childhood experiences account for her present dysfunction), be counseled by social workers about changing residences or neighborhoods, and be thoroughly interviewed by criminal justice personnel so that the perpetrator of her rape might be caught. As a result of these contradictions, the victim receives mixed messages: "Do I feel badly because of my brain, my childhood, my social milieu, or because someone did something to me that I didn't like?"
Confidentiality. Many medical professionals will rationalize their lack of cooperation by utilizing the issue of confidentiality. This can be frustrating to someone tyring to gather as much information as possible in order to provide proper assistance. This lack of cooperation further impedes the coordination of services leaving the victims with a feeling that they have to settle for whatever they can get rather than what is rightfully theirs.
Referral. While criminal justice personnel will always refer the crisis victim to medical assistance, the reverse referral does not always occur. Some medical personnel are reluctant to get involved when there is a suggestion of criminal activity or when the situation may warrant law enforcement investigation and intervention. Again, this lack of cooperation is a detriment for the person who is in need of total crisis intervention services.
The conceptual problems described in this chapter reflect limitations that exist in the total picture of crisis behavior and crisis intervention. It is unfortunate that the conceptual models have remained so separate from each other. To the degree that this occurs, communication between professionals treating crisis situations is impaired, progress is slowed, and the victim, who is at the center of all this, is shortchanged. Whereas human beings are simultaneously biological organisms, psychological beings, and members of social systems, a comprehensive integrated set of guidelines that incorporate all these conceptual models fails to exist. The test of a skilled criminal justice crisis intervener is the assemblage and integration of the separate orientations. To accomplish this best, the crisis intervener should be aware of the various conceptual models that are likely to intervene at the same time, and be knowledgable of their orientation, the terminology unique to their discipline, the different evaulation techniques, and each treatment modality. The proper attention to each of the different disciplines that impact on the victim's life is essential to the resolution of a crisis.
In this chapter the conceptual models that are implicit in crisis intervention have been identified and discussed. The five conceptual approaches commonly used are the mental health advocate or counseling, the biological or medical, the psychiatric, the psychological, and the social. Some of the variables that determine the choice of approach include the ideology of the clinician, the diagnosis, the effectiveness of available treatments, available services, and the immediacy of the situation. By recognizing the various