During his high-pressure career in advertising sales, Jay prided himself on his strength, resilience, and athleticism, largely taking his health for granted, despite a longstanding history of asthma-related limitations. However, after a debilitating and terrifying adulthood bout of pneumonia and several subsequent breathing-related medical emergencies, he began to experience what he calls panic attacks. In the shadow of the “media hype” around the pandemic and actual mold-related difficulties in his home, Jay’s capacity to work has become compromised, and he has developed an unrelenting preoccupation with his health alongside a gripping fear of having additional, uncontrollable panic attacks. Jay presents to Paladino on the heels of his most recent panic attack; he is frustrated, agitated, anxious, and desperate for relief.



From this front row seat to Paladino’s powerful work with this client, you will learn how to address your own crisis clients’ complex emotional and behavioral needs by:

• Forming quick, empathic connections
• Reframing negative thinking patterns
• Capitalizing on clients’ narratives and metaphors
• Focusing on resources and strengths
• Making plans in order to re-establish control
• Solidifying commitment to therapeutic plans
• Following up to ensure plans are working

Paladino grounds his clinical approach in the Hybrid Model of Crisis Intervention, developed by Richard James and Burl Gilliland. Consisting of seven tasks, this model provides a flexible template for working with clients in crisis, which you can adapt to meet the needs of your own clients. These seven tasks include:

Predispositioning and Engagement: Establish a connection with the client, clarify expectations and therapeutic intentions, and build a working alliance

Problem Exploration: Explore the client’s perception of the crisis, define the problem from the client’s point of view, and identify precipitating events across affective, behavioral, and cognitive domains

Providing Support: Identify past and present coping mechanisms (both effective and ineffective); communicate empathic concern while providing three levels of support: psychological (connection skills), logistical (resources and needs), and social (finding supportive friends and family members)

Examining Alternatives: Consider readily available support options, identify positive/constructive thinking patterns, and reframe problems to lessen anxiety

Planning to Re-establish Control: Identify resources for immediate support, solidify coping mechanisms, explore and address possible suicidal ideation, and co-develop a realistic and immediately actionable suicide prevention plan

Obtaining Commitment: Review the plan, revisit and solidify implementation, and get firm commitment from the client

Follow-up: Obtain verification of client’s stability and use of post-crisis resources, including referrals

So, whether you’re working remotely, in a counseling center, school or in the field at the scene of a crisis, you’ll be able to quickly adapt this highly flexible model to fit both your therapeutic style and your clients’ needs for immediate stabilization and access to resources and support.