crisis intervention technique and principles

4.  To explain the meaning of the term crisis.
 To define the term crisis.
 To Enlist the types of crisis.
 To explain the phases of crisis.
 Discuss the signs and symptoms of crisis.
 To define the term crisis intervention.
 Enlist the aims of crisis intervention technique
 Explain the principles of crisis intervention.
 To discuss the various techniques of crisis
intervention
 To explain the role of nurse in crisis intervention.

5. Crisis is a state of disequilibrium resulting
from the interaction of an event with the
individuals or family’s coping mechanisms,
which are inadequate to meet the demands
of the situations, combined with the
individuals or family’s perception of the
meaning of the event.
(Taylor 1982)

8. CAPLAN (1964) has described four phases of
crisis as described below:

9.  Perceived threat acts as a precipitant that
generates increased anxiety.
 Normal coping strategies are activated, and
if unsuccessful, the individual moves into
Phase II.

10.  The ineffectiveness of the phase I coping
mechanisms leads to further disorganization.
 The individual experiences a sense of
vulnerability.
 The individual may attempt to cope with the
situation in a random fashion.
 If the anxiety continues and there is no
reduction, the individual enters Phase III.

11.  Redefinition of the crisis is
attempted and the individual is most
amenable to assistance in this
phase.
 New problem solving measures
may also affect a solution.
 If problem solving is unsuccessful,
further disorganization occurs and
the individual is said to have
entered Phase IV

12.  Severe to panic levels of anxiety with
profound cognitive, emotional and
physiological changes may occur.
 Referral to further treatment resources is
necessary.

13.  Depression
 Anger, guilt , tension , fear
 Neglect in performing self care activity
 Irrational and blaming others
 Helplessness, uselessness
 Panic
 Low self esteem

14.  Uncontrollable crying
 Lack of confidence
 Withdrawal behavior
 Irritable
 Rigid in nature , Denial
 Disorganized behavior and unable to think
realistic
 Impaired judgment
 Lack of control

15. Crisis intervention is a technique used to
help an individual or family to understand
and cope with the intense feelings that are
typical of a crisis. Nurses function as part of
the interdisciplinary team in the use of crisis
intervention as a therapeutic modality.

17.  Be specific, use concise statements, and avoid
over whelming the patient with irrelevant
questions or excessive detail.
 Encourage the expression of feelings.
 A calm, controlled presence reassures the
person that the nurse can help.

18.  Listen for facts and feelings-.
seeking clarification, paraphrasing
and reflection are effective
strategies.
 Allow sufficient time for the
individuals involved to process
information and ask questions.
 Help patients legitimize feelings by
letting them know that others in
similar situations have experienced
comparable emotions.

19.  Catharsis: The release of feelings that takes
place as the patient talks about emotionally
charged areas.
 Clarification: Encouraging the patient to
express more clearly the relationship
between certain events.

20.  Manipulation: using the patients emotions,
wishes or values to benefit the patient in the
therapeutic process.
 Reinforcement of behavior: giving the patient
positive reinforcement to adaptive behavior.

21.  Increasing self esteem: helping the patient to
regain feelings of self worth.
 Exploration of solutions: examining
alternative ways of solving the immediate
problems.

23. During this phase the nurse collects data
regarding the following factors:
 Precipitating event or stressor
 Patient's perception of the event or stressors
 Nature and strength of the patient's support systems,
coping resources.
 Level of psychological stress patient is suffering from
and the degree of impairment he is experiencing.
 Patient’s previous strengths and coping mechanisms.

24.  Ineffective individual coping
 Ineffective family coping.
 Altered family process.
 Post trauma response

25.  Dynamics underlying the present
crisis are formulated.
 Alternative solutions to the
problem are explored.
 Steps for achieving the solutions
are identified.
 Environmental support needed to
help the patient is decided upon,
coping mechanisms

27.  Environmental manipulation
includes interventions that
directly change the patient's
physical or interpersonal
situation.
 These interventions may
remove stress or provide
situational support.

28.  Similar to the diagnosis and treatment of a
specific problem in a specific patient.
 It is particularly useful in combined
situational and maturational crises and also
beneficial when symptoms include homicidal
and suicidal risk.
 The nurse must use the intervention that is
most likely to help the patient develop an
adaptive response to the crisis.

29.  The nurse should give credit for successful
changes to patients so that they realize their
effectiveness and understand that what they
learnt from crisis may help in coping with future
crisis.
 If the goals have not been met, the patient and
nurse can return to the first step-assessment
and continue through the phases again.