Crisis intervention services in Slovakia According to Act no. 448 from 2008 on social services, a social service is a professional activity, a service activity or another activity or a set of these activities, which are aimed in the case of crisis intervention at solving the crisis social situation of a natural person and family.

According to Act no. 485 from 2013, amending Act no. 448/2008 Coll. on social services, an unfavorable social situation according to this law is a threat to a physical person by social exclusion or a limitation of his ability to integrate socially and solve his problems independently: a) due to the fact that he does not have the necessary conditions to satisfy basic life needs, b) for their lifestyle or way of life, c) for a severe disability or adverse health condition, for one's lifestyle, way of life, addiction to addictive substances or addictive harmful activities,". It further regulates and supplements Act No. 485/2013 for jeopardizing her development due to her disability, if it is a child under seven years of age," : d) due to the fact that she has reached the age necessary to be entitled to an old-age pension according to a special regulation e) for the performance of care of a physical person with a severe disability, f) for endangering the behavior of other natural persons or g) because she has become a victim of human trafficking or, if she has become a victim of the behavior of other natural persons, this means domestic violence, gender-based violence or a violent crime. For remaining in a spatially segregated location with the presence of concentrated and generationally reproduced poverty." According to this law, a social crisis situation is a threat to the life or health of a natural person and family that requires an immediate solution by the social service. Social service is performed mainly through social work, with procedures corresponding to the knowledge of social sciences and knowledge of the state and development of the provision of social services.

Crisis intervention social services are provided to solve the unfavorable social situation of a natural person. Social crisis intervention services can have a low-threshold character. Social crisis intervention services are: 1. field social crisis intervention service, 2. provision of social services in facilities, which are: 2.1. low-threshold day center, 2.2. integration center, 2.3. community center, 2.4. dormitory, 2.5. shelter, 2.6. halfway house 2.7. emergency housing facility, 3. low-threshold social service for children and family,

A social service that is of a low-threshold nature is considered a social service that is easily accessible for a natural person, especially considering the place where the natural person is staying and the amount of payment for the social service. The social service is provided anonymously without proving the identity of this physical person with an identity document and regardless of the manifestations of the consumption of an addictive substance. The goal of a low-threshold social service is to make it easier for a physical person to contact the social environment, access social services or support and assistance provided according to special regulations, and thereby support their integration into society.

The field social service of crisis intervention is provided to a natural person in an unfavorable social situation and its content includes activities aimed at searching for such natural persons, professional activities, service activities and other activities aimed mainly at carrying out preventive activities, providing social counseling, social rehabilitation, assistance in exercising rights and interests protected by law, and creating conditions for the distribution of food or food.

The most serious manifestations characterizing the crisis: An acute crisis comes suddenly, with an ominous character, is associated with loss of life or injuries, requires matching the relevance of values and goals, creates fear and helplessness that require quick decision-making.

  • Every crisis brings with it destabilization, both psychologically and socially.
  • The crisis brings with it increased susceptibility, which can cause changes in behavior (e.g. passivity sometimes requiring hospitalization, refusal of school), which require stabilization.
  • In the phase of small labile causes, for example, a word that leads to aggression and which can have unpredictable consequences for the future can have a big impact. (Grundlagen der Krisenintervention: Einführung und Anleitung für helfende Berufe, 1997)

Crisis intervention theory and other approaches to aid

One of the strengths of crisis intervention theory is that it can be easily combined with other approaches to aid. For example, with regard to: Counseling - due to the time-limited nature of the crisis, it is unlikely that long-term counseling would be appropriate. However, in a time of crisis, short-term intensive counseling can prove very beneficial, as a person in crisis is much more likely to openly make the necessary changes in their life than they would be when they have settled into the relative safety of homeostasis. Cognitive Behavioral Work - the basis of this approach is the idea that behavior needs to be changed for some reason (because it causes problems or anxiety), then the underlying belief that leads to the behavior that needs to be changed. In times of crisis, there is likely to be a stronger determination to change core beliefs, a greater motivation to try new ideas or approaches to situations. Tasks focused on practice - this means establishing where you are now, where you want to be, and what steps need to be taken to transition from (problematic, unacceptable situation) to (less problematic, acceptable state). These steps are then built in terms of the tasks to be achieved. A lot depends on motivation, and in times of crisis, the motivation to bring change will probably be higher than at other times. Solution Focused Approaches - focuses on strengths, and in particular identifying and establishing a situation where the problem is not covered by the question (for example, if someone has panic attacks, what are the situations when he or she does not panic? How can the lessons from this then be applied to the situation when the panic occurs?). This is very consistent with the emphasis on positive potential in crisis intervention. Lawyer - people in crisis are of course trying to cope. In such cases, it can be difficult to stand up for your rights and to prevent abuse or injustice. They may therefore need the support of a lawyer to help them get through this difficult time. An advocacy plan based on the principle of crisis intervention is likely to act directly as an advocate at the beginning, but then to support the affected person to develop self-advocacy so that they are able to use the positive potential of the crisis, learn new skills and develop new personal resources. Here we could add mediation services as an out-of-court dispute resolution. Group work - refers to crisis work in limited time and it can be difficult to coordinate participants to work in a group. However, if possible, it can be very useful and motivating, as the person concerned can use the support of the group as an emotional and practical resource, as well as developing new ways of coping.

Crisis intervention represents an acute professional intervention by a helping professional with a client who has found himself in a crisis and is unable to adequately solve his problematic situation. The goal is to eliminate threats and create strategic forms of assistance that eliminate threats to the client and his surroundings, create space for client activation and stabilization, and restore internal balance. In crisis intervention, the first step is the provision of immediate assistance, which includes emotional support, socio-legal assistance and the provision of social strategic networks to meet the needs of the client and his current crisis situation.

Everly & Mitchell (1999 In. George W. Doherty, 2007) define crisis intervention as 'providing psychological care to victims in distress, assisting these victims in returning to an adaptive level of functioning to prevent the potential for negative affect and psychological trauma.'

A person in a crisis situation should first of all use his potential and therefore the path of self-help in solving a stressful situation. It is followed by help from the surroundings, i.e. the narrower and wider social environment. He uses social support within his social environment. When it is not possible to manage the given situation on one's own, the help of a social worker, or another professional or a layperson, comes in as part of helping to manage the crisis situation.

Thus, crisis intervention begins, the basis of which is managing the state of the crisis situation using available strategic procedures (ventilation of emotions, calming down) and setting goals. After mastering them, help and guidance of the client to self-help and self-actualization is needed again.

As part of the configuration of goals in the process of crisis intervention - that is, the solution here and now - it is important, after the immediate elimination of the threat to the client's life and the provision of basic needs - on the basis of the already acquired knowledge about the issue, to characterize the goals together with the client and harmonize them together (if the client is physically and psychologically able) to the overall, i.e., the main goal and sub-goals, which need to be solved immediately and subsequently as part of solving the problem. Occurs:

  • The independent work of a social worker, whose task is to map the available strategic options for solving the given problem, clarifying the individual possibilities of the client and his closer social environment, which can be helpful to him.
  • Construct the possibilities of the social and organizational structure of the region for solving the problem and map the social network
  • Analyze knowledge about the given problem, which is dealt with based on professional, casuistry and information possibilities

Intervention in crisis intervention is always short-term and involves the creation of specific goals within specific behavior that can only be created in a short time horizon, without pre-planned procedures.

Intervention

In traumatic crises, the goal of the intervention is primarily to reduce the patient's psychophysiological tension or stress level. Even if internal or external threats no longer exist, the patient should subsequently be advised to undergo psychotherapeutic treatment to manage the crisis event.

Figure: 4 Stages of Cullberg's Traumatic Crisis Model

Therefore, crisis intervention is a time-limited intervention, with a specific therapeutic approach aimed at the immediate stabilization of the patient: the patient should be emotionally relieved and his activity and decision-making abilities restored. In principle, crisis intervention should meet the following requirements:

  • faster start,
  • intervention time limit,
  • ensuring safety for patients and the environment,
  • to create rapid interdisciplinary cooperation (psychotherapist, doctor, emergency personnel, police) in the case of self-harm and harm to others,
  • adjust the treatment focus to the current crisis trigger of the situation and/or crisis trigger,
  • with the aim of quick relief in connection with the crisis of psychosocial suffering conditions,
  • use of the patient's resources and his social environment,
  • a flexible therapeutic attitude, from listening to directive conversation or active negotiation, depending on the patients' condition,
  • transparent, comprehensible and unambiguous therapeutic approach with clear communication. (D'Amelio R., Archonti C., Falkai P., Pajonk F., 2006)

The provider of crisis intervention social services must obtain authorization to provide these services according to a special law and must be registered in the register of providers. Professional crisis intervention activities are carried out by: Field social worker, village social worker, social curator, social counselor, social therapist, social assistant, psychologist. For illustration, we also present forms of crisis intervention:

Tab.: Forms of crisis intervention (Kozoň et al., p. 353, 2013) Outpatient assistance – is provided to clients who personally come to the counseling office (or outpatient clinic) of certain institutions primarily intended to provide assistance to people in crisis (e.g. crisis center outpatient clinics), or institutions whose competence is secondary to providing crisis intervention (e.g. outpatient clinics of psychotherapy workplaces, clinical psychologist offices, psychiatric offices, family counseling centers, etc.). Clients can seek outpatient help based on their own discretion, but they are usually "directed" by other facilities - helplines, workers from health or social institutions, the police, etc. Hospitalization – is the short-term placement of a client in crisis in the so-called A "crisis" bed is best in institutions designated for this purpose, i.e. in a crisis center. Hospitalization occurs if the client's condition is such that it does not allow him to stay at home and provide other forms of assistance. Field and mobile services – consist in the transfer of the crisis intervention process (and thus also the relocation of the crisis mobile team or crisis intervention) to the place where the individual (or individuals) is in crisis (it can be a school, home, hospital, street or place where a disaster or accident occurred). Telephone assistance – offers clients in crisis support and help via telephone. It is usually provided by trust lines. Helplines can be narrowly specialized for a group of clients (Gay helpline, helpline for children and youth) or for a specific problem (Helpline AIDS, DINGIR helpline for sects, contraceptive line Cilestína) or they can provide services to a wide range of callers. Internet help - is implemented through a relatively new medium - the Internet. Due to the ever-growing number of Internet users and the great communication possibilities of this media, we can assume a growing interest in this form of help (Špatenková et al., 2004).

The goals of crisis intervention are:

  • providing comprehensive counseling (social, psychological, legal and economic),
  • provision of social assistance and social services (crisis intervention, social assistance, telephone line, individual approach, prevention...),
  • eliminating violence and its negative consequences in society,
  • protection of human and civil rights and legally protected interests of clients of all age categories,
  • prevention of socio-pathological phenomena, prevention of deepening of the negative consequences of the crisis,
  • cooperation with police forces, state offices and non-state organizations and associations,
  • publication and distribution of information materials for the general public regarding the mission and content of the work of individual crisis centers

Provided crisis intervention services

  • crisis intervention,
  • social and legal advice,
  • operation of the crisis telephone line,
  • support groups,
  • internet consultation,
  • different types of therapy,
  • social diagnosis,
  • social assistance,
  • distribution of clientele to competent experts, preventive activities,
  • mediation of legal, psychological and pedagogical services,
  • help to manage the crisis, crisis intervention and help in crisis situations,
  • psychological care: psychodiagnosis, crisis intervention and help in a state of psychological crisis, provision of individual and group intervention and psychotherapy, psychological help, methodical help, processing complex reports at the request of authorities and courts.
  • ensures material conditions for satisfying basic life needs either directly or indirectly.

Conclusion

In accordance with the legislation of the Slovak Republic, in accordance with the current legal status, crisis intervention in the existing system of social assistance in Slovakia fulfills two main tasks - to solve the acute crisis situation of an individual of a group or community, in the framework of securing not only their needs, but also to inform them about the claims that arise from the legal norms governing the system of social protection, the provision of social services and social prevention, social assistance benefits, and to help citizens in material and, above all, in social need.

Author: PhDr. Soňa Šrobárová, PhD. List of bibliographic references

GEORGE W. DOHERTY : Crisis intervention training for disaster workers, Rocky Mountain DMH Institute Press; 1st edition, 2007, p.288, ISBN-10: 1932690425 , ISBN-13: 978-1932690422 D'AMELIO R., ARCHONTI C., FALKAI P., PAJONK F. Psychologische Konzepte und Möglichkeit der Krisenintervention in der Notfallmedizin. In Notfall Rettungsmedizin. [online]. 2006. year 2, no. 9, p. 194-204. [cit. 2013-10-18]. Available online: . ISSN 1436-0578. ŠPATENKOVÁ, Naděžda et al. Crisis intervention for practice. Ed. 1. Prague: Grada, 2004, 200 p. Psyche (Grada). ISBN 80-247-0586-9. Grundlagen der Krisenintervention: Einführung und Anleitung für helfende Berufe/Basics of crisis intervention An introduction and guide for the helping professions. Freiburg im Breisgau : Lambertus-Verlag 1977. 245 S. : 13 graph. Darst. ; 21 cm Brochure; ISBN: 3784101526 (EAN: 9783784101521 / 978-3784101521) NEIL THOMPSON: Crisis intervention, Publisher - Russell House Publishing Limited, p. 128, ISBN-10,1905541678, ISBN-13,9781905541676 ACT NR SR No. 448/2008 Coll. SR of October 30, 2008 on social services and on amendments to Act no. 455/1991 Coll. on trade entrepreneurship (Trade Act) as amended BAŠTECKÁ, Bohumila et al. Field crisis work: psychosocial intervention teams. Ed. 1. Prague: Grada Publishing, 2005, 300 p. ISBN 80-247-0708-X. KOZOŇ, Antonín et al. Ethical issues of socialization: social work and related scientific disciplines. Trenčín: Faculty of Social Studies of the University of Sládkovičov, Jan Amos Comenius University, Prague, University of Health and Social Work St. Alžbety, Bratislava, Karlovy Vary University, Society for Social Integration in the SR, Trenčín, 2013, 474 p. ISBN 978-80-89533-10-7.