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16 Cards in this Set
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Any significant event during the rehabilitation process that threatens to jeopardize or destroy the treatment effort. Crisis have many causes and can be directly related to alcohol and or other drug use (relapse) or indirectly related. Suicidal gestures, divorce or separation, psychotic episodes, or outside pressure to terminate can all bring about a _________. |
Crisis |
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Those Services which respond to an alcohol and or other drug abusers needs during acute emotional and/or physical distress. |
Crisis Intervention |
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1. A crisis is a state of mental and emotional confusion that is caused by the perception of threat. 2. It involves a sense of urgency. 3. It may last a few hours to a few weeks
Traumas that set off crisis 1. A trauma is an objective event that damages a person's sense of well-being and creates anxiety. 2. For a trauma to set off a crisis, the person has to perceive the traumatic event as very threatening 3. There are four types of traumas that set off crisis a. Situational- the circumstance causes the upset Examples: death of a loved one, the breakup of an important relationship, serious illness, serious financial problems, spouse military deployment,Family violence b. Developmental- the process of growing through life stages can cause upset Examples: peer pressure, marriage, children leaving home, and retirement c. Intrapsychic- thoughts and feelings can create upset Examples: identity confusion, thoughts and feelings greater during interpersonal friction, suicidal thoughts D. Existential- a sense of emptiness and lack of purpose in life causes upset Examples: recognition that daily activities don't provide meaning and satisfaction and live and avoid or feelings of emptiness results Reactions to crisis 1. People in crisis perform some form of reactive behavior or to reduce emotions. 2. Common Reactions: A. Shock B. Anxiety: the trauma may overwhelm some people they feel like they are falling apart. C. Depression: the trauma may flatten some people creating a sense of hopelessness. D. Anger- the trauma may outrage some people. E. Intellectualization: the trauma may cutoff thoughts and feelings in some people. They use rational thinking to get through the crisis. |
Causes and reactions to crisis |
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1. To stabilize the individual so no further deterioration in functioning occurs. 2. To relieve the individual of as much pressure as possible. 3. To convert the emergency to a solvable problem and resolve it. 4. To return the person to his/her pre-crisis level of functioning. |
Goals of crisis Intervention |
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1. Established rapport- this must be done rapidly at the beginning of the interview - the client must feel he / she has a knowledgeable Ally who will see him/her through the crisis. 2. Gather relevant data a. To assess the risk of danger to self and others b. To become informed about current problem. c. To assess client's ability to cope with the crisis. d. To form a realistic treatment plan. 3. Refrain the crisis into a solvable problem and potential growth situation 4. Helps the client examine realistic options for solving the problem 5. Contact necessary support individuals who can help carry out the plan of action - possible contacts include: family, friends, employer, physician or psychiatrist, or Service agencies. |
Process of crisis Intervention |
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1. Empathy a. Helps to rapidly develop rapport. b. Helps clients to relax. 2. Good questioning skills a. Ability to gather information quickly for an individual who is in the midst of intense emotions. b. Able to be direct yet tactful. 3. Rapid assessment a. Quickly and accurately pinpoints the big issues. b. Determines risk factors c. Discovers options to solve the problem 4. Realistic viewpoint a. Does not make false promises to the client b. Knows own limits in being able to help so does not feel responsible for the client beyond professional duties. c. Asks for help when needed to assure client will receive the best help available. 5. Uses resources available a. Client's Network b. Professional Network C. Agency net worth
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Qualities of an effective crisis counselor |
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A. Risk factors 1. Many people think about suicide but would never actually attempt it - others are potential suicide vict 2. Certain circumstances increase the potential for suicide a. Suicide is associated with depression 1. The signs of depression are not always obvious: Sadness, guilt, inadequacy, hopelessness, weight loss, loss of appetite, loss of sexual desire, sleeplessness, and fatigue 2. Men commit suicide more frequently than women though women attempted more 1. At greater risk are: a. Teenage boys b. Men older than 50 years c. Older people rather than younger people d. One who suffered a recent permanent loss e. Someone who is seriously ill f. Someone who does not have a network of caring people g. People who have unstable relationships h. Alcohol and drug dependent people I. Impulsive people j. Emotionally burned out individuals
B. Cues to suicide potential 1. In talking with an individual, the counselor needs to be alert to the above 2. The counselor must also know the following cues of immediate danger: a. The client has decided on a method, time, and place - lethality increases with such methods as shooting, jumping off a bridge, and fast-acting drugs. b. Suddenness of the desire to kill oneself c. Depression 1. Especially if sudden 2. If combined with: a. Psychotic thinking b. Alcohol and drug use c. Confused thinking d. Anger and aggression |
Suicide |
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This is the systemic approach to screening and assessment of individuals start to have the substance use disorder, being considered for admission to addiction related services, or presenting in a crisis situation. The core function of crisis Intervention relates to a counselor services to their plan when there has likely been some precipitating event to shift the client from the usual state of conflict or crisis during intense state of acute distress. In order to determine that a client is in a crisis State a counselor first must be aware of accomplish between the client and the client's total situation |
Clinical evaluation |
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To be competent in this criterion, the counselor should know the elements of a crisis and be able to relate the elements to an actual client. A counselor needs to understand the predisposing factors present before the precipitating event, describe the crisis event, and the describe the clients response to include feeding and behaviors of the client. A counselor needs to answer questions such as "What is the crisis!" and "Why is this a crisis for this client?" |
Recognize the elements of the client crisis |
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To be competent in this criterion, a counselor knows the steps that should be followed for a specific client's crisis. It is important that the counselor know immediate actions that are appropriate to the nature of the crisis. There is usually a series of steps for a counselor to take in number of crisis situations: Calling 911,Checking for safety, determine whether a plan exists for doing harm to self or others, and determine supports that the client has available. Insuring a client's safety and the safety of others is a continuous responsibility of the counselor untill the client is no longer under the counselor's care. |
Implement an immediate course of action appropriate to the crisis |
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To be competent in this criterion, a counselor relates to the crisis to the current treatment plan or its revision, and understand how a crisis can be used within the counseling, referral or consultation core functions to enhance the client's overall treatment. This criterion addresses what a counselor does after the crisis is resolved. A crisis event can often be used to enhance treatment; to gain insight into their effective methods of treatment; and may result in a revision of the client's treatment plan |
Enhance overall treatment by utilizing crisis events. |
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1. Taking down the counter should form irritation with the client the so the individual will talk about suicide A. Prepare him / herself for the flood of emotional confusion that will pour out. B. Don't interrupt client to relieve his / her own feelings of discomfort about suicide- take care of own needs later with a colleague C. I don't know how to act calm keep any in her upset hidden because it will only agitate the client 2. Identify the key issues A. Clarify what the precipitating event was B. Address the current problem in concrete terms- don't shift Focus to past problems which will minimize the importance of the current suicide issue. 3. Assessmentality based on A. Concreteness of plan B. Sex C. Age D. Depression E. Resources F. Important relationships G. Losses 4. Evaluate the client's strength and resources which can be called upon to decrease the threat of suicide. 5. Design a treatment plan and put it into action A. That's the plan to postpone suicide and set a time to talk again make yourself for agency available for contact before the date of the client finds it necessary B. Help the client begin to reduce stress by action, if appropriate C. Contact resources 1). Psychiatrist for evaluation 2). Inpatient hospitalization 3). Client's Network D. Plan for follow-up treatment 1). Provide hope that someone cares 2). Provide hope that something can be done to make life bearable 6. If a client informs the counselor that he / she has frequent thoughts of suicide and a definite plan which he / she will carry out if a counselor tells anyone, the counselor should: A. Immediately notify his or her clinical supervisor B. Formulate a protective treatment plan |
You're designing a treatment plan and put it into action |
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1. In talking with an individual, the counselor needs to be alert to the above listed risk factors. 2. The counselor must also know the following cues of immediate danger: A. The client has decided on a method, time, and place, legality increases for such methods as shooting, jumping off a bridge, and fast acting drugs B. Suddenness of a desire to kill oneself C. D 1. Especially if sudden 2. If combined with: A. Psychotic thinking B. Alcohol and drug use C. Confused thinking D. Anger and aggression 3. Sudden improvement and depression D. Confused thinking and feeling, indicating inability to cope |
Cues to suicide potential |
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1. The counselor should form a relationship with the client so the individual will talk about suicide a. Prepare him / herself for the flood of emotional confusion that will pour out B. Don't interrupt client to relieve his / her own feeling of discomfort about suicide-take care of my needs later with a colleague C. Act calm keep any inner upset hidden because it will only agitate the client
2. Identify the key issues a. And clarify what the precipitating event was b. Address the current problem in concrete terms- don't shift Focus to past problems which will minimize the importance of the current suicide issue.
3. Assess lethality based on Concreteness of plan ,sex, age, depression, resources important relationships and losses. 4. Evaluate the client strength and resources which can be called upon to decrease the threat of suicide. 5. Design a treatment plan and put it into action a. Ask the client to postpone suicide and set a time to talk again make yourself for agency available for contact before the date if the client finds it necessary. b. Help the client begin to reduce stress by action, if appropriate c. Contact resources 1. Psychiatrist for evaluation 2. Inpatient hospitalization 3. Clients Network d. Plan for follow-up treatment 1. Provide hope that someone cares 2. Provide hope that something can be done to make life bearable
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Dealing with a suicide crisis |
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Gather relevant data a. To assess risk of danger to self and others b. to become informed about current problem Medical A. Current symptoms B. Precipitating events C. History of the medical problem D. If alcohol and drugs are involved 1). Include what drug, dose, and when taken 2). Provide information immediately to Medical personnel 3). Allow enough time to observe the client and then interview him/her after the substance level has decreased in order to collect history and plan treatment E. If the client presents a psychotic symptoms, a medical evaluation is needed 1). Antipsychotic medication may be given to control their psychotic symptoms 2). Genesis that the client is out of crisis when he shows a marked decrease and thought disorder |
Process of crisis Intervention |
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1). Strengths A. Personal B.support Network: family, friends, and employer C. Physical: finances, housing, and transportation D. And the fewer the resources, the greater the danger 2). Weaknesses same categories of strengths To form a realistic treatment plan 3). Reframe the crisis into a solvable problem and potential growth situation A. Decreases the pressure on the client on a solution is possible- helps to increase level of functioning. B. Enables the counselor to point out: 1). What the client is doing that worsens the problem and makes it less soluble 2). What the client is doing that listens to problem and makes the problem more solvable C. Clarifies of focal problem that caused the crisis 4). Help the client examine realistic options for solving the problem A. Way the advantages and disadvantages of each option B. Choose the most workable option C. Make a plan of action |
To assess client's ability to cope with the crisis |
