crisis

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Crisis and Intervention
Presenter: Monika Sharma
Lecturer,CON,DMCH,Ldh.

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Most people live whether
physically, intellectually or morally in very
restrictive circle of their potential being. They
make use of very small portion of their soul’s
resources…….. Great emergencies
…………Crisis shows us how much greater
our vital resources really are….. Than we
supposed.
Williams James

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Crisis is a turning point
Webster
Crisis is a passage
Sheehy
Greek krinein, meaning to decide.
Chinese term signifies two character weiji
which signifies ‘Opportunity’ as well as
‘Danger’
Definition

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Definition
A crisis is an overwhelming reaction to
a threatening situation in which a
person’s usual problem solving
strategies fail to resolve the situation
resulting in a state of disequilibrium.

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Difference between Stress And
Crisis
Stress is everyday wear and tear.
Person uses usual coping
mechanisms.
Prolonged stress has potential to
reduce the emotional health of a
person.

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Characteristics of Crisis
Temporary.
Experienced as sudden.
Perceived as life threatening.
Communication impaired.
Actual or perceived loss.
Usual coping behaviors unsuccessful.
Self-limiting – usually lasts 4 to 6 weeks

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Characteristics of Crisis
Cognitive uncertainty
Physiological symptoms
It is a struggle for equilibrium and
adjustment to problems that are
perceived as insolvable.
After a crisis the individual may function
at a higher level, the same level or a
lower lever.

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Myths about Crisis
People in crisis suffer from mental illness
People in crisis cannot help themselves
Psychiatrist can intervene in crisis
Crisis intervention is a psychotherapy
Crisis intervention happens for a one time
shot and produces changes for a short time
only.
New bonding resolves crisis.

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Types Of Crisis
Dispositional/ Situational Crisis
Developmental/maturational Crisis
Adventitious/traumatic Crisis
Anticipatory life transition crisis
Crisis reflecting psychopathology

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Situational Crisis
Acute response to the external
situational stressor.
 Job Loss
 Abortion
 Financial Change
 Job Change
 Abuse

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Developmental crisis
Crisis resulting from unresolving
conflicts of one’s own life.
 Passing from school-age to adolescence.
 Passing from adolescent to adult.
 Entering in old age.

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Anticipatory life transition crisis
Normal life transitions which are
anticipated but individual feel lack of
control over them.
 Leaving home
 Getting married
 Having a baby
 Beginning a career
 Retirement
 Death of loved one
 Aging

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Adventitious Crisis
Unexpected uncontrollable external stresses
by which person experiences overwhelmed.
 Natural disasters- hurricanes, flood, fire,
earthquake.
 National disasters- war, riots.
 Crime of violence- Child abuse, rape, assault,
bombing in crowded areas.

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Factors influencing outcome of crisis
Perception of event.
Physical and emotional status.
Personal maturity.
Previous experiences.
Realistic aspects of current situation.
Cultural influences.
Helping resources.

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Vulnerability to Crisis
Intensity of exposure to situation.
Low education level.
Preexisting psychiatric symptoms and
diagnosis.
Prior history of traumatic exposure.
Family history of anxiety and antisocial
behavior.

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Child abuse
Poverty
Cultural expectations that prohibit
asking help from others
Degree of threat to life involved in
exposure to the situation.
Vulnerability to Crisis

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Effect of Crisis
Disrupted homeostasis.
Altered functional level.
Failure of coping mechanisms.
Physiological symptoms.
Psychological symptoms.

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Stages of Crisis
Stage I: Mounting tension
Stage II: Plateau of disorganization
Stage III: Mobilization of all internal
and external resources
Stage IV: Adaptation or maladaptation

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Phase I
Exposure to critical incident/Initial
impact/Shock.
1hr. to 24-48 hrs.
 Disruption of homeostatic balance.
 Discomfort.
 Motivation to reduce discomfort.
 Trial and error problem solving begin.
 Tries customary coping.

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Management of phase I
Ensuring safety of the client. (ABC)
Clarifying the event.
Objective presentation of event.
Help to confront the crisis.
Encourage to verbalize.
Help the person to help himself.

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Phase II
Emotional crises/Defensive Retreat
Hours to weeks
 Previous coping mechanisms fail.
 Increase anxiety.
 Experience distress and disequilibrium.
 Motivated to seek help from others.
 Motivated to learn new coping skills to
relieve distress.
Resiliency

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Management of Phase II
Ensure safety of the client.
Assess resiliency.
Mobilize support systems.
Help the client to seek help.
Break complex problem into small tasks &
focus on specific task.
Help the client to identify new problem
solving strategies.

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Phase III
Crisis resolution/acknowledgement of reality
 Defines issues.
 Deals with feelings.
 Utilizes resources.
 Use different perspective to see the problem.
 New problem solving techniques used.
 Reduction in anxiety and discomfort.

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Management of Phase III
Help client in readjustment.
Support in dealing with feelings &
issues.
Help in practicing and evaluation of new
coping strategies.

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Phase IV
Post crisis adaptation/change
6 weeks to 12 months
 Less vulnerability for particular problem.
 Learns new and more adaptive coping.
 Improved functioning.
 Personal functioning.

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Ineffective Resolution of Crisis
Prolonged hope.
Denial.
Dysfunctional
reactions.
Anger
Hostility.
Irritability.
Lack of initiative.
Sadness.
Worthlessness.
Hopelessness.
Guilt.
Apathy.
Suspicious.

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Ineffective Resolution of Crisis
 Feelings of isolation.
 Prolong identification of
the deceased person.
 Psychosomatic illnesses.
 Intrusions.
 Avoidance reactions.
 Substance use disorder.
 Compulsive ritualistic
behavior
 Depressive features
 Neurosis
 Psychosis
 Post traumatic stress
related disorder

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