Our ASWB exam content outline tour now stops here: Methods to develop, review, and implement crisis plans. Let's dig in and then try a practice question on the topic.
Crisis plans are essential for preventing harm, stabilizing crises, and ensuring coordinated responses for individuals experiencing acute distress. The process includes developing a plan, reviewing it regularly, and implementing it effectively when needed. Below is a structured approach.
Developing a Crisis Plan
A crisis plan should be individualized, proactive, and collaborative, involving the client, family, and professionals.
Key Steps:
Assess Risk Factors & Triggers
- Identify potential triggers such as trauma reminders or relationship conflicts.
- Assess suicidal or homicidal ideation, self-harm risks, or escalating behaviors.
- Consider medical conditions, substance use, and environmental stressors.
Define Early Warning Signs
- Document changes in behavior, mood, or thoughts that indicate distress.
- Examples include withdrawing from others, increased agitation, impulsivity, or sleep disturbances.
Establish Coping Strategies & Self-Help Techniques
- Identify healthy coping mechanisms such as grounding exercises or breathing techniques.
- Encourage self-soothing activities like journaling or calling a trusted friend.
- Promote mindfulness, cognitive restructuring, or relaxation techniques.
Identify Support Systems & Resources
- List trusted individuals such as family, friends, therapists, or crisis hotlines.
- Include community resources such as mental health centers or emergency contacts.
- Provide hospitalization options if needed.
Clarify Roles & Responsibilities
- Define who does what in a crisis, including caregiver responsibilities and emergency contacts.
- Ensure everyone involved understands their role.
Create a Written Action Plan
- Outline a step-by-step response for different levels of crisis, from mild to severe.
- Include safety measures such as removing access to lethal means.
- Ensure the plan is easily accessible to all involved parties.
Reviewing a Crisis Plan
A crisis plan should be a living document, regularly updated to reflect changing needs, progress, or new risk factors.
Review Frequency:
Scheduled Reviews
- Every three to six months in outpatient settings.
- At discharge or transition points in residential or inpatient settings.
After a Crisis Episode
- Evaluate what worked, what didn’t, and what needs adjustment.
When Risk Factors Change
- Update the plan if there are changes in medications, diagnoses, stressors, or social supports.
Key Considerations:
- Does the plan still align with the client’s needs?
- Are coping skills and supports still effective?
- Do emergency contacts remain accurate?
- Has the client experienced changes in mental health symptoms?
Implementing a Crisis Plan
Effective implementation ensures timely intervention and coordination during a crisis.
Key Implementation Strategies:
Train Involved Parties
- Educate clients, families, and professionals on when and how to use the plan.
- Conduct role-play or simulations for emergency responses.
Follow the Step-by-Step Response Plan
- Use early interventions to prevent escalation.
- Engage coping strategies such as de-escalation techniques.
- If symptoms worsen, activate emergency support.
Coordinate with Crisis Services
- Utilize hotlines, mobile crisis teams, or emergency responders if needed.
- Ensure hospitalizations follow the least restrictive model.
Document the Crisis Event & Response
- Record what happened, actions taken, and outcomes.
- Update the crisis plan as needed based on lessons learned.
Takeaways
- Development: Identify risks, define warning signs, establish coping strategies, and create a step-by-step plan.
- Review: Update regularly, especially after crises or life changes.
- Implementation: Train all involved, follow the plan step by step, and coordinate with crisis services.
On the Exam
A question on the ASWB exam based upon this material might look like this:
A social worker is helping a client develop a crisis plan after a recent hospitalization for suicidal ideation. The client has a history of major depressive disorder and self-harm but is currently stable. The client is willing to engage in safety planning. What should the social worker do FIRST when developing the crisis plan?
A. Identify the client’s warning signs and triggers for distress
B. Provide the client with a list of emergency resources and hotlines
C. Discuss inpatient hospitalization as a primary crisis response
D. Encourage the client to engage in mindfulness practices daily
Know how you'd answer?
A crisis plan should start with understanding the client’s personal warning signs and triggers for distress to prevent escalation (A). Providing resources (B) is important but should come after the plan is personalized. Hospitalization (C) is a last-resort option, not the first step in crisis planning. Mindfulness (D) can be part of coping strategies but is not the first step in creating a plan.
Get lots and lots more practice with Social Work Test Prep's full-length practice tests.
