supporting Families in Crisis. Training Guides for the Head Start Learning Community. HHS/ACF/ACYF/HSB. 2000. English.




Last Reviewed: June 2009

Last Updated: January 10, 2013