Crisis Intervention - The assumption is that you work in a Crisis Center and the client has come to you.
Case 1 -
Roberta worked for financial investment firm for 20 years when she was promoted to a senior vice president. Unfortunately, about three months after her promotion, the investment firm experienced major financial setbacks. As a result Roberta and three other senior vice presidents were laid off. Roberta was emotionally devastated by the layoffs. What makes matters worse is that she was within five years of retirement and she has two children attending expensive private universities. Since Roberta was given notice of the layoff approximately 2 weeks ago, she just sits and stares out of the window all day. She feels immobilized, angry and betrayed.
Roberta can probably best be described as being in the stage or shock of depression. She is immobilized by the news of her layoff. Roberta is also experiencing regret for taking up promotion however the saying" hindsight is always 2020" applies here. She knows she also would have regretted not taking the promotion resulted in higher pay, more prestige, and better benefits. The most important question is how to begin to mobilize Roberta's internal resources and her external net network resources to begin the road to healing from this loss. Roberta has sought counseling through her health insurance plan, which he was allowed to keep as part of her severance package.
Questions:
Describe your assessment of this case.
Outline your next steps
Assess whether there is depression, anxiety and/or anger that has become immobilizing Medications? What other areas might you contemplate to help Roberta?
Case 2 -
Maria is a 19-year-old college student in her sophomore year. She told her roommate that she has been feeling depressed over problems that she has been having with her boyfriend. Recently Maria found out that her boyfriend had been cheating on her with a mutual friend. When she confronted her boyfriend he denied the accusations and told Maria she was just being paranoid and crazy. He then seized the moment to break up with her. This made Maria feel more angry and depressed. Maria now feels discarded and used. She cannot get out of bed, sleeps excessively, cannot concentrate, has no appetite and has been missing classes. She did well in her freshman year, but she is on a scholarship and is afraid that if her grades to drop she will lose the scholarship and have to return home to attend a local community college. Maria reports that she feels overwhelmed. She feels that nothing she does make things any better. She tried calling the hotline of a local mental health clinic today because she felt so upset that she was considering taking her roommates prescription medication and washing it down with vodka. Maria explained to the crisis worker the hotline that she had been in counseling while she was in high school after her parents separated. Maria describes feeling lifeless and hopeless, having no energy to do anything. She also reported that nothing is really enjoyable to her anymore and that as a result she has become more isolating and more reclusive, preferring to be alone. Maria also stated that she is not been eating or sleeping very well. Although she initially told a crisis counselor that she was not feeling suicidal, she stated that since the problems with her boyfriend began she feels she has nothing to live for.
Questions:
How would you conceptualize Maria's case?
After establishing a rapport with her what are the next steps?
Hospital or remain at home? Explain your choice.
How might you resolve this case?
Case 3 -
Richard is a 43-year-old separated father of two. He has sought counseling at the recommendation of a coworker who was concerned about Richard making threatening remarks and depressive statements. This coworker was also worried because of Richards increased use of alcohol and explosive anger outbursts at work. Richards Richard explains that he recently separated from his wife after 20 years of marriage and that he does not know if he can go on without her. He is restless and angry as he describes how his wife kicked him out of his home because she wanted "to find herself". Richard suspects she is seeing a guy she works with at her part-time job. Richard states that the thought of them together "drives me crazy" and apparently this is where his threats are focused. Richard had made some vague threats about killing his wife and lover if he ever caught them together and has also threatened to wait for him after work and beat him up. Richard denies any domestic abuse history with his wife, Richard is currently living alone in a rented room and has few friends other than his coworker whom he seems to trust and confide in. Richard also confided in his coworker that he is both a handgun and a rifle in his possession.
Questions:
What is the possibility of his acting out?
If the client suddenly walks out of the session, what would you do?
Does the counselor need to notify Carol and her boyfriend of the threats?
What about the guns?