Using the Triage Assessment Form
Jordan is a married female that is in fear of not just her safety, but her husband Jake’s as well. The night before he leaves their home, they had engaged in an altercation about his alcohol consumption. The next day, he leaves with a gun and Jordan discloses that she is fearful of what he will do next.
Triage Assessment of the Client
The learner first looked at where Jordan scored on the affective domain. She rated Jordan number 1 under anxiety/fear, and rated her number 2 under anger/hostility. In the case study, Jordan acknowledges that she is terrified for her safety and Jake’s as well. The reason that the learner rated Jordan 2 under anger/hostility was because she displayed agitation during the session. Then, the learner rated Jordan’s affect as a 7 under moderate impairment in the affective severity scale. James and Gilliland (2013) advise that we need to beware of the client’s body language and verbal cues that they are projecting” (James & Gilliland, 2013). Jordan’s body language would have shown her fear, even if she had not verbally expressed that to the counselor. Moderate impairment was selected because Jordan’s affect was impaired. She was visibly frustrated that her physical need for safety had not been met.
In the behavioral domain, the author rated Jordan as number 2 in avoidance and number 1 in immobility. Jordan displayed avoidance by taking no action in the situation. She refused to call the police and appears to avoid dealing with the situation. In this case, Jordan might display avoidance because she is unable to act and is immobile in that moment. Blodgett, Behan, Erp, Harrington, & Souers (2008) declares, “Intimate violence is now recognized as a long-term mental health, life adjustment, and physical health risk for both adults and children” (p.74). On the behavioral severity scale, the learner had a difficult time making an accurate assessment. She rated Jordan as a 5 under minimal/low impairment because her behavior of looking at the doorway is not effective, but she is not behaving in a manner that is harmful to herself or others. However, she is impaired to the point where she is immobile and unable to respond to handling the situation.
In the cognitive domain, she assessed that Jordan’s physical needs for safety are not being met. Psychologically, Jordan is unable to feel safe in her own home. Socially, she has at least 1 close friend who brought her in so she could receive services. On the moral spectrum, Jordan disliked Jake’s drinking because he acts aggressive and violent. The learner rated Jordan at 10 on the severe impairment scale because Jordan cannot focus on anything outside of the crisis, and is unable to make decisions regarding the crisis. She displays confusion at handling Jake’s mood swings and the situation as a whole. When the learner added up all of the scores, Jordan received 22 as her complete score.
Diagnostic Skills and Techniques
Myer & Conte (2006) acknowledges, “Assessment of a crisis begins by identifying the crisis” (p.964). In this case, the immediate crisis is getting Jordan into a physically safe environment. Then, the counselor can provide resources about substance abuse and domestic violence. An important skill that should be used in any crisis situation is providing support (James, 2013). In Jordan’s case, it is important to show empathy and a willingness to help work through the crisis with her. A possible solution would be to try to explore if Jordan could live at her friend’s place until the crisis calms down. Another technique that might help Jordan is to help her develop new coping skills to help her work through the crisis. Kanel (2012) suggests collaborating with the client to develop a plan because they are more likely to follow a plan that they had input in (Kanel, 2012).
The learner would use the hybrid model in Jordan’s case. James (2013) emphasizes “Initiating contact, defining the crisis, provide support, assess safety, examine alternatives, and reestablish control” (p.52-56). All of those steps would help Jordan resolve the immediate crisis and prepare her to make other decisions about her marriage afterwards.
In Jordan’s situation, she has displayed normal crisis characteristics such as displaying fear and remaining in an immobile state. Developmentally, it would also be appropriate for Jordan to be scared of Jake’s behaviors and drinking. However, life-span development would dictate that Jordan’s marriage is distressed due to negative communication between them and it is a sign that their relationship is in a crisis (Newman & Newman, 2015).
It is crucial that culturally appropriate interventions are used whenever possible. When a client experiences oppression, poverty, and substandard education, it increases the likelihood of them having continuous stress that could be a factor in a crisis (Sullivan, Harris, Collado, & Chen, 2006). The case study does not list their race or religious beliefs, but knowing those could help the clinician with appropriate treatment. If Jordan was African-American, then the clinician might explore the role that spirituality plays in her life. After ensuring her physical safety, maybe Jordan is given spiritual resources, such as a referral to a Christian counselor. If her husband’s drinking stemmed from possible economic difficulties then resources for employment and affordable housing might be appropriate. The key is to understand the cultural factors that might influence a crisis.
In conclusion, the learner got to practice filling out a triage assessment form, and applies the results to Jordan’s case study. She explained her rationale in her assessment and reflected on why Jordan received certain scores. This assignment helped the learner to practice what she learned about assessment, and attempt to apply culturally sensitive techniques.
Blodgett, C., & Behan, K., & Erp, M., & Harrington, R., & Souers, K. (2008). Crisis intervention for children and caregivers exposed to intimate partner violence. Best Practices in Mental Health. Retrieved from: Capella Library.
Kanel, K. (2012). A guide to crisis intervention (4th ed). Belmont, CA: Brooks/Cole.
Sullivan, M., Harris, E., Collado, C., & Chen, T. (2006). Noways tired: Perspectives of clinicians of color on culturally competent crisis intervention. Journal of Clinical Psychology. Retrieved from: Capella Library.