Sally and Mike Have Experienced the Tragic Case Study

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Sally and Mike have experienced the tragic loss of their son. Their differential coping mechanisms are creating new conflict in the marital relationship. Sally reports morbid reflection and possible suicidal ideation. Mike has possibly reached a state of acceptance about their son's death, but he might also be stuck at the first stage of Kubler-Ross's model, which is denial. There are several layers of this crisis, but it is important to target issues in a straightforward way to keep the crisis intervention brief, as it is designed to be.

Crisis interventions using the ABC Model are designed to be brief and to the point. In the case of Sally and Mike, the ABC Model can be combined with the application of Kubler-Ross's Five Stages of Death and Dying. These five stages include Denial, Anger, Bargaining, Depression, and Acceptance. Reaching a point of acceptance is a treatment goal.

The ABC Model of Crisis Intervention entails first developing contact and building rapport. Active listening and the cultivation of empathy are the tools used to achieve this goal. Second, the therapist identifies the actual problem. It is a critical part of the crisis intervention process. It is important to stay focused, and find key cognitive clues for change. Finally, coping is the last phase of the ABC model. It is the coping phase, during which time client and counselor work together to create a maintenance plan.

Intervention strategies begin with the A in ABC: establishing rapport. While it is tempting for the therapist to rush through this phase to get to the root of the crisis in step B, not much will be achieved without first establishing trust and building empathy. In this case, the therapist establishes rapport with both Sally and Mike. Hopefully, Sally and Mike are able to reach a place of empathy for each other. The therapist can serve as a role model for empathy by developing rapport early in the dialogue. One of the cornerstones of step A is the use of specific and targeted communication strategies. Most of these strategies involve active listening, which means paraphrasing and checking in often with the clients. "Use of these basic rapport-building communication skills invites the client to talk, brings calm control to the situation, allows the client to talk about the facts of the situation and the counselor to hear and empathize with the client's feelings," (Text, p. 2). The therapist uses Step A to clarify the issues and prepare well for step B in the Model of Crisis Intervention.

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After listening intently to the needs of the clients in Step A, the therapist moves on to the heart of the matter: the crisis itself. The precipitating event has been established as the death of their son. Through a series of interview questions, the therapist uses a strategy to determine Sally's perceptions of the event. It is best to determine the perceptions of Sally and Mike separately to address the marital discord. The therapist will determine Mike's perceptions. Having the couple voice out their perceptions in a systematic way will help them recognize where the other person is coming from so that they can develop more respect for one another and realize their grieving processes are different.

If, as it is assumed, Mike is stuck at the Denial States, then Sally is easily tagged at the stage of depression. If this is so, the therapist can tacitly understand Sally may be more prepared to reach the final stage of the Kubler-Ross model: acceptance. If, though sounding out Mike's perceptions, it is determined that he genuinely does accept his child's death as being "part of life," then Sally can hear his grieving differently. He is not being insensitive about their son; but he is being insensitive about her needs to express her grief. As the text points out on page 12, it is necessary to decrease some of the subjective distress that is impacting both Mike and Sally at this critical stage. If increasing Sally's functioning is a core goal, then Sally can express her feelings in therapy in a safe manner. Sally has already expressed the meaning behind her son's death: it means that the natural order of life has been turned upside-down. It means that she has done something wrong as a mother. It means she has failed, and that she has nothing left to live for. As she reaches this stage, the therapist must check in for genuinely suicidal ideation. Sally can eventually be offered reframing techniques as a core component of the intervention. She may be able….....

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