Once the therapeutic contact with the client is successfully achieved and the crisis identified, together the nurse and client explore new coping methodologies, which may involve new ways of problem solving and decision-making. These processes can foster greater personal growth and mastery.

Encourage clients to consider alternative coping strategies. Trusting clients with their own ability to create solutions is imperative, as doing things to a person in crisis without his or her active participation can lead to failure (Hoff, 1995), and a lack of client commitment to the crisis resolution process.

The plan must be problem-oriented, focus on the immediate problems that directly contributed to the crisis, and reflect the client’s culture and functional level and personal commitment to the problem-solving process (Hoff, 1995).

Avoid probing in-depth personality patterns or underlying psychological problems. If the client is so anxious or incapable of thinking clearly or able to make a decision, the nurse assumes a more active role temporarily. According to Hoff (1995), the client at this point, is allowed to borrow some of the ego functions of the counselor until adequate cognitive/emotional abilities to problem- solve are restored.

If the client is highly emotional, allow sufficient time to express feelings. Provide the client with simple directions for action if the client’s behavior and thinking are very disturbed. This approach is based on the intrinsic belief in a person’s ability to help himself or herself once the acute crisis is over (Hoff, 1995). Nurses need to know when to let go of the control so the client can once again take charge of his/her life. Experienced, self-aware and self-confident nurses can more easily do this through a process of ongoing clinical supervision, as described by Rolfe (1990).

Mobilize client support networks to bolster renewed coping through referrals to appropriate community resources. Include significant others in the planning for a client, particularly if they are a future resource for the person. According to Hoff (1995), the plan should assess if the family or significant others are part of the problem or part of the solution. The nurse, in collaboration with the client (individual or family), may also suggest alternative options to assist with crisis resolution.

The plan must be realistic, time-limited, concrete and flexible. The client needs to know that specific actions will be occurring at agreed-upon times and places. This structure will allow for the ongoing changes in the client’s life, and will enhance hopefulness and coping.

Follow-up is an essential component of best practices in crisis intervention. It involves assessing whether clients’ coping strategies are effective, enhancing supports as needed, and evaluating the outcomes of crisis resolution. This follow-up is best planned and arranged by the professionals who help the client work through the crisis event.

Areas of consideration during the follow-up phase include:

• Did the client carry out the crisis plan, and what was the outcome?
• Does the client have a plan to work towards meeting, through alternative actions, his/her goals?
• Does the client require additional or alternative linkages to community resources and supports?