CARE-squared: teaching a novel parallel-process approach to crisis management

Objective: Given rising national rates of depression, anxiety, suicidality, and trauma, and with the associated rise in screening for mental health concerns in medical settings, medical and behavioral health clinicians increasingly identify and manage mental health crises during time-limited visits. Through 2 clinical case examples, this article introduces CARE-squared, a novel approach to teaching crisis management, grounded in client support and clinician self-care, that can be used in a variety of health care settings.

Method: This article describes the need for crisis management in health care settings, reviews literature on existing Psychological First-Aid frameworks, and highlights principles of trauma-informed care. The article then introduces CARE-squared, a four-step parallel-process model of crisis management, designed to guide health care trainees' support of clients in crises while simultaneously maintaining patient alliance, de-escalating, and managing clinician stress during a crisis.

Results: Two clinical cases highlight the applicability of CARE-squared to rapid crisis management during in-person and telehealth visits.

Conclusion: CARE-squared provides a novel, parallel-process approach to support patient care and clinician wellness. It has broad applicability to clinician training and practice and potential utility for a variety of presenting concerns and health care settings.