Crisis Intervention Blueprint for Substance Use Counselors
Stages of Crisis Intervention: A Practical Guide for SUD Counselors (NYS CASAC, CADC, or CAC)
What Is Crisis Intervention? A No-BS Guide for Substance Use Counselors (NYS CASAC, CADC, CAC)
This is how to effectively help someone in crisis through the stages of crisis intervention without freezing, fixing, or falling apart. Let’s be clear: being a substance use counselor doesn’t mean you’re a superhero. It means you show up when things are messy, raw, and when someone’s spiraling at 3 a.m., and the only thing standing between them and using again is you. Yes, you, the NYS CASAC, CADC, or CAC who thought today was just another shift. This is what crisis intervention really looks like. It’s not just theory; it’s survival, and it involves understanding the steps of crisis intervention.
Crisis Intervention Blueprint for Substance Use Counselors
Whether you’re a NYS CASAC, CADC, or CAC, you need to master the 3 stages and 9 steps to assess fast, act with purpose, and follow up so your clients never face their darkest moments alone.
So let me tell you what nobody told me when I was knee-deep in my own chaos: showing up for someone in crisis isn’t about having answers. It’s about having presence. Not the smug, therapist-knows-best type either, I’m talking about the gritty, uncomfortable, “I see you, and I’m not flinching” kind of presence.
Crisis intervention sounds like some clinical, white-coat bullshit until you’ve actually had to do it. And I’m not talking about saving someone from a burning building. I’m talking about sitting on a cracked vinyl couch at 3 a.m., with someone detoxing and shaking, or holding the phone as your friend whispers that they want to disappear. You learn real fast that textbooks don’t cover everything. But some of them actually do get the bones of it right. So let’s talk about that.
Let’s break this down using Golan’s three-stage model and Dixon’s nine steps, not because we’re nerding out, but because these actually mirror what I’ve seen and lived through in recovery spaces, shooting galleries, and grief-soaked group therapy circles.
What Is Crisis Intervention, Really?
Crisis intervention isn’t about solving someone’s life. It’s about helping them get through the next hour without breaking. It’s about being grounded when someone else isn’t.
And if you’re working in this field, whether you’re in outpatient, residential, MAT, harm reduction, or mobile services. You’re going to see it. Often.
Clients don’t spiral on your schedule. They crash in the waiting room. They unravel mid-check-in. They collapse in a group after pretending everything was fine.
Knowing how to navigate that moment isn’t just a nice skill. It’s the difference between connection and collapse.
Let’s break it down using two models every substance use counselor should know.
Golan’s 3 stages of crisis intervention:
Whether you’re a NYS CASAC, CADC, or CAC, you need a clear, time-limited roadmap for crisis work. Golan’s 3-stage model keeps you focused and effective: Assessment → Implementation → Termination. In plain terms, you clarify what happened and what’s happening now, set immediate goals with concrete tasks, then review progress and lock in a forward plan so the client leaves steadier than they came in. Read the overview here: Golan’s 3 stages of crisis intervention.
STAGE 1: ASSESSMENT
Where everything begins.
Don’t jump in with a treatment plan or a lecture. You shut up and tune in.
Ask yourself:
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What just happened?
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What’s this client’s emotional state?
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Are they sober? In withdrawal? At risk of harm?
You don’t need a clipboard. You need awareness.
I once watched a client punch a wall after a phone call. Staff wanted to write him up. I sat down next to him and asked, “What happened?” He told me his sister OD’d. That was the first time anyone had asked. That’s assessment.
Say things like:
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“Tell me what brought you here today.”
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“What’s going on in your body right now?”
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“Do you feel safe?”
Then define the problem together:
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“So the main thing we’re dealing with is you feel like you can’t stay clean if you leave this building. Yeah?”
Now you’re working with something real.
STAGE 2: IMPLEMENTATION
Time to build a plan that doesn’t suck.
This isn’t about long-term treatment goals. This is about now.
You ask:
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What has helped you cope before?
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Who’s in your corner?
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What can you hold on to today?
I had a client once say, “I’ve got nothing.” But then she mentioned her cat. That cat became her anchor. We built from there.
Set small, immediate goals:
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Text a friend instead of your ex.
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Write down what’s keeping you alive.
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Call for a bed. Just call.
This is triage, not therapy.
If they walk out with one tool and a thread of hope, you’ve done your job.
STAGE 3: TERMINATION
Most people screw this up. Don’t be like most people.
You don’t ghost once they stop crying. You wrap it with care.
Talk about:
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What shifted in the session
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What stayed the same
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What is the plan if things fall apart again
Say:
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“You made it through that.”
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“You reached out instead of using.”
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“Here’s how we’ll follow up.”
This is how you close without abandoning.
Now, let’s run through Dixon’s 9 steps. Think of this as your street-smart map for when the storm hits.
Dixons’ 9 Steps of a Crisis Intervention Plan
Whether you’re a NYS CASAC, CADC, or CAC, you need a nuts-and-bolts crisis playbook, Dixon’s 9-step plan keeps you moving with purpose: build rapport fast, make room for emotion, map the precipitating event, assess safety and functioning, name the “why” behind the reaction, help the client regain clear thinking, recommend and implement concrete supports, close once they’re back to baseline, and follow up to reinforce stability. It’s a clean sequence you can lean on when everything feels urgent. Read it here: Dixon’s 9 Steps of a Crisis Intervention Plan
Step 1: Build Safety Fast
Forget formalities. Clients in crisis don’t need polished—they need real.
You show up like a human. Present. Grounded. No judgment.
If they feel embarrassed, say:
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“You’re not weak. You’re in pain. That’s not the same thing.”
That breaks the ice.
Step 2: Let It Spill
Let them vent. Cry. Scream. Shake.
Don’t tell them to calm down. Let it out.
Once, I sat next to a client crying so hard she choked. I handed her a cup of water and said nothing. She later said, “You didn’t flinch.” That mattered more than any advice I could’ve given.
Step 3: Get the Story
In this step of crisis intervention, you allow emotions to settle and then get curious.
Ask:
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What happened?
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When did it start?
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What have you tried?
You’re not looking for blame. You’re finding the thread.
Step 4: Check the Damage
Time to assess the risk.
Are they suicidal? Do they have somewhere to go? Are they hallucinating? Have they used it recently?
Ask:
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“What’s your biggest fear right now?”
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“Are you safe to leave here today?”
This tells you what you’re really working with.
Step 5: Help Them See the “Why”
In this step of crisis intervention, you’re not just treating the crisis. You’re helping them understand it.
Say:
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“You lashed out because you’ve been abandoned before.”
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“You used because you didn’t feel worthy of staying clean.”
You’re showing them their behavior makes sense. Not excusing it—understanding it.
That’s where change begins.
Step 6: Bring Their Brain Back Online
You’ve stabilized emotion. Now bring in logic.
Write things down.
Name the plan.
Remind them they’re not broken.
Say:
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“Here’s what we know.”
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“Here’s what’s next.”
That builds trust.
Step 7: Make a Micro-Plan
You’re not building a life. You’re building a lifeline.
Ask:
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“What can we do right now?”
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“Who can we call?”
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“Want me to walk you over to the nurse?”
Keep it grounded. Keep it real.
Step 8: Close with Clarity
Don’t disappear.
Say:
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“Today was rough, but you showed up.”
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“Let’s check in again tomorrow.”
Let them know they’re not just another crisis. They’re a human worth following up with.
Step 9: Follow Up
This isn’t fluff. It’s what separates a genuine substance use counselor and support from performative care.
I had a client who blew up in a group. It bothered me all day. Before I left for home, I called her to be sure she was okay. I didnt expect her to pick up my call, but she did. We talked for about 15 minutes about her day after the group, the events of the group, and what she planned to do. I told her I’d hoped to see her in the group the next day. Several days later, she thanked me for that call. She wasn’t sure if the call stopped her from using that night or if she was determined to stay sober. We both decided that it was a little of both.
Follow-up matters.
Final Words for Substance Use Counselors
Whether you’re a CASAC in New York, a CADC in New Jersey, or a CAC in Georgia, your job isn’t to save anyone. Your job is to be there when the world falls apart and to help someone see that it’s not over yet.
Crisis intervention isn’t clinical perfection. It’s a human connection.
You don’t need a PhD. You need presence. Consistency. Guts.
And the willingness to say:
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“I’m not going anywhere.”
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“You don’t scare me.”
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“Let’s get through this together.”
That’s how you become someone your clients can trust.
That’s how lives start to change. One crisis at a time.
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