III YR BSC NURSING

1. Presented By Mrs Bemina JA
Assistant Professor
ESIC College Nursing
Kalaburagi

2. At the end of the class students will be able to
• Define crisis
Explain the types of crisis
• Define crisis Intervention
Explain the principles of crisis Intervention
• Explain the techniques and process of crisis
Intervention
• Explain the approaches of crisis intervention

3.  Crisis is an integral component of every day life
 A crisis is any event that is going to lead to an
unstable and dangerous situation affecting an
individual
• a time of intense difficulty or danger.
• a time when a difficult or important decision must be
made
• the turning point of a disease when an important
change takes place, indicating either recovery or death.

4.  Crisis is a perception or experiencing of an event or
situation as an intolerable difficulty that exceeds the
person’s current resources and coping mechanisms. -
James (2008)
 DEFINITION OF CRISIS
It is defined as 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 situation combined with the
individuals or family perception of the meaning of the
event .
Taylor 1982

5.  (1)Maturational or developmental crisis
 (2)Situational crisis
 (3)Adventitious crisis

6.  Developmental crisis (also referred to as maturational
or internal crisis) may occur at any transitional period
in normal growth and development.
 The transitional periods where individuals move into
successive stage often generate disequilibrium.
 Individuals are required to make cognitive and
behavioral changes that accompany development,
precipitate factors are normal stress of development
(eg. Adolescence, Retirement ,marriage and
parenthood)

7.  A situational crisis is a response to a sudden and
unavoidable traumatic event that largely affects a
person’ social biological and psychological identity
and roles.
 Examples of events that can participate situational
crisis are sudden traumatic event.
 Unexpected Job Loss ,
 Serious Car Accidents,
 Loss Of Spouse,
 Academic Failure,
 Birth Of A Child With A Disability Or
 Diagnosis With A Chronic Or Terminal Illness
Affects How People Perceive Themselves.

8.  Social crisis is accidental, uncommon and unanticipated
and result in multiple losses and radical environmental
changes.
 An adventitious crisis occurs outside the person precipitate
by an unexpected event.
(eg. Natural disaster , fires , floods , war etc.)
 These crises affect many people who experience both
acute and post traumatic stress reaction.
 This type of crisis is unlike maturational and situational
crisis because it doesn’t occur in the lives of all people.

9. • Is an effective, short-term therapy that focuses only
on immediate problems to be resolved.
• The primary goal of intervention is to return the
individual to a higher level of function and restore to
their pre-crisis level of functioning
• Includes a variety of technique based on the
assessment of the individual
It requires timely and skillful support to help cope
with his/her situation before physical deterioration
occurs

10. 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.

11.  1.To decrease emotional stress and protect the crisis
victim from additional stress.
 2.To assist the victim in organizing and mobilizing
resources or support system to meet unique needs and
reach a solution for the particular situation that
precipitated the crisis.

12.  To reduce the intensity of an individual’s emotional,
mental, Physical and behavioral reaction to a crisis.
 To help the individuals return to their level of
functioning before the crisis.

13.  In addition to being nonjudgmental, flexible,
objective, empowering , supportive, following are
considered to be essential requisites for service
providers to enable and individual to a journey from a
vulnerable crisis
 Ability to create trust via confidentially and honesty.
 Ability to listen in an attentive manner

14.  Provide the individual with the opportunity to
communicate by talking less.
 Being attentive to verbal and non verbal cues.
 Pleasant, interested, intonation of voice.
 Maintaining good eye contact, posture and
appropriate social distance if in a face to face situation.
 Remaining undistracted, open honest, sincere.
 Asking open ended questions.
 Asking permission, never acting on assumptions.
 Checking out sensitive cross-cultural factors.

15.  The length of time for crisis intervention may range
from one session to several weeks, with the average
being four weeks.
 Crisis intervention is not sufficient for individuals with
long standing problems and it may range from 20
minutes to 2 or more than 2 hour.

16.  It can take place in a range of setting such as
•Hospital Emergency Room
•Counseling Centers
•Mental Health Clinics
•School
•Social Service Agencies
Crisis Centers.

17.  Conducting the interview
 History: personal and familial
 Any means and plans the client may have about
carrying out the risk behavior
 Observations during the interview
 Level of anxiety; desperation; despair; sense of
hopelessness; contact with reality.

18. •Reduce distress
•Help to solve problems
•Avoid maladaptive coping strategies
•Improve problem solving strategies

19.  Focusing
 Catharsis
 Clarification
 Manipulation
 Suggestion
 Reinforcement of behavior
 Support of defenses
 Raising self esteem
 Exploration of solution

20.  Focusing technique can elicit more coherent
information for assessment as well as help the client
pull themselves together cognitively and emotionally.
A focused interview can serve as an instrument of both
assessment and intervention.
Catharsis:
 The release of feelings that takes place as the patient
talks about the problems
Clarification:
 Encouraging the patient to express more clearly the
relationship between certain events.

21. Suggestion
 Influencing a person to accept an idea or belief
 Reinforcement of behavior
 Giving the patient positive response to adaptive
behavior.
Support of defenses:
 Encouraging the use of healthy, adaptive defenses and
discouraging those that are unhealthy or maladaptive.
 Rising self esteem
Increasing self-esteem:
 Helping the patient regain feelings of self - worth
Exploration of solution:
 Alternative ways of solving the immediate
problem.

22. Immediate crisis intervention OR Psychological first aid
Second phase
Third phase

23.  It involves establishing a rapport with the victim,
gather information for short term assessment and
service delivery and averting a potential state of crisis.
 Immediate crisis intervention also includes caring for
the medical, physical, mental health and personal
need of the victim and providing information to the
victim about local resources or services.

24.  The second phase of crisis intervention involves an
assessment of needs
 to determine the service and resources required by
the victim in order to provide emotional support to the
victim.
 The purpose of second phase is to
 determine how the crisis affects the victim’s life, so
that a plan for recovery can be developed, allowing
the victims to begin towards the future.

25. Recovery intervention helps victims re- stabilize their
lives and becomes healthy again.
It also involves helping the victim prevent further
victimization from the criminal justice system or other
agencies, the victim may come into contact with in the
aftermath of victimization.

26.  Aguilera (1982) list four steps in the process of crisis
intervention.
 They are follows:-
 Assessment/Defining the event
 Planning therapeutic intervention
 Implementing techniques of intervention
 Resolution of the crisis and
 Anticipatory planning

27.  Assessment
 Planning
 therapeutic intervention
 Implementing techniques of intervention
 Resolution of the crisis
 Anticipatory planning

28.  Affection
 Expression and management of feelings involving
 Techniques of ventilation;
 Psychological support;
 Emotional catharsis.

29.  Helping the client understand the connections between
the stressor event and their response.
 Techniques include clarifying the problem;
identifying and isolating the factors involved;
helping the client gain an intellectual understanding
of the crisis
 Also involves giving information; discussing
alternative coping strategies and changing
perceptions.

30.  Pulling together needed external, environmental
resources ( either familial or formal helping agencies)
 Any and all three approaches may be used at any time
depending where the client is, emotionally and
cognitively.
 The goal is to help the client restore pre-crisis levels of
functioning.

31. Role of nurse in assessment
 During this phase the nurse collects data regarding the
following factors
Precipitating event or stressor
Patients perception of the event or stressor
Nature and strength of patients support system
Level of psychological stress
Patients previous strength and coping
During this phase the nurse begins to establish a positive
working relationship with client

32.  Primary nursing diagnosis in crisis intervention are:
 Ineffective individual coping
 Ineffective family coping
 Altered family process
 Post trauma response

33.  The previously collected data are analyzed and specific
interventions are proposed
During this phase the nurse will undertake the following
activities
 Dynamics underlying the present crisis are formulated
 Alternative solutions to the problems are explored
 Steps for achieving the solutions are identified
 Environmental support needed to help the patient is
decided upon coping mechanism that need to be developed
and those which need to be strengthened are identified

34.  The following interventions are carried out to resolve
crisis
 Environmental modification
 General support [warmth, acceptance, empathy and
reassurance]
 Generic approach [to reach high risk individuals and
large groups] it applies a specific method to all
individuals faced with similar type of crisis
Debriefing victims are helped to recall events and
clarify traumatic experiences
 Individual approach[ using various techniques ]

35.  Both the nurse and the patient review the change that
have occurred
 The nurse should give credit for successful changes to
patients
 If the goals have not met the both go back to continue
the steps from the beginning

36.  Mobile crisis programs
 Telephone contacts
 Group work
 Disaster response
 Victim outreach programs
 Crisis intervention centers
 Health education

37.  •What is Crisis?
 •What is Crisis Intervention?
 •Describe the process of Crisis Intervention
 •Explain the approaches used for crisis intervention?