Crisis Intervention
CRISIS- turning point in an individuals life that produces an overwhelming emotional response. CAPLANs STAGES OF CRISIS 1. Person is exposed to a stressor, experience anxiety, and tries to cope in a customary fashion. 2. Anxiety increases when customary coping skills are ineffective. 3. Person makes all possible efforts to deal with the stressor, including attempts at new methods of coping 4. When coping attempts fail, the person experiences disequlibrium and significant distress
CATEGORIES OF CRISIS
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Maturational Crises- sometimes called developmental crises. Predictable events in the normal course of life, such as leaving home for the first time, getting married, having a baby, and beginning a career. Situational Crises- unanticipated or sudden events that threaten the individuals integrity, such as the emotional illness in the individual or family members. Adventitious Crises- sometimes called social crises. Include natural disasters like floods, earthquakes, hurricanes, war, terrorists attack, riots, violent crimes, rape or murder.
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Crisis Theory and Intervention
Crisis - State of the reacting individual who find himself in a hazardous situation in which the habitual problem solving activities are not adequate and do not lead rapidly to the previously achieved balance state (Kaplan) Crisis Intervention - Means the entering into the life situation of an individual, family o group to alleviate the impact of a crisis including stress in order to help mobilize the resources of those directly affected, as well as those who are in significant social orbit (Lindemann)
Phases of Crisis
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initial- there is rise in tension in response to the initial impact of stress. Intermediate- emergency problems- solving mechanism are called forth which may lead to an actual solution of the problem. Third phase of major disorganization occurs if no solution occurs.
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THE PERSON IN CRISIS EMPLOYS VARIOUS CHARACTERISTIC COPING PATTERN
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maladaptive- avoidance, fantasy, regression, panic Adaptive- able to verbalize, seek and use help from the environment
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General principles which apply to giving constructive assistance to person in crisis
1. Help the troubled to confront the crisis by helping to verbalize and to comprehend the reality of situation. 2. Help him to confront the crisis in doses which can manage, being cautious not to overly dampen the impact. 3. Help him to find the fact since these are often less awesome than speculations about the situation. Fantasies can be more frightening than reality. 4. Help him by not giving false reassurance. Acknowledge the validity of fear and gives reassurance that there is faith in his ability to mange 5. Do not encourage him to blame others, since blaming is a way avoiding the truth (projection) 6. Help him to seek and accept help because he needs it, by seeking it he is acknowledging the trouble exists. 7. Help him accept assistance with his everyday tasks since crisis disorganize and disorients energies due to the excessive amounts of energy directed to the tasks of resolving the problems. 8. Help the individual to solve his problem.
Concept of Loss by Kubler- Ross
Grief- process of coping with a loss Stages of Death and Dying
1. 2. 3. 4. 5.
D- denial and isolation A- anger B- bargaining D- depression A- acceptance
Stages of Grief Shock and disbelief 2. Developing awareness 3. Restitution and resolution of the loss
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Concept of Death throughout the Life Cycle
Toddler (1-3 y/o) No specific concept of death and thinks only in terms of the living. - Reacts more to pain and discomfort of illnesses and immobilization. - Experience separation anxiety.
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Nursing intervention: focus on parents assist parents to deal with their feelings. - Encourage parents participation in childs care.
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Preschooler (3-5 y/o)
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Death is kind of sleep. It is form of punishment. Life and death can change place with one another If a pet dies, they may request funeral and burial
Nursing approach
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utilize play for expressing thoughts and feelings. Explain what is death that it is final and not sleep. Permit a choice of attending a funeral.
School age (5-12 y/o)
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Death is personified Child fears mutilation and punishment Anxiety is alleviated by nightmares and superstitions Death is perceived as a final process.
Nursing approach
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Accept regressive or protest behavior Encourage verbalization of feelings
Adolescent (12-16 y/o)
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Mature understanding of death. May have strong emotions about death, silent, withdrawn, angry. Worry about physical changes.
Nursing approach
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Support maturational crises Encourage verbalization of feelings Respect need for privacy and personal expression for anger, sadness or fear.
Adult
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Death is disruption of lifestyle Death is viewed on terms of its effect on significant others
Older Adult
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Emphasis is on religious beliefs for comfort. A time of reflection, rest and peace.
Nursing approach
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Allow ventilation of feelings Respect need for privacy
