This can assist with empowering a youth and/or caregiver who may otherwise feel helpless or hopeless about managing high-risk, high-stress situations.
This is an opportunity to strengthen engagement with the youth and/or caregiver by focusing on the most concerning or troubling aspects of a youth’s behavior as well as providing a reason to increase phone contacts with either party at the onset of treatment.
This intervention pairs well with Motivational Interviewing or Cognitive Behavioral Therapy approaches.
Crisis Escalation Curve
When assessing for safety and risk factors, focus should keep in mind elements of a youth and family’s life (people, environments, danger) that contribute to the development of negative behaviors (violence; delinquency).
A safety risk involves the potential for harm to self, others, property, and/or community
DOWNLOAD Crisis Escalation Curve PDF (Pictured below right.)
Below comes from an IHBT workshop presentation by Bobbi Beale, PsyD in relation to youth/client, family, and clinician safety.
Stabilize, Reduce Risks, and Plan for Safety
– Symptom stabilization: Prevent a chain reaction of negative life events (Mark Katz)
– Address basic needs
– Build resources and supports where they are needed
– Develop safety net of supports
– Establish basic safety
– Create trauma-free recovery environments
– Crisis stabilization
– Safety planning
– Reduce risk factors
– Decrease risk generating environments and people (e.g. negative peers)
Protective Measures in the Home: Safety Walk Through
– Safety tour of the house
– Completed with parent or caretaking adult (and not the youth)
– Walk through each room of the house prompting the parent/adult with safety questions:
–Tell me what is in this room that could pose a danger to someone?
–Think about your son or daughter and what they may have done before–what is in this room that we need to secure?
– Have parents secure items of concern and confirm actions were taken
Developing a Plan for Crisis Response and Stabilization
When assembling and developing a Plan for Crisis Response and Stabilization, the following facets should be kept in mind and ensured:
– Implement safety plan (Requires 24/7 availability)
– Decide on level of intervention and type of response
– Direct action: de-escalation/stabilization
– Model calm, non-threatening, yet directive approach
– Do not add to the family’s reactivity
– Verbal responses should be short and simple
– Create safe environment:
– Secure unsafe items
– Commitment to safety
– Therapeutic separation
– Mobilize supports
– Respite: Arrange for short term out of home stay
– Hospitalization or psychiatric assessment
– Stepped up intensity & monitoring (by family; IHBT staff)
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