Crisis Intervention in Psychotherapy

The process of change is a model for understanding crises in their context, engaging with all parties involved (e.g., client, friends, and family) using their values, culture, and language, honoring their goals, and shifting vicious cycles to move everyone forward. In Crisis Intervention in Psychotherapy, J. Scott Fraser, PhD, works with a suicidal client—portrayed by an actor—who is facing several personal conflicts, including job loss, separation from his wife, and an unsupportive family system. In contrast to traditional crisis intervention based on risk assessment and safety planning, Dr. Fraser’s approach views crises as time-limited windows of opportunity for clinicians to tip vicious cycles of problem maintenance in new and positive directions through often counterintuitive interventions. His approach to crisis intervention draws on systemic and social constructivist ideas to inform a process of finding and using such tipping points to effect lasting change. This is demonstrated in the video as the therapy session ends with the client reengaged in life rather than being hospitalized. This powerful demonstration is framed by an interview and discussion with Dr. Fraser, hosted by Michael Rohrbaugh, PhD.

Traditional crisis intervention focused on managing risks and restabilizing clients. While often helpful, it sometimes misses windows of opportunity to use crises as springboards for transformative change. The process of change alternative embraces high motivation for change in crises and builds on clients’ context, values, and goals to make rapid shifts in their problematic solution patterns. While each different crisis has its own characteristic trigger, all crises follow similar vicious cycle patterns. Based in systems and constructivist theory, the process of change model identifies those vicious cycles and redirects them in more virtuous cycle directions. It aims for shifts in the “viewing and/or doing” of those involved in crises by aligning with their distress and building new directions within their worldview and values to support growth and change rather than traditional restabilization. Risk is mitigated as new solution patterns and goals are achieved.

J. Scott Fraser, PhD, is a clinical psychologist with nearly 50 years of experience. Regarding crisis intervention, he served as director of a crisis/brief therapy department in a large urban hospital-based community mental health center for over 14 years. As such, his staff served as the “front door of the center” for all first-time contacts, responded to the emergency department 24/7 over 100 times per month, as well as responding with police to domestic violence calls on a regular basis.

Dr. Fraser served as a consultant to the American Red Cross nationally and locally, spearheading a regional collaborative disaster response protocol. In his role as professor, he has worked with the Community Stress Response Center in Qiryat Shemona, in far northern Israel directing research on disaster response and directing dissertations. Dr. Fraser also served as professor, director of internship training, director of training, and associate dean across a 25-year career in the School of Professional Psychology, at the Wright State University, in Dayton, Ohio. He regularly taught doctoral courses and labs in crisis intervention and brief therapy, receiving an outstanding teaching award from the doctoral students for his work. Over the years he has trained in these topics across the US, Europe, the Middle East, and Asia.

APA Books of Related Interest

Fraser, J. S. (2025). Crisis intervention: Using tipping points to achieve transformative change in therapy. American Psychological Association.

Fraser, J. S. (2018). Unifying effective psychotherapies: Tracing the process of change. American Psychological Association.

Fraser, J. S., & Solovey, A. D. (2007). Second-order change in psychotherapy: The golden thread that unifies effective therapies. American Psychological Association. 

Scholz, R. Hall, S. R., Van Brunt, B., Vaz, A., & Rousmaniere, T. (2026). Deliberate practice in assessing self-directed violence. American Psychological Association.

Ford, J. D. (2021). Crises in the psychotherapy session: Transforming critical moments into turning points. American Psychological Association.

Knapp, S. J. (2019). Suicide prevention: An ethically and scientifically informed approach. American Psychological Association.

Bongar, B., Sullivan, G. (2013). The Suicidal Patient: Clinical and legal standards of care, third edition. American Psychological Association.

Kleepsies, P. M. (2008). Behavioral emergencies: An evidence-based resource for evaluating and managing risk of suicide, violence, and victimization. American Psychological Association.

APA Videos of Related Interest

The Process of Change in Integrative Therapy
J. Scott Fraser

Emotion-Centered Problem-Solving Therapy: Working With Clients With Suicidal Ideation
Arthur M. Nezu and Christine Maguth Nezu

Behavioral Emergencies
Phillip M. Kleespies

Cognitive–Behavioral Therapy for Clients With Multiple Problems
Gayle Y. Iwamasa

Relapse Prevention Over Time
G. Alan Marlatt

Working With Developmental Trauma
Julian D. Ford

Other Suggested Resources

Fraser, J. S. (2001). Crisis, chaos, and brief therapy: Constructive interventions in high-risk situations. In L. VandeCreek & T. L. Jackson (Eds.), Innovations in Clinical Practice: A Source Book (Vol. 19, pp. 95-111). Sarasota, FL: Professional Resource Press.

Fraser, J. S. (2020). The crisis interview: Strategic rapid intervention (Classical Article Series Republication) Journal of Systemic Therapies, 39 (2), p. 65 & 66-84.

The APA Book Nook Webinar Series, October 1, 2025. A Universal Approach to Crisis: Using The Process of Change Recording available in the future through APA Book Nook Webinars.