Cover image for People in crisis : clinical and public health perspectives
People in crisis : clinical and public health perspectives
Hoff, Lee Ann.
Personal Author:
Fifth edition.
Publication Information:
San Francisco : Jossey-Bass, [2001]

Physical Description:
xxiv, 489 pages : illustrations ; 26 cm.
Format :


Call Number
Material Type
Home Location
Item Holds
RC480.6 .H64 2001 Adult Non-Fiction Central Closed Stacks

On Order



Written by a pioneer in the field of community mental health, this updated edition of a classic crisis counseling resource helps prepare health care professionals and volunteers to work with the most vulnerable members of society--victims of crime, the homeless, battered wives, victims of environmental threat, and immigrants. An ideal book for those in social work.

Author Notes

Lee Ann Hoff is the founding director of the Life Crisis Institute, and is professor at the University of Massachusetts Lowell, and adjunct professor at the University of Ottawa, Faculty of Health Sciences.

Table of Contents

List of Tables, Figures, and Exhibitsp. xv
Prefacep. xvii
The Authorp. xxiii
Part 1 The Understanding and Practice of Crisis Interventionp. 1
1. Crisis Theory and Practice: Introduction and Overviewp. 3
What Is Crisis and Crisis Intervention?p. 4
Views and Myths About People in Crisis and How to Help Themp. 5
The Evolution of Crisis Theory and Intervention Contextsp. 8
Freud and Psychoanalytic Theory
Ego Psychology
Military Psychiatry
Preventive Psychiatry and Public Health
Community Mental Health
Primary Health Care
Crisis Care and Psychiatric Stabilization
Crisis Care and Chronic Problems
Suicide Prevention and Other Specialized Crisis Services
Sociological Influences
Cross-Cultural and Diversity Influences
Feminist and Victimology Influences
Life Crises: A Psychosociocultural Perspectivep. 16
Crisis Care: Intersection with Other Therapeutic Modelsp. 17
Differentiating Approaches to Helping People in Distress
Preventing Crisis and Promoting Emotional Growth
Crisis Services in a Continuum Perspective
Basic Steps in Crisis Carep. 26
Standards for Crisis Servicesp. 29
Summaryp. 29
Referencesp. 29
2. Understanding People in Crisisp. 33
The Origins of Crisisp. 34
Situational Origins
Transition State Origins
Cultural and Social-Structural Origins
Interrelationships Between Crisis Origins and Development
Stress, Crisis, and Illnessp. 42
The Crisis-Psychiatric Illness Interfacep. 44
Development and Individual Manifestations of Crisisp. 47
Why People Go into Crisis
How a Crisis Develops
The Duration and Outcomes of Crisis
The Sociocultural Context of Personal Crisisp. 56
Social Change Strategies in Comprehensive Crisis Carep. 57
Strategies Based on Reason and Research
Strategies Based on Reeducation and Attitude Change
Power-Coercive Strategies
Summaryp. 60
Referencesp. 60
3. Indentifying People at Riskp. 63
The Importance of Crisis Assessmentp. 64
Impediments to Adequate Assessment
Hazards of Inadequate Assessment and Psychiatric Labeling
The Distinctiveness of Crisis Assessmentp. 71
The Assessment Processp. 73
Distinguishing Levels of Assessment
Identifying Origins and Phases of Crisis Development
Assessing Individual Crisis Manifestations
Family and Community Assessment
An Assessment Interviewp. 87
Comprehensive Crisis Assessment
Philosophy and Context of Record System
Genesis of Record System
Service Formsp. 92
Initial Contact Sheet
Assessment Worksheet
Summaryp. 100
Referencesp. 100
4. Helping People in Crisisp. 103
Communication and Rapport: The Immediate Context of Crisis Workp. 103
The Nature and Purpose of Communication
Factors Influencing Communication
Relationships, Communication, and Rapport
Planning with a Person or Family in Crisisp. 108
Assessment and Planning Linkage
Decision Counseling
Developing a Service Contractp. 112
Evaluating the Crisis Intervention Planp. 114
Working Through a Crisis: Intervention Strategiesp. 117
Loss, Change, and Grief Work
Other Intervention and Counseling Strategies
Psychotropic Drugs: What Place in Crisis Intervention?p. 124
Crisis Intervention Illustrationsp. 127
Crisis Care in an Emergency Setting
Crisis and Psychosocial Care in a Primary Care Setting
Summaryp. 130
Referencesp. 130
5. Family and Social Network Strategies During Crisisp. 133
Social Aspects of Human Growthp. 133
Families in Crisisp. 137
Communities in Crisisp. 141
Individual, Family, and Community Interactionp. 143
Privacy, Intimacy, Community
The Individual's Extension Beyond Self
Social Network Influences on the Individual
Social Network and Group Process in Crisis Interventionp. 146
A Social Network Framework
Social Network Strategies
Crisis Groups
Crisis Assessment in Groups
Suggested Procedure for Group Crisis Assessment
Crisis Counseling in Groups
Group Structure
Counseling Families in Crisis
Self-Help Groups
Summaryp. 162
Referencesp. 162
Part 2 Violence As Origin of and Response to Crisisp. 165
6. Suicide and Other Self-Destructive Behavior: Understanding and Assessmentp. 167
A Framework for Understanding Self-Destructive Behaviorp. 167
Perspectives, Myths, and Feelings About Self-Destructive Peoplep. 170
Social Perspective
Psychological Perspective
Cultural Perspective
Ethical Issues Regarding Suicidep. 175
Characteristics of Self-Destructive Peoplep. 181
Self-Destructiveness: What Does It Include?
The Path to Suicide
The Messages of Self-Destructive People
Ambivalence: Weighing Life and Death
Assessment of the Suicidal Personp. 188
The Importance of Assessing Suicide Risk
Signs That Help Assess Suicide Risk
Typology of Suicidal Behavior: Assessing Immediate and Long-Range Risk
Understanding and Assessing Risk in Special Populationsp. 203
Young People
Distinct Ethnic and Sexual Orientation Groups
People in Hospitals and Other Institutions
Summaryp. 206
Referencesp. 207
7. Helping Self-Destructive People and Survivors of Suicidep. 211
Comprehensive Service for Self-Destructive Peoplep. 211
Emergency Medical Treatment
Crisis Intervention
Follow-Up Service for Suicidal People
Intervention with Self-Destructive People: Case Examplesp. 219
The Right-to-Die Dilemma
Low-Risk Suicidal Behavior
Moderate-Risk Suicidal Behavior
High-Risk Suicidal Behavior
Suicide Prevention and Intervention with Special Populationsp. 222
Young People
Distinct Ethnic and Sexual Orientation Groups
People in Hospitals and Other Institutions
Helping Survivors in Crisisp. 227
Team Analysis Following a Suicide
Support and Crisis Intervention for Survivors
Helping Child Survivors of Parent Suicide
Additional Outreach to Survivors
Summaryp. 232
Referencesp. 232
8. The Crisis of Victimization by Violencep. 235
Theories on Violence and Victimizationp. 238
Victimization Assessment Strategiesp. 241
Child Abusep. 243
The Problem
Child Witnesses to Violence and Murder
Preventive Intervention
Legal and Crisis Intervention
Follow-Up Service
Rape and Sexual Assaultp. 251
Rape as the Spoils of War
Preventing Rape and Sexual Assault
Crisis Intervention
Follow-Up Service
Woman Batteringp. 259
Crisis Intervention
Follow-Up Service
Crisis Counseling with an Abused Womanp. 267
Session One
Session Two
Remaining Sessions
Possible Problems, Issues, and Barriers to Progress
Husband Beatingp. 272
Battering of Lesbian, Gay, Bisexual, and Transgendered Partnersp. 273
Abuse of Older Personsp. 274
Prevention, Crisis Intervention, and Follow-Up Service
Application of Intervention and Follow-Up Principles
Battering of Parents and Teachers by Childrenp. 279
Other Sources of Victimizationp. 280
Victim Assistance After a Crimep. 281
Summaryp. 282
Referencesp. 282
9. The Violent Person: Individual and Sociocultural Factorsp. 289
Aggression and Violence: A Contextual Versus Adversarial Approachp. 289
Violence Against Police Officers and Health, Mental Health, and Crisis Workersp. 291
Crisis Intervention Trainingp. 292
Assessing the Risk of Assault and Homicidep. 293
Police-Mental Health Collaboration
Application of Assault and Homicide Risk Assessment Criteria
The Medicalization of Crime and Violence in the Workplacep. 297
The Crisis of Youth Violencep. 300
Factors Contributing to Youth Violence
Crisis Prevention and Intervention Programs
Men Who Batter Womenp. 303
Views on Battering and Batterers
Programs for Violent Men
Crises of People Prosecuted for Violencep. 306
Crisis Intervention with Assailants and Those Threatening Violence
Follow-Up Service
The Families of Prisoners
Primary Prevention of Crime and Antisocial Behaviorp. 310
Personal and Social-Psychological Strategies
Sociopolitical Strategies
Professional Strategies
Summaryp. 312
Referencesp. 313
10. Violence and Crisis from Disasterp. 317
Human Potential for Catastrophic Violencep. 318
Natural and Accidental Disaster: Prevention and Aidp. 320
Technological and Political Factors Affecting Aid to Victims
Psychological and Other Factors
Preventive Intervention
Individual Responses to Disasterp. 328
Community Responses to Disasterp. 331
Factors Affecting Recovery of Survivors
Resources for Psychological Assistance
Help During Impact, Recoil, and Post-Trauma Phases
Crisis Intervention and Follow-Up Service
Disasters from Human Originsp. 337
Preventing Post-Traumatic Stress Disorders
Follow-Up and Prevention
Summaryp. 345
Referencesp. 345
Part 3 Crises Related to Situational and Transition Statesp. 349
11. Threats to Health Status and Self-Imagep. 351
Crisis Care in Primary Health Care Settingsp. 352
Hazards to Physical and Emotional Healthp. 353
Crisis Response of People in Health Status Transition
Preventive Intervention
People with AIDS: Personal, Community, and Global Perspectivesp. 364
Illustration of the Crisis Paradigm
Women and Children with AIDS
The Worried Well, Prevention, and HIV Testing
Caretakers of People with AIDS: Support and Self-Care
Crisis Intervention in Mental Institutions, Transitional Housing, and Hostelsp. 380
Physical and Mental Handicapp. 381
Initial Crisis Point
Successive Crisis Points
Substance Abuse and Other Chronic Health Problemsp. 385
Chronic Self-Destructive Behavior and Crisis Intervention
Influence of Societal Attitudes and the Crisis in Psychiatry
Rescue Workers, Nurses, Physicians, and Social Workers in Acute-Care Settingsp. 390
Summaryp. 391
Referencesp. 392
12. Threats to Occupational and Residential Securityp. 397
Occupational Changesp. 398
Promotion, Success, and Economic Security
Paid and Unpaid Work
Work Disruption
Rural and Urban Occupational Transitions
Residential Changesp. 407
Anticipated Moves
Unanticipated Moves
Helping the Migrant
Homelessness and Vulnerability to Violencep. 412
Summaryp. 415
Referencesp. 416
13. Stress and Change During Life Passagesp. 419
Rites of Passage: Traditional and Contemporaryp. 421
Birth and Parenthoodp. 427
Common Crisis Points for Parents
Divorce and Single Parenthood
Stepfamilies and Adoption
Lesbian and Gay Parenthood
Surrogate Parenthood
Fatherhood in Transition
Adolescence and Young Adulthoodp. 438
Developmental Challenges and Stress
Sexual-Identity Crisis
Helping Young People
Helping a Family in Crisis
Intimate Relationships: Beginnings and Endingsp. 445
Intimacy as a Basic Need
Excessive Dependence on Intimate Attachments
Singles, Isolation, and Divorce
Middle Agep. 449
Old Agep. 451
Attitudes Toward Seniors
Services for Elderly People
Institutional Placement of Elders
Deathp. 456
Attitudes Toward Death
Helping a Dying Person
The Hospice Movement
Summaryp. 462
Referencesp. 462
Name Indexp. 467
Subject Indexp. 475