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1. CRISIS
“A crisis is self-limited and can last for
few hours to week. It is characterized by initial
phase in which anxiety and tension rise,
followed by a phase in which problem solving
mechanism are set in motion.”
- Kaplan and saddock,1998.

2. • Crisis is when a person goes through upheaval. They
become unstable and are unable to live life normally.
For some this may never come but for many this
instability is something that comes frequently.
• There is a difference between crisis and stress. During
crisis the person will be unable to function Stress can
be motivating and also damaging. It is always present.
Crisis is the buildup of stressors to beyond a point
where a person can handle the situation.
• During stress a person can still function. and will need
assistance to get back to functioning levels

3. CHARACTERISTICS
• Crisis occur in all individuals at one time or
another and are not necessarily equated with
psychopathology.
• Crisis are participated by specific identifiable
event.
• Crisis are personal by nature.
• Crisis is acute, not chronic .
• A crisis situation contains a potential for
psychological growth or deterioration.

4. • All crisis are experienced as sudden. The person is
usually not aware of a warning signal, even if
others could see it coming.
• The crisis is often experienced as ultimately life
threatening, whether this perception is realistic
or not.
• Communication with significant others is often
decreased or cut off.
• There may be perceived or real displacement
from family surrounding
• All crisis have an aspect of loss, whether actual or
perceived.
• The losses include an object,person, a hope, a
dream or any significant factor for the Individual.

5. FACTORS THAT PLACE INDIVIDUALS AT
HIGH RISK FOR CRISIS
• Intensity of exposure to the situation
• Low education level
• Pre existing psychiatric symptoms & diagnosis
prior history of traumatic exposure
• Family history of psychiatric problem
• Early separation from parents
• Family history of anxiety/ or antisocial behaviour
• Childhood Abuse
• Poverty

6. ORIGIN OF CRISIS
There are 3 categories of origin of crisis.
• Situation crisis(traditional terms-
unanticipated)
• Transitional crisis(Traditional terms-
maturational anticipated)
• Cultural/Social crisis.

7. Situational crisis
It can originate from 3 sources.
• Material or Environmental sources (e.g. fire or
natural disaster)
• Personal or physical sources:(heart attack,
diagnosis of fatal illness, bodily disfigurement)
• Interpersonal or social sources: (e.g: loved of
loved one or divorce).
• These situations are usually unplanned and
unexpected.

8. Transitional crisis
There are two types of transitional crisis:
• Universal
• Non-universal

9. Universal Transitional crisis
• Universal transitional states are life cycle
changes or normal transitions of human
development.
• Transitional stages of human development
that includes infancy, child hood, puberty,
adolescence, adulthood, middle age & old
age.

10. Non-Universal Transitional crisis
• Non-Universal Transitional states includes
such changes as marriage, retirement & the
transition from student to worker.

11. Cultural/Social Crisis
Crisis that have cultural & social sources
include the loss of job, stremming from
discrimination being the victim of deviant acts
of others & behaviour that violates social
norms such as robbery, rape, incident, marital
unfidelity & physical abuse.

13. PHASE-I/ PRECRISIS
EXPOSED TO
ANXIETY/SITUATION
USES PROBLEM SOLVING
TECHNIQUE UNABLE TO USE
PROBLEM WILL RESOLVE PROBLEM WILL NOT
RESOLVE
NO CRISIS MOVES TO
PHASE-II

14. PHASE-II/IMPACT
The ineffectiveness of the phase I coping
mechanism leads to further disorganization like
anxiety, discomfort, helplessness are further
increases.
The person’s ability to overcome stressor will
decrease and confusion and personal
disorganisation prevails.
If the anxiety continues and there is no
reduction, the individual enters phase-III.

15. PHASE-III/CRISIS AND RESOLUTION
Individual feels more pressure and unable to
respond, anxiety still increases.
All the internal and external resources will be
tried to relieve discomfort.
If problem solving approach is unsuccessful,
further disorganization occurs and the
individual is entered to phase IV.

16. PHASE-IV/POSTCRISIS
If the problem was not solved, tension reaches
to its peak, as the time passes burden increases
over time.
Panic state occurs.
Psychotic thinking, short attention span, impaired
relationship will be resolved.
Extensive treatment is necessary if negative
outcomes are appeared.

18. Anger
Anxiety
Guilt
Tension
Fear
Helplessness
Hopelessness
Lack of interest in self care.
Using unhealthy coping mechanism
Low self esteem
Uncontrollable crying

19. Frustration and depression
Confused
Immobilised
Unable to make decision
Lack of confidence
Hallucination and impaired judgement
Physical illness
Shortness of breathing
Anorexia
Irritable

20. Balancing factors
3 balancing factors are important to the successful
resolution of crisis.
• Perception of events: How individual perceive
and understand the event/crisis in their lives.
• Situational supports: The availability of people
who can help individual in crisis solve the
problem.
• Coping mechanism: All people under stress use
coping strategies to improve their situation.

21. CRISIS INTERVENTION
• Crisis intervention refers to the methods used to
offer immediate, short term help to individuals
who experience an event that produces
emotional, mental, physical and behavioural
distress or problems.
• Crisis intervention as a therapeutic strategy is
strongly humanistic.
• Central to the philosophy underlying crisis
intervention is the belief that people are capable
of personal growth and have the ability to
influence & control their own lives.

22. PURPOSE
• To reduce the intensity of an individual’s
emotional, mental, physical and behavioural
reactions to a crisis.
• To help individuals return to their level of
functioning before the crisis.
• To assist the individual in recovering from the
crisis and to prevent serious long term
problems from developing.

23. Goals For Crisis Intervention:
• Relief of symptoms of crisis.
• Restoration to precrisis level of functioning.
• Some understanding of the relevant
precipitating events.
• Identification of remedial measures.
• Initiating new modes of thinking, perceiving
feeling and developing new adaptive and
coping responses.

24. CRISIS INTERVENTION
TECHNIQUE
Abreaction
Clarification
Suggestion
Manipulation
Reinforcement of behaviour
Support defences
Raise the self esteem
Exploration of solution

25. INDICATION
People who attempt to suicide
Psychosomatic patient
Violent behaviour
Accident victims
Family crisis
Severe depression and anxiety
Marital conflicts
Drug and alcohol abuse.

26. CRISIS INTERVENTION MODEL

27. PHASES OF CRISIS
INTERVENTION: THE
ROLE OF THE NURSE

28. PHASE 1 : ASSESSMENT.
• Event that participated the crisis.
• Determine when it occurred.
• Physical and mental status.
• Determine the stressor .
• New coping method were tried , what was the
result.
• Assess suicide and homicide potential, plan and
means.
• Support system.
• Precrisis functioning.
• Use of substances.

29. PHASES 2 : PLANNING OF
THERAPEUTIC INTERVENTION.
• Goals are established for crisis resolution and
a return to, or increase in the precise level of
functioning.

30. PHASE 3 : INTERVENTION
• Use a reality oriented approach. The focus of the
problem is on the here and now.
• Remain with the individual who is experiencing
panic anxiety.
• Establish a rapid working relationship by
unconditional acceptance, by active listening, and
by attending the immediate needs.
• Promote an atmosphere for verbalization of true
feelings.
• Set firm limits on aggressive, destructive
behavior.

31. PHASE 4 : EVALUATION OF CRISIS
RESOLUTION AND ANTICIPATORY
PLANNING.
• Summarize what has occurred during the
intervention.
• They review what the individual has learned
and how he or she will respond in the future.
• Follow up therapy. If needed the nurse
provides the referral information.

32. THE IMPACT OF CRISIS WORK ON
NURSES
• Attitudes &strategies that can help nurse be effective in crisis
work.
• Strive for balance between professional life & your personal
life.
• Support people who have been victimized
• Search for new knowledge
• Be willing to create new support system.
• Be willing to create unskilled client
• Be willing to tolerate frustration.
• Respect each persons unique timetable
• Allow clients to make their own choices even if they are
believed to be misguided or wrong.
• Recieve regular supervision.

33. Conclusion
Stress can be confronted and reduced if and
only if we understand ourselves better,
analyze the behavior and identify the
stressors. The stress management techniques
will work if we are honest with ourselves and
adopt the techniques in their fullest spirit.