(c) Dr. Sharron M. Singleton 2010
Identify the need for crisis management and suicide prevention services for public school systems
Provide a basic overview of crisis development and how it may manifest in the school setting
Provide basic attending and active listening skills that can be utilized in crisis management
Discuss suicide prevention and assessment strategies appropriate for public school use
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
Crisis refers to a sustained period of acute emotional upset arising from a person’s perception of events resulting in a temporary inability to cope by means of one’s usual problem solving devices
Academic problems Altered states of consciousness Anger/low frustration tolerance Bully or bullied Chemical and substance abuse Criminal behavior Delayed cognitive and affective
development Emotional lability/depression External locus of control History and threats of violence Hypersensitivity Impulsivity Mental illness Preoccupation with violent themes Suicidal ideation
(c) Dr. Sharron M. Singleton 2010
Creates: Stress Distractions Hostile learning
environment Interferes
with: Ability to
concentrate Rhythm of
teaching Rhythm of
learning
Precipitating event Underlying factors or
circumstances Strong emotional reaction Inability to cope Defined by the person involved
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
SameBetterWorse
(c) Dr. Sharron M. Singleton 2010
The immediate and timely intrusion into a person’s life at a time when the stress he or she is experiencing is too great to be handled and managed through the use of usual coping mechanisms
(c) Dr. Sharron M. Singleton 2010
Diffuse the emotional level of the child
Guide the child through resolving the problem
(c) Dr. Sharron M. Singleton 2010
Present oriented Problem specific Worker is a direct,
active participant Focus is on the return of
the child to pre-crisis level of functioning
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
cquire rapport and information
•Provide support
•Build trust
•Build a relationship
•Collect information
•Conduct Triage Assessment
Assumes that it is necessary to assess crisis in three domains: affective, cognitive, and behavioral
Assessment in the three domains helps to capture the complexity of the crisis and suggests how directive the intervention should be
Triage Assessment System for Students in Learning Environments (TASSLE)
(c) Dr. Sharron M. Singleton 2010
Anger/hostility Anxiety/fear Sadness/
melancholy
(c) Dr. Sharron M. Singleton 2010
Perception of the eventThreatLossTransgression
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
Approach
Avoidance
Immobility
(c) Dr. Sharron M. Singleton 2010
oil down the emotions and problem or event
•Make the time relationship connection
•Identify the significance of the current appearance
•Identify the precipitating event
•Clarify the meaning of the event
•Establish a working goal
(c) Dr. Sharron M. Singleton 2010
oping skill development
•Switch to a problem-solving focus
•Utilize triage assessment score to guide work
•Create options
•Refer for service follow-up
(c) Dr. Sharron M. Singleton 2010
Eye contact Posture Physical distance Facial expressions Gestures Setting Position Voice tone Rate of speech Movement Level of energy
(c) Dr. Sharron M. Singleton 2010
(c) Dr. Sharron M. Singleton 2010
Purpose is to establish trust & rapport and clarify the emotional status of the individual
Task is to respond to the emotions revealed, not the content
(c) Dr. Sharron M. Singleton 2010
I hear sadness in your voice
Purpose is to clarify content, check perceptions, and provide feedback
Summarize in a concise form, the important content and emotions connected to the situation
(c) Dr. Sharron M. Singleton 2010
So, what I hear you saying is that you are more ill than you first thought and that’s really scary…
Purpose is to clarify and obtain information when the person is only giving vague clues
Repeat, word-for-word, what the person just said, with a questioning inflection in your voice
(c) Dr. Sharron M. Singleton 2010
Things will never be the same?
Purpose is to collect information while reducing the feeling of being interrogated
Begin all questions with what, when who, where, or how; never why
(c) Dr. Sharron M. Singleton 2010
What will never be the same?
Purpose is to build trust and rapport and validate the person’s right to have emotions
Task is to focus on feelings without justifying negative behavior
(c) Dr. Sharron M. Singleton 2010
It’s okay to feel frightened.
Purpose is to provide time for thinking and to set limits
Task is to remain silent for an effective period of time
(c) Dr. Sharron M. Singleton 2010
Purpose is to encourage the person to continue talking without interrupting them
Task is to let them know you are listening
(c) Dr. Sharron M. Singleton 2010
So, I said to her, I said, you don’t
really love me; …Umm…
Purpose is to redirect an unproductive interaction
Task is to set limits in a non-threatening manner
(c) Dr. Sharron M. Singleton 2010
I feel very uncomfortable when you talk this way because I know you really do want things to be better.
Adolescent suicide is generally unexpected
Among 10 – 24 year olds Homicide is the 2nd leading
cause of death Suicide is the 3rd leading cause
of death The survivors are left with
guilt, anger, and a sense of unfinished business with the deceased
(c) Dr. Sharron M. Singleton 2010
(c) Dr. S. M. Singleton, 2010
A situation in which an individual engages in behaviors for the intended purpose of ending his or her life
(c) Dr. S. M. Singleton, 2010
Feelings of hopelessness and helplessness
Magical thinking Psychache Certain situations
1. Sudden loss2. Lack of social supports3. Sudden changes in life
patterns4. Chronic physical or mental
illness5. Unfulfilled expectations
(self/others)6. Unexpressed anger
(c) Dr. S. M. Singleton, 2010
(c) Dr. S. M. Singleton, 2010
Direct expression of deep feelings of hopelessness and helplessness
Provision of clues1. Indirect verbal clues are expressions that
contain hints about suicidal plans2. Behavioral clues are hints that we get through
discussions of recent behavior 3. Situational clues are clues inherent in the
person’s situation that they reveal in discussion.
4. Syndromatic clues are a constellation of psychological factors that, in combination may indicate a risk for suicide.
(c) Dr. S. M. Singleton, 2010
If n o , c on tin u e w ith th e c ris is in te rven t ion p roce ss
In itia te h e lp o r in it ia te a trace
O ffe r to p rovid e m ed ica l h e lp if n eed ed
If yes , fin d ou t w h at th ey h ave d on e
C on trac t fo r h e lp
D iffu se am b iva len ce an d an g er
F in d a h ook fo r th e p e rson to w an t to live
A sc erta in p lan o f ac tion
D iffu se em otion s
If n o , red u c e le th a lity if n ecess ary
If yes , fin d ou t if th ey h ave a lread y d on e an yth in g
A sk th e q u es tion : A re yo u com m ittin g s u ic id e?
R ec og n ize c lu es
E s tab lish ra p p ort an d lis ten fo r em otion s
Trust your suspicions that the young person may be self destructive
Tell the child that you are worried about him/her; then listen with a nonjudgmental and supportive attitude
Ask direct questions Don’t act shocked or debate whether suicide is right
or wrong Don’t promise to keep the intentions a secret Don’t’ leave the child alone if you think the suicide is
immediate Don’t be embarrassed or reticent about getting help Ensure that the child is safe and that the appropriate
adults responsible for the child are notified Assure the child that something is being done and
that their feelings are not being discounted Assume an active and authoritarian role as needed to
protect the child at risk Actively acknowledge the reality of suicide as a
choice but do not “normalize” suicide as a good choice
(c) Dr. S. M. Singleton, 2010
Allen, M., Burk, K., Bryan, E., Carter, D., Orsi, R., & Durkan, L. (2002). School counselors’ preparation for and participation in crisis intervention. Professional School Counseling, 6(2), 96-102.
Bridge, S., Hanssens, L., & Santhanam, R. (2007). Dealing with suicidal thoughts in schools: Information and education directed at secondary schools. Australasian Psychiatry, 15(supplement), s58-s62.
Brock, S. E., Sandoval, J., & Lewis, S. (2001). Preparing for crises in the schools: A manual for building school crisis response teams. New York: John Whiley & Sons.
Couvillon, M., Peterson, R. L., Ryan, J. B., Scheuermann, B., & Stegall, J. (2010). Teaching Exceptional Children, 42(5), 6-17
Klicker, R. L. (2000). A student dies, a school mourns: Dealing with death and loss in the school community. Philadelphia: Accelerated Development.
Suicide assessment and treatment. Knox, K. S. & Roberts, A. R. (2005). Crisis intervention and crisis
team models in schools. Social Work, 27(2), 93-100. Sandoval, J. (Ed.). (2002). Handbook of crisis counseling,
intervention, and prevention in the schools. Mahwah, NJ: Lawrence Erlbaum.
(c) Dr. Sharron M. Singleton 2010