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78 Cards in this Set
- Front
- Back
Ego strength is: a) how proud and self-centered the person is b) the amount of energy available to overcome PTSD c) the ability to understand the world realistically and act upon it to get one's needs met d) all of the above e) none of the above
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C |
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An example of effective coping behaviour is: a) learning to accept that oneself cannot be trusted in crisis situations b) learning to master the problem as it comes to you as a whole c) mastering feelings where possible d) none of the above |
C |
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Caplan believed that all of the following are characteristics of effective coping behaviour EXCEPT: a) actively exploring reality issues b) trusting in oneself c) freely expressing feelings d) none of the above |
D |
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The idea of growth and optimism comes from which theory? a) Behaviourism b) Psychoanalytic c) Cognitive d) none of the above |
C |
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Suicide Prevention became wildspread in the: a) 1800s b) 1960s c) 1990s d) 1980s |
B |
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The cognitive-behavioural theories have contributed which of the following to crisis intervention? a) Interpretive techniques b) The problem solving model c) The exploratory model d) All of the above e) None of the above |
B |
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Caplan's list of effective coping people includes the ability to invoke help from others. |
T |
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Discuss the trilogy definition of a crisis. |
1. Precipitating event 2. subjective distress 3. coping fails |
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Describe how a crisis can be both an opportunity and a danger |
Danger- no crisis intervention, non-adequate coping mechanisms, lowered functioning/psychosis/suicide
Opportunity- seeks help, grows and develops from the challenge of dealing with a precipitating event |
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How does someone become crisis prone? |
Crisis prone person doesn't use proper coping mechanisms, continually ends up at lower levels of functioning until ego strength is completely depleted |
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What are Caplan's 7 characteristics of effective coping people? |
1. actively exploring reality issues and searching for information 2. freely expressing both positive and negative feelings and tolerating frustration 3. actively invoking help from others 4. breaking problems into manageable bits and working through them one at a time 5. being aware of fatigue and pacing coping efforts while maintaining control in as many areas of functioning as possible 6. mastering feelings where possible, being flexible and willing to change 7. trusting in oneself and others and having a basic optimism about the outcome |
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When might medication be useful for someone in a crisis? |
When subjective distress needs to be immediately reduced because it is too great, temporary relief low ego strength, history of mental health problems |
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How is stress different from a crisis? |
stress- a person experiences negative event and negative emotion, doesn't experience impairment in functioning because they have coping skills
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Discuss the history of crisis intervention from the 1940s to the 21st century |
-1942: Coconut Grove, nonprofessional counselling -1946-1964: baby boom, increase in birth problems -1950s: Psychotropic medication, deinstitutionalization of mentally ill people -1957: Short-Doyle Act -1963: Community Mental Health Centers Act -1960s: professional journals re: suicide/crisis intervention, professional counselling -1960s-1970s: grass-roots movements, paraprofessionals -1970s-1980s: professionalization of mental health, licensed counsellors, long-term counselling -1980s-1990s: return to crisis intervention, community mental health |
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Contributions of Psychoanalysis |
-finite psychic energy -ego strength |
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Contributions of Humanism |
-client potential -reflective/empathetic techniques |
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Contributions of Existentialism |
-responsibility/choice -anxiety is normal |
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Contributions of Cognitive-Behavioural Approaches |
-behavioural problem-solving model -person's cognitive view of the problem -homework, follow-up |
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Contributions of family systems model |
-change makes people anxious -why pathology is so common in families, why change takes so long (people prefer stability) |
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How did the intro of psychotropic medication and the deinstitutionalization of the mentally ill influence current crisis intervention and provision of mental health services? |
-mentally ill could be managed on an outpatient basis -led to Community Mental Health Centers Act, provision of mental health care to less severe cases -short term crisis intervention |
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"Duty to Warn" came from |
The Tarasoff Case |
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In which stage of cultural sensitivity is culture distracting from clinical effectiveness? a) unawareness of cultural issues b) heightened awareness of culture c) burden of considering culture d) towards cultural sensitivity |
C |
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Mexican-American families are most likely to be: a) disengaged b) matriarchal c) enmeshed d) none of the above |
C |
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African Americans and Asian Americans usually prefer to deal with counsellors in a problem solving model |
True |
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Etic issues refer to those behaviours that are particular to a specific culture or subgroup |
False |
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Emic issues refer to universal culture behavior |
False |
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When MUST a counsellor breech confidentiality? |
-elder abuse -child abuse -when a client is dangerous towards others |
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When MAY a counsellor breech confidentiality? |
-signed waiver, continuity of health care, to provide supervision, access of records to court, health insurance claims, when a person is a danger to themselves |
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How might countertransference affect crisis intervention? |
interferes with ability to be calm, objective, and client-focused |
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What are the symptoms and causes of burnout? |
-symptoms: dizziness, nausea, headaches, fatigue, palpitations, shortness of breath, cognitive impairment, major depression, panic disorder, psychosomatic illness, social withdrawal, substance abuse, deterioration of family and social relationships
-causes: disillusionment, tedium, low positive feedback, human tragedies, unpredictable danger, mass hysteria, fear of environments |
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What are effective methods of lessening burnout? |
fun with teammates, work discussions, peer cohesion, social support, more time in direct contact with consumers, control over time at work, control over workload, ability to organize own work, recognition of quality of care, clarity over role at work |
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Describe one behaviour pattern typical of:
Asian-Americans African-Americans Mexican-Americans |
Asian-Americans: Shame and obligation African-Americans: distrust of society Mexican-American: ataque de nervios |
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What are the stages that a counsellor goes through when becoming culturally sensitive? |
1) unawareness of cultural issues 2) heightened awareness of culture 3) burden of considering culture 4) movement toward cultural sensitivity
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What issues might a gay man face when coming out? |
inner battle with 'deviance' shame fear of rejection fear of unknown reactions losing home/job/respect |
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Which basic attending skill is probably the most powerful tool in creating an empathetic environment? a) clarifying b) reflection c) summarization d) open-ended questions |
B |
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What is the purpose of using basic attending skills? |
to develop rappot and let client know that counsellor is concerned and respectful |
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Give three examples of open-ended questions. |
How have you been feeling? What have you done? What is your sadness like for you? |
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Provide a reflective statement for:
a) anger b) sadness c) joy d) fear |
anger- You sound frustrated sadness- I see tears in your eyes joy- You seem to be smiling a lot. fear- You sound afraid. |
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Describe each of the following: a) reframing b) educational statement c) empowerment statement d) validation statement |
reframing: defining a situation differently from the way the client interprets it
educational statement: factual information about the crisis
empowerment statement: present client with choices, personal power
validation statement: telling the person that their feelings are normal and understandable |
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Compare and contrast Kubler-Ross' stages of death and dying and Worden's task of mourning |
Stages: 1) denial and isolation (Task 1. Accepting reality of loss)
2)anger 3)bargaining (Task 2- Experience Pain of grief) 4) depression
5) Acceptance (Task 3- adjusting to new environment)
(Task 4- withdrawing energy and reinvesting)
Stages: fixed sequence, "need" to go through each, lack of empathy
Tasks: not timed, no sequence, action by bereaved, work towards goal |
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What are some special needs of a parent who has lost a child to death? |
-lost dream of future -weakened marriage/ parent-child relationships -father can't express emotions -societial norms (3 days leave--losing job) -shortened attention span -need to talk/be listened to/changing needs -don't inhibit talking about child |
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What are some issues that children face when their families become blended? |
-loyalty issues -guilt over bonding with another adult -stepparent's rules/expections |
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Describe the 4 stages of successful mourning |
1. Accepting Reality of Loss: getting over denial, permanence 2. Experiencing Pain of Loss: crying/yelling/ruminations, moving past avoidance 3. Adjusting to Environment without deceased: coping on own, taking over roles, develop new skills 4. Withdrawing Emotional Energy from Deceased and Reinvesting: overcome guilt, love others, no time limits, can talk/think about deceased without pain |
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5 symptoms of PTSD |
-feelings of detachment -numbing of feelings -sleep difficulties -intense fear/feelings of helplessness -difficulty concentrating |
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5 causes of PTSD |
-being in combat/war zone -personal/family vicitimization -surviving natural disaster -experiencing manmade disaster -sudden, unexpected death of a loved one |
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Describe the phases of community disaster |
1. heroic- emotions are strong, lots of help provided/altruism, high energy/motivation 2. honeymoon- shared experiences, anticipate help, community groups 3. disillusionment- people return to greed/jealousy/selfishness, utopia doesn't happen, bitterness when help doesn't come/aid leaves 4. reconstruction- need to rebuild, live independently/accept responsibility |
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How should critical incident debriefing proceed? |
-listening & empathizing -spend time with victim (support/reassurance of safety) -encourage talking to others/accepting help -help tolerance of other's irritability, redefine priorities/refocus energy -encourage functioning, maintain health -actively seek info -support groups |
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During middle childhood, the major role changes going on for the child deal with: a) bonding b) stagnation c) success and failures d) all of the above |
A |
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What is a need of most teens that is thwarted and leads to self-destructive behaviours? |
independence, autonomy, nurturance |
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Discuss the developmental stages and possible interventions for a crisis in each. |
1. infancy-> father fails to nurture->encourage open communication, educate on need for involvement 2. toddler->overcontrolling parents->educate parents about need of toddler to have power over self 3. preschool->child is overly agressive/competitive and can't share/cooperate->teach parents how to help child submit while still feeling worth 4. childhood->child fails to master social/physical/academic skills-> encourage child to develop competence in something 5. adolescence->parents fail to listen->teach parents active listening, empathetic understanding 6. young adult->parents fail to let go/overcontrol->help parents to grieve loss, focus on new involvements 7. middle adult->failure of marital bonds after child leaves-> marital counselling, increase marital interactions 8. mature adult->anger/shame about dependence on family->family therapy to address feelings and communicate needs |
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What are characteristics of teens with eating disorders? |
1. highly emotionally reserved/cognitively inhibited 2. prefer routine, orderly, predictable environments, react poorly to change 3. show heightened conformity/deference to others 4. avoid risk/react to stressful events with strong distress 5. focus on perfectionism, negative self-evaluation, fear of adulthood |
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Who is considered one of the founding fathers of modern suicidology?
a) Freud b) Farberow c) Caplan d) Lindemann |
B |
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A good strategy for a middle risk suicide client is: a) support comments b) no suicide contract c) family suicide watch d) all of the above |
D |
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Psychotic decompensation is: a) a state of increased energy b) a state of active delusions and hallucinations c) a state of increased independence d) none of the above |
B |
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Farberow's work with suicide began with WWII veterans |
TRUE |
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10 questions a crisis worker should ask during a suicide assessment |
1. Have you thought of killing yourself? 2. How often... 3. How badly do you want to die (scale 1-10) 4. Do you perceive suicide as weak or strong? 5. Do you have a suicide plan 6. Do you have the means 7. When were you thinking of doing it? 8. Have you given things away? 9. Have you made any attempts in the past? 10. Has anyone close to you committed suicide in the past? |
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Effective crisis intervention for high-risk suicide client |
involuntary/voluntary hospitalization possible medication |
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Effective crisis intervention for middle-risk suicide client? |
-written no suicide contract -increased contact -family watch -medication evaluation -brief voluntary hospitalization -find out what stopped them, encourage living for that -reframe/support |
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Effective crisis intervention for low-risk suicide client? |
-supportive crisis intervention -verbal no-suicide contract -maintain regular contact throughout crisis intervention |
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5 things a crisis worker should explore with possible homicidal client |
1. active or passive engagement in violent/dangerous behaviour 2. stating that they will go through with violent/dangerous behavior 3. a plan to follow through 4. means to follow through plan 5. background of violent/dangerous behavior
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How is the mental status exam useful for a crisis worker? |
- helps determine if someone is psychotic, gravely disabled, a danger to self, or a danger to others -structured to describe a person's current state of mind |
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What are the categories of the MSE |
appearance, attitude, behaviour, speech, mood & affect, through process, thought content, perception, cognition & orientation, insight, judgement |
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How is self-mutilative behaviour different than suicide? |
-sometimes no suicidal intent -main purpose to regulate emotional or physiological experiences -impulsive disorder: prevalent in a variety of emotional/personality disorders |
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What is bullying and how should we intervene? |
Bullying is aggressive behaviour that is intended to cause distress or harm, involves a power imbalance, and occurs repeatedly over time
Intervention: -schoolwide climate to discourage bullying -survey students to find out nature/extent/attitudes of bullying -train staff to recognize and response to bullying -develop consistent rules against bullying -review + enhance disciplinary code against bullying -discuss bullying issues in the classroom -integrate bully-prevention across curriculum -provide counseling (individual and group) to bullied children -provide counseling to bullies -involve parents in prevention -use teachers and staff to increase knowledge and motivation |
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The unemployment rate is on the rise. |
False |
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What are some issues a person faces when he or she loses a job? |
-loss of identity/social life -huge portion of time that used to be spent at job is now spent looking for a job (exhausting) -perceived loss of control -loss of status (esp. in high-level jobs) -financial challenges |
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Hallucinations |
false sensory perceptions.
-auditory: schizophrenia -visual/tactile: substance-abuse withdrawal -gustatory/olfactory: organic brain disorder
Always indicative of a serious illness, you should consult a doctor |
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Psychotic Decompensation |
-state of being out of touch with reality -symptoms: delusions, hallucianations -usually happens after stopping medications or at beginning of first schizophrenic episode -also associated with BPD and paranoid disorders -usually requires involuntary hospitalization |
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Calibration |
range of allowable behaviours in a family |
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Counteraction |
-behaviours that family members engage in when trying to stop a family member behaving outside of family rules |
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differentiation/individuation |
process where a young adult establishes a mature identity and capacity for intimacy needed to assume adult roles/responsibilities |
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disengagement |
when parents do not relate to their child in a nurturing manner and the child feels little support or belonging |
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enmeshed |
when an individual lacks separateness from others with whom they have an emotionally intense relationship |
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evolutional crises |
normal stages that a family experiences as it evolves through life span of members. Crises come from having to adjust to formation of subsystems: marital, parental, sibling, grandparent |
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homeostasis |
steady, stable state of a family which is maintained when family members adhere to the family rules and roles (both verbal and non-verbal) |
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runaway |
a family in crisis |
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hypervigilance |
state of preparedness and anxiety that often occurs after being personally attacked |
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logotherapy |
psychotherapy by Victor Frankl when a client is encouraged to actively explore meaning in their lives and behave in ways to work toward a more meaningful existence (finding meaning in crisis) |