What is Crisis Intervention and How Does it Intersect with Applied Behavior Analysis?

What is a crisis? For some, it may be a natural disaster or the death of a loved one. For others, it may result from a loss of control or structure. In the mental health field, it’s best described as a traumatic event that results in an individual’s inability to apply previously used coping methods to handle the emotional, mental, physical, and/or behavioral reactions that result.

Most people are able to learn and apply coping methods (behaviors) to deal with stressful events. But when old coping methods don’t work and individuals are no longer able to apply new ones, medical and therapeutic interventions may need to come to the rescue. In other words, while all people experience stressful and traumatic events in their lives, when individuals are unable to work through them and control how they react to them, they are said to be in a crisis, making them good candidates for crisis intervention services.

Crisis intervention services are set into motion when an individual requires immediate care for acute disturbances in thoughts, mood, social relations, or behavior.

According to statistics published by the Agency for Healthcare Research and Quality, there is a significant need for mental health crisis services in America. Between 2006 and 2014, emergency room visits in the U.S. increased 15%, while ER visits for mental and substance abuse disorders increased 44% during the same time.

ABA in Crisis Intervention

The techniques of applied behavior analysis (ABA) are a natural fit for crisis intervention counseling, as both are focused on learning and relearning behaviors to produce better outcomes. ABA is used by crisis intervention specialists to help patients extinguish negatives thought processes and behaviors that can lead to a crisis and implement new behaviors through positive reinforcement.

The evidence-based science behind ABA makes it a smart choice for producing immediate and long-lasting results when counseling individuals in crisis.

Crisis Intervention Specialist Job Description

Individuals experiencing a crisis show clear signs of distress and functional impairment and are unable to cope or function, and they may be at risk of harming themselves or others. Crisis intervention specialists work with individuals to provide mental health services to individuals who are in an acute, unbalanced psychological state.

Any number of events or circumstances can be considered a crisis in the eyes of the patient, and the crisis can be real or perceived. Medical illnesses and mental illnesses are often the source, although life-threatening situations, changes in important relationships (death of a loved one), substance abuse, and criminal victimization can all result in a crisis situation. Individuals with behavioral and developmental disorders may also experience psychological crises due to changes in environment, routine, or other circumstances.

Crisis intervention therapy may consist of one session or several sessions over the course of days, weeks, or months. Children, adolescents, and adults all benefit from crisis intervention therapy, and services are often available 24 hours a day, seven days a week.

Just some of the locations where crisis intervention therapy may take place include:

  • Hospitals
  • Crisis centers
  • Counseling centers
  • Correctional facilities
  • Mental health clinics
  • Schools
  • Community/social services agencies
  • Telehealth (often available through telephone hotlines)
  • Domestic violence shelters
  • Youth shelters
  • College counseling services
  • Government agencies (FEMA)
  • Nonprofit agencies (Red Cross)

Examining the Objectives and Desired Outcomes of Crisis Intervention

A crisis isn’t just a stressful or traumatic event; it’s the response to the event (whether real or perceived) that turns a difficult event into a crisis. Patients in crisis have lost control and are in a state of imbalance, volatility, or instability. They are unable to apply past coping skills or the coping skills they are applying are ineffective. Fear, anger, helplessness, anxiety, depression, confusion, agitation, and thoughts of suicide or homicide are just some of the feelings that result.

Enter crisis intervention specialists, mental health professionals who are proficient at providing immediate, short-term help to individuals who experience an event over which they lose the ability to use problem-solving and coping skills. Here’s how they help:

  • Crisis intervention specialists help patients understand their response to the crisis and the feelings and behaviors that accompany this response. They may help patients implement new or previously used coping skills that are designed to replace the current, negative coping skills they are implementing. For example, instead of coping with fear and anxiety by using alcohol or illicit drugs, the crisis intervention specialist would encourage the patient to implement relaxation techniques or seek social support.
  • Crisis intervention specialists also help patients seek alternative coping skills if the ones they previously used are no longer effective or appealing. During this approach, they would help the patient implement a new coping skill, encourage the patient to try it, and then together evaluate its outcome.
  • Crisis intervention specialists help patients make a plan of action for dealing with future crises. Helping patients recognize when behaviors and feelings begin to change so they can prevent future crises by implementing the appropriate coping skills is also an important part of crisis intervention therapy.
  • Crisis intervention specialists often collaborate with other medical and mental healthcare providers during treatment and are an excellent source of valuable resources for patients. In the event of a mental health emergency (e.g., suicidal, self-harm or homicidal behaviors), crisis intervention specialists focus solely on protecting the patient and others until the proper medical intervention can take place.
  • Crisis intervention specialists help patients at risk of experiencing future crises to prepare and maintain a crisis plan.
  • Crisis intervention specialists often oversee and/or participate in a critical incident stress debriefing (CISD), which involves bringing together the proper professionals (psychologists, psychiatrists, social workers, school personnel, etc.) and often times the patient’s family to identify and assess the situation (usually within 24 hours of the crisis event) and intervene by putting the proper interventions into motion.

It’s important to remember that crisis intervention counseling is not a substitute for medical attention and psychotherapy. Instead, it is part of the full continuum of care and should complement other forms of therapy.

The Value of ABA in Crisis Counseling

It is the goal of the crisis intervention specialist to reduce or moderate the individual’s reaction to a crisis and help the individual return to a stable level of functioning. Alongside proper medical interventions, crisis intervention specialists help individuals in a crisis develop new coping skills and eliminate negatives ones.

In fact, implementing strategies that are focused on introducing new behaviors and eliminating maladaptive behaviors is at the heart of crisis intervention therapy. Applied behavior analysis (ABA) is often utilized to accomplish these goals, with crisis intervention specialists often using positive reinforcement to help patients learn or relearn positive behaviors, with the ultimate goal to help patients regain control.

An example of ABA in crisis intervention counseling would be working with a patient experiencing a heightened sense of dread and anxiety due to the death of a loved one. The crisis intervention specialist would help the patient discover what behaviors may have led to the crisis. For example, after learning that a patient isolated themselves and began drinking alcohol to cope, the crisis intervention specialist would then work with the patient to adopt positive behaviors to replace maladaptive ones. This might mean reaching out to friends and family or attending a support group instead of turning to isolation as a positive behavior replacement.

How to Become a Crisis Intervention Specialist

Though crisis intervention could very well be their primary role, the people that do this work are educated, trained, and licensed mental health professionals:

  • Psychiatrists
  • Psychologists
  • Clinical social workers
  • Mental health counselors
  • Marriage and family counselors
  • Behavior analysts

Counselors

Mental health counselors, family counselors, marriage/couple counselors, and addictions counselors may be educated and licensed at various educational levels in most states. Non-supervised, full-authority, independent clinical work that involves diagnosing patients and developing treatment plans always involves a master’s or higher degree and state licensure in the specific role.

The American Counseling Association provides state-specific information on licensing requirements for counselors.

Behavior Analysts

Behavior analysts are educated at the master’s or doctoral level in behavior analysis, education, or psychology, though starting in 2022 the field will open up to professionals with backgrounds in other relevant areas like social work and human services. Currently, ABAs are licensed to practice in 30 states.

The Behavior Analyst Certification Board provides links to each state’s regulatory board website for information on licensing requirements for behavior analysts.

Social Workers

Depending on the jurisdiction, social workers may be licensed at the bachelor’s, master’s, and/or doctoral levels, though for all full-authority, independent clinical roles – the ones most often associated with crisis intervention work – a master’s in social work (MSW) is the standard minimum in all states.

The Association of Social Work Boards maintains state-specific information on licensing requirements for social workers.

Psychologists and Psychiatrists

Both psychiatrists and psychologists are doctoral-trained, board-certified mental health professionals.

The Association of State and Provincial Psychology Boards maintains state-specific information on licensing requirements for psychologists.

The Federation of State Medical Boards maintains state-specific requirements for initial medical licensure for psychiatrists.

Specialty Certification

Specialty certification for mental health professionals is widely available:

BCBA Certification

Adding certification as a Board Certified Behavior Analyst (BCBA) through the Behavior Analyst Certification Board to your qualifications will allow you to serve as an ABA expert in your field.

To qualify for this designation, you must complete a master’s degree in psychology, education, or behavior analysis that includes acceptable graduate coursework in behavior analysis and a defined supervised practical experience. You may also qualify by completing a degree in one of these three areas and completing a Verified Course Sequence (VCS). Lots of schools offer the VCS as either a stand-alone graduate course sequence or as a post-graduate certificate. Many times, these schools offer the VCS entirely online.

Even if your master’s degree wasn’t in psychology, education, or behavior analysis, you may still be able to complete the VCS. That’s because in 2022, the BACB will remove the degree restrictions, opening up the BCBA to a wide variety of master’s-level practitioners in the human services field.

In anticipation of this change, many schools that offer the VCS have already removed the degree restrictions, allowing counselors, social workers, and other professionals to complete this comprehensive course of study in ABA now. And then, in 2022, you’ll have the option of completing the required experiential and exam requirements necessary to earn the BCBA designation.

Crisis intervention specialist Salaries

The U.S. Bureau of Labor Statistics (BLS) provides an overview of what mental health professionals in counseling are earning, as of May 2018. The following statistics provide average salaries for a number of mental health practitioners at the 25th, 50th, 75th and 90th percentiles:

  • Healthcare social workers: $43,530, $56,200, $70,280, $84,870
  • Social workers, all others: $44,360, $61,980, $76,970, $86,760
  • Substance abuse, behavioral disorder, and mental health counselors: $34,950, $44,630, $57,580, $72,990
  • Counselors, all others: $32,490, $42,130, $59,340, $77,310
  • Therapists, all others: $39,700, $53,850, $71,540, $95,130
  • Marriage and family therapists: $38,170, $50,090, $63,300, $82,240

A closer look at what crisis intervention specialists are earning is available by examining recent job posts:

  • Crisis Counselor, Small Talk Children’s Assessment Center, Lansing, MI: $42,000-$55,000
  • Crisis Counselor, UPMC, Altoona, PA: $39,457-$63,252
  • Crisis Counselor, Town of Chapel Hill, Chapel Hill, NC: $47,117-$62,170
  • Crisis Stabilization Counselor, Roscoe, NY: $32,240
  • Police Crisis Counselor, Nashville Police Department, Nashville, TN: $48,437-$54,894

 

Salary and employment data compiled by the United States Department of Labor’s Bureau of Labor Statistics in May of 2018 – (https://www.bls.gov/oes/current/oes_stru.htm). BLS salary data represents state and MSA (Metropolitan Statistical Area) average and median earnings for the occupations listed and includes workers at all levels of education and experience. This data does not represent starting salaries. Employment conditions in your area may vary.

Individual job listings with educational requirements and salary information accessed directly from internet job boards and directly from the sites of employing agencies and do not constitute offers of employment.

All salary and job growth data accessed in October 2019.