Journal of Clinical Psychology

Initially, treatment should address the most severe reaction, permitting clinicians to address salient needs in a manner appropriate to the severity of the reactions. As the severity of the reaction varies throughout the crisis event and treatment, clinicians should adjust the treatment to meet clients’ needs. By totaling the severity scales, crisis workers can also judge how intense and directive the treatment should be: the higher the score, the more direct the intervention. Generally speaking, low scores (3–12) indicate a recom- mendation for no treatment or a nondirective approach. Clients whose total on the sever- ity scales is in this range may simply need a sounding board to resolve the crisis. Clients whose total on the severity scales is in the middle range (13–23) need clinicians to part- ner with them to help resolve the crisis. This approach is more collaborative, requiring clinicians to be more active. When clients’ total score on the severity scales is high (24–30), a direct approach is needed. Clients in this range are vulnerable and need a support system. Clinicians will be extremely active and engage in active problem solving with clients. If any severity scale score is 10, hospitalization is strongly recommended.

Case 1

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The case of Ann involves a crisis in which she was coping with her apartment’s being burglarized. Ann was referred to the clinician by a friend, Gail, who was worried that she might need help in dealing with the burglary. Because our article concerns assessment, we report on the first 15 minutes of the interview. The setting is an urban agency that helps people who have been victims of a crime.