Crisis intervention: A review of outcome research.

Abstract

Crisis intervention studies conducted in suicide prevention/crisis intervention programs, in psychiatric settings, and with surgical patients are critically evaluated. In the first area the impracticality of suicide as an outcome measure and the need for shifting evaluation emphasis from crisis worker performance to client behavior change measures is stressed. Also, the virtual impossibility of demonstrating overall program impact on the community and the need for developing internal program evaluation procedures is noted. Studies in psychiatric settings suffer from considerable methodological shortcomings that prohibit definitive conclusions; studies operationally specifying treatment components are greatly needed here. Studies with surgery patients indicate the necessity for developing intervention techniques most appropriate for individuals differing in their typical manner of dealing with stress. In all settings, outcome measures should be appropriate to the situation and logically related to the goals of intervention. In the two decades following Eysenck's (1952) classic survey calling into question the effectiveness of the traditional psychotherapies, the growth in output of research studies of therapeutic process and outcome has been phenomenal (Bergin, 1971; Marsden, 1971). However, crisis intervention, a therapeutic technique that is receiving increasing use, as indicated by the recent proliferation of suicide prevention/crisis intervention centers and telephone hot lines, has gone largely uninvestigated until recent years. This is probably due to the fact that as a clinical technique it does not fall under the rubric of traditional psychotherapy, and since initial attempts at formulations of crisis theory and delineation of technique have not been developed until recently (Aguilera & Messick, 1974; Caplan, 1964; Lieb, Lipsitch, & Slaby, 1973; McGee, 1974; Schulberg & Sheldon, 1968; Taplin, 1971).