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Most mental health practitioners across have been taught to do risk assessments, and to reduce danger to their clients and those around them. However, many providers lack a thorough understanding of the cause and nature of mental health crises--and struggle to safely and successfully provide crisis intervention.
This book explains how providers can seize the opportunity of crises and tip them toward rapid resolution. Dr. Fraser shows readers how to envision crises as time-limited windows of opportunity in which clients can achieve new insights and move in positive directions in their lives. He offers a concrete, easily understandable model for understanding crises in their proper context, engaging with clients through their values, culture, and language, honoring their goals, and breaking cycles of crisis for good. It also shows how different types of crises reflect similar vicious cycles, and how each of those cycles can be tipped toward resolution by embracing the contextual process of change perspective.
Crisis Intervention Using Tipping Points to Achieve Transformative Change in Therapy
by Fraser, J. ScottFormat: Paperback
Pub. Date: 2025-02-11
Publisher(s): American Psychological Association
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Summary
Author Biography
J. Scott Fraser, PhD, is a clinical psychologist with nearly 40 years of clinical practice, supervision, training, and academic teaching He has served as director of internship training, associate dean, and director of clinical training and as professor of clinical psychology in the doctoral program at the School of Professional Psychology at the Wright State University in Dayton, Ohio. Before that, he was director of a crisis/brief therapy center in a large general hospital setting for 14 years. He has published many papers and books, including Unifying Effective Psychotherapies: Tracing the Process of Change (APA Books, 2018), and the DVD titled The Process of Change in Integrative Psychotherapy, which uses the process model described in this book.
Table of Contents
Contents
ACKNOWLEDGEMENTS8
Prologue: Wei Ji9
Introduction12
Chapter One19
Defining Crisis20
Misguided Assumptions21
Mistaken Applications21
System Levels.22
Mechanical Systems22
Organismic systems22
Sociocultural Process-based systems23
Problems with the Traditional Views of Crisis23
Assuming stability versus change23
Perceiving danger not opportunity23
Assuming change is mainly gradual verses rapid24
Assuming reality is stable and fixed versus co-created through process24
The importance of context25
The need to unify all crises within an appropriate model of change25
Chapter Two27
Feedback is the heart of systemic causation.27
The quest for a stable and predictable world.28
Making sense of our chaotic world.29
Stability and Change:29
The Threat Rigidity Hypothesis31
Paradox and Creative Change32
The history of a process view of our world.33
Process and Chaos35
Chaos and Flow35
Context39
Crisis Attractors41
Fractals42
Catastrophe Theory44
Following the Process47
Observers define crises47
Rules, Regularities and Constraints within open systems channel their ongoing interaction patterns47
Positive and Negative Feedback Loops are Complimentary48
Constancy/Stability and Change are interrelated48
Change is constant and can be rapid48
Small changes can have cascading large results.48
Not all small changes will initiate cascading change49
A small sample of current patterns may reflect much larger system patterns49
The goal of crisis intervention is thus shifting patterns49
Chapter Three51
Crisis as a “Window of Opportunity” for rapid intervention.52
Key Elements of All Effective Rapid Intervention53
Key Crisis Concepts55
Trigger Points55
Developmental life crises56
Incidental life crises:56
Endemic life crises:57
Crisis Attractors58
Solution-generated problems59
Problem-generated systems60
Crisis Patterns60
Generic response patterns61
Specific response patterns62
The Process of Change Intervention Process70
Relationship Establishment70
Generic Intervention Options74
Rationales and Reframing74
Context and Contracting:76
Normalizing77
Predicting77
Positioning and Restraints78
Prescribing79
Chapter Five83
Trauma and Post-trauma85
PTSD Models88
Vicious Cycles of PTSD91
Treatments That Work For PTSD94
Exposure-Based Approaches95
Present-Centered Treatment95
Posttraumatic Growth as an Alternative98
Growth as an Alternative99
Violating Our Assumptive World100
Searching for Meaning101
Positively Re-Solving Crises and Trauma103
Disclosure in a positive context105
A Process of Change Approach to Crises and Trauma106
Chapter Six109
Hazardous Intersections110
Predicting Suicide113
Psychache and Tipping Points114
Suicide as not a “thing-in-itself”116
Risk versus Treatment Oriented Assessments118
The Problem with No-Suicide Contracts119
Promising Pathways to Positive Intersections122
The Therapist Sphere123
The Client Sphere124
The Cultural Sphere125
The Alliance—The Intersection of all three Spheres125
The Golden Thread of Effective Intervention126
Chapter Seven135
Definitions138
A history of grief models138
Stage Models140
Task Models141
Intervening in Grief and Mourning144
The debate over what works.144
Complex Grief or Complicated Grief Disorder as an intervention target146
The “New Wave” of Grief Interventions147
The Process of Change in Grief Intervention147
Being there with most grieving people.149
The Dual Process Model.151
Making Meaning of Loss and Growing Beyond155
Meaning making.155
Posttraumatic Growth156
Revisiting the Chapter’s Initial Cases157
Recycling With Grief Intervention163
Chapter Eight165
Intimate Partner Violence as an Endemic Crisis165
Defining the Problem and its Scope167
Definitions:167
Incidence167
Barriers to Change.170
Changing the Cultural Context173
Changing Laws174
The shelter movement175
The Duluth Model and its impacts.177
General Reversals yet Inconclusive Results178
The Client and Practitioner Spheres179
“Battered Woman’s Syndrome” as a potential Generic Pattern180
The Power and Control Wheel183
Victim/Survivor Interventions184
Women’s Groups184
Social Advocacy.184
CBT185
Perpetrator Intervention186
Batterer’s Groups187
The ACTV approach189
Research on ACTV192
Reprising the Process of Change at Tipping Points Individually192
Chapter Nine198
Rape as an Endemic Crisis200
Attractors and tipping points.201
MeToo:201
Defining Sexual Assault and Rape203
Definitions203
Incidence:204
Vast Underreporting204
Barriers206
Interventions in Sexual Assault207
Changing the Cultural Context208
The Violence Against Women Act (VAWA) of 1994208
Culture Wars209
The advent of Rape Crisis Centers210
International Women’s Day and Take Back the Night212
The advent of SANE Nurses213
Video and Online Options.216
The Uphill Battle to change the cultural context sphere.217
Intervention with bystanders217
RAINN219
The Client and Practitioner Spheres220
“Rape Crisis Syndrome” as a potential Generic Pattern221
Effective Interventions with Sexual Assault Survivors224
Most common response patterns.224
Second-order change.225
Broad-based effectiveness226
Post-traumatic growth from sexual assault227
Chapter Ten231
Following the Thread235
Trauma.235
Suicide as a potential Incidental Crisis236
Grief and Mourning as a Developmental Crisis236
Intimate Partner Violence as an Endemic Crisis237
Sexual Assault as another Endemic Crisis238
Convergence239
Conclusions and Directions240
Endings and Beginnings241
REFERENCES243
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