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Crisis intervention

Adapted from: Chapter 7, "Assessment and Treatment Planning," in G. Martin et al. (eds.), Methadone Maintenance: A Counsellor's Guide to Treatment (© 2003 CAMH)


The primary goal of crisis intervention at the beginning of treatment, and throughout the treatment process, is to determine whether there are acute needs that have to be addressed immediately.

Often clients present in crisis at the time of their first contact. For example, if a client presents to treatment and is homeless and has not eaten in days, a critical first step will be to help the client secure food and shelter. Problems requiring immediate crisis management also include suicidal behaviour or serious psychological distress and medical emergencies.

Written protocols help to ensure that crises are managed effectively (e.g., written procedures for assessing and managing suicidal behaviour). Medical and psychiatric emergencies should be brought to the attention of the attending physician, and the client should be referred or, if necessary, accompanied to the closest hospital emergency department.

MMT counsellors should keep some specific items and information materials available on-site to assist clients in crisis. These include money, tickets or tokens for transportation, clothing (in particular, winter clothes), and brochures listing food banks, free meal programs, emergency health services and drop-in centres. Counsellors should also have a list of shelters to which they can readily refer. Because long-standing prejudicial attitudes toward methadone clients still prevail, methadone clients may face obstacles when trying to access shelters or other treatment services. It may be necessary to engage in educational and advocacy initiatives to help reduce the obstacles faced by these clients.