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40 Cards in this Set
- Front
- Back
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History of Crisis Intervention
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-'42: Coconut Grove Nightclub fire: first non-professionals providing counseling
Eric LIndemann -Baby book increased miscarriages, etc. The Wellesley project-community mental health program, -50's Psychotropics discovered, and institutionalization -63 community mental health act -68 Lanterman Petris Short Act: specific requirements for provision of mental health services. -Crisis intervention model demonstrated to be more effective then long-term therapy -80's-90's community mental health makes a comeback |
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Definition of Crisis: James and Gilliand
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-Embodies danger and opportunity
-time limited, but can be a series of transcrisis points -Often complex and difficult to resolve -Life experience of worker helps effectiveness -Contains seeds of growth and impetus for change -Panaceas/ quick fixes not applicable in many cases -Confronts people with choices -Emotional disequilibrium and disorganization -Resolution of crisis and person-hood of crisis workers interrelate |
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Definition of Crisis: Mayer
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Adds to James/Gilliand
-should be viewed from the clients perspective. -is a reaction to a specific event/situation -must be understood by clients as unbearable -client must believe they do not have the resources immediately available to prevail over the situation |
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Definition of Crisis: Aguilera
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A psychological crisis refers to an individuals inability to solve a problem
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Definition of Crisis: Kanel
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Trilogy Definition
-A precipitating event occurs -The perception of this event leads to subjective distress -Using coping methods fail, leading person to function psychologically, emotionally, or behaviorally at a lower level than before the event |
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4 Stages of development
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-A critical situation, and a determination is made on if the persons normal coping mechanisms will do
-Increased tension and disorganization surrounding the event escalate beyond person's coping ability -Demand for additional resources to resolve event -Referral may be required to resolve major personality disorganization |
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A response condition
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Crisis can be thought of as a response condition where
-Psychological homeostasis is disrupted -Usual coping mechanism have failed to re-establish it -Distress through crisis has shown functional impairment |
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Crisis Intervention (in a nutshell)
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-Time limited (6 or less weeks)
-addresses only the specific issue -Focuses on client returning to a pre-crisis functioning |
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Crisis Types
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-Developmental: through growth/maturation
-Situational: events, unexpected, cannot be controlled -Existential: anxieties coming with human purpose, responsibility, independence, freedom, and commitment -Environmental crisis: natural/human-caused disaster overwhelming a person or group, inundated in the aftermath. Hurricanes, floods, earthquakes |
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Assessment Models: Psychoanalytic Theory
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The unconscious thoughts a person has will help them deal with the disequilibrium. Also, early childhood fixation is the reason this event became a crisis
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Assessment Models: Existential
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Anxiety is normal for humans, helps self-development
-Motivator to risk and grow -People have to take responsibility for own circumstances and realize many problems are self-caused |
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Assessment Models: Humanistic
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-Stresses clients ability to realize potential in the therapeutic relationship
-Crisis is a block, but also a potential growth -Counselor should be present with client to help them accept themself -Goal is to return self-evaluation to the person. They will be able to control own destiny that way |
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Assessment Models: CBT
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-Importance of understanding the crisis from the viewpoint of the client, then reframing
-6 basic steps: 1)define problem, 2)review what was tried in the past, 3)what does client want, 4)brainstorm alternatives, 5)selecting alternatives and commit, 6)follow-up |
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Assessment Models: Systems Theory
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Based on interrelationship/dependence among people and events
-Kanel uses the term "runaway" for true family crisis. This is when the negative feedback mechanisms fail to calibrate the system. Homiostasis cannot be created |
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Assessment Models:Brief
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Client encouraged to explore her past patterns, and how they have prevented success where it was desired. Focus on creative change and incorporation of new styles of relating to the world
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Assessment Models: Adaption Theory
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-crisis is sustained by maladaptive behaviors, thoughts, and defense mechanisms
-Crisis will alleviate when change to these occurs |
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Assessment Models: Chaos Theory
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Careful examination will show crisis is not as insoluble and chaotic as it seems. There may be some deep message in the chaos. Chaos can being motivation to positive action
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Assessment Models: Eclectic Crisis Intervention
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-using integrated concepts and strategies from all available approaches
-hybrid of all available approaches -Well versed in a number of approaches and theories, thus the worker can use what is needed for the individual client |
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Assessment Models: Hoff Model
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-Also called: The vulnerability model
-Assessment of vulnerability: -Hazardous event -percipitating factor -persons reaction -Suggests these signals may be affective, cognitive, or behavioral, and should be differentiated from distorted perceptions or mental illness |
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Assessment Models: Slaikeu Model
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Multidimensional assessment of affective, behavioral, physical, and cognitive aspects of crisis reactions
Changes to Lazarus's BASIC-ID -categorizes substance abuse as behavioral -Categorizes physical functioning as somatic functioning -combines imagery and cognitive dimensions into one catagory |
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Assessment Models:Hendricks and McKean Model
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"frontline model" of assessment
Involves 2 phases -securing the scene: getting needed info through " who, what when where why" -Evaluating the person in crisis: determine level of functioning, getting info on medical/psychiatric history |
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Assessment Models:ABC Model
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Kanel
organizes the crisis interviewing to be used in 10 min, one session, or 6 sessions. The goal to bring functioning to pre-crisis level -A:develop and maintain contact, rapport building, needed for next steps -B: identify problem, get directly to the issue, most important step -C: Assist the client in taking charge of behavior and coping |
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Assessment Models: Triage Assessment form
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(TAF)
-Assessing the domains of affective, cognitive, and behavioral functioning -Affective: anger/hostility, anxiety/fear, sadness/melancholy -Cognitive: Perception of transgression, threat, loss -Behavioral: approach, avoidance, immobility |
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Assessment Models: Six Step
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James & Gilliand
Two sections: Listening and Acting -Listening -Define the problem, insure client safety, provide support -Acting -Examine alternatives, make a plan, obtain commitment |
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Characteristics of Good Crisis Workers
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-Strong growth inducing life experiences
-Good guidance -Professional skills: attentive, congruence, analyzing, referral/, critical thinking, etc -Poise -Creativity/flexibility -Good energy -Quick mental reflexes -Other: Tenacity, delay gratification, optimism, calmness, objectivity, good self concept, reality orientation, courage |
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Stems in Crisis Intervention
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Assessment
Planning Therapeutic Intervention Intervention Resolution of Crisis and Planning |
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Stems in Crisis Intervention: Assessment
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-Assess problem
-Assess suicide or homicide threat -Consider hospitalization |
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Stems in Crisis Intervention:Planning Therapeutic Intervention
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-Figure out what pre-crisis equilibrium was
-How long since crisis and amount of disruption -Consider client strengths, skills used in the past, and support system |
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Stems in Crisis Intervention:Intervention/resolution
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-Aim to help gaining intellectual understanding of the crisis
-Awareness of feelings, this is tension reducing -Explore new/different coping mechanisms -reopen social system/ network -reinforce adaptive coping -Make realistic plans for future -assess how to handle similar crisis int he future |
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Categories of Crisis Intervention
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Demobilization
Crisis Management Briefing (CMB) Defusing Critical Incident Stress Debriefing (CISD) |
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Demobilization
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-Michell & Everly refer to this as quick informational and rest session
-Occurs when there is a major incident needing over 100 personnel -Screening to look for those in need of assistance -Rare, reserved for large-scale incidents -Goals: assess well-being, mitigate impact of event, provide stress management info, provide rest&food, assess other needs |
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Crisis Management Briefing (CMB)
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-Used with large groups of primary victims
-Goals: provide information rumor control reduces sense of chaos Provide coping resources facilitate follow-up increase cohesion and morale assess other needs restorative |
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Defusing
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-Similar to debriefing but shorter, 20-45 min
-includes: introduction, exploration, information -Goals: mitigate impact of event, accelerate recovery, assess needs, reduce cognitive/emotional/psychological symptoms |
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Critical Incident Stress Debriefing (CISD)
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Group of meetings/discussions about a traumatic event(s)
-Stages: -Intro -Facts -Thoughts -Reactions -Symptoms -Teaching -Re-entry -Goals: mitigate psychological impact of trauma, prevent PTSD, assess for those needing follow-up |
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Steps for Crisis INtervention
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-Intervene immediately
-Stabilize by creating support, order, and routine- provide them tools -Facilitate understanding -Focus on problem-solving -Encouraging self-reliance |
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5 goals of Crisis intervention
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Stabilization and safety of victim
Mitigation of stress Normalization of feelings Restoration of function |
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Crisis intervention is
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support (not psychotherapy)
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Fundamental Principles
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Simplicity
Brevity Pragmatism Innovative Proximity Immediacy Expectancy |
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Advocacy
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An action taken by a counseling professional to facilitate removing external barriers to the clients well-being
2 purposes: -increase clients sense of personal power -help change environment to be more responsive to client needs |
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Advocacy
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An action taken by a counseling professional to facilitate removing external barriers to the clients well-being
2 purposes: -increase clients sense of personal power -help change environment to be more responsive to client needs |
