Supportive Solutions Approach to Crisis Response

Models of crisis intervention for civilian populations have been around since the 80's. The most recognizable model and one that has been thoroughly integrated into crisis response practices and lingo however is Critical Incident Stress Debriefing/Critical Incident Stress Management (CISD/CISM). The popularity of CISD/CISM worked both for and against this model as the training and practice standards spun out of control in recent years. Although many claim to use CISD/CISM, there are few examples of it being practiced or even trained in its truest form, outside of the International Critical Incident Stress Foundation (ICISF).

Despite the controversy, crisis response as a service continues to be in demand. Evolving research and newer techniques have resulted in different models and approaches surfacing in the past few years. In 2003, Blythe, Gist and Slawinski developed a resiliency approach to crisis intervention that was offered as an alternative to CISD/CISM. This approach continues to evolve under the tutelage of Richard Gist, Ph.D. Other groups are incorporating newer practices into older models to better accommodate the populations they serve.

The Supportive Solutions Approach

Supportive Solutions, Inc. has developed a strengths-based approach to crisis response that recognizes the importance of the individual's natural social support system in the recovery process. The Supportive Solutions approach is based on eight practice assumptions:

1. In a crisis event, each individual's response is unique. People differ in how they react or when and if they experience a reaction to an event. Although many groups claim to acknowledge this uniqueness, the "interventions" vary little from group to group or individual to individual.
   
   
2. Each individual is the "expert" in their own recovery process. We, as professionals, bring tools or techniques that individuals may choose to use to manage their reactions or which will enhance the strengths that they have developed over a lifetime. We facilitate what is already there – strengths and coping skills, re-connecting with supports and resources.
   
   
3. The natural recovery process needs to occur without artificial interventions disrupting the process. Allowing the individual to define what they need from us is paramount. "Help" whether psychological first aid or practical assistance should fit seamlessly into the natural process.
   
   
4. The helping process should be individualized. Avoidance should be appreciated as a defense that protects us. In moderation, avoidance may serve to temper initial responses, provide control and ultimately allow the person to "time" their emotional expression of the experience. Defenses are given to us for a reason and to ignore the implication of breaking down defenses prematurely is bad practice in any field.
   
   
5. The role of the mental health professional is to facilitate the individual's ability to tap into established strengths developed over a lifetime and encourage application to current reactions. Many times a crisis causes the individual to lose connection with their past abilities, skills and strengths. Our role is to enhance their competence by helping them to reconnect with these strengths in order to access supports and resources available to them.
   
   
6. Support and resources are offered to the individual to be used at their discretion. Individuals need to have the option to choose when and how, and if they want to use support systems and resources. Support systems and resources may be used in very different ways and at different times in the recovery process.
   
   
7. Individuals should be provided with a means of self-evaluation in order to assess the need for future resources or support. This can be done with very simple forms or journaling. Self-evaluation allows the individual to measure progress, change (or lack thereof) and affirms their ability to manage their recovery process.
   
   
8. A strengths-based approach is culturally sensitive and can be readily adapted for use with many cultures. The "individual as the expert" allows the facilitator to adapt the Supportive Solutions approach to the needs of the individual and their culture. The individual can define the support systems that will be most meaningful to them rather than allowing the facilitator to select systems that will present barriers to entry.

The foundation for this approach

The choice to combine a strengths-based perspective and social system support approach was based on the ease of practical application and the inherent nature of strength and support systems in everyone's life. In the aftermath of a crisis event, it is important to help instill a sense of competence and order back into the lives of those affected. Focusing on strengths and support seems the logical foundation for recovery process. The literature on both social support systems and a strengths-based perspective reflects the appropriateness of this approach for crisis response.

Social support systems provide the cushion needed in everyday life to manage the routine ups and downs that we face. It should be no surprise then that these systems would play such a key role in helping us to moderate the reactions we experience following a crisis event. Yet, until recently, the most natural form of "help" has been overlooked and actually minimized in lieu of expert assistance. Our own natural support systems were replaced at times by artificial processes, which in some cases were of little value or escalated the reactions that we were trying desperately to avoid.

The common thread throughout the literature on social support systems is the connection between social support and the augmentation of the individual's ability to access their own strengths and resources (Caplan,1974, House, 1981, Maguire, 1991 & 2002, Tracy, 2002). Studies have also been done which reveal that social support systems provide protection from stress (Maguire, 1991).

The enhancement of effective social support systems becomes crucial in times of crisis, for several reasons. Natural supports systems typically provide a wider net of coverage than experts can typically provide. In many cases the natural resources are immediately available for the individual's use. Overlooked resources might become accessible to individuals through their natural contacts (Maguire, 1991). Positive support can also counterbalance any comments that could be perceived as unsympathetic or disparaging. Both Caplan (1974) and House (1981) acknowledge this as a benefit of social support systems. Brewin (2003) states that "the main value of support may be to shield the survivor from unhelpful influences" (p. 189). He continues by saying that "arguably, support is most effective when it remains under the control of the survivor, who can choose whether and how to access it" (2003, p.189).

Although social support systems cannot provide all needed resources or services, a system of this nature can offer a foundation from which all others can be based. The use of natural support systems, such as families, friends, significant others also reduces the need for more expensive professional services, thus providing both a cost effective and efficient method of providing support.

Strengths-based perspective

A strengths-based perspective has been widely embraced by many mental health professionals as the foundation for work with clients regardless of race, gender, age or religious beliefs. This perspective has been described by Jan Ligon (2002) in the following way:

...A strengths perspective acknowledges that the client possesses knowledge, abilities, resiliency, coping and problem-solving skills that are there to be employed. Certainly people get stuck, become overwhelmed, or experience events that render them unable to fully utilize their strengths. It is important to identify and amplify these strengths so that clients can go back and rediscover what has already worked for them in the past. Therefore the role of the [mental health professional] is to facilitate the process, to serve as a bridge to the client's own resources, to move ahead and seek solutions(p. 99).

This strengths-based perspective is in essence the antithesis of some of the most popular crisis response models currently in use. Many crisis response models assume a "medical model" approach which typically focuses on "pathology, dysfunction and symptoms" (Ligon, 2002, p. 99). A medical model also supports the role of the expert rather than the individual as the key to recovery. The need to intervene, diagnose and treat becomes the focus. An intervention of this nature may actually impede the natural progression of recovery. In reality, during the early stages of a crisis, less may be more (Brewin, 2003).

A strengths-based approach lends hope, promotes competence to manage reactions and works in conjunction with the social supports that provide a "safety net" as the individual moves through the recovery process. A crisis event will challenge an individual's skills and resources. A strengths-based approach allows the individual to embrace the challenge, utilize skills, and access support systems and necessary resources in their process of recovery without creating barriers to natural recovery.

Crisis Response

Despite the popularity of models which encourage or require more active interventions in the early stages of a crisis event, it is becoming more evident that the provision of safety, support, information and resources may in fact prove to be most effective (Brewin, 2003). This process allows for the natural unfolding of responses, acknowledges the individual's unique reactions to an event of this nature and provides the individual with the necessary control to take an active role in his/her recovery. Early interventions should interfere as little with natural recovery processes as possible (Brewin, 2003). The role of the early intervention should be clearly defined as one that will enhance the natural recovery process and connection with support systems, provide information and access the necessary resources at the individual's choosing.

Placing the individual in the role of "expert" in their own recovery process allows an increased sense of competency, reinforces past learning and provides a platform from which new skills sets can be built. More importantly, individuals can make culturally sensitive choices in selecting their support systems, which are essential to the individual's well-being over the long run.

A crisis response that incorporates both a strength-based and social support systems approach minimizes the harm that can be generated by more artificial intervention techniques used in other crisis response models. Instead, by using the individual's internal and external natural resources, the process of crisis support is a reflection of a person's expressed needs, not created ones.

Summary

Crisis response continues to be an evolving field and the Supportive Solutions Approach, like most, will undergo revisions, updates and changes. Any approach worth its merit should.

We believe that by providing crisis response services that focus on strengths and effective use of supports and resources, individuals are provided with the tools to manage their recovery process. Our goal is to provide the "right response... at the right time."

References

Brewin, C.R. (2003). More battlegrounds: Preventing and treating PTSD. In Post-traumatic stress disorder: Malady or myth. (p. 189). London: Yale University Press.

Caplan, G. (1974). Support systems and community mental health: Lectures on concept development. New York: Behavioral Publications.

House, J. (1981). Work, stress and social support. Reading, MA: Addison-Wesley.

Ligon, Jan. (2002). Fundamentals of brief treatment: Principles and practices. In A.R. Roberts & G.J.Greene (Eds.) Social Work Desk Reference. (p. 99) New York: Oxford University Press.

Maguire, L. (1991). Social support systems in practice: A generalist approach. Silver Spring: NASW.

Maguire, L. (2002). Clinical social work: Beyond generalist practice with individuals, groups and families. Pacific Grove: Brooks/Cole

Tracy, E.M. (2002). Working with and strengthening social networks. In A.R. Roberts & G.J.Greene (Eds.) Social Work Desk Reference. (p. 402). New York: Oxford University Press.

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