9.1 Supervising through Crisis

What Is It?

When a family is experiencing a crisis, the grief and uncertainty, perhaps the sense of danger, can be overwhelming to the family, the home visitor, and the supervisor. Every program needs to have partnerships with relevant community agencies and faith-based organizations that can provide specific, culturally competent intervention. The program should have protocols to follow in the event of a crisis. Home visitors must receive orientation and periodic training around what to do in case of a family crisis. People are much more likely to respond appropriately in a crisis if they have had an opportunity to think through what they would do in that situation.

However, the human element in the supervisory relationship needs to be acknowledged. Real people may be experiencing something terrible and wrenching in their lives. Home visitors are emotionally involved in the painful experience with families for whom they have come to care. Your work is to help the home visitor remain focused, aware of, and able to safely experience his or her own reactions, and continue to plan and implement services for the family. You also help the home visitor provide all necessary and appropriate concrete and emotional supports to the family.

Home visitors routinely report families dealing with crises such as these:

  • Intimate partner or child abuse
  • Substance abuse
  • Sales of illegal substances
  • Mental illness
  • Sudden illness or death in the family (including miscarriage)
  • Food insecurity
  • Eviction
  • Fire
  • Natural catastrophe
  • Homelessness
  • Detention and deportation
  • Deployment of one or both parents
  • Weapons in sight
  • Violent neighborhoods
  • Police presence or parental arrest
  • Divorce or sudden breakup of the parental relationship

How To

The Home Visitor’s Handbook (see Chapter 8.6, “Coping with Crisis”) describes the signs of crisis that the home visitor should look for, and ways to help families cope. Following are suggestions from the supervisor’s perspective for supporting the home visitor and the family when managing a crisis.

Establish and maintain partnerships

Ensure that the program has partnerships in place with community agencies and faith-based organizations that can provide specific, culturally relevant information and competent intervention:

  • Police
  • Social services
  • Children’s Protective Services
  • Women’s shelters
  • Homeless shelters
  • Cultural and faith-based services
  • Immigration agencies
  • Public health centers
  • Food banks
  • Mental health services

Establish and enforce policies and protocol

Ensure that the program has policies and protocols in place for responding to emergencies:

  • Articulate the procedure the home visitor is expected to follow.

    • What happens on the scene?
    • Who is contacted immediately?
    • What actions does the home visitor take?
    • What reports are written?
  • Articulate the procedure the supervisor is expected to follow.

    • How does the supervisor contact the home visitor?
    • What does the supervisor say to the home visitor?
    • What information is elicited?
    • What actions does the supervisor take?

Support the home visitor and family

  • Provide concrete supports through program partners and protocols: safety, food, diapers, housing, clothing, or other necessities.

  • Be available to the home visitor as soon as he or she is available to talk to you.

  • Be open. Ask the home visitor, "Where do you want to start?" The home visitor may feel most pressed to share his or her own reactions and concerns, recount the events, plan for the immediate interventions- or maybe just sit quietly in a safe place and think.

  • Listen without judgment. The home visitor may be very angry with the family or with him- or herself, especially if someone in the family has come to harm. The home visitor may feel overwhelmed, frightened, or confused by the situation and not know how to take helpful action. Honestly assure the home visitor, “You can never know how you’ll react to something like this. There’s no right or wrong reaction. Just talk to me and we’ll look at this together.”

  • Understand that witnessing a traumatic event or the aftermath of a traumatic event can seriously affect the home visitor. It may be appropriate to refer the home visitor to consult with your program's mental health consultant or an outside mental health professional.

  • Use a trauma-informed approach. According to the Substance Abuse Mental Health Services Agency,1
    a program, organization, or system that is trauma-informed:

    • Realizes the widespread impact of trauma and understands potential paths for recovery;
    • Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
    • Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and seeks to actively resist re-traumatization.

    A trauma-informed approach can be implemented in any type of service setting or organization and is distinct from trauma-specific interventions or treatments that are designed specifically to address the consequences of trauma and to facilitate healing.

  1. Substance Abuse Mental Health Services Agency, "Trauma-Informed Approach and Trauma-Specific Interventions," http://www.samhsa.gov/nctic/trauma-interventions

Experience It

Supervising through Crisis Clip 1

Brenda Jones Harden, PhD, Institute for Child Study, University of Maryland, talks about engaging parents experiencing significant challenges.

Reflection Questions:

  1. Several times, Dr. Harden mentions keeping the focus on the child. How do you help home visitors keep the focus on the baby while addressing the parents’ issues?
  2. What concrete methods does your program use to keep families engaged? What could you use that you don’t currently use?

Supervising through Crisis Clip 2

Jennifer Boss, director of the National Center on Early Childhood Development, Teaching and Learning (NCECDTL), and Connie Phillips, EHS director of the Onslow County Partnership for Children Jacksonville, NC, talk about keeping the child in focus when the parent is in crisis.

To view the full webcast, go to: Parent–Child Relationships: The Cornerstone to School Readiness in the Home-based Option

Reflection Questions:

  1. Reflect on some opportunities that your staff have for “pivoting,” where they focus on the parents’ issues and then pivot to how those issues might be affecting the child.
  2. What supports does your program have for staff when families are in crisis?

Learn More

Website with information on understanding trauma and supporting individuals who are experiencing trauma and the effect on their service providers. Substance Abuse Mental Health Services Agency.