In the film World Trade Center, directed by Oliver Stone (2006), the focus is placed on the first responders that assisted with the crisis that occurred at the World Trade Center in 2001. Specifically, the film focused intensely on two police offers who were trapped under the wreckage of the World Trade Center tower. When considering the events of the day, the nature of the attacks themselves are rather intriguing from a counseling perspective, especially when considering the aftermath and the potential trauma to those directly affected, and to those on the front-line of response. First, when the initial plane hit the building, no one knew if it was an accidental hit, or some other act. Second, when the next plane hit, this changed the perceptions of safety among those involved; at this time, it was clear that these attacks were not random. Third, this sequence of attacks led to mass confusion and it was a further disruption of the notion of safety. Finally, the nature of these attacks led to continued concerns with safety and security among the American public.
In considering the two police officers, they experienced multiple traumas. In fact, they directly experienced a threat to their own lives, they were exposed to an incident in the elevator shaft that could potentially lead to survivor’s guilt, and they witnessed an individual jumping out of the tower. As such, the potential for trauma-related psychological distress is extremely elevated. Considering that they were trapped in the ruble for hours, a direct threat to their life was present, and this is the first criterion necessary for a diagnosis of a trauma or stressor related disorder. In addition to their direct experience, they also experienced the initial trauma along with others who were in New York that day; they experienced fast realization that these were attacks as opposed to accidents.
Steps to Alleviate Crisis
Immediate crisis interventions have been developed, and according to Greenstone and Leviton (2002), clinicians should assess for distress, impairment, and instability, in a logical and organized manner. According to these researchers, when attempts to help are backed by theory and a systematic model, the potential to exacerbate harm is reduced. As such, Roberts’ Seven-Stage Crisis Intervention Model (1991, 2000, 2005) may be the most helpful in discerning how to best help these individuals. The Seven Step Plan, as presented by Roberts and Ottens (2005), is as follows. First, the clinician should plan and conduct a biopsychological assessment and the clinician should assess for lethality and imminent danger. Second, the clinician should make contact in a psychological manner in which to quickly establish a therapeutic and collaborative relationship. Third, major problems need to be identified, including precipitants to the crisis. Fourth, feelings and emotions surrounding the events should be explored. Fifth, exploring alternatives and developing new coping styles and strategies is recommended. Sixth, an action plan should be devised to help restore the individual to a certain level of activity and functioning. Finally, follow-up and booster sessions should be decided upon.
Teaching Coping Skills
In terms of coping skills that could be taught immediately following the crisis, I would teach distress-tolerance skills, such as using distraction, relaxation, and self-care related activities. Specifically, when considering the two main police officers in the movie, distraction may help them cope in the aftermath of the events. They may benefit from listening to their favorite music, watching their favorite movies, talking walks, and setting the stage for adequate sleep. They may benefit from learning a breathing exercise and/or a progressive muscle relaxation exercise to help them calm themselves down when they are anxious, or they can use these before they go to sleep.
According to the American Psychological Association (n.d.), many of the steps towards developing resilience include utilizing social resources in the journey forward. In fact, the first recommendation made by the American Psychological Association is to re-establish connections with close others. Specifically, they state that accepting support from others is a key piece of the trajectory towards resilience. Second, they suggest re-assessing the cognitions associated with the event, while accepting that the event has already occurred. Third, they recommend developing realistic goals that can still be met despite the event. Fourth, they suggest taking actions instead of avoiding potential problems or unpleasant situations. The other recommendations provided by this organization largely focusing on tending to oneself. Specifically, they suggest engaging in exercise and relaxing activities while also looking for opportunities to learn more about oneself.
In considering the steps to crisis intervention, combined with known coping skills, and factors that promote resiliency in individuals and communities, it is recommended that the following steps be taken with the police officers that were the main subjects of the film. First, it is important to assess any remaining threat to the police officers. Next, it is critical to quickly form a supportive therapeutic relationship. Next, the officers should discuss their feelings and emotions surrounding the events that just occurred, and then they should work with the clinician to devise a goals and a plan for future sessions. In between sessions, these officers should be encouraged to connect with significant others and with their community to promote resiliency. Moreover, they should practice coping skills in-between contacts with mental health services.
- American Psychological Association (n.d.). The road to resilience. Retrieved from: http://www.apa.org/helpcenter/road-resilience.aspx
- Greenstone, J.L., & Leviton, S.C. (2002). Elements of crisis intervention: Crises and how to respond to them (2nd ed.). Pacific Grove, CA: Brooks/Cole.
- Roberts, A.R. (1991). Conceptualizing crisis theory and the crisis intervention model. In A.R. Roberts (Ed.). Contemporary perspectives on crisis intervention and prevention (pp. 3-17). Englewood Cliffs, NH: Prentice-Hall.
- Roberts, A.R. (1995). Crisis intervention and time-limited cognitive treatment. Thousand Oaks, CA: Sage.
- Roberts, A.R. (2000). Crisis intervention handbook: Assessment, treatment, and research. (2nd ed.). New York, NY: Oxford University Press.