Crisis interventions

A review of the literature on the benefits of having support within a home environment compared with hospital based treatment14 describes the benefits of home treatment as:

  • Crisis interventions that are carried out in the environment in which the crisis occurred are more likely to be based on an understanding of the situation of crisis and incorporate existing social needs
  • The context of home treatment tends to equalise the power relations between the professionals and the service users (and/or families).
  • Being more conducive to identifying and focusing on service user needs and priorities.
  • Clinicians’ exposure to service users’ homes makes it possible for treatment to evolve according to the changing needs of service users.
  • The safety and comfort of being at home helps service users to focus down on the actual problems.
  • Home treatment helps to normalise crises, making the experiences of crises less stigmatising to service users.
  • Time is more flexible in home treatment, providing a greater opportunity for the team to gain a deeper understanding of the context of the crisis.
  • Service users are better able to try out new skills in real life situations.
  • Home treatment is easier for service users and families to accept, and is less disruptive and burdensome to them.
  • When there are children in the homes the team has the opportunities to relate to them and to understand how families are affected and family dynamics.

The use of specific psychological therapies within crisis settings has been gaining ground  (brief therapy, solution focused therapy, psychotherapy, Mindfulness and Cognitive Behavioural Therapy (CBT)) with studies from New Zealand indicating that crisis clinicians used a wide range of psychological interventions drawn from a broad theoretical base15.

There is emerging interest among experts on the value of adopting cognitive behaviour strategies and family focussed approaches in crisis intervention16 17 with some focus on the management of suicide risk18 with reduced maladaptive cognitions and as a result decreased suicidal ideation being indicated19.