Author Note
Crisis Case Management
Crisis Case Management
Ed Price
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Ed Price
Email: eprice10@liberty.edu
Ed Price
School of Behavioral Sciences
Department of Community Care & Counseling
Liberty University
2
Crisis Case Management
Crisis Case Management
Nature of the Crisis
For this exercise I watched an episode of the TV series, ‘Intervention’, Season 23,
episode eight. The title of the episode is ‘Brea’ which is also the name of the title character
whom this episode’s intervention is focused on. The nature of the crisis that Brea is a 23-year-
old chronic drinker and addict. Her crisis has multiple components. From a sitiuational crisis
perspective Brea and her family point back to the discovery that her assumed father was in fact
her stepdad. It was that point in her adolescent development that her family described ‘a rupture
in connection’ (Brea, 2021).
At first glance it would also appear that Brea began experiencing an existential crisis in
response to her being made aware of her paternal relationship. Brea and other family members
point to Brea’s loss of trust and faith in her mom because of the hiding of the identity of her
stepdad. Brea also began an interpersonal crisis as she emerged from puberty and into
adolescence. Discovering the identity of her stepdad started her down a road of use and abuse.
Her initial drug of choice was alcohol and by age 15 she was drinking heavily. In her mom’s
words, ‘when the drugs started, everything else ended (2021).
Although not clearly addressed in the docuseries, Brea is in the middle of a spiritual
crisis. Brea and her family are living in Nova Scotia. Canada is not known for overt spirituality
and many Canadians are not religious or spiritual at all. Many addictions are rooted in trauma
and manifest as shame. From a spiritual perspective, there is a God shaped vacuum in the heart
of every man or woman which cannot be filled by any created thing, but only by God, the
Creator, made known through Jesus (Clinton & Scalise, 2013, p. 57). Brea is clearing searching
for that thing to make her feel whole and complete.
3
Crisis Case Management
Alleviating the Crisis
To help the potential counselee, Brea, discover healing in recovery it will be necessary to
create a plan and work with the family and support system in advance of any action. Every root
cause of shame must be discussed and not withheld. Sources of substance as well as individuals
who enable or are co-dependent need to be identified in advance. Although it can seem
conspiratorial in nature, working in advance to identify the problem can provide a greater chance
of success.
Define the Problem – It would seem the problem is straight forward and, in a sense,
simple. In fact, it is multi-faceted and complex. Brea has a physical addiction to alcohol
that requires her to consume daily. Removing her suddenly could cause serious health
consequences and even death. Brea also has enablers or co-dependents who purchase her
alcohol for her.
Her current boyfriend, Derek, is an admitted alcoholic and enables Brea with alcohol.
We learn that Derek is providing alcohol to Brea not only have a drinking buddy but to
keep Brea away from using other substances. The problem defined is Brea is addicted to
substances and a chronic drinker with an alcohol addiction doing damage to her body that
has the potential to end her life if not treated medically.
Take Action – The next step of crisis counseling is action. All parties need to move
towards meaningful, purposeful, and goal-directed behavior (Wright, 2014, p. 165). Help
all parties to understand the crisis and tie it back to an event if possible. When taking
action consider any previous crisis. For Brea, her mom describes the loss of a boyfriend
who Brea went to rehab with. That boyfriend overdosed and died. Mom stated that Brea
4
Crisis Case Management
never got closure and never said goodbye as she wasn’t present at the time of the
boyfriend’s death.
Be aware of the potential counselee and related parties’ communication skills. Ask
questions to get to the cause of the crisis. Questions like; “What happened to make
you/them so upset?” or open a discussion with; “I’d like to hear what happened”. Taking
the role of facilitator or director can help all parties function better in a crisis. People
want to be taken care of and assuming responsibility for decisions and leadership allows
engaged parties to process more effectively.
Consider how each party involved perceives the situation at hand. A change in venue
might allow for calm. Removing certain individuals and allowing space can be a much
needed pause. Changes is environment may allow for persons to engage and begin to
process and communicate. Ask those involved how they’ve processed crises like this
before. Ask the potential counselee to do the work to become involved and build
confidence.
Guarantee Safety – This is a difficult task to provide safety for the addict as she is still
in active addiction. Safety can certainly be a suggestion to the addict. Whether it is
received is not the responsibility of the counselor prior to treatment. Safety measures and
boundaries can certainly be delivered to the family, codependents, and the support system
of a potential counselee. Healthy boundaries could include reducing or eliminating all
contact, removing sources of financial assistance, changing locks, and unfriending on
social media. At the onset of assisting in a crisis it is important to use techniques to lower
anxiety, guilt, and tension to provide emotional support (Wright, 2014, p. 162).
5
Crisis Case Management
Provide Support – One of the reasons a problem becomes a crisis is lack of adequate
social support. In my ministry, when I ask someone what the opposite of addiction is the
response will occasionally be, sobriety. The appropriate answer is that the opposite of
addiction is community. Isolation is the number one tool the enemy uses to speak death
over an addict. The writer of Hebrews tells us; ‘And let us consider how we may spur
one another on toward love and good deeds’ (Hebrews 10:24, 1984, NIV). Texting,
social media, phone calls and being physically present are simple ways to prevent
isolation. Be sure to expand their support system so that it grows beyond you, the
pastoral counselor.
Teaching Coping Skills
A goal of crisis counseling is to help people accept responsibility for the crisis and seek to
grow from the experience (Crisis Counseling from a Biblical Perspective, 2021). Teaching and
sharing coping skills can be an active part of healing and recovery for the family. Some
suggestions for copings skills could include;
Group therapy
AL Anon meetings
Re-establishing roles
Assuming old rituals and routines
Resuming social activities
Creating self-care practices, (exercise, meditation, hobbies, etc.)
Learning new skills
Attending to finances
Accepting responsibility and rejecting toxic blame and gossip
6
Crisis Case Management
Developing Resiliency
When responding to addiction or addiction recovery it is important to have a strong
support system. The ability to have your network speak life over you during times of crisis is
crucial for stability and growth. Equally important is the ability for the person(s) in crisis to be
able to reach out to their network for support whenever needed. Faith communities can be a
solid support community during times of crisis. Clergy and staff can become the de facto
providers of mental health counseling in the context of pastoral care (Johnson & Johnson, 2014,
p. 175).
Helpful to building resilience is having your community be one of shared or likes
experiences. An addict’s family will find wisdom and sound advice in families that have
journeyed down similar paths. The ability to manage feelings and. Impulses in a healthy way
can often come in the reflections and advice we hear in conversations with our common
community. Resiliency will often come over time with the development of skills used in times
of crisis. Often crisis is an opportunity to advance or retreat. Community will help you to
advance in times when you feel like surrendering.
7
Crisis Case Management
References
Brea. (2021). A&E. Retrieved February 20, 2022, from
https://play.aetv.com/shows/intervention/season-23/episode-8.
Clinton, T. E., & Scalise, E. (2013). The Quick-Reference Guide to Addictions and Recovery
Counseling: 40 topics, spiritual insights, and easy-to-use action steps. Baker Books.
Crisis Counseling from a Biblical Perspective. (2021). Retrieved January 17, 2022, from
https://canvas.liberty.edu/courses/205245/pages/watch-crisis-counseling-from-a-biblical-
perspective?module_item_id=19733717
Johnson, W. B., & Johnson, W. L. (2014). The minister's guide to psychological disorders and
treatments. Routledge, Taylor & Francis Group.
Wright, H. N. (2014). The Complete Guide to Crisis and Trauma Counseling: What to do and say
when it matters most! Bethany House Publishers.
Zondervan Bible Publishers. (1984). The holy bible, New International Version.
