Sanford Brown College Managing Highly Distressed Clients Case Study

Module 04 Course Project – Managing Client EmotionalityManaging the emotions of clients involves understanding the strengths and weaknesses of clients so that
the Human Services Professional is sensitive to client needs when actively engaged with them.
Sometimes clients may respond through anger, shock, or may not show emotions outwardly. Still, the
Human Services Professional has to assist all clients with processing individualized thoughts and feelings
so that a progressive plan of action for addressing the crisis can be developed.
As you continue to develop the Crisis Support Plan for your chosen crisis situation, it is essential that you
are ready to support a highly distressed client who is having difficulty working through the situation. In a
3-page FULL paper, written in APA format using proper spelling and grammar, address the following:
1. Perform some library research to identify strategies that Human Services Professionals can
use when managing clients in emotional and/or psychological distress post-crisis. Describe
the techniques that you feel will be most valuable in your Crisis Support Plan. Be sure to cite
your sources.
2. What factors in your scenario need to be considered when developing a plan for supporting
your highly distressed client?
3. Why is it important for a Human Services Professional to manage highly distressed clients
who are having difficulty managing their emotions independently? What are the potential
outcomes (both positive and negative)?
4. What are the things that one should NOT do or say when working with highly distressed
Crisis reading
Cultural Diversity in Crisis Matters
Culture Plays an Important Role in How Crisis is Perceived
As Human Services Professionals,
we are charged with handling a wide variety of circumstances that impact the client populations we serve.
Many of these incidents will involve crisis situations. Crises are universal and affect all people in similar,
but also different, ways. Sources of crisis can include but are not limited to natural disaster, domestic
violence, change in marital status, economic burdens, the death of a loved one, chronic or terminal health
conditions, medical emergencies, loss of employment, assault, or burglary. Even though there is a
universality to crisis situations, it is essential to understand that culture plays an important role in how
crisis is interpreted, both for the crisis intervener and the person in crisis.
The role of the Human Services Professional is to provide immediate and temporary emotional first aid to
the person in crisis; this is also called psychological/emotional first aid. Interventions are utilized to assist
the client in crisis and to target the circumstances of the presenting problem. The goal is to reduce the
level of stress for the person in crisis, modulate the intensity of the stressors, and return to a level of
normalcy at the pre-crisis level of functioning. Due to the need for immediate response on the part of the
Human Services Professional, factors of culture and cultural identity are often neglected (e.g., age,
gender, sexual orientation, race, ethnicity, language, nationality, religion, occupation, income, education,
mental and physical abilities). When working with someone in crisis while respecting cultural differences,
it may be best to say, “It is important that I ask some personal questions in order to best help you. Is it
okay that I do that?” Asking permission can go a long way toward building rapport following the perceived
crisis event. After symptoms of the crisis are stabilized and controlled, acknowledgment and appreciation
of the culture of the person in crisis can help to identify cultural resources for aftercare. Resources such
as family, church, and ethnic or specialized agencies can provide continuing support needed after the
immediate and urgent symptoms are controlled.
Understanding client differences and the characteristics relative to these differences is an iterative
process for all Human Services Professionals. This means that it is imperative that all Human Services
Professionals must be aware of how individuals perceive situations and to be sensitive in how to respond
both verbally and non-verbally. What we say must be respectful with all clients, regardless of his/her
cultural identity. In concert, non-verbal communication, such as in how we look at clients and the physical
disposition or posture(s), must be in a non-threatening and non-judgmental manner. Paying attention to
how we respond involves being cognitively aware of our presentation, but most importantly,
understanding that differences in culture (whether we identify or not) should always be valued and
appreciated. The more that is known about many different cultures, the more a Human Services
Professional will be able to authentically interact within virtually any diverse circumstance. Through this,
techniques and strategies towards providing a resolution to perceived crises will be authentic and based
upon knowledge of the application of cultural competencies.
Cultural Competence and Crisis Intervention
Human Services Professionals must
be able to illustrate a strong understanding of his/her own culture but also how cultural characteristics
influence belief systems. By definition, culture can be simply defined as the shared traditions and customs
of a group of people. These shared traditions and customs can relate to history, participation in events,
folklore, and relevant institutions. Culture can be shared by people of the same ethnicity, language,
nationality, or religion. Culture involves a system of rules that are the base of what we are and affect how
we express ourselves as part of a group and as individuals. We all develop in some type of culture. Our
environment determines what we learn, how we learn it, and the rules for living with others. These rules
are transmitted from one generation to the next and are often adapted to the times and locale. The rules
are absorbed by children as they develop, whether through word-of-mouth or just “osmosis.”
Cultural Competence
Cultural competence is a non-threatening process. It is a process of acknowledging and validating who
people are, regardless of where they come from. Cultural competence is defined as a set of positive,
respectful, and professional behaviors, attitudes, and policies that come together in a system, agency, or
among professionals and enables that system, agency, or those professionals to work effectively in crosscultural situations. This means that cultural competence involves Human Services Professionals being
respectful of all whom s/he interacts with and that the agency/organization aligned with the professional
has procedures that respect all individuals being served.
In the field of human services, cultural competence is important because it can provide a framework for
connecting with others in a genuine way, as well as providing services to clientele in an authentic,
respectful, and truthful manner that assists in establishing a foundation of trust. Most professionals in the
field of human services have witnessed the potent power of cultural competence in action when deescalating clients in crisis situations.
As human beings, it is important for us to feel validated and respected. This is particularly true in crisis
situations. It is important to note that a Human Services Professional’s lack of cultural competency is not
indicative of lack of validation and respect of his or her client, but rather a lack of a repertoire of skills that
allow professionals to genuinely and effectively communicate this validation and respect to the clients
they serve. When Human Services Professionals lack cultural competency, limitations and boundaries
may be placed on the level of connectedness and trust the client has toward the professional serving
As professionals work with people in crisis, it is extremely crucial that they are aware of their own issues,
and when intervening in cross-cultural situations, it is important that they ask themselves silent questions,
such as the question “What am I feeling now?” In addition, when Human Services Professionals intervene
during a crisis, it is highly important that they develop an awareness of their own prejudices around
cultural diversity. This can present challenges for professionals. Self-awareness work around issues of
culture diversity requires a willingness to engage in deep reflection regarding how prejudice can manifest
in one’s work during crisis intervention. For example, if a Human Services Professional believes that
clients of Latino heritage only respond to Latino professionals, it is likely that s/he will take this belief into
a crisis situation and that this belief could possibly impede the ability to effectively serve the client during
the crisis. The culturally-competent Human Services Professional should be able to adapt their skills to
different cultures, refraining from a one-size-fits-all approach to crisis intervention.
Cultural competence is very important in all crisis matters. Cultural competence starts with the Human
Services Professional and is transitioned through his/her interactions with any client that s/he serves. If
Human Services Professionals are willing to engage in the necessary work required in practicing from a
culturally competent framework, it means that s/he has self-awareness of their own cultural bias(es) and
can assist clients in feeling validated and respected throughout all phases of crisis intervention. Cultural
competence is a paramount value that must be embraced by both professionals and the agencies they
work within in order to effectively manifest at a level that will be meaningful to clients during crisis
intervention. Effective crisis intervention practiced with cultural competence results in positive outcomes
for all involved in the crisis intervention.
5 Essential Principles of Aligning Ethics and Cultural
Ethical considerations are extremely important in crisis intervention, thus indicative of the relevance of
aligning ethics and cultural competence through the implementation of 5 essential principles. When
interacting with clients through an ethical and culturally-competent approach, it is important to 1) value
diversity, 2) conduct a cultural self-assessment, 3) understand the dynamics associated with differences,
4) institutionalize (or systemically apply) cultural knowledge, and 5) adapting to diversity.
1. Valuing Diversity
Valuing diversity is the first very important principle. This involves accepting and respecting differences
between and within cultures. As people, oftentimes we presume that a common culture is shared
between members of racial, linguistic, and religious groups, but this may not be true. A group might share
historical and geographical experiences, but individuals may share only physical appearance, language,
or spiritual beliefs. Our cultural assumptions can lead us to wrong conclusions. As people move to new
areas and mesh with other cultures, it creates a kaleidoscope of subcultures within racial groups.
2. Conducting a Cultural Self-Assessment
As Human Services Professionals, we teach individuals to look within themselves and to be honest within
themselves. Self-assessment is necessary because it allow the Human Services Professional to look at
parallels and inconsistencies with how s/he interacts with others and to utilize introspection and research
towards improving in one’s craft. This is a continuous process that all Human Services Professionals
should partake in due to the fact that our work is enhanced through experience, supervision, and revision
of practice(s).
3. Understanding the Dynamics of Difference
Many factors can affect cross-cultural interactions. Bias due to historical cultural experiences can explain
some current attitudes. For example, Native Americans and African Americans, among other groups,
have experienced discrimination and unfair treatment from dominant cultures. Mistrust coming out of
these experiences may be passed on to the next generations of these groups, but ignored within the
dominant culture. An oppressed group may feel mistrust toward the dominant culture, but members of the
dominant culture may be unaware of it or not understand it. Human Services Professionals planning to
interact with varying cultures need awareness of such a dynamic if they want to be effective. Remember
that organizations that employ Human Services Professionals can be intergenerational. A group that
worked with an ineffective, culturally incompetent organization 15 years ago, may not know that the group
has the same name but is in a “second life” — a new staff, a new board, and a new approach to working
with the community. This means the organization has some work to do and must be aware of this
dynamic in order to be newly effective. Being proactive rather than reactive about change produces a
synergistic organization. Anticipating change is a basic dynamic in the development of synergy. Synergy
is more than just teamwork. It’s the magic that happens when people are truly working together,
understanding one another deeply, and in total agreement about their beliefs and goals, at least as far as
their work goes. Synergy happens only if people treat each other with respect and effectively
communicate with each other.
4. Institutionalizing Cultural Knowledge
Cultural knowledge should be integrated into every facet of an organization. This means that Human
Services Professionals collectively and individually and responsible for ensuring that they exhibit cultural
competencies, but also that the organizational setting and environment support this concept. Because
valuing diversity, conducting cultural assessments, and understanding differences are a necessity when
working within agencies and in facilitating crisis work, staff must be trained and be able to effectively
utilize knowledge gained. Policies should be responsive to cultural diversity.
5. Adapting to Diversity
Crisis intervention is diverse due to the perceptions of a crisis and the types of interventions that are put
into place. Human Services Professionals must adapt to diversity through understanding values,
behaviors, attitudes, practices, policies, and structures that make it possible for cross-cultural
communication. When Human Services Professionals recognize, respect, and value all cultures and
integrate those values into the system, the needs (to include crisis matters) can be addressed with all
types of respective groups
Evidence-Based Practice (EBP) and Strategizing During Crisis Moments
Evidence-Based Practice (EBP)
Human Services Professionals are
increasingly seeking information about evidence-based practices (EBP). This is due to the nature of our
professional work in interacting with clients and wanting to provide interventions that can produce
favorable, long-term results. Numerous resources are emerging to help connect research to practice and
provide information that can be helpful to practitioners. Since the term evidence-based practice is used in
numerous ways, it constitutes a proactive shift in how Human Services Professionals learn, practice, and
evaluate their trade. By definition, evidence-based practice is a systematic approach to practice that
begins by formulating an answerable question. Once a practice-specific question has been identified,
then the Human Services Professional can seek the best evidence from research that answers the
question. Evidence-based practice is a process in which the practitioner combines well-researched
interventions, ethics, and the understanding of diversity and culture to guide and inform the effective and
efficient delivery of services.
7 Principles for Applying EBP to Crisis Intervention
Evidence-based practice, within the realm of crisis intervention, involves seven principles that should be
followed by Human Services Professionals:
1. People (or clients) respond best in crisis intervention when the procedure is simple. The
simple application of crisis intervention techniques allows for the best chance of having a
positive effect.
2. Brevity, during the process of psychological first-aid/crisis intervention, should remain short
from minutes up to an hour. Crisis intervention is meant to be short-term, in terms of duration,
with a follow-up method that is based upon a case-by-case situation.
3. The use of a crisis intervention model allows for creativity to ensure that specific steps are
followed, based upon information that is provided by the client throughout the crisis
intervention process. It is okay for the Human Services Professional to be creative, while
implementing a crisis intervention plan.
4. Keep crisis intervention practical and pragmatic. Impractical suggestions can cause an
individual under duress to potentially feel more frustrated due to the perceptions from the
crisis experience(s).
5. Proximity is important, as the provision of support services should be close to the client’s
normal area of function. The most important thing about proximity is that support should be
within a safe area, or safe zone, that allows the client to feel a great sense of comfort.
6. The immediacy of services involves crisis interventionists (Human Services Professionals) to
be accessible and able to provide services right away. Crisis situations demand rapid and
immediate interaction and intervention, and delays in services can undermine the
effectiveness of supportive services.
7. Crisis interventionists should work to set up expectations that are reasonable and can produce
a positive outcome.
Evidence-Based Strategy in Crisis Intervention
In crisis situations, Human Services Professionals should utilize a crisis model, such as the Six-Step
Method to Crisis Intervention. Because successful crisis intervention programs involve the application of
evidence-based practices, it is important to have a grasp of the crisis situation, conceptualize options,
actively listen and provide consequences, compromise, and to execute. Each of these areas align with
most crisis intervention models and can be summed up as such:
Understanding the Crisis Situation: The first step in a verbal intervention is to identify the situation
and/or the overall issue, which is creating distress between the individual and themselves, someone else,
or their environment. Without first having an understanding of what it is a client is up against, or what
specifically s/he is dealing with, it is likely to be more difficult to begin resolving the issue. It is highly
necessary to utilize active listening skills to gain an initial grasp of the client’s feelings and/or thoughts
regarding the situation and what they are challenged by.
Conceptualizing the Options: As Human Services Professionals we assist clients with a means towards
finding immediate solutions. Many times offering simple yet effective options to the client may prevent the
situation from continuing towards further aggression. These options should encompass all activities that
can assist the client in dealing with the situation and his/her emotions at that time.
Active Listening and a Discussion of Consequences: If the client is unable or unwilling to utilize any of
the options that have been collaboratively discussed, and continues to escalate in feelings of distress, it is
important to validate the client’s feelings and to discuss options and potential consequences associated
with options discussed.
Coming to a Compromise: Make every attempt to encourage the client to come up with a viable option.
Allow them to voice their opinions (respectfully) and if they are willing to listen, then there is at least the
possibility of making a Compromise.
Execution of a Plan of Action: Once the compromise has been achieved then it is time to take action
and implement it. If applicable, the Human Services Professional may wish to make a verbal or written
contract to enhance the solidity of the agreement. Continued encouragement should be provided to the
client to keep up the positive behavior. In this final phase, Human Services Professionals should
congratulate clients on overcoming an obstacle, or obstacles, and on working through the process of deescalation in a crisis.

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