Working with Families in Crisis

Written by Lindsey Moss, LCSWA, Mecklenburg County CDSA

Being an early intervention provider allows us the unique opportunity of working with children and families in their most natural environment.  Through this approach, we are able to build close relationships with families, which ultimately helps us provide the most appropriate support and intervention.  While building these relationships, we get to know each family member on a personal level and become involved in many family dynamics.  By entering a family’s home, we quickly transition from being a stranger to being a familiar team member. Families open their homes and their hearts to us in an effort to ensure that their children’s needs are being met in the best way possible.  Most of the time, families are eager for us to share in positive life experiences, including welcoming a new baby, acquiring a new job, and celebrating when their child has met a developmental milestone.  However, there are times when family members look to us as a support during times of crisis.  They view us as part of their team and rely on us for additional support during difficult times.  Working with families in crisis is very difficult because most of us do not have the expertise or training to adequately address specific crises.  However, as a team member and resource for the family, there are ways that any of us can assist the family during their time of need.  Here are some tips to keep in mind…..

• Meet the family where they are.  It is imperative that families feel heard and supported.  We enter homes with a focus on the IFSP outcomes and routines.  Although the family has identified a need for our services and are routinely involved in our sessions, on some days, they may be less likely to participate due to their current situation. During these times, it is important to acknowledge what the family is going through.  We can offer support by simply stating “This is difficult” or “I realize you are very overwhelmed.” 
• Be an active listener.  Put other things aside and focus your attention on the family and their current needs.  Show that you are listening by nodding your head and verbally validating their concerns.  Provide feedback to let the family know that you heard them.  Being an active listener does not always mean offering a solution.  Remember that every person responds to differently to life stressors, and offer any solutions you may have in a respectful way, being mindful of your personal biases.
• Develop a plan.  After listening to the family and understanding the crisis situation, assist the family in determining next steps.  Encourage the family to seek out natural supports through their family, friends, church members, or coworkers.  Determine if there is someone involved with the family already that may be most appropriate to address the crisis (i.e. Family Counselor or social worker), and assist the family in connecting to this support.  If appropriate, encourage the family to speak with their service coordinator, as well as other IFSP team members, to see if any additional support services may be beneficial.  In the event that the crisis is creating an unsafe environment for the children in the home, contact your local Child Protective Service agency to communicate your concerns.  If necessary, provide a list of local mental health agencies to assist the parent or caregiver in meeting his/her individual needs.
• Follow up.  After leaving the family’s home, check in with them before the next visit.  This will again help the family feel validated, and it will also let you know if the family continues to be in crisis so you can assist in planning for upcoming visits.  You may need to contact other members of the IFSP team to discuss additional ways to address the family’s needs – service coordinators can continue to follow up with the family as part of their regular support to the family.  During your next appointment with the family, spend a few minutes checking in about how they dealt with the crisis so that you can become familiar with how each family copes with stressors and better assist them with problem-solving in the future.
• Take care of yourself.  Working with families in crisis is a challenge.  It is important for us to be in the moment with families; however, this can cause a great deal of job-related stress, which can ultimately result in burn-out.  To prevent burn-out, we need to develop self-awareness about our own personal needs as it relates to dealing with stress.  Remember, before we can begin to take care of others, we have to first take care of ourselves.  Some helpful ways of dealing with work related stress include:

• Talking through difficult cases with coworkers and support staff;
• Setting work-related boundaries, such as having a start and stop time for each day and limiting responses to emails and phone calls after work hours;
• Taking time for yourself by exercising, relaxing, or reading a book (not about early intervention); and
• Allowing yourself to take time off from work, because everyone needs a vacation, even it if is just for a day and is spent at home.

No matter our role with the family, most likely all of us have worked with a family in crisis.  Please remember that there are always resources available through the service coordinator or other IFSP team members when faced with a challenge.  What are some other ways that you have addressed similar situations?  (Please remember, keep it functional, confidential, and constructive…)