Crisis intervention in the emergency department

The word crisis implies a challenge to the personality, family, and community created by an altered set of circumstances for which adaptive resources are not readily available. It has long been recognized that mastery of a crisis can result in an enrichment of the personality, which then acquires resources to deal with similar events in the future. Failure to meet the challenge results not infrequently in a maladaptive response, which, too, is likely to be applied to similar challenges in the future--thereby burdening the personality with a handicap. Intervention in crisis aims at assisting the individual toward meeting his or her crisis successfully, and at times entails little more than guidance, advice, or education. When analyzed more adequately, intervention implies an evaluation of the resources within the individual, an evaluation of the resources among those who surround the individual in the family and the community, and an assessment of his or her past personal history. This takes into account how the individual has handled previous crises in his life; educational, vocational, marital, and social achievements; preferences; values; and what he or she expects from professional help. The individual is then invited, with those around him and involved with him, to examine the strengths that are available to him and to participate where possible in planning the steps immediately necessary for the successful resolution of the crisis.