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The Hybrid Model of Crisis Intervention is an applied model, of which the first three steps are widely recognized as Psychological First Aid (James & Gilliland, 2013).

Can you please read the Case Study below. Consider that you are a crisis counselor at a local agency and Rita has come to a drop-in counseling session with you to talk about her concerns. How would the Hybrid Crisis Intervention Model be useful in thinking about Rita's presenting issues and the ways in which you would work with her during the first session? In addition, can you describe how you would use this model in working with Rita and give some specific examples to illustrate your ideas.

CASE STUDY: Rita is a 35-year-old African American businesswoman, who lives with her Latina partner, Aresha. She is a graduate of high school and a post-high school vocational-technical institute. She holds a certificate in auto mechanics. She has never been to a counselor before. She has come to you at the suggestion of a close friend who is a school counselor. Rita owns and operates an automobile tune-up and service shop. She employs and supervises a crew of mechanics, tune-up specialists, and helpers. She works very hard and keeps long hours but maintains some flexibility by employing a manager. Rita's partner Aresha is a college-educated accountant. They have two adopted children: a daughter who is 13, and a son who is 8. The family rarely attends church, and they do not consider themselves religious, but they are church members. Their close friends are neither from their church nor from their work. Rita's problem is complex. She constantly feels depressed and unfulfilled.

She craves attention but has difficulty getting it in appropriate ways. For diversion, she participates in a dance group that practices three nights a week and performs on many Friday and Saturday evenings. Rita, Aresha, and their children spend most Sundays at their lake cottage, which is an hour-long drive from their home. Their circle of friends is mainly their neighbors at the lake.

Rita's relationship with Aresha has been going downhill for several years. She has become sexually involved with Sam, a wealthy wholesaler of used automobiles. She met him through a business deal whereby she contracted to do the tune-up and service work on a large number of cars for Sam's company. Sam's contracts enable Rita's business to be very successful. Rita states that the "chemistry" between her and Sam is unique and electrifying. She says she and Sam are "head over heels in love with each other." While she still lives with Aresha, she no longer feels any love for her.

According to Rita, Sam is unhappily married, and Sam and his current wife have two small children. Rita states that she and Sam want to get married, but she does not want to subject her two children to a breakup right now. Sam fears his wife will "take him to the cleaners" if he leaves her for Rita right now. Lately, Sam has been providing Rita with expensive automobiles, clothing, jewelry, and trips out of town. Also, Sam has been greatly overpaying Rita's service contracts, making her business flourish. Aresha does not know the details of Rita's business dealings with Sam, but she is puzzled, jealous, frustrated, impulsive, and violent. Aresha used to slap Rita occasionally. Recently however, she has become more frustrated, impulsive, and violent. Aresha has beaten Rita several times in recent months. Last night she beat her worse than ever. Rita has no broken bones, but she has several bruises on her body, legs, and arms. The bruises do not show as long as she wears pantsuits.

Rita has told her problems only to her school counselor friend. She fears that her boyfriend would kill her partner if he found out about the beatings. Rita is frustrated because she cannot participate with the dance group until her bruises go away. Rita is feeling very guilty and depressed. She is not particularly suicidal, however. She is feeling a great deal of anger and hatred toward Aresha, and she suffers from very low self-esteem.

She is feeling stress and pressure from her children, from Aresha, and even from Sam, who wants to spend more and more time with her. Recently, Rita and Sam have been taking more and more risks in their meetings. Rita's depression is getting to the point where she does not care. She has come to you in a state of lethargy-almost in a state of emotional immobility. Rita has decided to share her entire story with you because she feels she is at her wit's end, and she would not dare talk with her minister, her physician, or other acquaintances. You and Rita have never met but she feels this is the best approach, even though she is uncomfortable sharing all of this with a stranger.

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Solution Summary

This solution describes the Hybrid Model as an applied Crisis model.

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The Hybrid Intervention

A hybrid approach to counseling consists of combining two components to address the problem in a general or crisis situation (e.g., Mikler, Venkatachalam, & Ramisetty-Mikler (2007). They conducted a study with persons who had schizophrenia in Japan utilizing a combined agent-based modeling and cellar automated paradigm. Specifically, they integrated a computational model involving spatio-temporal geography and populations demographics into a framework to identify risk groups in the population and points of control in areas to manage the crisis of epidemic diseases. In another hybrid example, researchers brought together the variables associated with Occupational therapy and community living to investigate relapses associated with psychotic diseases (Thomas, Fuller, Kennel, Nuboni, Liberman, & Shin-Ichi, 2000).

In any crisis situation, it is expected that in a time of urgent crisis and need, it is acknowledged that positive consequences are needed to help the person who is caught in a cycle of hopelessness to find some hope (McAdams & Keener, 2000). The Hybrid Model of Crisis omtervemtopm is made up of seven task-oriented goals that include: (1) predisposition, engaging, and initiating contact; (2) Problem exploration/defining the crisis; (3) [providing support; (4) examining alternatives; (5) pre-planning to reestablish control; (6) obtaining commitment; and (7) follow-up tasks (www.quizlec.com). Following is the application to the current case study.

Pre-dispositioning/Engaging/Initiating Contact

Based on the Hybrid Model of Crisis Intervention, the first task would be to predisposition, engage and initiate contact with the client. Therefore upon making the initial contact session with Rita, a part of the task would be to plan based in anticipation of her possible unwillingness to accept any responsibility for her problems. After gaining Rita's trust in the therapeutic relationship, and following the steps in the model, the therapist and the client should be engaged in a ...

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