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CRISIS AND CRISIS INTERVENTION Lecture Notes
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- 2. “ Most peopleexist in a state of equilibrium; that is everyday lives contain some degree of harmony in their thoughts, wishes, feelings, and physical needs.”
- 3. CRISIS • Is aserious interruption or disturbance of one’s biologic, psychological, or social integrity • As undue stress occurs, one’s equilibrium can be affected • The person may lose control of feelings and thoughts, thus experiencing an extreme state of emotional turmoil… CRISIS!!!
- 4. MATURATIONAL CRISIS • Theseare normal process of growth and development that evolve over an extended period that require the person to make some type of change (one’s lifestyle is continually subject to change) Examples: puberty, marriage, aging process
- 5. SITUATIONAL CRISIS • Anextraordinary stressful events that could affect an individual or family regardless of age group, socioeconomic, or sociocultural status Examples: Economic difficulty Illness, accident Divorce, death
- 6. CHARACTERISTICS OF CRISIS •Occurs suddenly, when the person, family, or group of individuals is inadequately prepared to handle the event or situation • Normal coping methods fail, tension rises, and feeling of guilt, anger, shame, and helplessness occur • Generally short in duration (24 hours to 36 hours), rarely (4-6 weeks)
- 7. • Can causedincreased psychological vulnerability, resulting into: Potentially dangerous, self-destruction Socially unacceptable behavior Opportunity for personal growth • Outcome depends upon the availability of appropriate help
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- 9. PRECRISIS • A stateof equilibrium in which a person is able to cope with everyday stress
- 10. IMPACT (INITIAL, SHOCK) • Occurrenceof stressful events resulting into: High level of stress Inability to reason logically Inability to apply problem-solving approach Inability to function socially
- 11. Helplessness Anxiety Confusion, chaos Disorganization Possible panic Maylast to few hours to few days
- 12. CRISIS 0R DEFENSIVE RETREAT •Inability to cope results in attempts to redefine the problem, avoid the problem, or withdraw from reality • Ineffective, disorganized behavior interferes with daily living • Denial of the problem
- 13. Rationalization about thecause of the problem Projection of feelings of inadequacy onto others May last a brief or prolonged period of time
- 14. RECOIL, ACKNOWLEDGEMENT, OR BEGINNINGOF RESOLUTION • Acknowledges the reality • Attempts to use problem-solving approach by trial and error • Tension and anxiety resurface as reality is faced • Feelings of depression, self-hate, low self-esteem may occur
- 15. RESOLUTION, ADAPTATION, AND CHANGES •Occurs when the person perceives the crisis situation in a positive way • Successful problem-solving occurs • Anxiety lessens • Self-esteem rises • Social role is resumed
- 16. POSTCRISIS • May beat higher level of maturity and adaptation owing to acquisition of new positive skills • May function at a restricted level in one or all spheres of personality due to denial, repression, or ineffective mastery of coping and problem-solving skills
- 17. • Persons whocope ineffectively may express hostility, exhibits signs of depression, or abuse alcohol, drugs, or food • Symptoms of neurosis, psychosis, chronic physical disability, or social maladjusted behavior may occur
- 18. PARADIGM OF BALANCING FACTORS •Factors which can lead affect a return to equilibrium (Aguilera, 1982) Realistic Perception of An Event: - When a person is able to distinguish the relationship between an event and feeling of stress - The perception rather than the actual event will determine his reaction of the situation
- 19. Adequate Situational Support AdequateCoping Mechanisms to Help Resolve the Problem: - Are those methods one usually employs to cope with anxiety or stress and reduce tension in difficult situation (be it conscious or unconscious)
- 20. CRISIS INTERVENTION • Anactive but temporary entry into the life situation of an individual, family, or a group during the period of stress • it is an attempt to resolve immediate crisis when a person’s life goals are and usual problem-solving method fail • Client is called on to be active in all steps of the crisis intervention process
- 21. GENERIC APPROACH: • Focuseson particular kind of crisis, with: - direct encouragement of adaptive behavior - general support - environmental manipulation - anticipatory guidance
- 22. INDIVIDUAL APPROACH: • Stressesthe present and shows little or no concern for the developmental past • Places an emphasis on the immediate cause of disequilibrium • Can be used as secondary or tertiary prevention • Can be effective in preventing future crisis
- 23. GOALS OF INTERVENTION 1.To decrease emotional stress and protect the crisis victim from additional stress 2. To assist in organizing and mobilizing resources or support system to meet unique needs and reach a solution for the particular situation or circumstances that precipitate the crisis
- 24. 3. To returnthe crisis victim to a precrisis or higher level of functioning
- 25. STEPS 1. Assessment 2. Planningtherapeutic intervention 3. Implementing techniques of intervention 4. Resolution of the crisis and anticipatory planning
- 26. ASSESSMENT: Attempts to: “What hashappened?” “Who is involved?” “What has caused?” “How serious is the problem?”
- 27. Crisis worker determinesthe following during the assessment process: - The onset of crisis - The precipitating factors of the situation - The person’s perception of the event - The degree of disruption to the person and others - Person’s strengths, past methods used in coping, and usual support system
- 28. - Whether theindividual is suicidal or homicidal - Whether there are complicating dangers present - Should hospitalization or special treatment necessary
- 29. PLANNING: • The personshould be involved in the choice of alterative coping methods • The needs and reaction of the significant others must also be considered • Doing something positive, even if the assessment is incomplete, is helpful in a crisis and is better than no help at all
- 30. THERAPEUTIC INTERVENTIONS: • Depends on: -the pre-existing skills - the creativity and flexibility of the crisis worker - the rapidity of the person’s response
- 31. • Must helpthe crisis victim: Explore coping mechanism Remember or recreate successful coping devices used in the past Devise new coping skills • An attempt also is made to establish new supportive and meaningful relationships an experiences • Reopening the person’s social world
- 32. THE FOLLOWING THERAPEUTICTECHNIQUES ARE RECOMMENDED WHILE PERFORMING CRISIS INTERVENTION: Display acceptance and concerns and attempt to establish a positive relationship Encourage the person to discuss present feelings (denial, anger, guilt)
- 33. Help person confrontreality of the crisis by gaining intellectual and emotional understanding of the situation (one step at a time) Explain that the person’s emotion are a normal reaction to the crisis Avoid giving false reassurance Clarify fantasies, contrasting them with facts Do not encourage to place blame for the crisis on others
- 34. Set limit ondestructive behavior Emphasize the person’s responsibility for behavior and decisions Assist the person in seeking help with ADL until resolution occurs Nursing intervention is evaluated and modified as necessary.
- 35. END OF LECTURE ~QUIZLATER